Janet: Doctor Borkin, is cortisol important for survival? Is that true?”
Dr. Borkin: “Cortisol elevates the blood sugar back into normal ranges. Insulin is used to maintain blood sugar to keep it from going too high. Cortisol is at the other end of the spectrum. It keeps the blood sugar from going too low. It is also the primary stress hormone along with adrenaline. Cortisol elevates in order to maintain blood sugar. What we look at is to determine how much of this is directly related with a person’s inability to maintain reserves of energy because they are not digesting foods correctly and absorbing the nutrients adequately.”
Janet: “Does cortisol affect all the cells in the body?”
Dr. Borkin: “Every cell in the body is affected. We are not one solid unit. We are actually a community of trillions and trillions of members. It is like having the largest factory in the world or in the universe, and the most well organized. If this were a corporation, it would have trillions and trillions of workers and only eight supervisors or managers and one CEO. Those eight supervisors make up the endocrine system or hormonal system.”
Janet: “What is the order or organization in the hormonal system?”
Dr. Borkin: “In most cases any typical abuse is handled on a local level without having to go to a manager. When a manager is needed, it becomes a bigger problem. When it goes to multiple managers, higher up in the hierarchy, it becomes a monumental problem. When it goes to the CEO of the hormonal system, the person is in big trouble. The master control mechanism is called the hypothalamus.”
Janet: “How does the hypothalamus control the body?”
Dr. Borkin: “The hypothalamus is the link between the hormonal system and the autonomic nervous system. When imbalances in the body arrive at a critical point, when the body goes into a state of chaos, the hypothalamus has to take control. It is inescapable.”
Janet: “Does aging have any affect on the cortisol levels in the body?”
Dr. Borkin: “As we get older and these hormonal dysfunctions occur, it causes things like chronic fatigue and Fibromyalgia. Too much cortisol can even cause heart related symptoms.
Janet: “Are there tests for hormonal imbalances?”
Dr. Borkin: There are tests that determine if it is in fact the heart or a cardiac problem, or if in all actuality, it is simply a hormonal dysfunction. If the original problems would have been properly managed when it first started, it would never have manifested or gone that far.”
Janet: “How does mainstream medicine deal with hormonal imbalances?”
Dr. Borkin: “The mainstream thought in the scientific and medical communities is if something is low you simply elevate it. The problem with this philosophy is that if you change something on the left then something on the right changes.
Janet: “You were telling me about how the body uses the sex hormones to deal with stressful situations. Can you elaborate on that a little?”
Dr. Borkin: “When it comes to the hormone testosterone, we are dealing with a situation where we are converting the normal production of testosterone into the stress hormone cortisol. When we throw in more testosterone because the levels are low, it is like throwing lighter fluid on a raging fire. The extra testosterone fuels the abnormal functioning of the hormonal system.”
Janet: “Is it dangerous when the body starts stealing hormones from one area for another?”
Dr. Borkin: “There are increasingly severe problems if the causes of hormonal imbalance are not addressed. Even when you supplement hormones that are too low, this does not solve the original problem. Just because a level is low, it does not mean you are going to elevate that hormone if it is being converted into another hormone.”
Janet: “Is that why just supplementing testosterone without checking the other hormone levels is dangerous?”
Dr. Borkin: “This is really where the major mistakes are made by most practitioners. Testosterone is a fascinating hormone. We have been studying testosterone longer than any other steroid hormone. We know a lot about testosterone but not enough.”
Janet: “Testosterone seems to be a very important hormone. What have the studies shown?”
Dr. Borkin: “What is interesting about testosterone levels is that if we look back 50,000 years ago, testosterone levels were extremely high at that time. Testosterone is also a survival hormone. It is responsible for allowing us to go into a hostile environment and survive extremely stressful situations.”
Dr. Borkin: “Approximately 200 years ago, if you were a pioneer crossing the country on a wagon train, testosterone is the hormone that got you through. It also allowed a woman to make it in a hostile environment. If the levels of testosterone were as low as they are today, generally speaking, there is no way we would have been able to conquer that kind of environment.”
Janet: “So, does that mean testosterone is important to both men and women?”
Dr. Borkin: “Testosterone is extremely important. It also has a very powerful affect on motivation. It is also involved in many, many other processes. Not all of these processes are unrelated to sex.”
Janet: “Does testosterone have any relationship to the growth hormone?”
Dr. Borkin: “There must be a balance between testosterone and growth hormone. We have heard a lot about growth hormone. The use of growth hormone can be fabulous, if it is used in the proper manner.”
“Dr. Borkin: “I like to use the analogy with my patients that growth hormone is kind of like putting a turbo charger on your car. If you only have two tires on that car and then add a turbo charger, it is going to spin around out of control much faster than it would have before.”
Janet: “Are there different types and levels of the same hormones in the body?”
Dr. Borkin: When we look at the use of certain hormones, we want to create the proper foundation. In order to balance the specific levels of hormones in a man or a woman, we want to look at the free fractions, those levels of hormones that are accessible, that are going to be utilized.”
Janet: “Why do you test the hormone levels in the saliva?”
Dr. Borkin: “Saliva is easy to collect and shows the bioactive availability of the different hormones. Once we determine what the fluctuations are throughout a 24 hour period, we begin to understand what is really going on.
Janet: “Do hormone levels change naturally throughout the day?”
Dr. Borkin: “A man’s testosterone levels are not constant throughout the day. They change dramatically from the morning, when they are at their highest level. At midnight, they are at their lowest point.”
Dr. Borkin: “When we look at these 24-hour measurements, we are able to determine the time of the day to supplement. It is not only determining what those levels are, but this is a guideline for accurately supplementing at exactly the right time. If the hormone is high at a specific time, you do not supplement it then. You wait until it is low.”
Janet: “How do you provide additional amounts of absorbable hormones to the body?”
Dr. Borkin” When it comes to supplementation, we only have a handful of methods of getting it into the body. If you take supplements orally, there is no guarantee that when you put something in your mouth it ever gets to the target tissue, especially, if we have some kind of digestive disturbance or malabsorption.
Dr. Borkin: “If something interferes with the proper absorption or utilization of nutrients or hormones, then the oral route is not really the first choice. When it comes to the use of a hormone, there is the “First Pass Mechanism” where a hormone is utilized through the digestive tract to get it into the blood stream.”
“When we take a look at this mechanism, it relies on the digestive tract working properly. The liver must work correctly in order to obtain approximately 5% of the hormone for use in the body. That is like depositing a hundred dollars into your bank account and getting to use five dollars. So, it is not a real effective method of getting the money into the account.”
Dr. Borkin: “The same is true as far as contributing hormonally. If we wanted to get these hormones into the blood stream, in their entirety, we would use injectibles. But, that is not real user friendly. Most people would not want to do that several times a day, even if it was medically indicated.”
Dr. Borkin: “A new delivery system is “Transdermal Delivery.” I have been working with this technique for twelve years. In the last twenty years, scientists have been focusing on this type of delivery system. Transdermal delivery mechanisms, such as the Nicorette, testosterone and estrogen patches, are now treatments of choice.”
Dr. Borkin: “These are mechanisms applied to the skin. The chemicals are delivered through the skin. You get the equivalent of what you would get if it was injected directly into the body. It is no different injecting than it is to take something transdermally, if it is a true transdermal device.”
Janet: “How is the transdermal delivery system different than just applying lotions to your skin?”
Dr. Borkin: “This is where I need to explain the difference between a transdermal and a topical. There are many products, especially progesterone creams that claim to be transdermal but they are not. They are only topical.”
Dr. Borkin: “They call themselves transdermal because the size of the progesterone itself is so small. If apply the progesterone itself to the skin, it is small enough so it goes through the pores of the skin and winds up in the blood stream to a certain extent.”
Dr. Borkin: “Unfortunately, much of what you apply is actually stored in the skin and in the fat cells. A true transdermal delivery mechanism is the equivalent of directing it through a specific apparatus directly into the blood stream. It is similar to drinking a glass of water filled with ice. If you insert a straw, you get more of the fluids.