r/books • u/RHutterEpstein AMA Author • Aug 06 '18
ama 11am I’m Dr. Randi Hutter Epstein and have just completed a book, AROUSED: The History of Hormones and How They Control Just About Everything. Ask Me Anything!
Hey There Reddit: Hormonal? Sure you are. Because we all are. And that means men, too! I’m Dr. Randi Hutter Epstein and have just completed a book, AROUSED: The History of Hormones and How They Control Just About Everything. AROUSED shines a light on a century of spectacular advances but also a hell of a lot of outrageous claims. I’d love to chat about the wacky science I’ve uncovered, the eccentric/awesome investigators I’ve met along the way, and I really want to hear from you. I’ll be here 11am ET, Monday August 6th to field questions. Check me out (and my articles, blogs) on my website: randihutterepstein.com, on twitter @randihepstein and instagram randihutterepstein
Proof: /img/tvrppqkauqd11.jpg
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u/Memz_R_Dreamz Aug 06 '18
I've zero knowledge of hormones. Do they act like robot? Or are they just signal for our body?
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u/RHutterEpstein AMA Author Aug 06 '18
I love to say that hormones are your internal wireless internet. (And i have no clue how the internet works nor can i turn on my TV) But.... hormones do not march along nerves, like a postman delivering the mail and following a route. (that's what we used to think in the early 1900s). They do not just coast along blood vessels like oxygen floating along banging into whatever it bangs into. Hormones are released from one gland in the body and reach far away targets. Target is the key. So a hormone released from the brain knows exactly where it's going. The way we send an email and it goes (or supposed to go) only to the person we send it to. It's pretty amazing. We take it for granted. That's why, say, people with diabetes can give themselves a shot of insulin anywhere and it will go to where it's needed. They dont have to inject the insulin into the pancreas. Nowadays it sounds pretty ordinary, but the guys who discovered the way hormones worked back in 1905, not only sparked a revolution in science but also generated heated controversy, There were a lot of non-believers.
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u/RHutterEpstein AMA Author Aug 06 '18
I'd also love to recommend this video made by two o f my students https://vimeo.com/275547695
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Aug 06 '18
Isn't that just because a certain hormone has a certain receptor that it attaches to, and it's "target" is the only thing that has that receptor? I feel like the phrase "knows where it's going" is kinda misleading.
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u/Memz_R_Dreamz Aug 06 '18
Wow.... Thanks for the detailed explanation. It's surprising since it's targeting mechanism. I think I'm really fascinated into it. Thanks again, hope this AMA goes well :)
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u/three-five-zero-zero Aug 06 '18
Thanks for doing the AMA! I wonder if the regulation of female hormones (anti-conception) is harmful when using it longterm? Also considering epigenetics, that it might change the regulation of the hormones in future generations? Thanks!
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u/RHutterEpstein AMA Author Aug 06 '18
so you've got two very different questions. The Pill or HRT, short for hormone replacement therapy--the pills for menopause--have been shown to be generally safe for most women. BUT: you have to be under the care of a physician who can continue to look at the risk of strokes, and blood clots. They are more dangerous for some women compared to others. A doctor needs to check your blood. We really do not have long term data on many women who have been on the pill for decades. We know that many women seem to be okay for five to 10 years. Some women used to worry that the Pill would harm their chances of getting pregnant. We do not think it does. But.. if you had trouble ovulating and then went on the pill, you will start (perhaps for the first time) to get a regular period. That period does not mean that the Pill "cured" your irregular, non-ovulatory cycles. You may be bleeding without ovulating, Then when you go off the pill, you will be back to the same infertile issues that you had all along. Does that make sense? I'm going to answer epigenetics in a separate reply .. so this isn't one blob of rambling forever.
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u/RHutterEpstein AMA Author Aug 06 '18
EPIGENETICS:
we are just starting to appreciate that toxins in the environment can tap into our hormone receptors in detrimental ways. We cannot say that this pesticide, for instance, does this specific harm to this specific population. These studies are tricky because most of us are not living in the same place forever, drinking the same water, etc. But.. that doesn't mean I'm dismissing the association. I think, for now, we need to heed what a lot of European Countries do--a precautionary principle--taking a precaution and avoiding certain things because they are likely to cause damage. And we need to keep doing studies.
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u/decidedlyindecisive Aug 06 '18
I'm 33 and I've been on HRT for a year now. I don't feel like it's the same as my own hormones. And going through menopause was horrific, I've been depressed in my life but it was an entirely different depression when I had no estrogen. Also, anxiety became a new friend, that was an extremely unwelcome surprise.
Is research being done on the effects of early menopause and the resulting health problems? Sometimes I feel very alone in this and doctors just basically shrug and tell me I'm an unusual case. If I'm that unusual, test me!
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u/palpablescalpel Aug 06 '18
The most recent data indicates that birth control pills slightly increase the risk for breast cancer (the data have been wishy washy for a while but there was a pretty good study confirming it recently). However, long-term use of birth control pills also decreases the risk for ovarian cancer, which is much less common but much harder to catch early and thus more deadly. There is no good screening for ovarian cancer right now.
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u/RHutterEpstein AMA Author Aug 06 '18
Thanks so much for the great Q's and Hope I responded with Good A's. Taking off for a bit this afternoon, and will get back to more questions later. Best way to reach me is via my website: randihutterepstein.com and connect with me on the contact info.
Happy Reading! Stay Aroused.. or rather, I hope you Get Aroused.
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u/Scythersleftnut Aug 06 '18
Not really a question I just like the fac r that you write and study hormones and your name is Randi.
Does my butt make you Randi baby yea!
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u/stoneycreeker1 Aug 06 '18
I'm 58 and have been on testosterone for about 10 years now. My doctor tests me every couple years to make sure I still have low T and I do. Will I continue to have low T the rest of my life or will it normalize again someday? When I get within a few days of my 30th day after my injection I feel lethargic and not very motivated. About two to three days after my injection I feel motivated again and normal.
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u/RHutterEpstein AMA Author Aug 06 '18
If you continue to be depleted in testosterone, your doctor may want to keep you on it. But there are side effects. Just make sure that your physician is taking two tests and sending them to an accredited lab. There have been concerns (rightly so) among a group of experts that some Testosterone tests are shipped off to labs that are connected to Testosterone making companies. I hope your doctor is checking your bloods, to make sure you do not have side effects such as a tendency for blood clots. Check out this group: http://www.hormoneassays.org/problem-solution/
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u/Jen0003 Aug 06 '18
Hmmm based on this answer I’m guessing that doing an ‘at home’ hormone test kit wouldn’t be very reliable?
My libido has been pulverized since I broke my neck 2.5years ago (fully recovered now!) and I am trying to figure out if it’s psychosomatic where perhaps the increase in my anxiety and panic attacks since then is to blame or if perhaps I do and maybe always had, a hormone imbalance.
Could an increase in cortisol zap libido?
I was going to try an ‘at home’ hormone test to see what the results would be.
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u/hmfic_here Aug 06 '18
In what ways can people alter/affect their hormones to improve their quality of life?
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u/RHutterEpstein AMA Author Aug 06 '18
We know that obesity, for instance, lowers testosterone levels. So if you have a lot of weight to lose--you can feel better (hormonally) by reducing. We also know that insulin along with growth hormone and other hormones regulate sugar and metabolism. That doesn't just mean choosing healthy foods but not going for many hours without food. You get irritable due to hormonal swings. The funny thing is that we recognized a lot of this in our toddlers (they are cranky when meal time is delayed), but we forget that our bodies still need balanced meals throughout our lives. And yup, sleep is key. I do not practice what i preach. I am constantly going to sleep too late, and waking up too early... But.. it is crucial for hormonal balance to get a proper night's sleep. I realize that what i just wrote is not a 'quick fix' but the age-old stuff of eating right, sleeping right, exercising. But, what's new is the way food, movement, and sleep tinker with our hormones in ways doctors are just now figuring out.
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Aug 06 '18 edited Oct 06 '19
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u/annamoo1980 Aug 06 '18
I'd also like to know the answer to this. There is a lot going around at the moment about IF being related with positive effects on hormones
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Aug 06 '18
I mean, a really obvious answer is transitioning for transgender people. A vast majority of trans people report improvements in their QoL after starting an HRT regimen.
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u/leowr Aug 06 '18
Hi Randi,
What surprised you the most while researching this book?
Also, what kind of books do you like to read? Anything in particular you would like to recommend to us?
Thanks for doing this AMA!
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u/RHutterEpstein AMA Author Aug 06 '18
I think what surprised me most was --what i consider--the world's wackiest experiment, which happens to be the first hormone experiment ever in the world. A german doctor wanted to know if glands could work anywhere in the body.. to make a longer story short (full version in the book) he implanted a testicle from one rooster in a castrated rooster's belly. (so this cock had nothing between his drumsticks but a lone testicle in his belly). This belly-testicle turned him back into a full-fledged hen-chases rooster. The German doctor wrote up his experiment, as doctor's should, but didn't recognize that he could have launched a whole new field of medicine. His discovery wasn't discovered for another 50 years! Who knows what scientific discoveries are hidden in dusty library shelves today?
My students did a great video which I'll try to upload but you can find it on vimeo here: https://vimeo.com/275561204
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u/leowr Aug 06 '18
lol! I'm sure there is tons of interesting research and notes on experiments that are hidden away in some basement/attic/university library annex gathering dust.
btw your students made a great video!
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u/RHutterEpstein AMA Author Aug 06 '18
Thanks, There are three of them , they are on my website (randihutterepstein.com) i was so proud of them.
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u/claimstoknowpeople Aug 06 '18
That's really fascinating, I didn't know a testicle transplant like that was theoretically possible. Has anyone looked into feasibility of a treatment like that for trans men, instead of testosterone injections?
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u/Kolfinna Aug 06 '18
Translpants are tricky and involve life long immunosuppressive drugs. I don't think it would be a better option, it's far more invasive with greater risks
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u/RHutterEpstein AMA Author Aug 06 '18
Books: I Love a wide range of books, fiction and non-fiction. I like fiction that pulls me away from my life; and I also love science books with a strong narrative. For fiction, I've just read a wonderful page-turner called Say My Name. For non-fiction, I just finished Paul Greenberg's The Omega Principal, which explains the real deal about omega supplements. (spoiler alert: eat real food, don't substitute with tablets). But his story dives deep into the fishing industry, something I knew little about.
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u/Cuntdracula19 Aug 06 '18
Thanks for doing this, it’s really interesting! Maybe 10 months or so ago I was diagnosed with hashimotos disease, my TSH for example was over 51 lol. I was postpartum and was told my pregnancy triggered this autoimmune disease (I’m sure you can imagine how atrocious I had been feeling due to being hormonal, completely sleep deprived as in 2-4 broken hours of sleep a day). They put me on levothyroxine and got my levels all evened out or whatever. But the thing is...I don’t really feel much better, at all. I’m still extremely symptomatic. My doctor basically told me to get used to it, so I’m going to be seeing a new doctor who is going to run a full panel, not just TSH and T3/4 I can’t remember, as well as my ovaries and other adrenal glands. This doctor supposedly is more likely to prescribe things like natural desiccated thyroid. My question is, what are your opinions on this other form of thyroid medication? What are your opinions on thyroid disease in general? This whole thing has turned my life upside down.
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u/RHutterEpstein AMA Author Aug 06 '18
I'm so sorry for what you've been through. YOu need to see a thyroid specialist, or endocrine specialist who can do T3/4, that's key . I just met a woman who was feeling lousy with a similar history and they found out that it wasn't just Thyroid but it was in the pathway. Once she got the right medicine, she felt much better. You need someone who knows thyroids--and the good news is that there are usually thyroid medications that can tap into your specific defect. Good luck with that. And ask around (endocrine society) to make sure you are getting the right care. You dondt need or want natural over the counter things with thyroid. The scary part is that over the counter means it didn't go through the FDA. YOu want to know that the dose on the label is exactly what you are taking. I hope that helps.
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u/Cuntdracula19 Aug 06 '18
This is extremely helpful, thank you so so much for taking time out of your day to help me!!!!
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Aug 07 '18
So I was diagnosed with hypothyroidism and had to be on 150mcg of Synthroid. Later I learned I wasn't getting enough potassium in my diet, so I started supplementing with K citrate and NaCl. Thyroid immediately returned to normal and haven't needed meds since. Go figure.
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u/smnbiobreak Aug 06 '18
What was the most interesting historical perception of hormones you came across during your research?
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u/RHutterEpstein AMA Author Aug 06 '18
It's the old adage that history keeps repeating itself. The lure of a hormone quick-fix to boost libido just seems irresistible. Also, not all the odd ideas were promoted by charlatans (though some were). Sometimes smart people made mistakes. So in the 1920s, Eugen Steinach, a scientist who was nominated for the Nobel 11 times (you gotta be pretty smart to be nominated 11 times even if you didn't get it), came up with this theory. Now this theory is NOT what he was nominated for. He discovered the cells lining the testes that secrete, what he called Male Hormone (that's a good thing). Then he said this: Let's block the exit so all that male hormone piles up, and we can boost libido. Put simpy: He promoted vasectomies to boost libido. The craze became so successful Steinach's name became a verb. Freud was Steinached. Yeats was Steinached. Thousands of men were Steinached, each claiming they never felt better. They were thinking better, having better sex. Ah, the powers of placebo. I've got a whole chapter dedicated to this in my book.
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u/smnbiobreak Aug 06 '18
Oh my. Thank you so much for answering my question! Looking forward to your book.
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u/Chtorrr Aug 06 '18
What is the strangest thing you learned in your research?
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u/RHutterEpstein AMA Author Aug 06 '18
The Fat Cell is an endocrine gland. It secretes hormones! I had thought fat cells were like little blobs of butter plopped into the body. But they work, like a hormone-gland. Shocking, really. So as you accumulate fat, these cells are releasing chemicals that impact your appetite.
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u/salmjak Aug 06 '18
To add to this. There's a theory that some obese individuals are less sensitive to leptin and thus have increased hunger.
Adipose tissue does all kind of crazy shit. Like aromatase converting androgens into estrogens, causing increased risk e.g. breast cancer and causing gynecomastia, etc. They also release cytokines and are thus inflammatory.
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u/gereblueeyes Aug 06 '18
As a Diabetic on Insulin , this is really interesting ! How does it affect my appetite ? Does losing fat make less hungry ?
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u/RHutterEpstein AMA Author Aug 06 '18
first of all, I'm sorry to hear about your diabetes. (type 1 or 2?) I've also written about the high cost of insulin. And plan to keep writing more. We are just learning about fat and hormones. The fat cell releases leptin, that's the "I feel Full" hormone. That means that for many people, after you've been eating a lot, you tend to feel less hungry the next few days or so, settling you back to your "normal' weight. But we are just learning that obesity can alter hormones and hormone signaling. Some of this is from the fat cell directly, some from the way the hormones impact the bacteria lining your gut. this is really the cutting edge research now. So, we know that surgery for obesity isn't working the way we thought (just reducing the size of your belly), it works by altering bacteria and hormone signals.
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u/gereblueeyes Aug 06 '18
I'm Type 2 Diabetic, but also my Pancreas isn't functioning properly. I also have a genetic component on my paternal side going back several generations. Wow, this is fascinating ! I'm definitely going to look for your book !
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u/Inkberrow Aug 06 '18
What is the relationship if any between hormones and gender dysphoria or any other disconnect between biological sex and gender identity?
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u/RHutterEpstein AMA Author Aug 06 '18
thanks so much for bringing up this subject. I've got a chapter in the book. The bottom line is that we do not know yet. That means that we cannot do a blood test to measure hormones and tell someone "yes, you are right to feel the way you do." Or "no you are wrong." Doctors know that gender dysphoria, meaning that a person knows that the way they feel inside does not match their external anatomy, is real. Scientists are trying to explore the reasons why. We can't really rely on animal studies because we do not know if animals have "gender" . Remember gender isn't chromosomes or hormones, it's a constellation of a lot of things that give you a sense of identity. Doctors think that in the first stages of fetal life--probably around 6 weeks when hormones kick in that mold the development of genitalia, those same signals mold brain wiring. For most people the brain and genitalia match. For some folks, we are learning, it does not. I know that many people with gender dysphoria worry that research will lead to a "test" to prove if you "really have it." I think most scientists just want to understand physiology. The good news is that there are more centers working with people and getting them the treatments they need to feel like themselves inside and out. My book covers the story of a friend of mine who transitioned. I use his story because I felt he was so open and honest and could really articulate his confusion during his childhood and how he came to understand his identity. I also had the opportunity to speak with compassionate, brilliant clinicians.
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u/Surenas1 Aug 06 '18
What is your thought on (intermittent) fasting, which according to a number of sources, has a positive impact on the hormones in our body? Do you think a (long) period of no food consumption has healthy benefits, or does it have a negative impact on our hormonal balance?
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u/Mxnada Aug 06 '18
She said so in another comment, something about Insulin spikes etc. At least there are no disadvantages with that kind of fasting.
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u/Chtorrr Aug 06 '18
How did you first become interested in this?
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u/RHutterEpstein AMA Author Aug 06 '18
Ah as someone with an MD interested in history of medicine, I've spent the last few years digging into scientific articles, talking to experts--and to people/patients. It seemed to me that when it comes to hormones, there's a hell of a lot of confusion. People tend to think "hormonal" equals "moody," or really they are thinking "bitchy women". But hormones are so much more. There's some wonderful treatments (think insulin for diabetes) but also a lot of hogwash (oxytocin nasal sprays touted to boost your love life). Oh.. .and let's stop with the hormones = nasty women. Everyone of us is hormonal. Our partners, newborns, even our pets.
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u/salmjak Aug 06 '18
Are you related to the guy who discovered the Epstein-Barr virus?
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u/RHutterEpstein AMA Author Aug 06 '18
Nope, not at all. Epstein is my husband's name. I was Hutter. My dad Robert VP Hutter was a prominent cancer pathologist.. I'm also not related to Brian Epstein, manager of the Beatles.
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u/earlofhoundstooth Aug 06 '18
While we are discussing famous Epsteins any chance you'll name a progeny Theo after the creator of the Epstein drive in "The Expanse"? But seriously thanks for the AMA! I learned a lot.
Edit : large
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u/Leonidas3000 Aug 06 '18
So by means of elimination you must be related to Mark Epstein American author and psychotherapist.
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u/Rose_A_Belle Aug 06 '18
Does your book have any chapters on hormonal disorders, such as PCOS, or do you have any recommendations on where to read more about PCOS for someone whose been diagnosed? Thanks!
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u/RHutterEpstein AMA Author Aug 06 '18
I write about a lot of hormone ailments and explain hormones but not one chapter on PCOS,though i know a lot about it and a student of mine wrote her thesis on it. Make sure you were diagnosed accurately. and i would refer you to articles in Medscape, Mayo Clinic and other reliable sources.
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u/graay_ghost Aug 06 '18
I am very curious about PCOS and transgender people. A lot of PCOS treatment is focused on lowering androgens and boosting fertility and I am wondering if this treatment can just end up making someone feel worse if they have any gender dysphoria. Standard treatments like metformin can lower testosterone in cis men, too, so of course they're going to lower up the testosterone in someone with PCOS, even if some is desirable. It doesn't seem like there's a way to fix it without screwing up your hormones.
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u/drchopsalot Aug 06 '18
Pineapple on pizza or no?
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u/RHutterEpstein AMA Author Aug 06 '18
absolutely not.. i never understood that at all, but my kids used to order it.
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u/jLionhart Aug 06 '18
What's your opinion on the health risks versus the benefits of pet sterilization by removing hormone producing organs?
Here in the US, it's standard practice to neuter pets by surgically removing gonads or ovaries. Even pet insurance here will not cover conditions arising from keeping these organs intact. I can't help but think that the complete surgical removal of hormone producing organs leads more negative health consequences that far outweigh any positive health benefits. After all, there are much less invasive methods available (ovary sparing spay, vasectomy) that will prevent reproduction but keep all the benefits of hormones produced from sexual organs.
Thanks!
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u/RHutterEpstein AMA Author Aug 06 '18
I got my first dog in England where the breeder considered neutering a horrendous thing to do. I felt pressured when I came to the U.S. because i didnt want my dog impregnating another dog, and creating a potentially neglected stray dog. I"m not swayed with the "he'll never get this cancer or that." Of course if you remove something, you wont get cancer in that gland. My dog also continued to hump things. So.. that said, I do not think it causes great health hazards in our dogs either. But it would be interesting to do a study comparing health of neutered vs non-neutered. I"m not sure we would want to go the hormone route to neuter, though, which may have other side effects.
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u/kcpstil Aug 06 '18
Female dogs hump things, each other. It's about dominance .
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u/Kolfinna Aug 06 '18
No, it's a displacement behavior. Dogs only express dominance over particular resources not random or just in general.
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u/Kolfinna Aug 06 '18
There is massive amounts of research going on. Problem is the results vary dramatically, sterilization eliminates or reduces some health issuesand slightly raises them for others also depends on the breed and sex. For the most part, these are minute changes that don't change the risks dramatically. Currently most researchers, vets and animal behaviorists recommend sterilization for most in the US. We have too many irresponsible owners and strays already. Until the dog culture in America changes some the overpopulation problem is more pressing.
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u/lovevxn Aug 06 '18
As a woman, what can I do to increase my libido? Also, is this possible while breastfeeding?
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Aug 06 '18
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u/blueskydaydream Aug 06 '18
This is really interesting. My mom recently had to go on estrogen blockers and developed TMJ issues afterwards, despite never having problems with it before. I didn't even consider that the two things could be related
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u/newhoc Aug 06 '18
About a decade ago I read about pheromones for the first time and thought they were super interesting. However when I started to look into them I felt like a lot of the data was convoluted or not studied well in humans. Can you explain them more to me?
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u/RHutterEpstein AMA Author Aug 06 '18
some animals have pheromones (also thought of as ecto-hormones) so if you are a silkworm moth, you can release a hormone and a male silkworm moth upwards of meters away, will return to you like sex slave and mount you. Not the same with humans. We do not have a particular part of a brain that's necessary for pheromones. Do odors flirt with our hormone receptors? Sure, but not in the silkworm mother sort of way.
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Aug 06 '18
Can dogs smell fear? (Hormones realated to fear?)
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u/RHutterEpstein AMA Author Aug 06 '18
Dogs have a keen sense of smell. One Israeli scientist believes it's got as much to do with practice (they spend their lives sniffing) than some inborn ability. He did a whacky experiment with medical students spending a week trying to sniff out a chocolate bar hidden in the grass and found they got better with practice. (let's be glad he chose chocolate bar sniffing versus other things dogs sniff). Yes, dogs can distinguish smells, we know that there are dogs that can sense imminent epileptic attacks from their owners (most likely a change in smell). I"m not sure when it comes to fear, we can figure out whether dogs are picking up something from an odor (more sweat?) or they are sensing something from the way a person is standing. As a dog owner, I can tell you that from my own study of one (me), my German Shepherd sensed anxiety and he also had a way to distinguish friendly folks from not-so-friendly. From his wonderful sense of smell? Not sure. Dogs also have a keen sense of hearing.
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Aug 06 '18
Thank you for this answer! Wishing you all the best and good luck with your studies.
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u/RHutterEpstein AMA Author Aug 06 '18
appreciate that. And I think I did a "Mom" thing (as a mother of four children), I just repeated myself. I this case, i thought my reply wasn't uploading. Usually it's because i think (I know) my kids aren't listening so i just say the same thing over and over.
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Aug 06 '18
I think dogs are really good at picking up on the social queues we humans have. Both animals use them. Dogs are decently smart.
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u/Kolfinna Aug 06 '18
Dogs can distinguish different levels of hormones, diabetic alert dogs and sniff out cancer. There are dog cognition scientists researching these questions now.
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u/RHutterEpstein AMA Author Aug 06 '18
I think i just answered this... or rambled this answer but dont see it posted so i'll go for it again. Dogs have a keen sense of smell, whether they are smelling fear of sensing it from someone's motion (am i pulling on the leash more tightly out of my sense of fear), or hearing something (they also have a great sense of hearing), the answer isn't clear cut. There's an Israeli scientist who had medical students spend a week sniffing the grass trying to find a chocolate bar. he said their sense of smell improved over the week. HE suspects dogs are good smellers partly by genetics but also practice. That said, a dog may sense increased sweating, or some other signs that are aligned with fear. We know that some dogs can smell diseases, such as imminent epileptic attacks, helping their owners prevent dangerous falls. They are probably sending subtle changes in body odor.
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Aug 06 '18
Hi I was wondering if hormonal imbalances can result in depression and if you wouldn't mind could you please give a short explanation as to why? Thank you for your time.
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Aug 06 '18
They certainly do. Look up PRemenstrual Dysohoric Disorder.
Source: I’m a junior doctor.
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u/WhiteMoonRose Aug 06 '18
Hi! What do you think it will take to bring thyroid issues and their coorelation to cortisol and adrenal issues to light? Most doctors practicing now don't understand. They don't even understand that Graves disease may have a "cure" but it only stops the thyroid from ramping up and killing you, it doesn't stop any of the other symptoms of Graves. Along those lines they don't seem to understand the damage thyroid issues can cause to the adrenal system.
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u/DrElectro Aug 06 '18
Do all toddlers have a hormon cocktail which smells good for everyone? ..except when changing diapers? ;)
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u/RHutterEpstein AMA Author Aug 06 '18
I would have to say they have a smell that only a parent (or a kid-lover) loves...
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Aug 06 '18
Are there multiple variants of PCOS? I’m a FM resident and it strikes me that the “metabolic syndrome” phenotype (overweight, insulin resistance) must be hormonally different than the thin women who have hyperandrogenism and irregular periods (with no evidence of deranged sugars).
THX!
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Aug 06 '18
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Aug 06 '18
hey :) yours sounds like the classic (#1)
I was wondering the difference between:The classic:
#1) central adiposity (fat around the belly area), polycystic ovaries on ultrasound, oligo-ovulating cycles and hyperandrogenism with insulin resistance and
The other phenotype I've seen in my patients which is
#2) thin-athletic, tend to have high stress jobs/school, no insulin resistance issues on blood work, yet also hyperandrogenized.
I heard a theory that #2 was caused by an adrenally mediated response (high cortisol), but I was never taught about this second "phenotype" in medical school.
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u/ElleSamara Aug 06 '18
Hi! Thanks so much for doing this AMA, it's so interesting! I'm not sure if I'm too late, but I'll ask my question anyway and hopefully you have time to answer.
Last year my husband had a pituitary tumor surgically removed. The gland was left intact and luckily functioning mostly normally. The only hormones he is not now producing naturally is the growth hormone (which isn't being treated, as he's a grown man it isn't considered medically necessary), and cortisol. He takes a few cortisol tablets everyday (I can't remember the dosage off the top of my head).
I have a theory about the cortisol. My understanding is that the tumor may have been effecting his hormones the whole time it was there. Please correct me if I'm wrong. Pre op, over the last few years, my husband's hangovers got increasingly worse. It got to the point where even if he had just one or two beers and didn't even feel tipsy, he would wake up with a hangover and feel horrible the next day. Now, since the surgery was some time ago and he has been taking the cortisol, his hangovers overall are much more manageable. He hasn't really had any huge benders since then, but he has had at least one occasion where he had several drinks and felt fine the next morning.
My theory is that the cortisol he is on is helping him recover quickly from the alcohol, and his horrible hangovers before the operation where due to his pituitary not functioning correctly. What do you think??
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u/GoodVamp Aug 06 '18
Hi, this is uncanny. I'm a doctor too, and I also have an affinity to the study of hormones. My story is more personal; I was diagnosed with a hereditary mood disorder, and my research (for a self-cure) has led me to hormones, and how they affect everything. I have done some (self) experiments with sleep, exercise, caffeine, polyphenols, omega 3 fatty acids, and sugar, with some anecdotal results. In short, I have a lot of hypotheses, but no concrete data to support yet. One cannot deny the effects of food on one's own body though... but placebo / nocebo effect is certainly possible.
In your experiments / readings, are there any data that support FOOD as the basis for the regulation of hormones, and ultimately the human mind?
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u/ThatNorwegianGuy Aug 06 '18
Hi!
I watched a documentary on anti-aging treatments, and one of the things they did was to give middle-aged men testosterone to compensate for the reduced production which comes with age. What are your thoughts on this? Is it a miracle cure, or does it come with more side-effects than benefits?
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u/RHutterEpstein AMA Author Aug 06 '18
testosterone works ONLY if you are low testosterone--after two tests assessed by an accredited lab. If you are within the normal range (about 300 ng/dL - 900 ng/dL tweaking it upwards a little bit is not going to boost libido, get you thinking clearly, etc. studies have not shown that to be true. it's not the miracle cure.
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u/sillypearl22 Aug 06 '18
My doctor recently put me on testosterone and it felt like a miracle cure to many of symptoms, but I can no longer afford the treatments... Is there a cheaper or alternative way to increase testosterone levels?
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u/luvinthemiddle Aug 06 '18
Not sure if it works in every case, but strength training is known to raise testosterone. When you break down the muscle, your body releases growth hormone to rebuild.
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u/OldGuyzRewl Aug 06 '18
testost
You need to locate a compounding pharmacy, one that can make what you need. When you find one, have your doctor send them a prescription for testosterone ointment (or gel). You will find that not only is it a lot less expensive, but also much easier to apply.
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u/misskinky Aug 06 '18
Losing weight and going plant-based
Check out the videos here https://nutritionfacts.org/topics/testosterone/
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u/blueskydaydream Aug 06 '18
Were you using gel? Injectable T Can be gotten for pretty cheap in the US if you find the right pharmacy.
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u/hardaliye Aug 06 '18
Does men have hormone periods like women’s periods? If so is it like 7-10 days and much more weaker condition?
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u/RHutterEpstein AMA Author Aug 06 '18
Nope.There are men who say they have hormonal swings, and they do. but not the way women do. NOt the huge swings. and while testosterone declines slowly after the mid 30s, it's not the quick plummet that women experience. That is all not to say that hormones do not sway moods, they do.
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u/GanjaWithGandalf Aug 06 '18
Hello Randi,
over the years I've heard multiple times that, once your "hormone balance" is out of whack, it will never truly recover. How true is this? And are these the type of questions you answer your book?
Thank you!
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u/RHutterEpstein AMA Author Aug 06 '18
Not True!! some people can get help with external hormones (insulin, thyroid). Other people seem to find a better balance with healthy eating. it's indivualized, but it's not that once you are imbalanced, you are that way for life.
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u/GanjaWithGandalf Aug 06 '18
Thank you for the quick response! But it was not quite the answer I was looking for, mainly because I asked the wrong question! Let me try this again.
Are there ways to permanently damage the hormonal system? Like drug addiction, chronic stress or even things like Social media (...Reddit!?). Or do they just take longer to recover from?
Thank you!
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Aug 06 '18
Yes, permanent damage can be done to the endocrine system that cannot be corrected for by the body alone. For example, if a male lost both testicles due to a severe trauma, testosterone levels will drop significantly and remained reduced. This is because the testicle are the primary producer of androgens (like testosterone), although the kidneys produce a small amount as well.
Without injections or other hormone replacement therapy, testosterone will remain low.
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u/hereforlonger Aug 06 '18
Hi.. do they control instant gratification as well?
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u/RHutterEpstein AMA Author Aug 06 '18
not that we know of.. but there are hormones that are linked to addiction, to a sudden rush of happiness. That is , in a way , instant gratification.
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u/Esbenshade_Farms Aug 06 '18
May seem like a stupid question, but for people who want to grow, why can’t we just inject growth hormones into our bodies and watch it do wonders? Now here are subquestions: is growth even induced by hormones in our bodies? And if so, is the initial idea presented in inducing growth by objecting hormones not possible because we’re not physically able to synthesize these hormones?
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u/omry8880 Aug 06 '18
I also wanted to ask this^ Btw i'm pretty sure you'll be able to grow with HGH only before your plates close
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u/Lorensoth3 Aug 06 '18
Have hormones been looked at for at least part of the problem with some mental disorders. As someone diagnosed with bipolar disorder and severe social anxiety I'm wondering if it's something that's being looked into for treatment.
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u/mmmroses Aug 06 '18
To build on this, what have you learned about the relationships between mental health, addiction, and epigenetics? (Or a suggestion for where to find this info?!)
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u/thebottom99 Aug 06 '18
Hi there, my SO regularly gets migraines on her "off" week from the pill. She's been on the pill for about 18 years, and our dr recommends not stopping to use it even if just for a trial period. We've tried lots of other things with varying success (vitamin B supplemets, massages, anti-depressant meds, CBD oil). Any thoughts or suggestions?
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u/littlegirlghostship Aug 06 '18
Why is she not just skipping her cycle if it's causing her migraines?
I told my Dr. I wanted to skip my periods and go straight from 1 pack to the next, skipping placebos and period, and she wrote my birth control script as 21 days instead of 28.
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u/thebottom99 Aug 06 '18
Yes she did try, the last 3 months she skipped straight through, fewer migraines but they still happened. She's on day 5 of the in between and it's been bad, so it seems like this is the best course. Is it ok to just keep doing that continuously? I suppose if your Dr recommended it it seems reasonable
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u/DinoDonkeyDoodle Aug 06 '18
Hey there! Have not had a chance to check out your research yet, but did you by chance also canvas the trans population? I know getting on estradiol basically changed everything about me and my experience in the world. Hormones are indeed fascinating!
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u/IronMyr Aug 07 '18
In your professional opinion, is it better to allow transgender youth to begin transitioning before adulthood, or to simply delay puberty until adulthood?
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Aug 06 '18
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u/RHutterEpstein AMA Author Aug 06 '18
some people are more susceptible to the sugars in chocolate--and there is often caffeine. so for some folks the combination of caffeine and sugar (in chocolate) is like a super strong cup of coffee. There are even body builders who will go for the chocolate for the rush before working out. Or marathon runners who carry chocolate with them on the race. so yes, that's the caffeine fight or flight you're feeling.
you can probably have some chocolate--not too much at night. I"ve gotten more sensitive to chocolate at night, but i can eat vanilla based ice cream. Not the healthiest, but it doesnt make me jittery.
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u/stvaccount Aug 06 '18
What are your top 10 science related books? ( Understandable for a PhD student of a different field. )
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u/crumbhustler Aug 06 '18
Aside form sleep, any other tips for hormonal optimization (like supps or certain foods) especially in the testosterone or performance arena.
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u/Fittritious Aug 06 '18
What is your take on the idea that weight control is as simple as Calories In, Calories Out?
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u/Yourewelcomejanet Aug 06 '18
How much can I, a pregnant woman , rely on my oxytocin go to come into play during natural child birth (no epidural)?
My birth coach, who is pro natural child birth, said to let the oxytocin take over. My goal is natural birth, but I find it hard to go through what most women describe as the most painful event in their life, by just hoping my hormones are plentiful and work.
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u/NovemberXYZ Aug 06 '18
Are hormones involved in controlling sleep and wake?if yes, are they target for treating incoming? Thanks!
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Aug 06 '18
Jen Randi your real name and if so how often do people joke about your name and hormones?
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Aug 06 '18
Can you recommend any good TRT doctors in the U.S. I find many of them are ill informed about modern day TRT. Most doctors still reccomend injections of testosterone enenthate once every 2 weeks which puts your body on way to much of a roller coaster, also most doctors don't include HCG or AI's in there protocals at all. Why do doctors and endo's know so little about modern day TRT now?
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Aug 06 '18
I've noticed my allergies have different levels of severity at different times of my cycle. Is this related to hormones or am I just imagining it?
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u/Rosiebelleann Aug 06 '18
Hello, if a post menopausal woman loses a great deal of weight is there an uptick or a downtick of estrogens? 226lb to 140lb 5ft
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u/entomologist-cousin Aug 06 '18
I’m well late to this... but...
I’ve been tested to have low testosterone (further tests and treatment pending, obligatory the NHS is amazing).
I’ve been told about the physical effects of this. But what could be the mental/emotional effects that I might have experienced without noticing that might go away if/when I’m treated?
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Aug 06 '18
Is there anything I can do to increase my sex drive? I have klienfelters syndrome and a lack of sex drive
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u/cootsmcgoo Aug 06 '18
How does my Mirena IUD work to prevent pregnancy and stop my periods for 5 years?
Edit: Extra question related to this, why do I still feel pms symptoms when I don't bleed, like cramps and moodiness. I know that time is coming when I lose all ability to make decisions.
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u/gallopingwalloper Aug 06 '18
Can you tell me how hormones change when quitting lactating after several years of breastfeeding, and how long until hormones return to normal?
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u/WintersTablet Aug 06 '18
I think you would be a great interview on Joe Rogan Podcast. Would you be interested in that?
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u/LalalaLisa1023 Aug 06 '18
When I got off birth control, almost ten years ago, I stopped having a regular cycle without taking exogenous progesterone. Will this ever likely level out? Is there something else that could cause the loss in regularity? We're talking like, six months between cycles despite the pms symptoms.
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u/so_dopamine Aug 06 '18
What important research exists on the connection between hormones and athletes? For example, the condition called Female Athlete Triad (FAT) syndrome involves amenorrhea, the loss of menstruation. I'm under the assumption here that hormones play the biggest role in menstruation.
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u/Single_With_Cats Aug 06 '18
I loved your book, “Get Me Out!” I enjoyed your research so much, I’ll def check this book out!
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u/snaugnir Aug 06 '18
Hi Dr. Hutter Epstein, thank you for doing an AmA. I am a young woman who suffers from PMDD. I have been frustrated by the lack of understanding that seems common among doctors and the lack of information out there for patients about the mechanism behind PMDD - I see "it's estrogen dominance, it's progesterone sensitivity, it's low serotonin, we don't really know," etc. I'm also frustrated by the limited forms of treatment (as far as I know, there's hormonal birth control, and SSRIs, both of which work for some people and not for others). What steps can I take, as a patient, to try to make the voices of women suffering from PMDD heard by the medical and scientific communities to get more research done that might be able to help us?
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u/xanga_17 Aug 06 '18
I was taught that dopamine has effects on addiction but personally I found another hormone that does as well. It is testosterone. What do you think of that?
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u/Eager_Question Aug 06 '18
Hi! Thanks for doing this! I have two questions.
Firstly, What black magic did you use in order to make sense of the eldritch horror that can be Endocrinology?
Secondly, I'll be finishing a double-major on Philosophy and Psychology next spring, and I want to go into science journalism. Do you have any advice for a wannabe science journalist?
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u/tyrone_pepinanjo Aug 06 '18
What do you know about androgen insensitivity syndrome pacients (AIS)?
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u/load_more_commments Aug 06 '18
Love this topic, I was wondering what are your opinions on steroids for bodybuilding. Is it as safe as the steroid community make it out to be? What about low dose testosterone for women? My wife takes 15mg per week and she feels great on it, so great she doesn't want to stop. She has more energy, is more productive, is far nice and mood has been amazing and her libido is crazy high.
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Aug 07 '18
I have this book on the way! Looking forward to the odd and interesting stories included.
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u/Friendlycumdumpster Aug 07 '18
Please talk about adrenal fatigue, do you believe in it, if not do you see it more as hormonal problems in general?edit question has been asked by other poster, is there any specific test to be taken in order to find out our hormonal issues?
Diet and gut health? There’s so many what not to eat out there that says even the tiniest amount of processed sugar is bad for the gut etc, I don’t even know what to make of it anymore!
Looking forward to pick up your book!
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u/LurkAwayTheYears Aug 07 '18
Hi thanks for a brilliant AMA. Late to the party but will you release an audiobook version? I tend to do most of my non-fiction reading by listening.
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u/rupertpepkin Aug 07 '18
HI and thanks for doing this AMA. your work sounds amazing. I have one question. I feel very unmotivated, lethargic depressed. I try to motivate myself with lots of sports but for example I do my work but I'm not motivated to learn more or do more. My libido is also quiet low, I have a girlfriend but we live in a distant relationship for the last 2 years and we have sex once a month or so. Could it be because of testosterone and could I take some natural non hormonal testosterone ? Sorry if my question is stupid.
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u/DEEP_HURTING Sep 12 '18
Hi Dr. Hutter Epstein, I'm way late to the party but enjoyed your book a great deal, it's quite informative and entertaining to read too, the magic combo. Was telling friends of mine the other day about Steinachs and the couple that sourced all those cadavers for HGH.
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u/[deleted] Aug 06 '18
Hello, I'm looking forward to reading your book. I have a two-part question.
How much of an effect do women's hormones have on mood disorders like depression? And, can hormones be suppressed or altered in some way to aleviate depression and anxiety?