Why Hormone Therapy Doesn’t Fix Everything

Welcome back everybody. This is our typical Friday podcast where we take a deep dive into topics you've asked about. And what I wanna do is revisit the idea of hormone optimization from a different perspective. People by now realize that November of last year, 2025, the FDA removed the black box warning on hormones and all of a sudden using hormone replacement therapy is now acceptable. But people in the integrative functional medicine world have been doing this for decades.

We never stopped using because we knew the benefit was there.

According to literature, maybe 140,000 women have died prematurely from lack of access to hormone replacement therapy. Between 40 and 70 million women were undertreated. Well, how can this be? Why is this? Well, according to the literature, hormone replacement therapy lowers your risk for heart disease about 50% and your risk of dementia for 30— about 35%. So to put this in perspective, if you're seeing a cardiologist, for example, and you're a female and you have cholesterol, blood pressure, and you're in the menopause age, postmenopausal age, which one has the biggest impact on your risk for heart disease? Treating your hypertension will lower your risk maybe 38%. Hormone replacement, 50%. So all of a sudden, using hormone replacement is more impactful on your risk for heart disease than treating your blood pressure. That's how big of a thing we got wrong for the last, you know, 20, 23 years roughly. So what is the difference between hormone replacement therapy, hormone optimization, and what I'm calling holistic hormone management? It's a newer level. Well, hormone replacement is simply checking a level and seeing your estrogen is low, your progesterone is low, your testosterone is low. Maybe your pregnenolone, which is your primary memory hormone, is low. Maybe it's your DHEA, which affects your risk for autoimmune issues. One of these is low and the other related hormones, and it's repleted typically topical testosterone pellet, topical estrogen or a pellet, oral progesterone, sublingual in some fashion. This worked 20, 30 years ago when it was simply an issue of replacing what was low. But in today's world, with the toxins, the chemicals, having all these autoimmune issues and the whole host of things, you have to look at hormone replacement a little differently, which is obviously have women come to office who've had their hormones replaced and they still have symptoms of their thyroid being off, or they still have issues with their gut, or hair loss, or memory issues. They're still having hot flashes because they have not had their hormones optimized. That's the second thing I want to talk about, is hormone optimization. For those of you who listen to our podcast, who've seen us, you're familiar with this. Hormone optimization is first dealing with the hormonal hierarchy, which is first your thyroid, your insulin for insulin resistance, and your cortisol, which is a big player. Cortisol, high cortisol or low cortisol. With hormone function, sex hormone function. Once those have been addressed, looking at your gut, which many times this is all happening at the same time, fixing your gut, dealing with your gut microbiome, which is the bacteria in your gut, working on detoxification. There are certain enzymes like beta-glucuronidase, for example, from certain bacteria that actually affect estrogen detoxification. So if your beta-glucuronidase is high, then all of a sudden taking calcium D-glucarate or something like that can have a massive impact on your estrogen dominance or estrogen detoxification. So your gut's a big, big player in this. And then dealing with the sex hormones. So that is our hormone optimization. Holistic hormone management is the next level with people you've done the replacement, they're not feeling better. You've looked at the gut, you've looked at thyroid, insulin, cortisol, and they're still having a lot of hormone, what it sounds like symptoms, even though these levels appear to be normal. Hormone optimization is actually taking the next level and looking at, so what are things that can actually affect in this world your hormones?

And you have to have a bigger view, a bigger lens.

And what I wanna do is give you an idea what that lens looks like right now.

Briefly, you're gonna deal with a couple level layers of things. First are hormone, certain nutrients, external factors that can affect circadian rhythms, emotional factors, pathological neurological processes, your inherited constitution, and then your acquired constitution. All of these can actually have an impact on your hormonal health and how you feel.

So what do I mean?

The first group, intoxicants, that's food, food additives, things like neuroendocrine disruptors, petroleum-based solvents in our food. All these can actually have a massive impact on your hormonal health and how your body— does your estrogen even work? Are your estrogen receptors even open? If there's bisphenol A, which is a neuroendocrine disruptor that looks and acts like estrogen, is bound there, then literally your own estrogen won't have a place to go do its work. The next level is dealing with water, and it's something that we're chronically dehydrated. It's a way our body detoxifies, but also has to do with the way we can get chemicals and toxins in our body. Aflatoxins, which are mold-related toxins, as well as your gut flora. Your gut can actually have bacteria that make these kind of biotoxins, endotoxins within your body that can have an adverse impact on your hormonal health. Sanitary applications, chemicals in your environment, cleaning stuff, a A lot of these are actually neuroendocrine disruptors. They disrupt your hormonal health. Some people just take all this and put it into the category of toxicity or toxins or detoxification. But it's interesting how the detergents, you know, the bedding you use, there's a lot of fire retardants actually built into bedding and stuff by law. And even though it's been removed in California and other states, it's still residual in the environment. Even oral contraceptives, using oral hormones actually suppresses your ovulation, suppresses your FSH and LH, and suppresses your natural estrogen, natural progesterone production. So if you've actually ever done a hormone panel on someone who's on a birth control pill, it's really interesting to see how their brain, the whole brain level down hormone production is suppressed, which will affect androgens or male-related hormones, will affect androstenedione, pregnenolone, and all these other hormones by taking oral contraceptives or other, even other pharmaceutical, either drugs that have estrogenic-like activities.

And sugar.

These are all things that are intoxicants, so toxifying in our body. The second is just lack of nutrients. So when you think about holistic hormonal approach, if you have low omega-3 levels, you have low levels of trace minerals, low iodine, your vitamin A is off, your D, which is really important for your body's inflammatory processes. All of a sudden, these nutrient deficiencies, either macro protein— there's a great example— fats, carbohydrates, or micro— these nutrients will impact your overall hormonal health. Again, we're talking about holistic hormonal care, big picture.

What else?

The third layer in this are actually external pacers. It's really interesting how our bodies are wired to need external pacers, external things that actually help regulate our day-night cycles. For example, when does the sun rise? When does the sun set? Um, moon cycles. It's really interesting. When I was in the emergency room, when I did my training, even afterwards and doing labor and delivery, it's amazing how many things, accidents, bipolar attacks, knifings, or babies being born, which I know seem unrelated, but it's really interesting how often these things would occur on full moons. There is an impact of lunar cycles on our mental health or hormonal health. And that we now are having this burgeoning realm of education and research on just the simple fact that not getting the first morning sunlight, those first morning beams to your eye actually set up your over your suprachiasmatic, there's a little timer that regulates your body's hormone fluctuations, et cetera. And getting accurate light, just being outside is a massive part of that. But also exposure to EMFs. You know, EMFs can disrupt that if you live near a cell tower, if you live near a radio station. It's really interesting how we've lost understanding and view that these things impact our neurological system, even though we know they are associated with cancer. And even though recently we've seen them used in warfare to cause TBI-like effects individuals, lower levels, which we're exposed to daily, can have similar day-night cycle disruptions, which can affect our hormone production. Emotional factors. This is where you get into this neural— this is the fifth, the fourth, the fifth one is, is these emotional factors that can affect your neural hormonal axis, your HPA, your hypothalamus pituitary adrenal gonadal axis. Chronic stress, trauma. It's interesting how in traditional Chinese medicine, the thyroid gland was thought to be the center of emotions, and we now know the thyroid has a massive impact on all the hormones. We talked about that in the hormone optimization, but chronic stress can have a massive impact on your thyroid hormone, and we'll see that as measured in an elevated reverse T3, which is literally a brakes on your thyroid production. And finally, pathologic neurological processes— shock, lack of rest, poor sleep cycles, trauma, big T trauma, little t trauma— all these can have a massive impact on not just hormone production, but also hormone function. If you're stressed, if your neurological system is wound up, your sympathetic system is overdrive, and all of a sudden, even if hormones bind to receptors and do what they're supposed to do, you're not gonna get desired impact. And then there's the whole idea of your constitutionality, what you're made of, your physical prowess. Are you physically active? Do you exercise routinely? Mentally and emotionally, are you stable? Do you have a high mental emotional IQ? Can you deal with social media? Can deal with everything going on in the world right now with a calm mind? Does it not trigger you? You have this, maybe not a strong, but a resilient or an even-keeled constitution. And it's really interesting. Traditional Chinese medicine refers to this as yin and yang, like what the things you're made of combating each other. But it's interesting how we're seeing now in medical literature, the idea of like having our daylight cycles balanced, having our rest as well as physical activity. That's literally a yin-yang concept. The physical activity Exerting yourself would be yin, and the yang would be rest and relaxation. You know, different way of thinking about things, but it always interests me that ancient peoples figured these things out years and years ago just by observing natural forces. They named it different things. It sounded a little weird, but they're describing similar things that we see now in our world. And finally is just acquired constitution, lifestyle, nutritional influences, belief systems, the environment you live in, social interaction. Emotional balance. All these things play into a holistic hormonal mindset. So if you're someone who's having hormone issues, who's seen all the specialists, done all the right things, you've balanced your hormones, still don't feel right, you've balanced your thyroid, your insulin, still don't feel right, your gut's better, still don't feel right. The question is, have you looked at all of these holistic hormonal things that can have an impact on you? Again, to list them once again, these intoxicants, nutrients, external pacers, emotional factors, pathological neurological processes, and then constitutional, your inherited constitution and your acquired constitution. So I encourage y'all to look at this. So we'll be doing more about this idea of a holistic hormonal approach because this is where I feel like all my patients now are missing the right keys. They've done all the right stuff. We balance their thyroid, you know, 80% of people, you do the basic hormone stuff, they feel better. There's a small percentage you have to do the more advanced stuff. Once you've taken care of their thyroid, their adrenals, their gut, You know, probably 80% of that, 20% they're better. That still leaves, you know, 6% of people, 8 to 10% of people are still struggling with their hormones, not quite where they need to be. And that's where having this more holistic mindset, I think, would be super useful. If this information's helpful, please like, share, subscribe as well. I'd like to hear your comments below. Like, do you feel like you're in this area? I feel like it's really helpful to get some feedback from those who listen to me to make sure we're giving out good information education-wise for people, because that's our ultimate goal is to educate, encourage, empower people to take charge of their health. So take care and we'll talk to you soon.