In a number of our programs, we’ve talked about the various ways that one can modify hormonal pathways—short of hormone replacement therapy (HRT). There are a few important enzymes that are gatekeepers for certain pathways. Two of particular importance are aromatase and 5-alpha reductase. We know the activity of aromatase can affect the conversion of testosterone to estrogens; additionally, the activity of 5-alpha reductase can affect the conversion of testosterone to dihydrotestosterone. Modulating these enzymes can therefore have a significant impact on the levels of testosterone and estrogens circulating in the body. As mentioned, there are a variety of factors that affect those enzymes, and we’ve put together a couple of handouts that list foods, herbs, and nutrients that have been shown to have these effects. We think this will allow you to easily choose specific supplements or foods to recommend to your patients that could be used before or with HRT.

To access the IFM Clinical Practice Toolkit, log in to your account, select My Education from the left-hand side, then click on the IFM Toolkit tile. To find these toolkit documents, search for “Maintaining Healthy Testosterone Levels” and “Aromatase Inhibitors” within the toolkit.