Sunday, September 8, 2013

HORMONES...Health or Sickness, Old or Young


Balance Your Hormones to Turn Back the Clock
Your hormones play a critical role in the way you think, act, and look.
by  Daniel  Amen, M.D.
Did you know that hormones have a huge impact on brain function, for both men and women? When your hormones are balanced, you tend to feel happy and energetic. When your hormones are off, everything and everyone in your life suffers. For example, did you know that low thyroid hormone is associated with overall decreased brain activity, which makes you feel depressed, irritable, and have significant trouble thinking (Image 7.1)?
Likewise, low testosterone levels have been associated with low libido, depression, and memory problems and have been implicated in Alzheimer's disease. We are only beginning to talk about male menopause, but for many men it is a real issue that needs to be treated. Low testosterone levels may be a significant cause of midlife crises and divorce. As his testosterone levels go down, he feels more negative, blames his wife, who is having her own hormonal issues, and looks outside of the marriage to feel young again. Of course, the new love usually doesn't make him happy.
Low testosterone levels also affect women. I once had a female physician come up to me at a lecture and tell me that at age fifty-one she had no interest in sex, her marriage was in trouble, and her mother had just died from Alzheimer's disease. She had NO idea that low testosterone levels could be part of her problem. Later she e-mailed me that her testosterone levels were near zero and that taking testosterone made a huge difference for her sexuality, her memory, and her marriage.

When testosterone levels are too high, men or women can be "too competitive," have commitment issues, be hypersexual, and struggle with acne or being too aggressive. A common condition in women associated with too much testosterone is called polycystic ovarian syndrome (PCOS). More on this in a bit.

Do you believe in PMS? I have five sisters and three daughters. I believe in PMS! But it wasn't until I met Becky that I finally had evidence that PMS was, in fact, a brain disorder. Becky came to my office after a brief stay in jail. In the week before her period, she often became moody, anxious, aggressive, and tended to drink too much. Shortly before she saw me, during the worst time of her cycle, she got into a fight with her husband, attacked him with a knife, and was arrested. When I met her, I decided to scan her during the worst time of her cycle, and then again two weeks later, during the best time. Becky's scans were radically different. During the difficult time of her cycle, her worry center was overactive, indicated by the arrow on Image 7.2, and her judgment center was low in activity, which may have been why she grabbed the knife. You can see the holes in the front of her brain. During the best time of her cycle, her brain looked much better (Image 7.3). Seeing her scans was so instructive, and on treatment she did much better. Hormone fluctuations can change your brain and literally rip apart your family.

Again, these hormonal shifts can cause seismic problems in relationships, Carefully testing and treating hormonal issues for both men and women is critical to the health of the brain as well as to the health of relationships. Let me give you a very personal example of how issues with hormones can affect your relationships.

I am married to a neurosurgical ICU nurse. While Tana is both beautiful and smart, she was also used to being very assertive, working around neurosurgeons all day long. She often joked, "What is the difference between a neurosurgeon and God?... At least God knows he is not a neurosurgeon." Tana also has a black belt in "tae kwon do" and her approach to romance was more like the typical guy's-—-we'd be cuddling together and she'd say, "Okay, that's enough, I've got to go work out." She also loved masculine dogs and had a big dog named Mack.
One of our first fights was over what type of dog we should get together. I wanted a King Charles cavalier spaniel—they're cute, little, fluffy, smart, and sweet. She wanted none of it. She actually said that the little dogs were nothing more than chew toys for the bigger dogs. So we compromised on an English bulldog. Frasier was cute, but not the kind of cute I was looking for.
When Tana was about thirty-eight years old, she went off birth control pills and noticed that her face started breaking out and her menstrual cycles became very irregular. Despite her young age, she thought she must be going through perimenopause, a period of time that can last several years prior to menopause. To figure out what was going on, she went to see her doctor. To her astonishment, she was informed that her cholesterol and triglycerides were high and that she was prediabetic. What?! Tana is five feet six inches tall, weighs 118 pounds, has about 15 percent body fat, works out like a nut, and eats all the right foods. That's crazy, she thought, I'm the healthiest person I know.
As we were both concerned about her health, a friend of ours introduced us to Dr. Christine Paoletti, a gynecologist in Santa Monica. It took only about ten minutes for Dr. Paoletti to suspect that Tana had a condition called polycystic ovarian syndrome (PCOS), which causes a woman to have too much testosterone. It is also linked to irregular menstrual cycles, skin breakouts, high cholesterol, and insulin resistance. An ultrasound confirmed the diagnosis. Why didn't any other doctors catch it? Tana doesn't fit the typical physical profile of a woman with PCOS. Most women with PCOS are overweight and have excessive facial and body hair.
Dr. Paoletti treated Tana with glucophage, a medication used to balance insulin and reduce testosterone levels. The changes were dramatic. Within a few months, her cholesterol dropped fifty points, her insulin levels normalized, her skin cleared up, and her cycle became perfectly regular. Even more dramatic were the changes in her personality. All of a sudden, she wanted to cuddle more, was less intense, less anxious, and after about six months she had to have a pocket poodle and called her Tinkerbell.

Now, I like to say, change your hormones, change your brain, change your body, change your personality, change your relationships ... and even the type of dog you have. It is clear that our hormones are heavily involved in making us who we are.


There are many myths and misconceptions about hormones. First, people usually think hormones are just a female issue. Wrong! Hormones are essential for health and vitality in both men and women. Second, most people— and even some doctors-—think of our hormone-producing glands as the sole source of any hormonal problems. Wrong again! In reality, the brain controls all the hormones in your body. Think of your hormones as airplanes flying through the air and your brain as the air traffic controller. Your brain tells them how fast they can fly, when they can land, and where they can land. For example, if your thyroid gland is overproducing, it doesn't know it. Your brain filters your blood to check up on your thyroid levels, sees that there is too much, and asks the thyroid gland to lower production. The hormone-producing glands don't communicate with each other, only with the brain, which controls them all.

Third, most of us think of our hormones—estrogen, testosterone, thyroid, and others—as individual and unconnected systems. Wrong again! For example, when a woman approaches menopause, many doctors look only at the ovaries. And when thyroid levels are off, they only test and treat the thyroid gland. This approach is wrong, because our hormones all work together to maintain balance. Think of the hormonal system as a symphony, with the brain as the conductor. If all the players are playing the right notes at the right time, it is a wonderful concert. But if the conductor takes a break and a single player hits a sour note, it ruins the whole effect. Similarly, when one hormone system is out of balance, it causes imbalances with the other hormone systems.
When your hormones are in sync, a magnificent mind, a slimmer body, clearer skin, better energy, a happier outlook, and improved health are the rewards. Hormonal imbalances lead to cloudy thinking, makes you fat, gives you acne and wrinkles, saps your energy, sours your mood, and increases your risk for disease.

What exactly are hormones? They are little chemical messengers that travel through the bloodstream, allowing the brain and bodily organs to communicate. You might be surprised to learn that hormones are derived from cholesterol. Cholesterol gets a bad rap in the media, but cholesterol isn't the enemy. Yes, it is true that when cholesterol is too high, it is associated with heart disease. But when it is too low, it is associated with homicide, suicide, and severe depression. Your brain and body need some cholesterol. Approximately 60 percent of the solid weight of the brain is fat, so you need healthy levels of cholesterol for optimal function. From cholesterol, your body makes a chemical called pregnenolone, a mother hormone, from which all the other hormones are derived. This hormonal tree is referred to as the hormonal cascade (Figure 7.1).

Like most people, you are probably most familiar with the body's reproductive hormones: estrogen, progesterone, and testosterone. But these are only some of the many hormones that help keep your brain and body balanced. In this chapter, you will discover how many other hormones play a vital role in the health of your brain and how your body looks, feels, and functions.

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