Remember "raging hormones," those glandular gremlins responsible for every embarrassing act of youth? Not only have they become respectable, they're all the rage.
Estrogen, testosterone, DHEA and melatonin are seen by millions of Americans as capsule versions of the fountain of youth. Best-selling books like "The Melatonin Miracle" and "The Super Hormone Promise" tout the ability of hormones to ward off the effects of aging. Even testosterone, so often blamed for aggressive behavior in men, is getting better press. Newsweek recently devoted a cover to hormone therapy, asking "Can It Keep Men Young?"
But little is known about the effects of taking most hormones. Only the benefits of estrogen replacement therapy have been clinically proven: It guards against heart disease and osteoporosis in post-menopausal women.
You still need a prescription for estrogen and testoterone. But DHEA and melatonin are available over the counter as nutritional supplements.
Although DHEA and melatonin are not approved by the Food and Drug Administration and no long-term research exists on their effectiveness, many people are reaching for them as if they were extra-strength vitamins. They are eager to try anything they hear will boost their immune system, vitality and libido. Some are even chewing DHEA gum.
But even those who are profiting from the hormone craze urge caution.
"I don't believe in people in their 20s and 30s taking hormones, or in people using them to build muscles," says 71-year-old physician William Regelson, co-author of the best-selling books "Melatonin Miracle" and "The Super Hormone Promise."
"My whole emphasis is hormone replacement," says Regelson, who takes hormones himself and believes they've made him more vigorous. "I signed a book recently for one young fellow who thanked me for writing the book and told me he was taking 300 milligrams of DHEA a day -- that's a pharmacologic dose larger than what you give in the clinical group to treat lupus. But what do you do with stupid people?"
Physicians worry that such "more-must-be-better" use of over-the-counter hormones may ultimately increase the risk of hormone-sensitive diseases such as cancer of the breast, ovaries, uterus and prostate.
"Somebody wouldn't go to the health food store and buy indeterminate levels of estrogen and testosterone," says Ronald Parks, a Baltimore physician who specializes in nutritional and preventative medicine. "If used at all, over-the-counter hormones should be used carefully and conservatively in consultation with a physician. People shouldn't look for a magic pill."
"People do feel that hormones have magical properties, that it's youthful to have them," says reproductive endocrinologist Marion Damewood, director of the Women's Health Center at Greater Baltimore Medical Center. "The thought is more prevalent in women, I think, because there's a time framework in which women lose hormones whereas the decline in men is much more prolonged."
Produced by various endocrine glands, hormones are chemical substances that regulate growth, metabolism and reproduction. Their increasing desirability is based on the unproven belief that losing hormones is always bad and replacing them is always good.
"The underlying assumption is that gradual hormonal decline is bad because some physical functions decline at the same time. But there's no proof of a causal link," says Richard Sprott, associate director of the National Institute of Aging and head of the biology of aging program.
At the moment, many physicians and scientists worry most about melatonin and DHEA, the hormones which share supermarket shelves with vitamins.
"We have no idea who's taking these hormones and what's happening to them," Sprott says. "You're not going to take over-the-counter hormones and drop dead next week, but we're concerned about the kind of harm which might take months to years to develop."
Lynne Lamberg, author of "Bodyrhythms: Chronobiology and Peak Performance," says that people taking melatonin, the popular hormone often used to induce sleep, are unwitting subjects in a large-scale, uncontrolled experiment.
"A lot of claims have been made about melatonin in a host of popular books but that doesn't mean that they mean anything," says Lamberg, who recently reported on melatonin for the Journal of the American Medical Association.
Stephen Busky, head of urology at Greater Baltimore Medical Center, believes the quest for hormone replacement is often spurred by articles "based on enthusiasms."
"There is a concept in the popular press that there are things out there that doctors know about and aren't telling the rest of us," he says. "There's a feeling that doctors won't share this information because it won't make money for us. Or that we're too conservative and have blinders on while these gurus are really in touch with things.