When I see a mom who has been tired since having kids, I check hormones. When I see someone with autoimmune disease, I check hormones. When I see someone who can’t lose weight or with skin problems, I check hormones. This is because hormones interact with many systems in the body. They play a role in regulating immune system, mood, sebum production, metabolism, and more. Here are some of the most common areas in which you may need to address your hormones to optimize your health:
Hormones & Female Reproductive Health
Most of us are familiar with estrogen and progesterone. Estrogen helps the female body mature follicles and release them at ovulation. Progesterone helps prepare the uterine lining for implantation of a fertilized egg (zygote). It also helps balance the effects of estrogen, which is very helpful for managing symptoms of PMS.
One of the most common things to go wrong when it comes to balanced estrogen and progesterone is something called estrogen dominance. This is a condition in which both estrogen and progesterone are in the range of “normal” but are not balanced. Your estrogen is much higher than progesterone so it “dominates” your hormonal picture and creates symptoms of estrogen excess and low progesterone such as PMS, cycle irregularities, sleep disturbances, mood swings, and weight gain.
Estrogen dominance is common because many environmental chemicals are structurally similar to estrogen. Chemicals in plastics, household mold, cosmetics, and synthetic fragrances all contain chemicals are examples. These are called xenoestrogens and they can amplify estrogen activity in the body. Estrogen dominance can also be promoted when we have poor gastrointestinal health that promotes the reabsorption of estrogen back into our blood streams instead of its elimination in the stool. Finally, fat cells likely store and make estrogen so elevated body weight can also contribute to estrogen dominance.
Besides imbalances in estrogen and progesterone, females can also feel the health impacts of imbalanced testosterone. In women, testosterone helps maintain libido, energy, body composition and mood.
Here are some symptoms that can occur when any of these 3 hormones get out of balance:
Symptoms of High and Low Estrogen
Symptoms of Elevated Estrogen:
Fluid Retention (bloating, weight gain, breast tenderness)
Symptoms of Low progesterone will be very similar to those of excess estrogen as the primary problem with low progesterone is estrogen dominance. Additionally, a woman may experience:
Increased pain sensitivity
Symptoms of High and Low Testosterone
Symptoms of Elevated Testosterone (in women)
Acne and oily skin
Excessive body and/or facial hair
Increased muscle mass
Irregular menses and/or infertility
Symptoms of Low Testosterone (in women)
Depression, Anxiety, and/ or Fearfulness
Decreased sexual sensitivity or difficulty achieving orgasm
Increased passivity of personality
Vaginal itching and/or painful intercourse
Poor muscle tone or strength
As you can see, balance of reproductive hormones can make a huge impact on how you feel overall!
Hormones & Immune System
Much of the interaction of hormones with the immune system is mediated by estrogen, which can be activating or inhibiting. Estrogen can bind to two different types of cellular receptors. The first type of receptor is called an alpha receptor and when estrogen binds it, a stimulating activity is produced. The second type of receptor is called beta and when estrogen binds to it, an inhibitory action is produced. In the immune system, alpha binding increases immune activity and beta binding decreases immune activity. To maintain a healthy immune system, you want a balance of both stimulation and inhibition.
Estrogen activation of the immune system stimulates cells that respond to infection and create antibodies as well stimulating chemical messengers involved in initiating inflammatory processes. Furthermore, excessive elevations in estrogen can lead to a process called “loss of tolerance,” in which the immune system begins to recognize your own cells as foreign and attack them. This is an important process in the initiation of autoimmune disease. Scientific studies have further demonstrated that immune cells have sex hormone receptors that, when bound, help determine the destiny of an immune cell.
Changes in hormones are also observed in autoimmune disease. For example, Rheumatoid Arthritis usually improves during pregnancy when sex hormones are high and worsens post-menopaussally when sex hormones have diminished. Contrastingly, elevated estrogens are believed to be a part of development of Lupus. In addition to elevated levels of estrogen and prolactin, decreases in the hormones testosterone, progesterone, and DHEA are observed in Lupus. In animal and laboratory studies, testosterone appears to be protective from immune activation and development of auto-immunity.
These findings illustrate the importance of addressing hormone imbalances when healing from chronic illness as hormone levels are critical to a healthy, functioning immune system.
Hormones & Weight
There are four hormones significant to weight healthy weight: estrogen, testosterone, cortisol, and thyroid hormones.
The effect of estrogen on body weight is easily observed by the changes the female body goes through during puberty and menopause. The onset of puberty occurs with rising estrogen levels. During this time, increasing body weight and fat deposition is commonly observed. The onset of menopause occurs with shifting of predominantly active estrogen to less active estrogen. During this time, weight gain is also common, demonstrating that estrogen levels that are too high or too low can contribute to weight gain.
This occurs for several reasons. First, estrogen causes water retention. When you have excess estrogen and diminished progesterone (which helps your body release water), you can gain water weight. Estrogen is stored and made in fat cells so imbalances in estrogen can encourage your body to hold on to fat. Estrogen is also involved in insulin sensitivity. Imbalances can promote the development of insulin sensitivity and subsequent weight gain. Finally, estrogen is an appetite suppressant so healthy levels are critical for helping manage caloric consumption.
Testosterone is key in maintaining body composition and supporting development of muscle. Correcting low testosterone levels is an important component in promoting weight loss. However, excess testosterone can promote a condition called androgen excess, in which levels of hormones in the testosterone family are too high, leading to weight gain. Because testosterone can convert to estrogen, elevated levels of testosterone may also promote weight gain mediated by estrogen dominance.
Cortisol is a hormone that is involved in stress response and balance of blood sugar and blood pressure. Cortisol should be secreted in short bursts to help you respond to stress, then be eliminated. When your nervous system get stuck in a fight or flight response, which can occur from chronic stress, fear, or unresolved trauma, it can lead to long term elevations in cortisol. These elevations tell your body that you are in crisis and your body responds by storing fat. The storage of fat is also also mediated by elevated blood sugar, which is a secondary effect of long term cortisol elevations.
Low cortisol may also play a role in weight gain. Functionally low cortisol can create debilitating fatigue that interferes with our ability to exercise. Low cortisol is also clinically observed to increase consumption of carbohydrate foods. Finally, cortisol is required to activate thyroid hormone and low cortisol may contribute to thyroid dysfunction that promotes weight gain.
Most people are familiar with the effects of thyroid hormone on the body. Almost every cell in the body has receptors that respond to thyroid hormone. Thyroid hormone is integral in maintaining heart rate, metabolism, healthy tissues, and more. Because thyroid helps speed up metabolism, having too little thyroid hormone, a condition known as hypothyroidism can create weight gain. Hypothyroidism can also create fatigue that can make exercise difficulty, further disrupting body composition.
Hormones & Energy?
Many of the same hormonal imbalances that create weight gain also create fatigue. Here are some of the most common fatigue promoting hormone imbalances that I see:
Imbalances in estrogen and progesterone: There are many mechanisms by which estrogen and progesterone imbalances may create fatigue but it is important to remember that both of these hormones interact with other hormones and the metabolism. For example, low progesterone can contribute to low thyroid function while low estrogen can contribute to low cortisol levels. High estrogen can contribute to insulin resistance and weight gain, both of which are associated with fatigue.
Low Testosterone and Low Thyroid: Because both of these hormones directly support energy production, functionally low levels can contribute to fatigue.
High or Low Cortisol: Because cortisol plays a role in wakefulness, stress response, and maintaining blood sugar levels, functionally low cortisol often manifests as extreme fatigue. However, elevated cortisol can also contribute to fatigue. In situations of stress, the adrenal glands release cortisol. Along with cortisol, they also release norepinephrine and epinephrine, more commonly known as adrenaline and noradrenaline. Have you ever felt exhausted after an adrenaline rush? This is similar to what you may feel with prolonged functional elevations in cortisol, a feeling that has commonly been described as feeling “wired but tired.”
While the hormone imbalances listed above can directly create imbalances, hormones also interact with many other body processes and can contribute to fatigue through secondary mechanisms like lower muscle tone, sleep disruptions, poor digestion, and electrolyte imbalances.
Hormones & Mood
If you have ever experienced menstrual related mood changes, you know that hormone changes can have an impact on mood. Deficiencies of cortisol, testosterone, and progesterone can all contribute to anxiety. Progesterone is well known for its calming effect on the brain, where it stimulates GABA receptors to reduce nerve firing. Imbalances in thyroid hormone, both high and low, have also been associated with symptoms of anxiety and depression.
Hormones & Sleep
Because of its calming effect on the brain, progesterone also aids in sleep and maintaining sleep throughout the night. Thyroid hormones and cortisol are also important players in promoting or disrupting healthy sleep.
A commonly observed symptom of hypothyroidism is insomnia or sleep disruption. Conversely, elevations in thyroid hormone can also shift the body into an arousal state that interferes with sleep.
There are 3 ways in which cortisol can disrupt sleep: functional elevation, functional deficiency, and changes in cortisol pattern. Functional elevations in cortisol can disrupt sleep by keeping the body in a state of fight or flight or arousal. You may experience racing thoughts or difficulty winding down. Functional deficiencies in cortisol can lead to fragmented sleep or waking during the night. Cortisol levels naturally drop overnight but when they get too low, your body secretes adrenaline which can wake you from sleep. Cortisol also follows a specific pattern throughout the day, called a diurnal pattern. It reaches its highest levels when you wake in the morning, to help you get out of bed and feel ready for the day. It then gradually drops throughout the day to prepare you for bed. In chronic illness, a reverse cortisol pattern is commonly seen in which the body struggles to secrete cortisol throughout the day and is finally able to produce some at night. This results in low daytime cortisol levels and high nighttime cortisol levels, experienced as daytime fatigue and nighttime wakefulness.
Hormones & Gut Health
Hormones work in connection with so many systems in the body and your gut is no exception. Hormones are metabolized (broken down) by the liver and excreted through feces. There are actually microbes in your intestines assigned to assist in the metabolism of estrogen. This collection of microbes is called the estrabolome. When there are changes in the estrabolome, due to fluctuations in gut health, your body increased the production of an enzyme called beta glucuronidase. Beta glucuronidase acts like a pair of scissors, chopping the proteins off of estrogen that escort them out of the body. This allows estrogen to be recycled and can further promote estrogen dominance.
Thyroid hormones are also sensitive to inflammatory changes in the gastrointestinal system. Problems with gut health can contribute to deficiencies of nutrients important for thyroid hormone production and activation. GI problems can also increase levels of inactive thyroid hormone, known as reverse T3, that can block the activity of active thyroid hormone.
Imbalances in hormones are almost always your signal to investigate the health of the rest of your body. This is because hormones are extremely sensitive to inflammation in the rest of your body. Hormone production can be interrupted at many levels. Hormone production begins in the brain where a gland called the hypothalamus signals another gland called the pituitary to release hormones that communicate with individual endocrine glands. Once pituitary hormones reach those glands, they stimulate hormone production. For example the pituitary hormone TSH causes the thyroid to release thyroid hormones while the pituitary hormone FSH results in ovarian secretion of estrogen and progesterone. Inflammation in the body can interfere with production of hormones at the level of the hypothalamus, pituitary gland, individual endocrine organs, hormone activation, or hormone metabolism. Inflammation that an interfere with hormone can come from the six triggers of autoimmune disease discussed in my chronic illness blog as well as the triggers of oxidative stress discussed in my sleep blog.
My Go To’s For Beginning to Balance Hormones
Test Your Hormones to Find out What is Going On: Because elevated symptoms of one hormone can present similarly to an elevation or deficiency of another hormone, testing is essential to finding out what is going on in the body. The way hormones metabolize can also create symptoms, even if that hormone is not intrinsically too high or low. Testing helps identify the intricacies of hormone imbalance.
Minimize environmental xenoestrogens as much as possible: switch from plastic food containers to glass; eliminate cosmetics (including makeup, shampoo, hair spray, nail polish, lotion, etc) that contain phthalates, dimethicone, or parabens; avoid synthetic fragrances (switch to naturally scented candles, soaps, lotions, laundry detergents, and air fresheners).
Track your cycle and associated symptoms. Knowing which phase of your cycle you are in when you are experiencing hormone related symptoms is essential to understand what is going on in your body.
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