A precision endocrinology approach focused on optimizing the levels and ratios of free, unbound, and thus biologically active hormones, rather than simply normalizing total hormone concentrations. This strategy recognizes that only the bioactive fraction can effectively engage cellular receptors and drive physiological responses. Clinical assessment must therefore focus on the dynamic equilibrium between total hormones, carrier proteins like Sex Hormone-Binding Globulin, and the free hormone fraction.
Origin
The term is derived from ‘bioactive,’ referring to a substance having a biological effect, and ‘hormone balancing,’ a core principle in restorative endocrinology. This concept evolved from the realization that total hormone measurements often fail to correlate with clinical symptoms or tissue-level effects, necessitating a focus on the truly functional hormone pool.
Mechanism
The mechanism centers on adjusting hormone replacement, nutritional status, and liver function to modulate the production of carrier proteins and enhance the clearance of less desirable hormone metabolites. This careful modulation ensures that target tissues receive an optimal and sustained signal from the free, unbound hormone. By precisely tuning the bioactive levels, clinicians can maximize therapeutic benefit while minimizing the risk of adverse effects.
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