Health: The First Pillar of Life

Dr. Karla Dionne Health; The First Pillar of LIfe

Diet, Nutrition & Exercise

Health is the first pillar of life. If you don’t have your health, then career, relationships and recreational activities are put on the back burner. As we age, we lose the functions (energy, stamina, focus, memory, etc.) that we need to be able to continue to live life fully. How can we regain that youthful vitality?

How aging affects men and women

For men, losing function is often a slow process. It tends to sneak up. A man may try to participate in activities that he used to enjoy, only to discover that he just doesn’t have the same strength and stamina anymore. His blood pressure may start to creep up, his fasting blood sugar and cholesterol may become elevated and he and others around him, may notice that he is more irritable.

For women, it can be a much more rapid process, especially if there has been a history of stress. When a woman approaches menopause and the ovaries reach the end of their time, symptoms such as hot flushes, night sweats and sleep disturbance may begin quite quickly. All of a sudden, she may start waking in the middle of the night, maybe sweating, unable to fall asleep for one to two hours or perhaps not at all. Brain fog may descend, memory problems begin and mood swings can occur. For some women, this time of life is very disabling and it occurs at a time when she is often very busy with a career, with children still at home, with volunteer work or perhaps with ailing parents. The effects of aging can be distressing for both men and women when they are no longer able to keep up with the life that they have created.


The kinds of treatments that I prescribe are very much dependant on what I find upon testing. I will discuss diet and exercise and make general recommendations in the beginning, but often patients correct their diet and improve their exercise on their own as soon as they start to feel better. We are not craving carbohydrates and avoiding exercise because we are bad people; we eat carbs and don’t exercise because our hormone levels are making us feel awful!

The first assessment usually includes the following:

Adrenal function

The adrenal glands are our stress glands. They produce our stress hormones such as adrenalin and cortisol and when the adrenal glands are not functioning optimally, we can feel tired and stressed. One of the hormones that is produced by the adrenal glands is DHEA. DHEA plays an important counter-regulatory role in balancing the actions of cortisol. Cortisol breaks down the body, turning muscle into glucose, in its effort to raise blood sugar so we can “fight or flight” and the action of DHEA is to build and repair the body when the fight or flight is over. DHEA is also important in the function of testosterone.

Thyroid function

Thyroid hormones are important to the body’s metabolism. They increase the number and activity of the mitochondria inside the cells. The mitochondria are responsible for producing ATP, which is what cells use for the energy that they need to do whatever their job happens to be. The most common symptom of low thyroid is fatigue which overlaps with the symptoms of poor adrenal function. We actually need good adrenal function in order to have good thyroid function. I have seen low thyroid function completely normalize by supporting the adrenals alone.

Sex hormones

These hormones include estrogen, progesterone and testosterone. It is important to assess the three main types of estrogen: estrone, estradiol and estriol. Estrone and its metabolites are the estrogens that are associated with cancer. Estradiol is the main estrogen that the ovaries produce. Estradiol has 400 roles in a woman’s body; 300 of those roles have nothing to do with reproduction but are needed in brain function, heart, bone, muscle, and bladder; that is, almost every system in the body. Estriol is a weak estrogen that is thought to be protective against cancer when it is in proper balance with the other estrogens. It is also important to assess the estrone metabolites because some are very estrogenic and are considered carcinogenic. If they are elevated or not in good balance, supplements can be taken to correct the way the body metabolizes estrogen.

System Triad

These three systems, adrenal, thyroid and gonadal, form a kind of triad, working together in balance. If one system is not working well, it impacts the other two. Stressed adrenals often start the problems, impacting the thyroid’s ability to work properly, which impacts the estrogen’s function. In men, a stressed adrenal system usually results in an overproduction of cortisol and an underproduction of DHEA. DHEA is required for optimal function of testosterone; therefore, low DHEA may present with symptoms of low testosterone in the face of blood tests that show normal levels of testosterone. The effects of having these three systems out of balance can be widespread, affecting health areas such as blood pressure, cholesterol, blood sugar and weight, to name a few.


Correct the metabolism

The first step in restoring health is to support the body’s normal metabolism. In order to produce hormones, the glands need adequate building materials, which include nutrients such as vitamins and minerals. Often these become depleted due to poor diet or due to such a high need for cortisol, for example, that even eating a healthy diet would not be able to supply enough nutrients. Supplementing the diet with the specific vitamins, minerals and herbs that support adrenal and thyroid function can produce remarkable improvements in energy levels. Other supplements may be directed toward improving areas such as blood sugar metabolism, digestion and the function of the immune system.

Hormone therapy

Hormone therapy is an important part of preventative medicine. Our aim is to restore the body’s ability to repair itself and repair won’t happen without hormones in proper balance. Hormones direct the nutrients from our diet to do what is needed. For example, calcium and magnesium cannot build bones until the hormones involved in bone metabolism create the correct environment and direct them to where they are needed. In women, estrogen and progesterone therapy can work miracles. Some women report that they feel normal again after starting hormone therapy and say that they feel better than they ever have.

In men, often it is only the DHEA that needs to be supplemented to restore hormone balance. As we age, the production of DHEA usually decreases before the production of testosterone and without adequate DHEA, testosterone does not work in the body as well as it should. If testosterone is needed, DHEA will usually also be prescribed since it is so important for optimal testosterone function. Human Growth Hormone (HGH) is also important for repair in the body and sometimes it needs to be supplemented, but usually if the testosterone and DHEA are working well and if exercise and sleep are adequate, HGH levels restore themselves naturally.

Frequently asked questions:

How do I take hormones?

Usually I prescribe hormone replacement as a topical preparation that is applied to the skin. Hormones are fat soluble and so absorb very well through the skin. I never prescribe oral estrogen because of its effect on the liver. Progesterone is usually topical, but oral progesterone can be helpful if there are problems with falling asleep, because is it very calming. Testosterone in women is always topical, but in men, even though it is usually topical, it can also be given as weekly injections.

How long do I have to take them?

There is no clear answer to this question, but it seems that the more activity in one’s life, the greater the need for hormones. I would suggest that hormones will be helpful until one retires and life slows down. Once life slows down, the need for hormones will be less and then it will be easy to reduce the dose and eventually stop the treatment.

Studies have shown that transdermal testosterone is more effective in the treatment of erectile dysfunction than is injectable testosterone. DHEA in women is usually given transdermally, because if taken orally, the liver will metabolize it into various forms of testosterone that we don’t necessarily want in women. In men, oral DHEA is convenient and we don’t worry about some of it being converted into testosterone.
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