Functional Endocrinology and its Impact on Your Health: Concluded

I previously left off our discussion on Functional Endocrinology's (FE) core theme being the fundamental question that ALL excellent diagnosticians and clinicians SHOULD ask, and that is "WHY?" is this hormonal disturbance or imbalance occcurring in the first place? This hormonal imbalance concept is not reserved exclusively for the cycling female that experiences a wide range of symptoms throughout her menstruating years or the post-menopausal woman that is suffers erratic shifts in mind, mood, and energy levels. Other hormonal disturbances of concern that are generally functional in their cause include but are not restricted to insulin surges, cortisol elevations, thyroid hormone imbalances, and male hormonal deficiencies, to name a few.

Remember, the primary objective of FE is directed at the RESTORATION of function to the endocrine system, and not merely to DOMINATE over the body's physiology with Hormone Replacement Therapy (HRT). Unfortunately for all too many a hormonally imbalanced patient today, his/her hormonal disorder tends to be viewed and treated as though his/her body no longer has any restorative capabilities, which is exactly how HRT's of today tend to view body physiology.(Incidentally, HRT has its place and its purpose clinically, but this is not the clinical scenario that I am presently addressing.) What a clinician like myself is interested in achieving with the patient is to attempt to restore function to improve the patient's physiology, thereby enhancing the patient's ability to synthesize whatever hormone that they may have been deficient in (if synthesis is the cause of the deficiency), and subsequently improving those hormonal levels that may have been depressed in the first place. Incidentally, there are also cases where the patient experiences an oversupply of a particular hormone or hormones, i.e. an excess, so I want to be abundantly clear on the fact that not every case of hormonal imbalance is necessarily one of deficiency.

For example, a 45 year old male presents to my office with a chronically reduced serum testosterone level that has a variety of clinical impacts, none of which have to do with libido, sexual performance, or sperm count according to the patient. HRT for this individual resulted in him being placed on AndroGel, which according to Androgel's formal website claims to be "the #1-prescribed testosterone replacement therapy." For this patient not only did it have very little impact on his serum testosterone levels after 30 days, it may have actually compounded his problem of mid-abdominal weight gain and fatty accumulation despite an intensive exercise regime of both heavy aerobic training (5 miles jogging 5 times/week) AND anaerobic as well as anaerobic threshhold training (weight training and martial arts)!

A review of this patient's previously taken blood chemistry reports and prior investigation into the "free fractioned non-protein bound hormones" via salivary sampling, quickly revealed that this particular patient was experiencing an adrenal gland stress pattern known as "Adrenal Fatigue." Additionally he suffered from a low Secretory IgA (SIgA) level, which is one of the body's primary immunoglobulins (better known as "antibodies"), that is secreted by various mucosal surfaces, such as the linings of the airways and your gut, which has a very crucial role in the protection of the body from bacterial and/or viral invasion along these surfaces. He also demonstrated a moderate to severe intolerance to gliadin, a food-allergy that is very common in today's "grain-happy" consuming populations, and happens to be found in wheat, rye, oats and barley to name a few. Yet quite interestingly, his male hormone profile (ie, testosterone and all of its related counterparts), was generally good...SO, what's the upshot to this patient's clinical concern, as to WHY (remember in FE we always want to ask the fundamental questions "WHY?") is he experiencing the accumulation of mid-abdominal fat and an increased waist-to-hip ratio despite such an intensive fitness regimen?

Based upon my analysis of this patient's blood and salivary testing data, it is evident that he is exhibiting a number of clinical concerns, each of which is functional in nature. Firstly, this patient demonstrates slightly reduced testosterone synthesis; secondly, he is demonstrating "up-regulation" of the enzyme "aromatase"(which is responsible for the conversion of testosterone into estrogen); and lastly, he is suffering from what is known in the FE community as Adrenal Stress Syndrome (which in this patient's case manifested as adrenal gland hypofunction). He additionally has a significant food sensitivity (gliadin) that will certainly compound his Adrenal Stress Syndrome and produce a number of very vicious cycles that will only aggravate his condition. The remedy for his complaints was to prescribe a number of specific formulations by Apex Energetics to produce the following effects:

1. To enhance endogenous testosterone synthesis (i.e. to make more of it from within)
2. To"down-regulate" the aromatase enzyme, thereby reducing the overactivity of this enzyme by inhibiting its action and preventing the conversion of testosterone into estrogen.
3. To provide proper nutritional support to his intestinal mucosa to help heal any damage to his gut lining and to ensure proper digestion by providing a full complement of digestive enzymes in conjunction with probiotic organisms to support healthy intestinal absorption. The additional intended consequence of restoring proper gut function to this patient is to eliminate the Adrenal Stress Syndrome which will automatically restore his exhausted cortisol and DHEA levels.

I now await the outcome of these recommendations, as indicated by both the patient's presentation subjectively and objectively, in conjunction with follow-up laboratory testing.

So in closing, my intent with this brief discussion and minor review of a single case history of one patient's endocrine data illustrates how from a functional approach we in FE tend to diagnose and treat the body, thus meeting the body's needs as opposed to running over it roughshod with dominant replacement therapies that offer little, if any, restorative capabilities. My primary objective is to facilitate your ability to modulate and regulate your own endocrine system, hence allowing your series of glands to release your own hormones, which are your intercellular chemical messengers. In turn, these chemical messengers act as your communication agents, instructing your body on how to respond and perform those specific actions that will give you optimal vim, vigor, and vitality all day long!

At the risk of appearing redundant, I think it now abundantly clear that we are addressing YOUR unique and specific endocrine requirements and allowing YOUR body to make the correction in truly holistic fashion, as opposed to giving you exogenous replacement hormones, which is not only narrow-minded and myopic, but potentiates doing more harm than good in the long run.

Cheers!

Theodore J. Bloukos, D.C., P.A.