Hormones & Anti-Hormones

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Hormones & Anti-Hormones
*Including Drug & Hormone Interaction Chart*

Medications, Supplements, Herbs & Other Substances
Question: I was told that my medication may be the reason why I feel like my hormones are low even though my lab tests (both saliva & blood) both show I have good levels. How do I find out if my medications are the cause of my hormone problems?
Quick Answer:
Your personal healthcare professional (who prescribed the medication) is you first source for answers. Just as valuable could be finding a local pharmacist who is available for consultation, to review your medications, supplements and other factors that may affect hormone function.
Hormones Affect Hormones
Any hormone, whether synthetic or bioidentical, will affect other hormones in the human body. When considering estrogens, progesterone and testosterone, realize that each one will help “balance/control/oppose” the other two.
Medications, Supplements, Herbs & Other Substances *
Some medications, supplements and other substances may also affect hormone levels and/or function. The affect may be due to decreased or increased production, interfering or competing with hormones binding to cells, or changes in how the hormone is metabolized and eliminated from the body. Review the following list. Talk to your healthcare professional if you suspect your hormones are being affected by any of these substances.
Learning More About Drugs & Hormones
This article will focus how steroid hormones are affected by various drugs. Hormones that are biochemically designated as “steroid hormones” include androgens, estrogens, progestogens & corticoids. These are also described as “sex hormones” and “adrenal gland hormones”. This document will focus on how this class of hormones is affected.
Prescription and non-prescription medications that affect hormones may be classified in various ways. This document will classify them by prescriptive class and by potential action significant to function of steroid hormones.

Prescriptive Classes:
Note: OTC = Over The Counter medications.
The prescriptive classes, which include medications that may affect steroid hormones, include the following. The classifications include both biochemical classes and functional classes. Not all medication in a class have the effects noted in this writing. Though this list in not comprehensive, it does attempt to include all information available at the time of this writing.
Estrogens - Noncontraceptive Use			Antifungals & Antibiotics (includes OTC)
Custom Compounded Estrogens			Psychiatric Medications
Progestogens - Noncontraceptive Use (includes OTC)			Cardiac Medications
Custom Compounded Progesterone & Pregnenolone			Fertility Drugs
Progestins For Contraceptive Use			Anti-Ulcer Drugs (includes OTC)
Estrogen & Progestogen Oral Contraceptives			Endocrinology Drugs
Androgens (includes OTC)			Anti-Androgens
Custom Compounded Androgens			Aromatase Inhibitors
Corticosteroids (includes OTC)			5-alpha-reductase inhibitors
Custom Compounded Corticoids			Estrogen Receptor Antagonist
HMG-CoA Reductase inhibitors			Selective Estrogen Receptor Modulator (SERM)
Immunosuppressants

Potential Actions:
The potential action significant to function of steroid hormones may be classified into those that enhance or work with the hormones (agonists) or those that oppose or work against hormones (antagonists).
Androgenic (A) – androgens (such as testosterone or DHEA) or substances with an androgenic affect in some fashion (though they may not have the optimal, well balanced androgen function seen in bioidentical androgens).
Anti-Androgenic (aA) – substances with an anti-androgenic affect. The effect may be due to competitive binding, interference with metabolic production or increased metabolic degradation of androgens. Some substances may have both androgenic and anti- androgenic functions.
Estrogenic (E) – estrogens (such as estradiol) or substances with an estrogenic affect in some fashion (though they may not have the optimal, well balanced estrogen function seen in bioidentical estrogens). Estrogens have antiandrogen properties in and of themselves. In addition, estrogenic substances may increase the production of SHBG (sex-hormone-binding-globulin), which preferentially binds testosterone, resulting in further interference with testosterone function. Estrogens taken by mouth are more potent inducers of SHBG then if taken in a transdermal form.
Anti-Estrogenic (aE) - substances with an anti-estrogenic affect. The effect may be due to competitive binding, interference with production or increased metabolic degradation of estrogens. Some substances may have both estrogenic and anti-estrogenic function.
Progestogenic (P) – progestogens (such as progesterone) or substances with a progestogenic affect in some fashion (though they may not have the optimal, well balanced progesterone function seen in bioidentical progesterone).
Anti-Progestogenic (aP) - substances with an anti-progestogenic affect. The effect may be due to competitive binding, interference with production or increased metabolic degradation of progestogens. Some substances may have both progestogenic and anti- progestogenic functions.
2-Hydroxylation Inhibition (2h) – substances that inhibit 2-hydroxylation activity – a metabolic pathway for estrogen detoxification. The net affect of inhibiting 2-hydroxylation may be decreased metabolic degradation of estrogens resulting in an excessive estrogenic function.
5-Alpha Reductase inhibition (5a) - substances that inhibit 5-alpha reductase activity – a metabolic pathway for the conversion of testosterone to the more potent dihydrotestosterone (DHT), a normal androgen in both genders. The net affect may is decreased conversion to DHT resulting in relative anti-androgen function.
Aromatase Inhibition (ar) – Aromatase is the enzyme that converts androgens to estrogens. By inhibiting this enzyme the net affect is decreased estrogen production. Some, but not all aromatase inhibitors produce a net androgenic function.
Glucocorticoid (Gc) – The endogenous glucocorticoid is cortisol, which has many synonyms. Glucocorticoids appear to universally oppose androgens, estrogens, and progestogens.
HMG-CoA Reductase Inhibitor (Hc) – Often used to decrease cholesterol & LDL levels, this class of drugs may decrease the production of steroid hormones, which are all synthesized from cholesterol. Though debated in the literature, if class of drugs does inhibit steroidogenesis, it may possess anti-androgen, anti-estrogen and anti-progestogen activity. Since LDL cholesterol is the primary substrate for steroidogenesis in some tissues there may be a relative substrate deficiency in some individuals.

The prescriptive class and the potential actions are plotted in the following table for easy cross referencing.
This table and the subsequent analysis of medications is part of the Menopause Type^® Test and Wellness Report.

*Medication Review*
	Key: (A) Androgenic, (aA) Anti-Androgenic, (E) Estrogenic, (aE) anti-Estrogenic, (P) Progestogenic, (aP) anti-Progestogenic, (2h 2-hydroxylation inhibition, (5a) 5-alpha reductase inhibition, (ar) Aromatase Inhibition, (Gc) Glucocorticoid, (Hc) HMG-CoA Reductase inhibitor.

Potential actions of various medications significant to androgens, estrogens, progestogens & corticoids.

Estrogens (For Noncontraceptive Use)

Conjugated Estrogens

Conjugated Estrogens, Synthetic

Diethylstilbestrol

Esterified Estrogens

Estradiol

Estrone

Estropipate

Ethinyl Estradiol

Custom Compounded Estrogens

Estradiol

Estrone

Estriol