Natural, bioidentical hormone replacement therapy and… Chinese medicine. For hearing loss!

Naturopathic doctors such as myself are often approached by patients who are interested in alternatives to conventional hormone replacement therapy. They are often scared off by their family doctors who suggest stopping synthetic estrogens and progestins in menopause since they seem to increase cardiovascular and cancer risk in certain groups.

There is some misconception by patients that the natural, bio-identical hormones offer a 100% safe alternative. Bio-identical estradiol (the major estrogen) still has growth-promoting properties and possibly cancer stimulating properties (though the risk is very small). This is usually off-set by some doctors by using a balance of the different types of estrogen, including estrone and estriol, along with progesterone. Nonetheless, I always tell my patients the reasons they stopped synthetic HRT may still apply to bio-identical HRT.

Having said that, even if I take a non-wholistic approach to a female’s menopausal symptoms, and simply use a good quality soy extract and a good quality herbal combination, 50% of the time the menopausal symptoms will drastically reduce. Add in proper diet, essential oils in ratios suggested by fatty acid blood testing, and the patient is usually very happy.

We can get that 50% success rate to closer to 90% if we address the non-sex hormone systems that also tend to fail as people age. Particularly, the adrenal glands. If I evaluate a menopausal patient and find that their adrenal hormone production is low, then nutritional support for the adrenals, injections of adrenal extract, and adrenal hormone replacement is an ace-in-the-hole for improving quality of life and symptoms. Usually, the adrenal hormones evaluated and used include pregnenolone, DHEA, and cortisol.

Now there seems to be another adrenal hormone that is important.

Aldosterone

Aldosterone is a hormone that is secreted by the adrenal cortex in order to maintain proper blood volume. It’s function is to help with the retention of salt in the blood, so that blood pressure and energy maintain constant. There are some studies on the use of florinef (an aldosterone-like drug) in cases of chronic fatigue syndrome – and the results have been a wash between positive and negative. I have not used this for chronic fatigue before and do not plan to, as other therapies have given great results.

However, I will start testing for this in aging menopausal females, and aging andropausal males. Why? For hearing loss.

Hearing loss often affects people as they age. Preliminary case studies from Jonathon Wright, MD, and the Tahoma Clinic, have suggested that aldosterone replacement can even restore some hearing, and help patients to discern words in a noisy environment as well.

I am most interested in this because in traditional chinese medicine, there is a theory that the “kidneys open up to the ears,” and thus symptoms such as tinnitus (ringing in the ears), vertigo, and hearing loss deserve a work up on the patient’s kidney system. In Chinese medicine, the patient’s “kidney system” corresponds to both the kidney organ itself, and the hormones secreted by the adrenal glands (ad-renal means beside-kidney).

I have not treated hearing loss before, as patients have always only mentioned it in passing. This is probably because they assumed there is nothing that could be done about it.

It turns out there may be something that can not only prevent further loss, but restore it.

1) Work up for hormonal deficiencies, especially adrenal hormones including aldosterone

2) nutritional support to prevent further damage to the hearing structures

3) work up and detoxification for toxins known to cause oxidative damage

4) a Chinese medicine approach with acupuncture and herbs

I would say the aldosterone and the adrenals would be the most important.

The point though? Although I do not use much traditional chinese medicine, the long history of use and its observations is proving to have clearly predictable anologies in western medicine. The story of aldosterone (from the adrenal glands or the “kidney” in chinese medicine terms) and hearing loss is only one. Another example would be how the chinese medicine concept of “blood” coming from the bones AND the kidney long pre-dated the discovery of the hormone EPO (erythropoietin). EPO is a hormone from the kidney that stimulates blood production.