Why is Hormonal Balance Important
Hormones are the chemical messengers of the body. Made in one organ and controlling other organs and systems, the complexity of hormonal functions and interactions are still being studied. Many medical conditions are as a result of overproduction or underproduction of hormones, leading to almost every symptom imaginable. So how do you identify and treat hormonal imbalances?
Using detailed history taking, symptom checklists and advanced hormone lab testing, the best treatment can be developed to correct hormone levels. Sometimes diet and lifestyle alone can be the key and other times prescription hormone replacement or hormone blockers are necessary. Between these extremes comes natural options such as herbs, antioxidants, vitamins and minerals.
Inflammation is one of the most important processes behind what leads to a diseased state. Too much or too little of insulin, cortisol, thyroid, estrogen, progesterone, testosterone, or DHEA can cause inflammation and also a multitude of symptoms.
Steroidal hormones all start with cholesterol. We need cholesterol, it is the “gateway” molecule that goes on through a series of biological and chemical changes to form our sex hormones and cortisol. Because of all the different pathways that cholesterol can take to get to an end product, there are many ways that too little or too much of any one or more hormones can be created. Whether this is due to nutrient deficiencies, genetics or other disease processes, it can all contribute to hormone imbalance and changes to health.
Types of Hormonal Imbalance
Hormones can be found in elevated or deficient levels. Too low of thyroid hormones can cause low energy, weight gain, cold body temperature and depression while too high can lead to anxiety, insomnia, weight loss and a hot body temperature. Too much testosterone in a woman can lead to the condition PCOS where obesity, hair loss, acne and irregular cycles are common.
There can also be too low or too high ratios of hormones to one another. For example, estrogen dominance is defined as high estrogen relative to the amount of progesterone. This could mean that a woman makes too little progesterone or has difficulties clearing out estrogen which leads to a build up or estrogen elevation. Symptoms of estrogen dominance include PMS, short menstrual cycles, heavy flow and sometimes hair loss and weight gain.
Top 5 Supplements to Promote Hormonal Balance
Proper nutrition and lifestyle balance will make the building blocks strong to any treatment plan when it comes to balancing hormones. Additional herbs, vitamins, minerals, antioxidants and sometimes pharmaceutical agents to replace hormones or block hormones can also be helpful. Before starting any new routine, it is important to consult with your naturopathic physician and test hormone levels to have the safest and most effective treatment plan developed.
With over 300 uses in the body, magnesium is at the top of list when looking at minerals and hormonal support. This amazing mineral helps to calm the nervous system, promote sleep and regulate brain signals for hormone production. Getting into parasympathetic mode (or “rest mode”) helps to regulate cortisol, progesterone, insulin and thyroid hormones. Speaking of thyroid, magnesium is required for the production of thyroid hormone and it can help with auto-immune thyroid conditions such as Hashimoto’s thyroiditis and Graves disease.
Magnesium activates Vitamin D to be in its most usable form, which contributes to lower inflammation, improving immune function, energy, and a healthy mood. Because of magnesium’s role with improving insulin sensitivity, it can also be used to help manage blood sugar. Amazing! There are several different forms of magnesium found in different supplements. Depending on the purpose for taking magnesium, the right type should be chosen wisely. Magnesium bisglycinate is the most absorbable form and is commonly used to promote sleep, support hormones, for headaches and to relax tight muscles.
Fish oil’s most medically potent component are the omega 3s. There are more than 10 different types of omega 3s, but the most important two are EPA (eicosapentaenoic acid) and DHA (docosahexanoic acid). Dietary sources of omega 3s are mainly from the ocean via fish, marine plants, algae and krill.
Lowering inflammation is one of the primary roles that EPA plays in the human body. This aspect is why Omega 3s are commonly used to treat inflammatory conditions affecting hormone-producing glands such as the thyroid, ovaries and adrenals. Hormonal imbalances caused by inflammation are quite common with Hashimoto’s thyroiditis, PCOS and adrenal deficiency as examples. Choosing a high quality Omega 3 supplement is very important. Professional brands will remove impurities such as heavy metals and other toxins before concentrating and producing supplements. Eating fish a few times per week will benefit, but sometimes adding a supplement is what is needed to see the best results.
Indian ginseng, Ashwagandha or the latin name Withania somnifera is a plant that has been used for centuries in traditional medicine. Originating from India, it is most famously known as an adaptogenic herb. Creating balance, whether that means to lower or to increase cortisol is the most common reason to prescribe Ashwagandha when it comes to hormones.
However, Ashwagandha has antioxidant, anti-inflammatory and hormonal effects and can be used for a wide range of conditions. Optimizing fertility, improving brain health and memory, improving thyroid hormone production, PCOS, female sexual dysfunction and adrenal dysregulation all are supported with this age-old medicinal plant. Typical doses are up to 600mg of extract per day however powders, teas and tinctures may vary with respect to active components. Some medications should not be taken with Ashwagandha so it is always advised to seek professional opinion before starting this herb.
Myo-inositol is a special type of carbocyclic sugar that was once thought to be closely related to the B vitamins. It is found naturally in some fruits, beans, seeds and grains. Inositol helps to balance hormones involved in fertility and metabolism and is very safe to consume. When taken twice per day, inositol helps to lower insulin resistance and can thus aid in weight loss and improved energy. It is also one of very few factors that can help improve cellular response to glucose uptake which can lead to improvements in hyperglycemia. When insulin resistance is improved, PCOS can also be vastly improved.
Inositol has been clinically shown to reduce thyroid antibody production and TSH levels in Hashimoto’s thyroiditis. A PubMed study (PMC5331475) showed a clinical drop in antibodies when inositol and selenium were integrated into supplement routines.
Vitamins B5 and B6
A tie for the last supplements on the list had to be with Vitamin B5 and Vitamin B6. Pantothenic acid is the active form of B5 and is an important player in adrenal hormone production. DHEA and cortisol are important steroid hormones synthesized in the adrenal glands and require healthy amounts of B5 to be produced. They contribute to general well being, energy, brain health, libido, muscle production and weight balance to name a few of many functions. B5 can be taken at a wide range of doses between 100mg to 1000mg per day.
Vitamin B6’s most active form P-5-P (pyridoxal 5 phosphate) helps to balance several hormones, namely estrogen and progesterone. Deficiencies in B6 can lead to lower progesterone levels and symptoms such as PMS, fatigue, anxiety and heavy periods may develop. Food sources of B6 include animal protein, grains, beans, potatoes and bananas. A therapeutic daily dose can range from 25mg to 100mg to help regulate hormone production.
Other Supplements Worth Mentioning
Zinc – This important mineral has a role in the production of multiple hormones such as growth hormone, insulin, thyroid and testosterone. It nourishes ovarian tissues to help promote ovulation and fertility and improves hormone-related symptoms such as acne, fatigue and hair loss. Natural sources of zinc include oysters, pumpkin seeds and organ meat but supplementation must be balanced with a small amount of copper. Zinc at 30mg per day would require 2mg of copper in order to prevent copper deficiency.
Vitamin D – Actually not a vitamin, Vitamin D is a prohormone meaning it has a role in signaling tissues to induce activity. Interrelationships between Vitamin D and the thyroid, ovaries, kidneys, bone and skin make Vitamin D’s function part of every body system. The regulation of immune function has been shown in multiple studies that correlate low Vitamin D to higher risk for auto-immune diseases, recurrent illness and depression. Dosage can vary considerably, the best way to individualize daily dosing is to test serum Vitamin D25OH levels and adjust accordingly.
Resveratrol – This healthy antioxidant that gives red wine its claim as a healthy indulgence, resveratrol can be found naturally in the skin of red grapes. This is the ultimate anti-aging supplement due to effects such as lowering blood pressure, protecting against oxidative stress (aging process), lowering inflammation, improving insulin sensitivity and even brain protection. Resveratrol helps to protect against the effects of certain types of estrogens that cause higher risks for some cancers.
Milk thistle – Silybum marianum, or milk thistle’s active ingredient silimarin has a wide range of health benefits. Liver detoxification, bile production, antioxidant, antiviral and anti-inflammatory actions can be achieved using different amounts of extract. Helping the liver to flush out excess hormones can balance menstrual cycles, skin and mood. Milk thistle can be consumed as a tea, a tincture or an extract.
What Else Can You Do to Regulate Your Hormones?
Hormone imbalances can interrupt sleep patterns whether it is difficulties with falling asleep or maintaining sleep. However, the foundations of sleep should be set-up to create the perfect environment for a restful sleep.
A completely dark room is important. Remove all lights (clocks, windows, hall lighting) as much as possible and create a quiet space, which might mean the addition of ear plugs. Having a routine before bed which includes turning off screens and lowering the lights 1 hour before bed can help improve natural melatonin production.
Sleeping in a cooler environment promotes REM sleep. So, ditch the fuzzy flannel pajamas and thick, multi-layered duvet. Cracking a window and lowering the thermostat may also help to find the ideal temperature.
Easier said than done, right? Taking a good look at the structure of your day and when a piece of relaxation of downtime can be fit in is really important. Meditation, journal writing, yoga, walking in the forest, tea time with a friend, reading a light fiction book – make it your time, whatever that means. These activities lower cortisol and can help to optimize other hormones such as thyroid, insulin and progesterone.
Consider changing up your exercise routine if it involves straight cardio or intense workouts 6 days per week. While exercise is important, the variety which includes yoga, walking, stretching and nurturing will help to balance the effects of high cortisol when exercising intensely.
Eat healthy fats and less carbohydrates
Plant based fats and fish or seafood have incredible health benefits, including hormone production. Nuts, seeds, avocado, olive oil and salmon are some examples of the healthy fats which should be present at each meal. 1-2 tablespoons at 3 meals per day is an excellent goal to work towards.
Complex carbohydrates from whole grains, yams and other root vegetables are good for the body. Proportionally, 25% of your plate can include these options, and that takes work to make happen. It is very easy to fill up a plate with 50% or more with noodles or rice, but try placing some back in the pot and adding more non-starchy vegetables instead.
Test your hormones
Sometimes, the deficiency and excess symptoms of different hormones overlap and it can be next to impossible to determine the root cause. Detailed hormone testing will match your symptom picture to your hormone production and metabolization.
The thyroid hormone system can be tested by a simple blood test. 6 markers in the blood will identify if there is an over or under production of hormones, a thyroid auto-immune disease and how well the cells are using thyroid hormones. The enhanced thyroid assessment includes TSH, free T4, free T3, reverse T3, anti-thyroperoxidase and antithyroglobulin antibodies. It is best to do the test fasting and in the morning without taking thyroid medications before the blood draw.
Insulin levels can influence sex hormones such as testosterone. Knowing your blood sugar is important and adding a fasting insulin blood value is even better. This can be added to any requisition and is of minimal cost. Insulin resistance causes weight gain, fatigue, hair loss and difficulties maintaining a balanced blood sugar level. Because some of these symptoms overlap with other hormones, it is important to test so that appropriate treatment protocols are initiated.
Sex hormones – estrogen, progesterone, testosterone and DHEA can be tested with urine or saliva samples. When looking for how the body processes hormones, the dried urine test is the best choice. There is an option to add on cortisol to complete the steroid hormones. Cortisol can also be tested using a 4 point cortisol analysis, the options for testing would depend on the symptom picture.
Effects of Hormonal Imbalance
Since hormones regulate practically every aspect of human health, there is an extremely wide range of symptoms and effects when hormone levels are too high or too low. Identifying which hormones are involved should be done by comparing the symptom picture and extensive blood and urine hormone testing. Certain blood tests are better than urine or saliva and the opposite is true where saliva and urine identify or uncover deeper relationships between hormones.
Conditions Commonly Caused by Hormonal Imbalance
There are many ways that hormones can be too high or too low. Diabetes can be as a result of low insulin, Cushings and Addison’s diseases are related to too high or too low cortisol. There are many in between conditions that are not as easily diagnosed but involve hormones.
Hypothyroid – low thyroid hormones cause the overall metabolic rate to slow down. This can lead to loss of energy, weight gain, depression, feeling cold or difficult to regulate body temperature, loss of hair, changes to menstrual cycles, skin changes and low libido. Confirmation of hypothyroidism is diagnosed by blood tests, however if not thorough enough, it can be missed. TSH, free T4 and T3, reverse T3 and thyroid antibodies should be run.
Hyperthyroid – elevated thyroid hormones. This is often as a results of the auto-immune condition Grave’s disease. Symptoms of a high metabolic rate include insomnia, anxiety, weight loss, heart palpitations, sweating, increased bowel and urination frequency along with appetite and thirst. This condition is usually evident with a TSH test and is followed up with free T3, free T4 and TSH receptor antibodies.
PCOS – PolyCystic Ovarian Syndrome is a complex condition where multiple sex hormones, cortisol and insulin hormones are either too high or too low. Common symptoms include obesity, hair loss, acne, irregular periods and cysts present on the ovaries. The important part about treating PCOS is to identify which hormones are the factors affecting symptoms. Insulin resistance is quite commonly one of the root hormone imbalances and is addressed with diet, lifestyle and supplement protocols with excellent success.
Infertility – Whether there is structural root or a hormonal root, infertility affects many couples trying to conceive. Working with a fertility clinic helps to determine if a structural or non-hormonal cause plays a role by using ultrasounds and specialized tests. Detailed hormone testing using both blood and urine samples will help to unfold any hormonal causes.
PMS – Premenstrual Syndrome combines both physical and emotional symptoms during the last two weeks before menstruation. For some women this presents 10 days prior and others a few days. Headaches, cramps, bloating,breast pain, insomnia, irritability and mood swings are the more common symptoms. Links to an elevated estrogen to progesterone ratio or low progesterone are quite common when tested by urine analysis. Balancing the hormone ratio and elevating progesterone with bioidentical progesterone can alleviate these symptoms and sometimes entirely resolve.
PMDD – Premenstrual Dysphoric Disorder is less commonly known and not well diagnosed. It is essentially severe PMS that can interfere with life to the point of suicidal ideations and ruined relationships. More public awareness campaigns have helped PMDD to become better recognized so that women can access medical interventions to lower symptoms. Sometimes PMDD can be linked with a lower luteal phase progesterone production and when bioidentical progesterone is prescribed, life changing changes result. Hormone testing is helpful to determine the root cause of PMDD.
Balding – Affecting men at any age, male pattern baldness can be difficult to treat. Hormonal reasons revolve around the high rate of conversion of testosterone into DHT, the most active androgen. The enzyme that controls this pathway is used as a target of treatment and several drugs will lower the conversion.
Erectile dysfunction – ED can have multiple reasons and should always be properly worked up by a physician to rule out more serious causes. Testosterone, thyroid and cortisol are the more dominant hormones that can impact ED, all of which can be tested by blood and saliva. Herbal support, lifestyle changes and supplemental hormones can provide a well-rounded treatment plan.
Gynecomastia – Elevated estrogen in men can cause physical symptoms such as breast tissue development. This is often as a result of a high conversion rate of testosterone into estrogen. Once breast tissue has been formed, it is difficult to resolve entirely and may require surgical interventions. Weight loss, estrogen blockers and specific dietary regimes can be helpful supportive therapies.
Insulin resistance – Prior to elevated blood sugar and diabetes, insulin will rise in order to regulate blood glucose levels. This heightened insulin response is termed insulin resistance (IR). Symptoms of IR include weight gain, especially abdominal weight, low energy, hair loss and irregular menstrual cycles. Testing either a fasting or challenged insulin blood or saliva level will give a clear indication of IR. Lifestyle and diet are the two most important treatments however supplements and sometimes prescription drugs can be used to help balance insulin and glucose which results in weight loss, hair growth and improved energy.
Adrenal dysfunction (formerly referred to as adrenal fatigue) – A low or high production of cortisol or an imbalanced 24 hour cortisol production can create multiple symptoms. High stress for prolonged periods of time, illness or inflammation can cause a gradual change to cortisol production. This can lead to a multitude of symptoms ranging from fatigue to anxiety, insomnia to chronic colds and flus. Cortisol levels can be evaluated using a 4 point collection of saliva or urine which is then plotted out on a graph. Herbs, vitamins, diet, lifestyle and looking at causes of chronic inflammation should all be incorporated into a well-rounded treatment plan.