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The Great Hormone Debate: What's "Normal"?

10/17/2011

1 Comment

 
I have just completed a letter to a friend's physician discussing the issue of hormone levels and what constitutes "normal." Sigh... I keep fighting the same battle over and over again.

As I explained to my friend's doctor, nobody in their right minds would tell us it's normal for a car's oil to run dangerously low after 20,000 miles, so you shouldn't replace it, or if you do replace it, just add a tiny fraction of what the engine needs to run properly. Yet that's exactly what the medical establishment tells us about our sex hormones...which, by the way, are about a whole lot more than sex. They keep our brains, hearts, bones and muscles (among other sexy bits) healthy and vibrant.

If we're talking about dull, boring hormones like cortisol, thyroid, or insulin, the answer to deficiencies is almost always to supplement the hormone until it reaches an ideal or optimal level and your body once again is operating the way it's supposed to. But when it comes to the sex hormones, the medical community behaves as if we were talking about recreational drugs, rather than substances our bodies were designed to run on.

The first place we get into trouble is with the definition of "normal." We typically get some kind of test, perhaps a blood test or a saliva test. The results come back and the lab flags any values that were either above or below their "reference values" as being abnormal. So that implies that anything within the reference range is normal.

But how do they determine the reference range? They test a bunch of presumed healthy people and set the highest and lowest scores as the top and bottom of the reference range. 

This seems like a reasonable thing to do, until you get into the touchy subject of sex hormones. And then the labs add a little twist: they set their reference ranges according to a bunch of "healthy" people in your age group. What that does is reset the numbers to show what's normal for people your age. But what if "at your age" most people are deficient in that hormone? Now the lab test is telling you that it's normal to be deficient. 

That's exactly what happens with hormones like estrogen, testosterone and progesterone. 

But even if they include all age ranges, they are still going to show that it's "normal" for some otherwise healthy folks to be at the bottom of the tank sucking fumes.

So when my friend's doctor told him his testosterone levels were good, he was comparing them to the reference values for men over 65...which are virtually always deficient! Instead he should be comparing them to the optimal values for the healthiest men in their prime.

What's equally important is the question of what's normal for you...or rather what's optimal for you.  In a perfect world, we should all have our hormones tested at various times in our lives, especially when we are at our healthiest, so we know what our body's chemistry looks like when we feel our best. Then as we get older, we can use those levels as benchmarks to know what we need to get back to.

But even that may be misleading, because, for example, research shows that the average testosterone levels in men of all ages have declined over the past few decades, presumably because of all the estrogen-like substances in our food supply and environment. So even at your youthful best your hormones may have been low or imbalanced.

Which brings us back to defining optimal ranges, and that may take a certain amount of art as well as skill to determine.  

The bottom line is that if you want to restore your body's chemistry to optimal levels, seek out a doctor who understands what that means and is willing to deviate from standard practice...in a responsible way...to get you back to where you need to be, both objectively and subjectively. And if you already have a doctor you really like and trust, encourage him/her to think outside the box. Perhaps print out this article for your next office visit. 

Life is too short to do things half way.  
1 Comment
acne scars link
9/30/2012 11:21:22 pm

I am also writing a blog on the same issue, I am obliged that your research has made my work very much easy and simple.

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    Author Pat O'Connell offers a variety of health-related articles for women and men. This information is for educational purposes only.
    NOTE: Please consult a medical professional before implementing these or any other health solutions. 

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