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So i’m here now with gillian einstein she’s from the university of toronto the focus of her research is really around hormones and how it relates to alzheimer’s disease hi julian hi so first let’s start with just basically what role do hormones play in our brain well we know from animal studies that estrogens and androgens have receptors in the brain on neurons as
Well as glial cells so the cells that communicate with each other and the cells that protect the cells that communicate with each other they’re all responsive to estrogens and androgens and their receptors on those cells and the receptors enable the estrogens and androgens to have both short term and very long term effects so i guess most importantly and what a lot
Of women would want to know is when you reach menopausal age and you have a drop in estrogen what does that mean for your brain well it’s a complicated question because it depends on each woman it depends really on where you started with estrogen and where you ended up with estrogen in menopause and if you don’t end up too different than where you started you’re
Probably in pretty good shape if you have a big drop in estrogen then that might be a problem so how does this open the door for opportunities in research related to alzheimer’s disease and hormonal levels of course the risk factors in alzheimer’s disease for men and have been known to be different and in women one of the risk factors is menopause it’s not as strong
As age itself or a bowi status but the lowering of estrogens people think removes a protective effect on the brain and this protective effect does have to do with making connections between neurons and growing neurons that estrogen is so good at doing people have begun to hypothesize that menopause itself might be a risk factor but i have to emphasize that it really
Depends on individual women so are we seeing more women with early onset well i don’t think we’re seeing significantly more women with early onset unless you actually take the population of women who’ve had a severe hormonal drop then they would probably have an earlier onset but we don’t completely know that yet i do think if you looked at a particular group of
Women you would see that among women women who had their ovaries removed and therefore are no longer making endogenous or in they’re not making their own estrogen they have a higher risk you said different women have different declines in estrogen when you say if it’s a more significant drop what is that drop exactly what is a significant drop yeah so obviously it’s
A more significant drop depends on what you made before but usually in measuring measuring estrogen in the urine it’s about it’s about 30 picograms per mil so it seems like a very small amount but it’s a small amount that has a big effect in the blood it’s a it’s a completely different kind of measure if you really want to know what your brain is seeing spit into a
Tube and give somebody your saliva to analyze so where are we in research like knowing how hormones impact also i was like what what is research trying to address in the longer term a research is trying to address really how estrogen loss either through natural menopause or prior to natural menopause might set the stage for quicker neural neurodegeneration loss of
Neurons accumulation of beta amyloid etc etc but one of the unfortunate things about this field is that even though over 70% as far as i can tell of the populations being studied or women people aren’t reporting their results as women and men and they’re not actually looking at risk factors particularly salient for women such as estrogen levels or loss of estrogen
One thing i did want to talk to you about was your study where you studied women who had had their ovaries removed at a younger age tell me a little bit about that study and what you determined from it we’re studying women who had their ovaries removed for medical reasons there are a very healthy population most of them have their ovaries removed between the ages
Of 35 and 45 and so our average age is around 45 we’re asking them questions about memory we’re giving the memory tests and we’re doing brain scans and we’re also looking at immune function inflammation and we’re starting to hopefully gather biomarkers actually and what we found we have changes in remembering a story or remembering a list of words over a delayed
Period women who have had their ovaries removed do more poorly on those tasks and this is also correlated with the the volume of the brain area that’s very vulnerable and disease called the hippocampus how many people have you participate in that study we have 60 participants in the study now who have had both ovaries removed and some with hormone replacement
Someone thought yeah god happer on hormone replacement okay the preliminary conclusion is hormone replacement therapy greatly benefits these women right in terms of brain health it helps them that’s for sure the other thing is if you still have your uterus that means that you need to have progesterone do you want a natural progesterone you do not want a synthetic
Progesterone meta-analysis studies show that the synthetic progesterone seems to be a pretty bad actor i really feel that people have underestimated estrogens for an awfully long time i think first of all people haven’t really gotten the connection the ovaries in the brain but also i i don’t think people you know what other drug have people been put on besides
Hormone replacement where they were put on it like it was candy and then whipped off it like it had no effect yeah it’s a very power you know estrogens and androgens are very powerful actors they act all over the body they act on full nats on heart every single body system is sensitive the message i would have for people who have alzheimer’s disease and there is
That i would say keep your ovaries if you possibly can yeah yeah and if you if you have them taken out really seriously consider hormone replacement yeah
Transcribed from video
What Role Does Estrogen Play in Alzheimer's Disease? Being Patient Speaks to Gillian Einstein By Being Patient Alzheimer’s