Hormones are fun. When I tell people I am an endocrinologist (a hormone specialist), some look at me blankly. If I'm feeling frivolous, I explain that it's to do with "sex and all that sort of thing". However, there is much more to hormones than sex, although reproduction would be impossible without them. Hormones regulate our growth, our appetite, the onset of puberty, the digestion of food and sleep patterns; they affect many other important aspects of our lives, including our immune response and mental health. If hormone levels are abnormally increased or decreased, this can result in a range of different symptoms.
A pain in the chest often indicates that something is not right with the heart, and breathlessness may similarly be caused by a condition in the heart or lungs. However, the symptoms of hormonal problems are often slow in onset and rather vague, so diagnosis may take months or even years. The world of endocrinology is very complex, affecting all areas of the body.
I have been an endocrinologist for over forty years. During this time, there have been huge advances in the way we understand hormones and their actions, as well as how we diagnose and treat people with hormone diseases. The human body's endocrine system was the last system in the body to be discovered (c. 1902). This is not surprising when you consider that it is quite unlike other systems, for example, the circulatory or nervous system. These are both distinct anatomical structures that fulfill certain functions. In contrast, you cannot see hormones. They circulate in the blood causing noticeable effects on various tissues. Thus estrogen from the ovaries at puberty causes breast development and testosterone from the testicles will eventually lead to hair growth on the face and other areas. This is the fundamental aspect of hormones. They are made in one part of the body and, in most instances, travel in the bloodstream affecting other parts.
Hormonal abnormalities can be problematic. Appetite is hormonally regulated, and obesity and other weight issues can be the result of hormonal and genetic abnormalities. Fluctuating levels of testosterone affect libido in both men and women, while problems with insulin sensitivity are often behind the increasingly prevalent disease of diabetes. Treating people with hormonal abnormalities can be extremely rewarding. People with thyroid hormone deficiencies can have an improved quality of life when treated, while those suffering a growth hormone deficiency can attain a normal stature with the right treatment. Some women cannot get pregnant for various hormonal reasons; by adjusting these levels they can conceive, with huge importance for their future lives.
This brings me to Meet Your Hormones. A highly illustrated and engaging book, it sets out to explain clearly and accurately what hormones are, how they work and what they do, and just how diverse the roles are that different hormones play. Drawing on the latest scientific research, the information if presented in an accessible manner with images illustrating the topics both imaginatively and memorably. The book features practical ways in which you can often help your hormones to help you, making the book both empowering and useful. It also looks at the most recent and significant medical research in the field of endocrinology, highlighting how important hormonal balance is for our well-being and pointing at what the future holds. I think you will enjoy reading this book, which besides its important scientific base is very well presented. I certainly hope so.
Professor John Wass, Professor of Endocrinology at Oxford University
One of the earliest written records of hormone action — a urine-based pregnancy test — has been found on a papyrus of 1350 BC. Egyptian women would moisten a sample of barley or wheat seeds with urine over the course of several days. If no seeds germinated, the woman was not pregnant. If barley seeds grew, she was carrying a boy; if wheat seeds grew, a girl. In 1963 the test was shown to detect raised levels of estrogens with a 70 percent success rate. Its accuracy in predicting gender, however, is not recorded...
Commonly known as the sleep hormone, melatonin is closely involved in determining our sleep/wake cycles. Produced by the pineal gland, melatonin signals to the brain that it is time to sleep. Ideally the levels of the stress hormone cortisol dip as the day goes on. This allows the effects of melatonin to take over, making us feel sleepy as the day draws to an end. As dawn breaks cortisol levels peak — waking us up, boosting our energy levels and turning on our appetite.
Tryptophan is one of the essential amino acids, used by the body to make proteins. It is a key building block of the sleep hormone melatonin (and the feel-good hormone serotonin, page 111), so ensuring your diet contains plenty of tryptophan will encourage sleep. Turkey has something of a reputation as a sleep-inducing food, but other sources of tryptophan such as cheese, soybeans, cod and dried spirulina — a seaweed — have higher quantities. Many fruits and vegetables also contain tryptophan, with bananas a well-known example.
Bone is adversely affected by the decline in levels of Vitamin D as you age; a reduced skin response to UV light results in a decrease in its production of up to 50 percent. The effect is compounded in postmenopausal women as their estrogen levels tail off (page 89), which further affects bone. The result is a higher incidence of osteoporosis (weakening bone density) and associated fractures, compared to men. Men are partly protected by their natural higher peak bone mass (bones achieve maximum density in both sexes around age 30). Although the dominant male sex hormone testosterone declines gradually with age, its protective effects on bone are far less significant than estrogen its equivalent, in women.
Our jet-setting ways can now propel us into different time zones faster than our bodies are able to adjust, leaving us with jet lag. If your body were to release cortisol in the morning, preparing you for the day ahead, only in response to increasing daylight, you would not experience jet lag. However, you might arrive at work late during the short daylight hours of winter. Skew your body clock by jetting into a time zone several hours earlier, and your body will release cortisol while you are trying to sleep.
People who do shift work also experience symptoms similar to those of jet lag: being hungry, tired and awake at the wrong times. If someone were to work night shifts constantly, their body would eventually adjust so that they had an increase in cortisol levels in the late afternoon, for example. However, constant changes in the times of work shifts — between day, twilight and night — mean that the body has a hard time establishing rhythmic patterns.
There is no evidence to suggest this is the case. Soy contains plant estrogens known as isoflavones, which are structurally very similar to the primary estrogen hormone in humans, 17-B-estradiol. Because isoflavones have a similar structure to estrogen, they can bind with estrogen receptors and trigger effects in the target cells. Concerns have therefore been raised that a diet rich in isoflavones may trigger early puberty in girls and lead to "feminizing" effects in boys. Recent reviews of studies published over the last 20 years have found no evidence to substantiate this. However, there does seem to be evidence that isoflavones may have a protective effect against cancer and many chronic diseases, including diabetes and cardiovascular disease. Studies are ongoing, but at the moment the evidence suggests that the benefits of eating a diet rich in isoflavones outweigh any potential costs.
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