LS 153 - How Hormones Control Almost Everything with Dr. Randi Hutter Epstein

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Welcome to the Longevity Show, Informing listeners on the important aspects of health, wealth and happiness to ensure you live life to its fullest. With fascinating interviews with top authors and gurus in the field. Along with the latest news in the science and technology of longevity, we're going to reveal expert advice and amazing secrets of living a longer and now, here's your host, Jason Hartman.

It's my pleasure to welcome Dr. Randy Hutter Epstein. She is a writer in residence at Yale Medical School, an adjunct professor at Columbia University Graduate School of Journalism, and the best selling author of Aroused the History of Hormones and How they Control Just About Everything. Randy, welcome. How are you?

Thanks. I'm aroused and I'm happy to be here.

And we should give the disclaimer that we are not just talking about this from the perspective that everybody is thinking right now, the sexual perspective. Because hormones control just about everything. As you say in the subtitle, they.

Control just about everything. And the word aroused, as we all know, means to arouse or to excite. And the the scientist in 1905 who was looking for a name for these potent chemicals said to a friend of his who was a University of Cambridge classicist, give me a find a Greek word. Because, you know, that's what doctors like to do. They like to name things after things in Greek. I need a Greek word for to arouse. He was thinking arousing cell receptors. Arousing your adrenal gland.

Yeah, right, right, right. Not, not, not what everybody thinks.

But he did worry about that, though. So his friend said, how about something along the lines of which means to arouse. But interestingly, he was thinking also the testes and the ovaries. And he was thinking libido. But when he gave his first speech and said, let's call them hormones to arouse, he intentionally did not mention ovary and testes. He said, we're talking adrenal glands, pancreas, pituitary. Because he didn't want to sort of bring sex up into his very lofty speech. But we are talking that too. But we're talking so many.

Well, hey, listen, it's part of humanity, part of everybody. So, you know, that's, it's not, shouldn't be ashamed to talk about it. So let me ask you this question. How many, I don't know if this is an easy answer or not, but how many hormones are there? How many do we need to think about I mean, everybody knows the biggies, right? Testosterone, estrogen, there's progesterone, There are many others I can't think of right now. But how many are there?

You know, I don't even know if I can put a number on that. I'm not sure a doctor can too. There's been an explosion because there's not just insulin, but then there's insulin factors, there's hormones. So it's like everything else in our chemical system that if there's. We have growth hormone, but then we have a growth hormone factor that's also a hormone. Affect how much growth? Oh, I just mean like other chemicals that are other hormones that play into the ups and downs of our hormones. And, you know, it's getting more complicated because now we know that. Well, the definition of a hormone is really any chemical that comes out of a gland and has a specific far away target. You know, not far away, New York to la far, but far away. Like brain to intestine, brain to testes. But it's become complicated. The more we learn about brain wiring and we have all these messages in the brain that are chemical, then we say, well, do we call that a hormone or do we call that a brain signal? So to give a tally of exactly how many hormones there are would probably get very complicated.

Okay, all right, good.

But we do have, the main ones have insulin and we have growth hormone and we have testosterone and progesterone and cortisol, which we think of as stress hormone. We have things that are pituitary gland releases, things like vasopressin and aldosterone. So the list really goes on and on because there's so many hormones that we might not talk about all the time that do affect our behavior and our growth and our bones and our heart rate.

Yeah, okay. Okay, good. So, you know, I was mentioning to you off air before we started today that I got curious. You know, I do host a show called the Longevity and Biohacking Show. And so I went to one of these kind of medi spas recently and talked to the people there about, you know, supplements and hormone supplements. And believe me, I am not keen in messing around with this stuff. I think it's very risky and I think we just don't know about it. But I could not believe how hokey these people were. I mean, it's a doctor run clinic. Clinic in quotes. But the whole thing just seemed like a big fat sales pitch to me. I mean, you know, just because you're wearing a white coat doesn't mean you're not a hokey salesperson, okay? I mean, is this, is this, Are, are people making a mistake by messing around with this stuff or is there a real place for it? Everybody's seeking the fountain of youth. You know, it's like, should they supplement with hgh, for example? That's when you hear, I hear the commercials on the radio constantly. I've never done it, but is it good, bad and different? What do you think?

Okay, my short answer is bad. My longer answer is if you're going to look into any kind of hormone supplement or you want to know anything about your hormones, and this is going to sound so silly, but you want to go to a hormone expert and you're thinking, well, of course you would. You want to go to someone who, the American Medical association recognizes that this person is a board certified endocrinologist or has done some sort of fellowship in what, what we, what the medical establishment recognizes as an expert in hormones. What's happening is some of these outlying places have their own certificates there it is hokey. You're right to say it felt so hokey.

I couldn't believe it.

You can study. I actually said to someone, a doctor who paid $3,000 to go in and take a test that gave him it, said something about being a hormone expert. And I said to him, you realize that the American Medical association doesn't recognize that certificate. You're not really like what we think of as board certified. And he said, yeah, but I'm going to get a diploma and I'm going to pin it on my wall and patient's notes won't know the difference.

Scary.

So that's kind of scary. Why? You know, yes, These guys have MDs, but you want to make sure that who you go to really knows hormones. That in terms of the American Medical association, they're board certified, or that they're your internist that has done some work in endocrinology. You also want to make sure that anything, any drug that you put into your body has gone through quality control. Because that way, you know, if it says it has a certain amount of hormones in it, you know, that's what's in it. The danger is not that you're getting a placebo. I'm all for placebos. And if you're drinking water and you think that this water is going to boost your libido, good for you. But I'm worried that there might be some things like bits of thyroid that can make your heart race or other things that you can get somehow over the counter, which I'm not sure or it should be over the counter, that has potent hormones in it that can really mess up your system.

Yeah, I'd say people better be careful with this stuff. And it's also expensive. Right, Right. And a lot of these hokey companies are just totally overcharging people too, because you can get the same thing on Amazon.com, literally the same brand name. I kid you not, I remember this TA65 or something like that, which is the supplement that they say extends your telomeres and will make you live longer. Right. And so I asked my doctor about that and you know, he wanted to sell it to me for a fortune. They got the exact same product with the same brand name on Amazon for a lot less money. So yeah, you know, I don't know. The whole thing's just, it seems like every industry feels like it's been either co opted or just corrupted at some level now. It's terrible. You really got to be very aware as a consumer nowadays, don't you?

You have to. So aware. And I also think, I mean, it's adding away, but I also tell people, which can be an uncomfortable conversation, but I've done it. Ask your doctor if they have, if they're financially tied to a certain company. You know, if your doctor says, well, you really need this hormone, do you have financial ties to that company? I've actually asked my doctor, she was fine with me asking and said I absolutely don't. But it's sort of crazy that we have to think that way. Is this new? Not really. We just didn't think about it. Maybe you remember there was a book in the 1960s called Feminine Forever and it really touted the wonders of estrogen. Now we know estrogen does help certain menopausal women.

Well, thankfully I don't remember that book because it's before my time, but go ahead. So, and this was a book for.

It was a book for women. It was a best seller. It was before we understood some of the dangers of taking estrogen alone because it can increase the risk of uterine cancer, cancer of the womb. But the book also made it sound like this was a fountain of use for women for just name it a bad disease, it would prevent it. Something good about you, it would increase it. What wasn't mentioned was that the doctor who became a best seller who wrote this book was funded by three drug companies who made estrogen. So it's not this new thing that these doctors are doing things like this, but we're hopefully more savvy to it.

Absolutely. Okay, well, tell us. I mean, your book really focuses on the history of hormones, right?

Yeah. I mean, I look at the history, but I really look at what's going on. I would say that I'm. I'm not predicting the future so much, but I don't. I'm not stuck in the history. I think if we understand the history, then when I talk about what we're saying now about testosterone or menopause or hunger hormones, we can understand it a lot better. We can understand sort of the flow.

Okay, so before we dive into a couple of your chapter heads in your book, a general question for you. It sounds like your thesis pretty much is, you know, don't supplement things from the outside. So that would kind of beg the question, can we help our bodies make them from the inside? For example, we can increase our testosterone by just sleeping, getting good sleep and exercise and eating. Right? Right. I mean, you know, just the basic natural things. Anything you want to say about just healthy habits that will help us improve our hormone balance?

First, I want to say I'm not anti hormone in terms of supplementing. I mean, I'm in menopause now and I do take hormone replacement therapy that's given to me by my doctor. It's not compounded, it's not from a clinic. It's from something that went through the fda and it's estrogen and progesterone, and it helps with my hot flashes and other symptoms. I don't think it's going to ward off many long term, you know, the diseases of old age. But I'm taking it for the symptoms. Now I think that in terms of supplementing, if you truly need a hormone, we can do a tremendous amount. Diabetics have to take insulin. There are people that lack growth hormones. So I'm not against supplements if they're needed. But yes, you're right. I don't believe that special diets. I'm not sort of one to say, oh, if you take out gluten, it's going to help your body balance this way, or if you take out whatever the other latest fat is, it's going to help your body that way. But there are certain things we do know, that obesity lowers your testosterone level. I don't think it's the reverse, I don't think. But some people say that testosterone burns fat. No, testosterone does not burn fat. But if you diet and you exercise and you lose weight and you get in better shape, that will boost your testosterone level.

Good, good. Advice. Okay, so what about on the other side of it, estrogen?

I think that, yeah, there's things that we can do to make sure estrogen is good for bone health. But it's the other way too, that walking, any sort of weight bearing exerc is really important for women and their hormones. Is it good enough that for some women they don't need hormone replacement therapy? Sure, you know, for some, but not all. But yeah. So I think again with women too, obesity does affect not even just estrogen, but it can affect other hormones too, like growth hormone. I mean, we know that diet does impact fertility. Say so for women who are obese and also for women who are extremely thin, have eating disorders in either direction. It mucks up your hormones in such a way because it's an extreme stress on the body. So if you're not eating enough for women, and we've known this for years, women who become very thin, it's a signal to the pituitary that the body is undergoing stress. And there are women that they say suffer from early menopause and it's their hormones are going down because of triggers in the brain that then signal to the rest of the body that, okay, we have to damp down on estrogen or damping down.

Here's an odd one. What about exercising too much?

You know, it's an interesting thing in terms of hormones and I think they're trying to piece it out. There's some studies that have looked at people under stress. You know, it's always hard to say, is it the exercise itself, is it the stress, is it the eating, is it not eating enough for your exercise? So there have been studies to show that while we just said exercise needs healthy helps your testosterone level, there have been studies to show that sort of men in combat who are exercising tremendous amounts, you know, with big packs on them and maybe not eating enough and also very stressed, their testosterone levels can go down. Again, the same for women. They've looked at sort of these, you know, long distance runners who are pounding away and exercising a lot and also very thin.

Yep. I had an ex girlfriend like that and I didn't think it was healthy.

Exactly. Now can we say is it the running or is it the eating? Because maybe if people that ran that long distance put in enough calories to make sure that they were function to.

Offset the calories, offset the stress of the exact same.

So it's really hard sometimes to piece these things apart. But yeah, I mean, the body doesn't do well with extremes and we know that when the body is under stress, this is when our hormones come out and start saying, okay, we have to lower this hormone or we're under stress. We have to try to maintain what's going on now. And the other fascinating thing we found out in terms of all this balance in food is that the fat cell, which we used to just think is, I don't know, a glob of fat. Like, I always pictured a fat cell, like a little bit of butter just kind of blobbing around your body. But the fat cell is an endocrine organ, so that's, again, tied into. If you have too many fat cells, it's not just filling you up like throwing marbles into, like, a balloon kind of thing. It's also sending off signals. We understand that now, but we're just now getting a bigger appreciation of what that means.

Okay, good. Want to ask you about. Obviously, whenever you talk about the subject of hormones, it wouldn't be complete without talking about gender. You know, how the study of hormones, how's that changed, you know, with the nature of gender and, you know, the sort of new, modern view of gender and all of this stuff, you hear a lot of it, you know, goes into the politically correct world, which annoys me a bit, I have to say. You know, I mean, certainly it's a big part of this discussion. And then I also want to ask you about criminality and criminal behavior and the hormone impact on, you know, whether hormones make someone commitment. Sure.

So let's talk about gender first. And it's interesting because up until the 1950s, the word gender really was only for grammar. And it wasn't until the 50s, you know, we called what we think of as gender. We just called sex. Your sex was a boy or your sex was a girl. Gender really came into the fore when we started realizing, okay, you might be xy, what we think of as male, you might have testes, but your gender identity, how you think of yourself, down deep, is much more than just your chromosomes or your external features. So when we talk about gendered, what I think people want to really know is, can we measure hormones? And is there something that we can do to look at hormones and say, this person, we can say they have a female identity, but down deep, they may not feel female. And so for most of us, if you measure hormones and you look at chromosomes, for most people, their external appearance will match how they feel inside, and then that's their gender identity. But for some people who now identify as transgender, who believe that their external appearance is different from what they feel inside. We don't really know the scientific basis for that. So it's not just hormones.

That's interesting. So you can't tell by hormone levels. In other words, you could have someone who identifies as the opposite of their.

They're what they look like. Their anatomy. Their anatomy, Right.

Yeah. Or their anatomy. But their testosterone or estrogen could say they're completely their own genitals. Absolutely.

We're still trying to figure this out. What some doctors think is that at birth, when, you know, babies in the first couple weeks all look alike, we all look sort of like that, like a little croissant. And then we start shaping into different bumps, turn into different things. Your head, your this. And then the genitals form around 14 weeks. What forms the genitals to go to? What we think of as male looking versus female looking are a flood of hormones. What usually happens is those same hormones are probably affecting the fetal brain. Exactly how, we don't know yet. Usually it's all aligned. Doctors have a hunch that even before you're born, the hormones that wired your brain that might cement some kind of identity are different from what's. Or the timing is different, or something's different from what's forming the genitalia or what's making you look externally. But we don't know. There's studies that you'll hear in the press that say, new study out, doctors found, you know, people that might look male but identify as female, their brain looks more female. Well, I can tell you that if we took a brain, just a brain, a male brain, and put it next to just a female brain, just right there on a lab bench and sliced it up, and you got some brilliant pathologist to look at it, he would not be able to say, oh, that's the male one and that's the female one. So then how are we going to know what one is? The one of a brain of someone who identifies as transgender when we're not even good at looking and saying male or female? So it's. It's a long winded way to say we are doing studies, we're trying to understand.

It's. It's still under research. But what about criminality, though? Can you look at the brain of a criminal? Or is it that. I mean, certainly, you know, we males commit most of the crimes or at least get caught.

Okay, well, the short answer, you know, testosterone.

Is it testosterone?

No, we're not good at predicting criminality. But the more fun answer is there's a great history of this so I'd like to tell a little story that in 1924, maybe some of your listeners have heard of what was considered the crime of the century, the Leopold Loeb murder trial. And this was for those people who have forgotten this little chapter. Were two rich kids about to go off to graduate school. One was already accepted to Harvard Law School. Two rich kids from Chicago decided they wanted to try to get away with murder. Not a good thing to try to do. They didn't get away, by the way.

What did. Did you say what you mean?

1924.

Okay, so 1924. Got it. Okay, go ahead.

They were caught right away. They pleaded guilty. They each blamed the other one. The parents were wealthy enough to get famous. Clarence Darrow, who would go on to do the Scopes trial for the teacher that was accused of teaching.

I believe the Scopes monkey trial, we all studied that.

The same lawyer, same fancy famous lawyer. What he did was said, let's get some scientists in. He wasn't trying to prove these boys innocent. He basically wanted to say their hormones made them do it. So this was 1924. We couldn't measure hormones then. We hadn't even isolated some hormones. They weren't even isolated until the end of the 1920s. So we're talking really the beginning of endocrinology. And yet he had these doctors come in and they X rayed the boys and interviewed them. And they had this machine called a metalometer. Metabolometer. I have trouble saying it, but it was supposed to measure your metabolism and that would be a clue to your hormones.

I'm thinking if, depending on how you tell us this trial turned out, a lot of people could get off the phone.

Oh, absolutely. Except for this one thing. The Doctors wrote a 300 page report, which I won't read the whole thing now, but I'll just tell you this. They said one of the boys had a hardened pineal gland which we now know controls melatonin and your sleep cycle. But then it was sort of thought to be something to do with your soul, your moral down deep soul. And the other boy was diagnosed.

That's the light source.

Exactly. And the other boy was given the vague diagnosis of multiglandula syndrome. And so the judge. And this might sort of suggest what is going on now in criminology. The judge said, this is fascinating. Wow. This field of endocrinology is great. We're glad you guys are doing this. But guess what? It's not going to get these two murderers off the hook. So. And I think even though today and then there were doctors saying, let's measure hormones and see who's more likely to do bad things. And then we can actually have a better society. We can prevent these kids. We can give them hormones and prevent them. We're not there yet. We haven't figured that out yet.

Fascinating, fascinating. What else should we know as we wrap it up? I mean, what can we maybe. What can we look forward to? What will the next five or ten years bring us in this field? Are we on the verge of any breakthrough? I think we are.

I think. I can't predict the specific breakthrough, but I can tell you in terms of the field, there's something exciting things coming up. So I would say one exciting thing is we are getting a better idea of hormones and behavior. And we can look at what we know about leptin and the hunger hormone and where it fits in. And the interesting thing is that we know that people that have a defect in this hormone become obese and they eat all the time. The fascinating thing is it's not because of their metabolism. It's not because they just can't burn calories. Calories faster. It's because they are compelled to eat. Which means that a hormone is tied to a behavior. And that's a clue that there must be other hormones tied to behaviors. And we're just now trying to figure it out. It's usually not a one hormone to behavior kind of thing, but it'll be a chain event. And as we understand that more, yes, I think we will be able to help people that might have huge behavioral issues. The other thing I think we're really starting to appreciate is how our hormones are tied to our immune system and to other systems in the body. And that can help us stay healthy. So in terms of, let's say, cancer patients, it used to be that we've made huge advances. Let's say it used to be that we weren't curing so many cancers. Now we are curing a lot more. But now people want more. They don't just want to survive. They want to make sure they're strong. They want to make sure they're having a quality of life. We're learning more about the effects of chemotherapy and some of the cancer treatments has on our hormones. And there are now endocrinologists that specialize in working with cancer patients so that they can now measure their hormones and say, here, let's try to make you feel better. Let's try to make you feel the person you were before so that you're not feeling hormonally off just because you suffered from cancer. And it's something that cancer patients should ask about. You know, there are women after breast cancer that have a lack of sex drive and they're embarrassed to talk to their doctors about it because they think, oh, gosh, they just cured me of breast cancer. I can't. I don't want to complain about this. Unimportant.

Yeah, don't be so ungrateful.

Exactly. Don't be grateful and say to your doctor because there are things that you can do. There are things. And doctors are now telling each other, ask your patients, how do you feel? How's your sex drive? Do you feel more tired? Because there are things that doctors can do to make your life better.

Interesting stuff, for sure. Very interesting stuff. Give out your website and tell people. Sure.

My website is randyhutterepstein.com. you can see other articles I've done. And if you just either go to your local bookstore online, you can find aroused. If you do, which I love to say if you do, Randy Hutter Epstein, Aroused, my book will come up. But you can also do aroused, the history of hormones and how they control just about everything.

And they sure do. Well, Randy, thank you so much for joining us.

Thank you. Thanks for inviting me.

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