Hormonal Update Volume 2 Number 4

Over-the-Counter Hormones

In 1994 the United States Food and Drug Administration (FDA) passed the Dietary Supplement Health and Education Act (DSHEA), making it possible for some hormone products to be sold over the counter (OTC) as dietary supplements. Among the products now available to consumers without a prescription are the hormones DHEA, progesterone, pregnenolone, melatonin, and androstenedione.

Since these hormone products may now be purchased without a visit to the doctor, OTC hormone preparations afford consumers more freedom of choice when it comes to their own healthcare. In addition, OTC hormone preparations are generally less expensive than prescription hormones. However, it is important to keep in mind that one reason for the lower cost is that these supplements are not subject to the rigorous and expensive FDA standardization process. Responsibility for the purity and safety of these products now rests with the manufacturers. And, now, educated consumers have more freedom to use them. Very few adverse effects have been reported for the use of over-the-counter hormone preparations; however, there is important information you may want to consider if you are planning to use OTC hormones, or if you are already using them.

What You Need to Know

Natural hormone production in the body is highly individual. Not everyone produces, or requires, the same amount of a hormone. In addition, your hormones work together in a very interrelated way. The delicate balance between hormones is as important as the level of each individual hormone.

Even though hormone levels decline with age, restoring them to more youthful levels can relieve symptoms and help provide disease protection. Supplemental hormones can raise your hormone levels. However, raising a hormone level too high can sometimes create additional symptoms rather than relieve them.

The way in which your body uses supplemental hormones is highly variable. The rate at which a supplemental hormone is absorbed, utilized, and then eliminated is unique to each individual. This makes it difficult to assign a single safe and effective dosage that is appropriate for everyone. As a rule of thumb, when choosing a dosage size, it is best to start with the lowest dosage. You can always increase to a higher dosage if indicated. 

Certain hormones in the body have the ability to change into other hormones - especially when taken in high doses. For example, DHEA can convert to estrogen and testosterone. Pregnenolone can become DHEA, and DHEA can become androstenedione...as well as testosterone, and estrogen. Therefore, if you are taking one hormone it is possible for it to alter other hormone levels.

You also need to be aware that hormones can interact with other medications you might be taking. It is wise to always discuss your over-the-counter hormone use with your healthcare practitioner. Make sure it is part of your medical history. 

What's Available Over-the-Counter

The hormones available over the counter are all natural, bio-identical hormones. Their molecular structure identically matches the structure of the hormones your body produces. Because of this, natural, bio-identical hormones cannot be patented; therefore, most pharmaceutical manufacturers do not market them. This means that OTC hormone products are not subjected to the rigorous FDA standardization process. Pharmaceutical companies can, however, patent the hormone delivery system as in the case of the estradiol patches. The hormones listed below are currently available over the counter in the United States. 

Androstenedione
Androstenedione is chemically converted into testosterone in the body. This increase in testosterone has many consumers (especially men) taking androstenedione in the hopes that it will increase muscle strength and stamina. However, despite the conversion, it might not be used as testosterone. It might instead be further converted into estrogen. Too much estrogen in men can lead to enlarged breasts and other negative side effects. Too much estrogen in women can lead to breast swelling, bloating, and mood swings. Women taking too much androstenedione can also experience the side effects associated with too much testosterone. 

DHEA
DHEA has been shown to help protect against the effects of stress, to increase and enhance energy levels, libido, memory and immunity. Research indicates that DHEA may help protect against some of the chronic degenerative diseases associated with aging - heart disease, osteoporosis, diabetes, Alzheimer’s disease, and rheumatoid arthritis, as well as cancer and lupus. In the body, DHEA can convert to estrogen and testosterone. If a woman is taking DHEA, and it raises her testosterone level too high, she might experience the side effects associated with excessive testosterone, including acne, oily skin, facial hair growth, irritability and anxiety. 

Melatonin
Melatonin helps control the cycles of sleep and is generally used to combat sleepless nights and jet lag. It is also associated with anti-aging. Once described at the ‘Prozac of the nineties’, there have now been reports that some people experience increased depression after taking melatonin. There are also reports of hallucinations and hallucinatory dreams associated with the use of melatonin, perhaps because of the dosage. Researchers have found that standard doses of melatonin are as much as 500 to 1000 times more melatonin than the body normally produces. PregenoloneShown to have positive effects on memory, sense of well-being, and energy, pregnenolone is considered a ‘mother hormone’. Through the body’s natural conversion process, pregnenolone is converted into the other sex steroid hormones, though it might be noted that this process has not been thoroughly studied. Some of the side effects associated with too much pregnenolone are over-stimulation and insomnia, irritability, anger, anxiety, acne, headaches, scalp hair loss, and irregular heartbeat. 

Progesterone
Progesterone, sometimes referred to as the calming hormone, is available over the counter in cream and lotion form. Popular with a wide range of women, transdermal progesterone has been reported to help relieve numerous premenstrual, perimenopausal and menopausal symptoms. There are a number of ways to use progesterone cream - daily, cyclically, or only on specific days of the month. How you choose to use it depends on the particular symptom relief you are seeking. One standard application is not necessarily appropriate for everyone, nor is one standard dose. Incorrect timing may cause or worsen irregular menstrual cycles. If the dose is too low, it may be ineffective. If it is too high, it may cause symptoms of drowsiness, breast swelling and tenderness, depression, and decreased libido.

How Saliva Testing Can Help You

 Many people are interested in taking hormones for their anti-aging benefits and disease protection. While there is some controversy over whether or not OTC hormones are safe and effective, one thing is certain. There is no reason to take hormones unless you need them. When it comes to hormones, more is not necessarily better. 

Saliva hormone level tests can quickly and easily tell you what your body needs, and, once you begin taking supplemental hormones, how your body is responding. If you are already using OTC hormones, saliva hormone level testing can help insure that your hormone supplementation program suits your individual needs. 

At this time androstenedione and pregnenolone cannot be monitored using saliva because of a cross-reaction with other hormones. Therefore, if you want to take OTC pregnenolone, it is a good idea to baseline test all of your hormones levels first, then, once you begin supplementing, to monitor them. In this way you will be able to determine whether or not the pregnenolone is cascading into other hormones and how much it is affecting your hormone levels.