Hormone Health & Hormone Imbalances
This is basically where you measure hormones – estrogen, testosterone, cortisol or thyroid – see what’s low and then replace the abnormal hormone with synthetic hormones.
The functional medicine model of hormone treatment looks to determine why hormones are imbalanaced and aims to correct the cause. Functional Medicine seeks to determine the source of the problem rather than simply treating a symptom.
For example, if your thyroid hormone is low – a conventional medical treatment would include increasing thyroid hormone. However, the two major causes of thyroid disorders are nutrient deficiency and autoimmune disease. Nutrient deficiencies could include iodine, zinc and selenium. If it’s an autoimmune issue, then the cause of the autoimmune problem should be investigated.
Simply adding thyroid hormone will not correct these underlying issues. So even though your thyroid hormone may go back to normal- the problem continues to exist and can actually create more damage and disease as time goes on.
What Happens With Hormone Imbalance?
The important thing to understand here is that your hormones can impact every part of your life – your state of mind and behavior, to eating habits and ability to respond and cope to stress.
You can only live a happy, healthy life if your hormones are properly balanced.
The good news is that hormones can be balanced naturally, safely and without causing undue harm to your body.
What Do Hormones Do?
Hormones then tell your body whether you are hungry, sleepy or stresed. Hormones are both suppressing and stimulating. They tell you when to stop eating and when you’re hungry. They tell you body when its time to wake up and be active as well as slow down and get ready for sleep. They even impact your confidence and ability to respond socially.
Hormones that we are most familiar with include sex hormones such as: estrogen, progesterone, and testosterone. When it comes to metabolism, many people might think of thyroid stimulating hormone or leptin. Then there’s brain chemicals such as dopamine and serotonin. Still, there are many other hormones such as insulin, growth hormone, cortisol, and melatonin. For the sake of clarity, we’ll just focus on a few.
Here’s a list of hormones and where they originate.
- Anti-Diuretic Hormone – helps to maintain blood pressure, blood volume and tissue water content by controlling the amount of water in the body
- Oxytocin – causes the ejection of milk from the milk ducts and causes constriction of blood vessels
- Dopamine – a neurotransmitter or brain chemical that helps to control the brain’s reward and pleasure centers; also helps to regulate movement
- Corticotropin-Releasing Hormone – the main element that drives the body’s response to stress, suppresses apetite, increases anxiety and improves memory
- Gonadotropin-Releasing Hormone – controls the production of luteinising hormone and follicle stimulating hormone from the pituitary gland.
- Somatostatin – inhibits the secretion of several other hormones, including growth hormone, thyroid stimulating hormone, cholecystokinin and insulin.
- Growth Hormone-Releasing Hormone – stimulates the secretion of growth hormone, an important regulator of growth, metabolism and body structure.
- Thyrotropin-Releasing Hormone – plays an important role in the regulation of thyroid gland activity.
- Triiodothyronine (T3) – plays vital roles in the body’s metabolic rate, heart and digestive functions, muscle control, brain development and function, and the maintenance of bones.
- Thryoxine (T4) – plays vital roles in digestion, heart and muscle function, brain development and maintenance of bones.
- Adreno Corticotropic Hormone – stimulates the production and release of cortisol from the adrenal gland.
- Growth Hormone – maintains normal body structure and metabolism.
- Luteinising Hormone – one of the main hormones that control the reproductive system
- Follicle Stimulating Hormone – regulates the functions of both the ovaries and testes. Lack or insufficiency of it can cause infertility or subfertility both in men and women.
- Proloactin – plays a role in lactation, acts on the reproductive system and influences behavior and regulates the immune system.
- Thyroid Stimulating Hormone – regulate the production of hormones by the thyroid gland.
Primary Sex Hormones
- Estrogen – found in both men and women, responsible for secondary sexual characteristics.
- Estradiol – powerful reproductive hormone that has a wide range of actions in both men and women.
- Progesterone – plays important roles in the menstrual cycle and in maintaining the early stages of pregnancy.
- Testosterone – plays a key role in reproduction and the maintenance of bone and muscle strength.
The tricky part is that these hormones can function differently in certain areas of the body. They can complement each other or function as opposties. And this is exactly why it’s so important for them to be in their proper ratio!
The Signs & Symptoms of Hormone Imbalance
Like I mentioned previously, hormones don’t simply become imbalanced. There is always a physiological reason and figuring that out is the most important step towards re-balancing them. Estrogen Dominance and Low Testosterone are the most common examples.
Early signs of hormone imbalance can include: acne, sweating profusely, dark circles under your eyes, depression, excess weight gain, fatigue, hair loss and breast changes.
You can also get an idea of what hormones are imbalanced based on certain symptoms.
Signs & Symptoms of Estrogen Dominance
- External Symptoms – weight gain, acne, increased body hair, increased facial hair, thinning skin, thinning hair, brittle hair/nails, belly fat, puffy eyes
- Internal Symptoms – night sweats, water retention, tingling in hands/feet, decreased energy, hot flashes, sugar/carb cravings, headaches, vaginal dryness, heavy menstruation, tender breasts, cysts in ovaries, PMS, fatigue, constipation, low libido, stiffness, inflamed joints.
- Emotional Symptoms – anxiety, stress, panic attackes, conecentration problems, depressed mood, irritability, sadness, excessive worrying, less energized
Signs & Symptoms of Low Testosterone
- Physical Symptoms – pale face, muscle loss, dry eyes, fat gain in abdomen/chest, hair loss, infertility, decreased strength, decreased bone mass
- Emotional Symptoms – low libido, depressive feelings, fatigue/lack of energy, confusion, irritability, sleeping problems, feeling stressed
The Underlying Causes Contributing to Hormone Imbalance
Let’s start with the gut!
1. The Gut-Brain (Hormone) Connection
Emerging research indicates that the gut microbiome plays a central role in the regulation of estrogen levels within the body and thus influences the risk of developing estrogen-related diseases such as endometriosis, polycystic ovary syndrome, breast cancer, and prostate cancer.
Not only does the microbiome impact estrogen levels, but we also know that the microbiome has an effect on total testosterone levels as well as cortisol (which can suppress testosterone and estrogen production).
What factors disrupt the microbiome?
Diet and lifestyle play the biggest factor in disrupting the gut microbiome. Antibiotics and hormonal contraceptives have been found to alter both the gut microbiota and estrogen levels within the body, suggesting that they may have an adverse impact on the community of bacteria in your gut.
A large body of research demonstrates that diet significantly impacts the gut microbiota. Notably, the consumption of phytoestrogens (foods that mimic estrogen) has been found to significantly impact the gut microbiota and the risk of estrogen-related diseases. Phytoestrogens can be estrogenic or antiestrogenic and can, therefore, have either a protective or causative effect on the development of cancer and chronic diseases.
This is exactly why it’s so important to have a comprehensive stool panel. Evaluating whether or not you have dysbiosis, gut infections, parasites and/or fungus is key to controlling your hormones. Dysbiosis can promote intestinal permeability, which in turns leads to inflammation, bacterial overgrowth and various autoimmune conditions which all disrupt hormone balance in several different ways.
HPA Axis stands for Hypothalamus Pituitary Adrenal Axis Dysfunction. This is relatively easy to understand because the hypothalamus and the pituitary are the glands that regulate all hormone production in the body, including stress and sex hormones. So if you have an imbalance in this axis, then, by definition, you’re going to have a problem with sex hormone production or adrenal hormone production or thyroid hormone production.
This means you will definitely have hormone imbalance if you have HPA Axis dysfunction.
Cortisol is the hormone that’s produced in the stress response. When we are under a lot of stress or chronic stress, we constantly have cortisol circulating in the body and your body then becomes “resistant” to it. This is very similar to insulin resistance – when the receptors of our cells no longer respond to insulin and we become diabetic. But in this case, our cells no longer respond to cortisol and we become cortisol resistant.
Once this happens, you can develop intestinal permeability or leaky gut, pregnenolone and estrogen problems.
Insulin is a master hormone that helps to regulate many metabolic processes that provide cells with energy. Major factors behind insulin and leptin resistance include poor diet, lack of exercise, inadequate sleep and/or imbalances in our circadian rhythms.
Insulin resistance can also lead to high cortisol levels – which of course can contribute to evertyhing that we just talked about with respect to the HPA Axis.
Insulin surges can increase the production of an enzyme called 1720-lyase, which in turn leads to higher testosterone levels. This is actually one of the primary causes of Poly Cystic Ovarian Syndrome (PCOS) in women and a common cause of infertility.
If your body loses its capacity to detoxify itself, bad things will happen. The liver plays a primary role in the detoxification of hormones. If phase 1 or phase 2 of the liver detox pathway is compromised, hormones will not be metabolized properly or broken down.
This is why it’s important to get the proper hormone testing done. Conventional testing usually involves blooe or serum. The problem with this is that blood or serum hormone testing only tells you how much “inactive hormone” is in the body. It doesn’t shed light on hormone metabolites, which can only be identified through urine.
Metabolized hormones or how your hormones are being metabolized are important to measure because they don’t activate the receptor sites of your cells the way fully active hormones do. They actually compete with those hormones and can throw off the normal regulatory feedback loops needed for proper function.
The end result is someone that has hormone imbalance symptoms but their labs actually appear to be normal.
Most americans are nutritionally deficient in the vitamins and minerals necessary for proper liver detoxification. On top of that, we are constantly exposed to a wide range of environmental toxins that damage detox pathways. These toxins include: heavy metals, mold, volatile organic compounds, pesticides and BPA.
Essential fatty acids are polyunsaturated fats. Alpha-linolenic acid is the essential fat on the omega-3 side, and linoleic acid is the essential omega-6 fat, but then you have the longer-chain derivatives of these, EPA and DHA on the omega-3 side and arachidonic acid on the omega-6 side.
The reason these are so important is that essential fatty acids influence prostaglandin production, and prostaglandins modulate hormone receptor site sensitivity and the response that happens when a hormone binds to the receptor.
Too much omega-6, for example, can lead to altered hormone receptor function, and this omega-6 linoleic acid is found in industrially processed plant oils, like soybean and corn oil, safflower, sunflower. These are oils that are typically found in processed and packaged foods, chips, anything fried, a lot of restaurant foods, but certainly most foods that come in a bag or a box, which comprise a disturbingly large percentage of calories for the average American.
EPA and DHA are found primarily in cold-water fatty fish and shellfish, and a fairly large percentage of people are not eating enough of this preformed EPA and DHA.
Now, in theory, alpha-linolenic acid, the plant-based omega-3 essential fat, can be converted into DHA, but that conversion is very inefficient. Less than one half of 1% of alpha-linolenic acid gets converted into DHA in most people. And too much omega-6 fat in the form of all of these processed and refined foods that are so common in the standard American diet actually reduces the conversion of ALA, alpha-linolenic acid, to DHA.
So what happens with all of that extra omega-6 is that when the hormone binds to the receptor site, the proteomic response that is supposed to happen is either diminished or exaggerated, and that can cause problems related to hormone excess or hormone deficiency.
If we tie this all back to another issue, which is blood sugar and insulin, it’s worth pointing out that insulin resistance decreases the conversion of alpha-linolenic acid to EPA and DHA as well.
It’s kind of like a perfect storm. One problem contributes to another and creates a vicious cycle of hormone imbalance.
If you have cortisol and HPA problems, that’s going to interfere with insulin and leptin signalling, which in turn will make your gut lining more permeable and lead to inflammation in the gut, which in turn leads to higher cortisol production, which leads to more insulin and leptin resistance, which interferes with liver detoxification, which can lead to a buildup of excess hormones, which — well… you should get the idea.
This is why it’s so crucial to address the underlying problems and not simply replace low or high hormones with more hormones. In fact, it should be obvious how it could even make things worse, which is unfortunately why I see a lot of women in my practice who have been on birth control pills for a very long time, not necessarily for contraception, but to regulate their cycle, and are having a ton of side effects and symptoms related to it, and they want to get off the pill, but it’s extremely difficult to do so, and it can take many months, if not years, to fully unwind all of the pathology and symptoms that were caused by being on the pill for that long.