What is BHRT?
Bioidentical hormone replacement therapy (BHRT) refers to the replacement of hormones that are identical to those that the body produces. Effective for both men and women, these hormones are commonly offered as creams, capsules, vaginal suppositories and injections. Treatment mainly focuses on hormones such as testosterone, estrogen, progesterone, dehydroepiandosterone (DHEA), cortisol, and thyroid.
Why give BHRT?
As women and men get older, we experience a decline in our production of natural hormones. Since hormones play a key role in regulating activity in our brain and body, regulating gene function, and overall effect on energy and a feeling of wellness, metabolism, stress and libido, replacement of these hormones is an amazing alternative to optimal health and vitality.
What is Functional Hypothyroidism?
The idea of functional hypothyroidism is that thyroid problems—which can cause fatigue, weight gain, difficulty staying warm, and constipation—sometimes elude detection by traditional blood tests. Functional medicine practitioners have maintained for years that going beyond these traditional screenings can, in many cases, help physicians identify problems that otherwise wouldn’t be detected. This, in turn, can lead to an appropriate therapeutic approach.
When evaluating possible thyroid problems, physicians traditionally have screened only for abnormal TSH and T4 levels. If these are normal, many physicians conclude that no thyroid problem is evident, and they begin considering other possibilities.
The functional hypothyroid thinking is that additional thyroid-related testing may be in order. The problem could involve, for example, the body’s inability to convert T4 to T3; excessive binding of thyroid hormones by proteins in the blood; or problems with the conversion of T4 to inactive Reverse T3. Problems with excessive binding of thyroid hormones or defects in conversion can render thyroid hormones ineffective.
Other factors might be at play as well; for example, if the adrenal gland isn’t producing appropriate amounts of cortisol, the thyroid won’t function normally. (Cortisol plays a key role in the body’s response to stress. Too much or too little cortisol can slow metabolism.)
Iodine deficiency also can affect thyroid functioning, as can low ferritin levels. Both iodine and ferritin are essential for appropriate production and function of thyroid hormones. Vitamin-D deficiency also can lead to symptoms of hypothyroidism.
These are only a few of the potential causes of functional hypothyroidism. The important point is that people with subclinical hypothyroidism are going undetected. The true rate of hypothyroidism in adults using diagnostic criteria of medical history, physical examination, blood thyroid levels along with basal body temperature may be closer to 25%, and significantly higher in the elderly, rising up to 40%.