Your hormones are the messengers of your body. Each hormone sends specific instructions to every organ and helps determine your mood, energy levels, weight, temperature, digestion, and many other aspects of your health. And yet, we don’t often appreciate hormones until they aren’t working well.
The major endocrine glands that make those hormones are your brain (hypothalamus and pineal and pituitary glands), thyroid, parathyroid, adrenals, pancreas, reproductive glands (ovaries and testes), and gastrointestinal tract.
With hormones, it’s all about balance. As Goldilocks lamented, they can’t be too high or too low; they have to be just right. Otherwise, imbalances can cause myriad health issues.
Mainstream medicine typically runs basic labs for hormone health. If your labs don’t come back “normal,” you’re typically given a synthetic hormone cream or pill that could have side effects. If those labs come back “normal” and you’re still experiencing symptoms, you may be told you’re either depressed, just getting older, or need to lose weight.
Functional medicine wants to find out the root cause of patients’ hormonal symptoms as well as support the body’s natural mechanisms for healthy hormone balance.
Here, I’ll go over some of the most common hormone problems that I see in patients, and that you may be going through right now. I’ll also explain which labs you may want to consider asking your doctor about:
1. Cortisol
Our adrenal glands secrete several hormones, and one of them is cortisol, your body’s main stress hormone. Adrenal fatigue happens when there’s an imbalance in this cortisol rhythm: Cortisol is high when it should be low, low when it should be high, or always high or always low. Adrenal fatigue is really a dysfunction of your brain’s communication with your adrenals — not the adrenal glands themselves. Because adrenal fatigue is mainly a brain stress problem, the solution focuses on minimizing chronic stressors.
What You Might Experience:
You’re slow to start in the morning
Cravings for salty or sugary foods
Low sex drive
You’re fatigued in the afternoon but get a “second wind” in the evening
Can’t stay asleep
Dizziness when standing up quickly
Afternoon headaches
Blood sugar issues
Chronic inflammation
Nails are weak
Often moody
Difficulty losing weight
The Labs: I run a 24-Hour Adrenal Stress Index, a salivary test that tracks your cortisol levels and HPA (brain-adrenal) axis quality.
2. Thyroid
Every cell of your body needs thyroid hormones to function healthily. There are many underlying thyroid problems that won’t show up on standard labs. For example: thyroid conversion issues, thyroid resistance or autoimmune attacks against the thyroid (Hashimoto’s or Graves’ disease).
What You Might Experience:
Feeling tired
Feeling cold in your hands, feet, or all over
Requiring excessive amounts of sleep to function properly
Weight gain, even with a low-calorie diet
Difficult, infrequent bowel movements
Depression or lack of motivation
Morning headaches that wear off as the day progresses
Outer third of eyebrow is thin
Thinning of hair on scalp
Excessive hair falling out
Dry skin
Mental sluggishness
The Labs: Mainstream medicine typically just runs TSH and T4 (inactive thyroid hormone) to determine thyroid hormone dosage. A functional medicine thyroid panel involves looking at many other labs such as Free and Total T3 (active thyroid hormone), Reverse T3, and thyroid antibodies to rule out autoimmune thyroid problems. For a full list of thyroid labs and how to interpret them, read “Why Your Lab Results Could Be Lying About Your Thyroid Health.”
3. Estrogen
The ratio of the three forms of estrogen — estrone (E1), estradiol (E2), estriol (E3) — is important for both women and men. Some research has linked imbalances in estrogens to increased mortality rates in those with heart disease as well as the progression of some cancers.
What You Might Experience With Not Enough Estrogen:
Vaginal dryness
Night sweats
Painful sex
Brain fog
Recurrent bladder infections
Feeling lethargic
Depression
Hot flashes
What You Might Experience With Too Much Estrogen:
Feeling puffy and bloated
Rapid weight gain
Breast tenderness
Mood swings
Heavy menstrual bleeding
Feeling anxious and/or depressed
Migraine headaches
Have had cervical dysplasia (abnormal pap smear)
Insomnia
Brain fog
Gallbladder problems
Weepy and emotional
The Labs: A full blood and salivary female hormone panel, including all estrogen isomers.
4. Progesterone
Both men and women need healthy progesterone balance. Progesterone helps to balance and neutralize the effects of excess estrogen. Without optimal progesterone, estrogen becomes harmful and out of control (estrogen dominance).
What You Might Experience:
PMS
Insomnia
Unhealthy looking skin
Painful breasts
Stubborn weight gain
Cyclical headaches
Anxiety
Infertility
The Labs: A full blood and salivary female hormone panel.
5. Testosterone
In both men and women, low testosterone is something that I commonly see in practice. Low testosterone in women has been linked in some studies to low sex drive, heart disease, and breast cancer. One study found that men with low testosterone had a greater rate of death.
What Women Might Experience With Too Much Testosterone:
Acne
Polycystic ovary syndrome (PCOS)
Excessive hair on the face and arms
Hypoglycemia and/or unstable blood sugar
Thinning hair
Infertility
Ovarian cysts
Mid-cycle pain/cramping
What Women Might Experience With Not Enough Testosterone:
Weight gain
Fatigue
Low sex drive
What Men Might Experience:
I often see the over-conversion of testosterone to estrogen in men. Men don’t produce estrogen like women but convert it through a process called aromatization. Excess activity of the enzyme aromatase can cause low testosterone and high estrogen in men resulting in:
Erectile dysfunction
Low sex drive
Weight gain
Irritability
Breast enlargement
The Labs: Blood and saliva testosterone and DHEA panel.
6. Leptin
Your fat cells aren’t just some unsightly nuisances that jiggle and make clothes not fit; they’re actually an intelligent part of your endocrine (hormonal) system. Fat cells produce a hormone called leptin.
One of leptin’s jobs is to tell your brain to use the body’s fat stores for energy. Leptin resistance occurs when leptin is not recognized by the body, specifically the hypothalamic cells of your brain. Your body then thinks it’s in starvation mode, which makes it want to store more fat.
What You Might Experience:
You’re overweight
You don’t lose weight easily
You have constant food cravings
You’re stressed out
The Labs: Serum leptin.
7. Insulin
Just like leptin resistance, insulin resistance is not a hormonal deficiency but a hormonal resistance pattern. Most people know insulin resistance when it comes to type 2 diabetes, but insulin resistance is also seen in many people who have not progressed to the full-blown diabetic disease.
This pre-diabetic metabolic syndrome is marked by this resistance to insulin. This means your body is producing insulin but your body is not using it properly. The problem here is that insulin is a fat-storing hormone, which makes weight loss an uphill battle for many.
What You Might Experience:
Cravings for sweets
Irritableness if meals are missed
Dependence on coffee
Become lightheaded if meals are missed
Feel shaky, jittery, or having tremors
Agitated, easily upset, or nervous
Poor memory
Blurred vision
Fatigue after meals
Eating sweets doesn’t relieve sugar cravings
Waist girth is equal or larger than hip girth
Frequent urination
Increased thirst and appetite
Difficulty losing weight
The Labs: Serum insulin, c-peptide, fasting blood sugar, and HgbA1c.
The Bottom Line: Because the body is all interconnected, if you have one hormone problem, you might have other ones as well. In other words, to say you have only one of these seven issues might be oversimplification — it could be all of these issues or a combination of some of these. It’s important to work with your health care provider to find out what hormone issues might be at play.
Recently, I’ve been working on rehabbing my own struggle with adrenal fatigue and have shared my journey to balance my hormones in my 90-day hormone reset article. I also share my favorite hormone-healing meals on my Facebook page. Because everyone is different, I also offer a free webcam or phone evaluation to get a personalized functional medicine perspective on your case.
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