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Ask Dr. Mike: Alternatives to Beta Blockers & What's the Best Way to Test Your Hormones?

Here you'll find the answers to a wealth of health and wellness questions posed by Healthy Talk fans.

Listen in because what you know helps ensure healthy choices you can live with. Today on Healthy Talk, you wanted to know:

What is the best way to test my hormones?

Hormones in your body are chemical compounds that act as messengers to all your cells, glands, organs and tissues. Each hormone in your body plays a critical role in the functioning of your overall health.

Unless you notice changes in your body, you typically will want to start testing your hormones in your 30s. In Dr. Mike's opinion, blood is the best way to test your hormones. But, if you want a specific hormone tested like estrogen, you should use the urine method.

My doctor prescribed propranolol (a beta blocker) to lower my blood pressure. Ever since I started taking it, I constantly feel fatigued and lethargic. At night I don't get any restful sleep. Why is this and what can I do?

Beta blockers are used to lower your blood pressure. They are ultimately used to bring down your heart rate as well as your hormone epinephrine (adrenaline) levels. Beta blockers are known to have some unpleasant side effects, including low energy and fatigue.

You might want to consider talking to your doctor about switching medications to an ace inhibitor, angiotensin receptor blockers, or calcium channel blockers. You might want to incorporate pomegranate extract, grape seeds, or milk peptides.

If you have a health question or concern, Dr. Mike encourages you to write him at This email address is being protected from spambots. You need JavaScript enabled to view it.  or call in, toll-free, to the LIVE radio show (1.877.711.5211) so he can provide you with support and helpful advice.

RadioMD Presents: Healthy Talk | Original Air Date: February 19, 2015
Host: Dr. Michael Smith

You’re listening to RadioMD. It’s time to “Ask Dr. Mike” on Healthy Talk. Do you have a question about your health? Dr. Mike can answer your questions. Just email This email address is being protected from spambots. You need JavaScript enabled to view it. , or call: 877-711-5211. The lines are open.

This next question, you know, I could do a whole seminar on this next question. But, I can also answer it pretty straightforward and simple at the same time.

The question is, “What is the best way to test my hormones? I see that there are different methods such as saliva, blood and urine and I’m just wanting to know you what your opinion is on these methods?”

You know, this is good because I talk a lot about hormones as a longevity specialist. You know, hormones are those key messengers between your brain and your body. And, as we get older, we just don’t produce hormones as we should, so your brain has a hard time talking to your body and if your brain can’t talk to your body, it can’t control physiology. It can’t control health and things begin to break down. Back in the 1960’s, there was an interesting study looking at age-related disorders like diabetes and heart disease--all that kind of stuff and how it relates. You know, when these diseases start to develop and how that relates to the loss of steroid hormones specifically, like testosterone and DHA and estrogen. Right around your 40’s and 50’s, all of these steroid hormones begin to drop in production in the body and that’s right when you see a lot of these age-related disorders kick in.

Now, I’m not saying that hormone deficiencies cause age-related disease, but definitely play a role. I mean, again, your brain knows what it needs to do, but in order for it to send out those commands to the body, to fix and repair and regenerate, it needs hormones. And, if they’re missing, then there’s a disconnect between the brain and the body. So, you know, I do think we should, probably your mid 30’s, start testing your hormones. Ask your doctor for a male hormone panel or a female hormone panel that’s checking all of the steroid hormones: testosterone, estrogen, DHEA, pregnenolone, progesterone. Also thyroid, maybe even growth hormone, cortisol, all of those should be in that type of profile.

The question, then, becomes how though? You know, there are doctors that like saliva. There are doctors that like to do a blood draw. There are doctors that even do hair now with hormones, urine. You know, the easy answer is blood. Blood is the best way to test all of this. Now, that depends on the hormone itself. So, I’m going to answer this question by saying, “Blood is the best way to go.” And, I’ll tell you why in a moment, but I will also mention—there’s a caveat there. If you’re checking estrogen--and especially estrogen metabolites--urine is best.

You see, if a hormone is heavily metabolized in the body, like estrogen, it’s probably best to test it in your urine because you’ll see all those metabolites. If you have a hormone that’s not heavily metabolized, like testosterone and DHA—the androgens, basically—blood is definitely the best way to go. But, if you have to decide. I mean, if you only have enough money to do one of these types of testing--one of these methods—blood is the best way to go.

Here’s why: As a doctor, I know how to interpret the blood results and that’s the simple answer. I mean, saliva testing—we still haven’t figured out what is an optimal for these hormones in saliva. As a matter of fact, what we’re finding is temperature; if there’s a little bit of blood mixed in in the saliva; whether you’re hungry or you just ate--all of that kind of disrupts the hormones in your saliva and it makes the test kind of unreliable.

Urine is a great way to do hormone testing, but the problem is, you really should do a 24-hour urine collection and no one’s really going to do that. So, you know what? At the end of the day, blood remains the best way. It’s simple. You know, as a doctor, I’m used to the blood levels, I know what they mean. I can find imbalances a little bit better. So, personally, I think blood’s the best way to go. I think until we optimize the saliva testing; until we figure out what those levels really mean—the same for hair analysis—they’re just hard to use. So, I do think blood is the best way to go.

Okay. Alright. So, let’s go on here. Do we have a caller on? Is that for me, Kevin, there? Ellen? Oh, she’s for the next show. Sorry about that. Alright. So, let’s go on here.

My next question is: “My doctor prescribed Atenolol,” which, it’s a beta blocker for blood pressure. So, “My doctor prescribed Atenolol to lower my blood pressure. Ever since I started taking it, I constantly feel fatigued and lethargic. Yet, at night, I don’t get any restful sleep. Why is this and what can I do?”

Yeah. So, that’s kind of weird, right? So, you’re taking a drug for blood pressure, fine. And, beta blockers do work well for that finding. But, here you feel tired during the day, but yet you’re not really sleeping at night. Yeah. That’s not great. “What can I do?” So, you know, the thing to remember about Atenolol—it is a beta blocker. You know, it reduces the effects of, ultimately, what are called “catecholamines”.

Catecholamines are neurotransmitters in the body that rev you up. So, if you take a beta blocker like Atenolol, you block the receptors that the catecholamines attach to and if you block those receptors, the catecholamines—these sympathetic, energetic neurotransmitters—can’t work, so it brings down heart rate. It brings down blood pressure. That’s kind of how it works, right? So, you block the effects of the catecholamines. You slow down heart rate. You relax blood vessels. You know, you can even improve the rhythm of the heart by doing that and lower blood pressure. But, the flip side of all this, you know, since beta receptors are effecting these receptors that the Atenolol is blocking which are all over you cells and tissues and they control multiple physiological and metabolic pathways. So that means, yes, they have terrible side-effect profiles. Beta blockers, especially the older ones, the older generation beta blockers like Atenolol, they just block all the beta receptors in your body. So, not only are you slowing down the heart and everything, but you also slow down the brain a little bit and you slow down your gut a little bit and there are just all kinds of side effects with it. You get really fatigued and have low energy, but you don’t get great sleep cycles. Those are known side effects of beta blockers.

So, what can you do about this? Well, I think you need to talk to your doctor. There might be some better options for you. As far as other drugs go, the classic ones to usually start with rather than beta blockers are called “ace inhibitors”. So, you can try those. There are angiotensin blockers, calcium channel blockers. These might be better choices for you. So, your doctor may just have to play around with it a little bit, but if your side effects—if the sleep disturbances and the fatigue are really starting to affect your everyday life--then I think you need to have a discussion with your doctor about it.

Hey, what about some natural things, right? I’ve talked about the trinity of nutrients for blood pressure control. Don’t forget about things like pomegranate extract, grape seeds, milk peptides. Those are milk proteins that have been broken up into small pieces called “peptides”. All of those have been shown to reduce blood pressure significantly. You know, take pomegranate alone. Pomegranate extract—about 200-250 mg a day can lower the top number 6, 7, 8 points and the bottom number 4 or 5 points. That’s not that far off from the drugs like beta blockers. You know? And pomegranate, pretty much, is well tolerated by people. I mean, the only downside of pomegranate is maybe it thins the blood a little bit. That’s it. So, there are some natural options as well. Maybe go check out and search the “blood pressure protocol” and see if there are some better options for you there. But, don’t stop the drugs—don’t stop beta blockers by yourself. That can be dangerous. So, talk to your own doctor. Tell them about the side effects. Talk about some of those nutrients.

This is Healthy Talk on RadioMD. I’m Dr. Mike. Stay well.