Hormone Health & Healthy Ways to Balance Your Hormone Levels
Think of your hormones like chemical messengers of your body. Each hormone sends specific instructions to every organ, making hormones responsible for just about everything your body does – how it works, how it feels, and how healthy it is. Hormones influence your mood, energy level, weight, temperature, digestion, and many other aspects of your health. And yet, we don’t often think about, let alone appreciate, our hormones until they stop working the way we want them to. And when that happens, because of their wide influence, we definitely notice.
Your hormones are produced in the major endocrine glands – your brain (hypothalamus, pineal, and pituitary glands), thyroid, parathyroid, adrenals, pancreas, and reproductive glands (ovaries and testes). Some hormones are also produced in your gastrointestinal tract. With hormones, it’s all about balance. As Goldilocks lamented (and I’m paraphrasing here), there can’t be too much or too little. Hormones have to be just right. Otherwise, a myriad of health issues can happen.
But when you suspect hormone imbalance, mainstream medicine typically runs only basic labs. 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, and that makes a lot more sense to me.
There can be many underlying causes of hormone imbalance:
- Chronic inflammation
- Methylation impairments like MTHFR
- Nutrient deficiencies
- Stress overload
- Toxin exposure
Let’s 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.
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Our adrenal glands secret several hormones, and one of them is cortisol, your body’s primary 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 functional medicine solution focuses on minimizing chronic stressors.
What you might experience:
- Trouble getting started in the morning
- Craving salty or sugary foods
- Low sex drive
- Fatigued in the afternoon but you get a “second wind” in the evening
- Trouble staying asleep at night
- Dizziness after standing up too quickly
- Afternoon headaches
- Blood sugar issues
- Chronic inflammation
- Weak nails and brittle hair
- Trouble losing weight
The Labs: I run a 24-Hour Adrenal Stress Index, a salivary test that tracks your cortisol levels, and an HPA (brain-adrenal) axis quality lab.
Every cell of your body needs thyroid hormones to function optimally. 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
- Cold feet, hands, or cold all over
- Requiring extra sleep to function properly
- Rapid weight gain
- Depressed or lack of motivation
- Morning headaches that subside as the day goes on
- Thinning of the outer third of eyebrows
- Excessive hair loss or thinning
- Dry skin
- Brain fog
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 my previous article here.
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 (1) as well as the progression of some cancers. (2)
What you might experience with low estrogen:
- Vaginal dryness
- Night sweats
- Brain fog
- Recurrent bladder infections
- Feeling lethargic
- Hot flashes
What you might experience with high estrogen:
- Rapid weight gain
- Breast tenderness
- Mood swings
- Heavy menstrual bleeding
- Migraine headaches
- Cervical dysplasia (abnormal pap smear)
- Brain fog
- Gallbladder problems
The Labs: A full blood and salivary female hormone panel, including all estrogen isomers, can shed light on the specific problem.
Both men and women need healthy progesterone balance. Progesterone helps balance and neutralize the effects of too much estrogen. Without proper progesterone levels, estrogen becomes out of control, also known as estrogen dominance.
What you might experience:
- Poor complexion
- Painful breasts
- Stubborn weight gain
- Cyclical headaches
The Labs: A full blood and salivary female hormone panel.
I often see low testosterone in both men and women in my functional medicine clinic. Studies have linked low testosterone in women to heart disease, low sex drive, (3) and breast cancer. (4) One study (5) found that men with low testosterone had a great rate of death. But you can also have too much.
What women might experience with excess testosterone:
- Polycystic ovary syndrome (PCOS)
- Excessive hair on the face and arms
- Hypoglycemia and/or unstable blood sugar
- Thinning hair
- Ovarian cysts
- Mid cycle pain/cramping
What women might experience with low testosterone:
- Weight gain
- 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
- Breast enlargement
The Labs: Blood and saliva testosterone and DHEA panel.
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 your body – specifically your hypothalamus in your brain – stops recognizing leptin. This can trick your brain into thinking you are starving, resulting in excessive and inappropriate fat storage.
What you might experience:
- Rapid weight gain
- Weight loss resistance
- Frequent strong food cravings
- High stress levels
The Labs: Serum leptin.
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 can also happen in those who are pre-diabetic, or have sub-clinical blood sugar imbalance.
This pre-diabetic metabolic syndrome is marked by this resistance to insulin meaning your body is producing insulin but the insulin is not doing what it should, i.e., shuttling blood sugar into your cells where you can use it. Instead, this ineffective insulin, through a cascade of reactions, results in excessive fat storage, making weight loss seem impossible.
What you might experience:
- Cravings for sweets
- Irritability or lightheadedness if you miss a meal
- Dependence on coffee
- Shaky, jittery, or tremors
- Feeling uncharacteristically agitated, upset, or nervous
- Poor memory
- Blurred vision
- Fatigue after eating
- Sugar cravings
- Waist girth equal to or larger than hip girth
- Frequent urination
- Increased thirst or appetite
- Weight loss resistance
The Labs: Serum insulin, c-peptide, fasting blood sugar, and HgbA1c.
The Bottom Line
Because all the systems in the body are 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 actually be at play.
Recently, I’ve been working on rehabbing my own adrenal fatigue and have shared my journey to hormonal balance in my 90-day hormone reset.
The Surprising Connection Between This Hormone Disorder + Blood Sugar Balance
Polycystic ovary syndrome (also referred to as PCOS), affects between 8 to 20 percent of women in America which makes it one of the most common endocrine disorders for women of childbearing age. And not surprisingly, it is also the biggest contributor to infertility in that age group. PCOS is characterized by an increase in male hormones known as androgens. Insulin resistance is also associated with this condition since high insulin levels can play a role in increasing androgen production and vice versa. This overload of androgen is responsible for throwing female body functions like menstrual cycles out of whack.
To be diagnosed with PCOS, you must be experiencing two out of these three key symptoms:
- Irregular menstrual cycles
- High androgen levels; symptoms include acne and excess facial hair
- The presence of ovarian cysts on an ultrasound
Although PCOS can be a debilitating disease that can affect your appearance and the possibility of having a family, it can also be managed with functional medicine tools. Here are five totally natural lifestyle ways to manage PCOS:
1. Monitor phytoestrogen consumption
These are plant-based estrogens that are not produced by your endocrine system but instead must be gained by eating phytoestrogen plants – one of which is the ever-controversial soy. Since soy is commonly found in a lot of plant-based and gluten-free products due to it’s high protein content, you need to be extra conscious when shopping. However, all legumes (think: flaxseeds, sesame seeds, and lentils) are considered phytoestrogens as well.
Deductive reasoning (and many studies) (6) would say though that since people with PCOS have high testosterone levels, phytoestrogen consumption could help mitigate symptoms. However, since soy is often processed and genetically modified, it can further perpetuate hormone imbalances by triggering an overload of estrogen which comes with its own set of symptoms.
Studies have shown (7) that flaxseed is just as effective as soy for reducing androgen levels due to its consideration as a lignin – a group of polyphenols found in certain plant foods. These work to help increase (8) sex-hormone-binding globulin, which lowers the amount of free testosterone in the body.
With all of this in mind, make sure to work with your functional medicine practitioner to run labs in order to determine the underlying cause of your specific health case. This is especially important since for some people legumes can perpetuate inflammation and further gut dysfunction.
2. Get enough sleep
Sleep is the time when your body regenerates cells and maximize hormone production. PCOS is often linked (9) to increased rates of sleep apnea because of the presence of insulin resistance. In fact, research has shown that people diagnosed with PCOS are more likely to also have insulin resistance. This inverse relationship should give you some extra motivation to turn off the TV and catch some Zzzs.
3. Experiment with adaptogens
Anyone who knows me knows my obsession with adaptogens. There are not many problems that can’t be helped with these plant-based natural medicines – hormone imbalances included. To be classified as an adaptogen it must fit three specific criteria:
- They are generally safe for everyone
- They help to manage stress
- They help to balance hormones
The sympathetic nervous system (10) is the stress control center of your body and also controls hundreds of pathways in charge of inflammation. When inflammation runs wild it can contribute to hormonal problems. It’s because of this fact that adaptogens can be a great tool for helping ease symptoms of PCOS. Some of my favorites include rhodiola, cordyceps, and ashwagandha.
4. Stay away from endocrine disruptors
Endocrine disrupters are toxins that throw the endocrine system out of whack by increasing or decreasing the production of certain hormones, interfering with hormone signaling, or binding to essential hormones. These chemicals are ones we come in contact with every day and are hiding in common items such as cleaning products, plastic packaging, cosmetics, and even our water!
You can find a list of the 12 worst endoctrine disruptors (11) at the Environmental Working Group (EWG) along with were they are typically found. Cleanse your life by eating organic foods whenever possible and switching to all-natural cleaning and beauty products. You can also check out my list of easy and effective ways to support your body’s natural detoxification process.
5. Manage your blood sugar and insulin
Due to the relationship between PCOS and insulin resistance, managing your blood sugar is an important part of alleviating symptoms. Using food as medicine is one of the main ways you can naturally control your blood sugar. The first step would be to make sure you are eating a clean diet filled with vegetables, organic meat, and a small amount of fruit. Beyond that, make sure to include ample amounts of healthy fats including coconut products, avocados, and wild-caught salmon which most people tolerate well. These work to bring blood sugar levels down by switching your body from a glucose burner to a fat burner.
Take it to the next level with intermittent fasting. Studies have shown (12) that IF is a powerful tool in increasing (13) metabolism and lowering insulin resistance. If you would like to try this, make sure you are working with your doctor to monitor your progress while your glucose is stabilizing.
The Best Hormone-Balancing Diets Ranked By A Functional Medicine Expert
When looking for a place to start rehabbing hormone health and addressing hormones and weight gain, many people often turn to the internet for answers. While the internet is a great resource, there can be a lot of often conflicting information on the best diets to heal chronic health problems. We have to remember that what works for one person doesn’t always work for another even when two people have the same diagnoses. However, there are a few specific eating styles that often work very well for hormone imbalances in particular. Take a look for my definitive ranking of the best hormone balancing diets based on the latest research and my clinical experience:
This acronym stands for the Autoimmune Protocol and it is my number one when it comes to treating autoimmune based hormone problems such as autoimmune-thyroid problems like Hashimoto’s disease.
Autoimmune conditions occur when a genetic weakness is triggered by an autoimmune system response to certain foods, viruses, or toxins, which all contribute to chronic inflammation.
An AIP diet takes out all potential inflammatory foods and is more strict than a paleo diet. It eliminates everything that a paleo diet does with the addition of eggs, chocolate, nuts and seeds, and nightshades like tomatoes and peppers. These foods tend to elicit inflammation in people with autoimmune problems.
2. Ketogenic diet
In the health community, the ketogenic diet is considered the new kid on the block. Even though it has been used for years as a natural treatment for children with epilepsy, it is gaining popularity for its ability to restore energy, fight inflammation, and regulate hormones.
This diet is high fat, low carb, and moderate protein. Every person has different daily calorie intakes and a specific ratio of fat, protein, and carbs that they must meet every day depending on your individual weight and health goals.
The goal of this diet is to reach ketosis. This is a state where your body uses ketones instead of glucose for energy. When your body no longer has a glucose source the body uses fat to produce ketones. Our bodies have always relied on fat for fuel from a biological (14) and evolutionary (15) perspective. Babies rely on fat from breast milk for brain growth and development. In fact, your brain is made of 60% fat!
Many studies have shown a ketogenic diet to be beneficial in managing blood sugar and controlling metabolism due to its focus on fat. And by feeding your brain fat it helps alleviate adrenal fatigue (HPA-axis dysfunction).
The wonderful thing about a ketogenic diet is that it can be done along with whatever other diet you are currently doing. It doesn’t matter what foods you are eliminating, you just calculate your ratios and meal plan around the foods you are allowed to eat. By nature, a ketogenic diet already takes out sugar, high-fructose fruits, and grains but even those following an AIP diet can thrive on this high-fat diet.
For those just starting to eat healthier, a paleo diet is a great place to start. It is less strict than AIP and other healing tools like a ketogenic diet or intermittent fasting can easily be added into this eating style.
Inflammatory foods like sugar and grains are eliminated with the addition of legumes. Beans contain phytate and lectin proteins which can contribute to digestive issues and lead to increased inflammation which can continue to feed hormone problems.
4. Intermittent fasting
Just like a ketogenic diet, intermittent fasting can easily be incorporated into any of these above diets. In my functional medicine clinic I often use different IF protocols to heal the gut and reduce inflammation. While intermittent fasting can be an amazing tool, it can cause some potential side effects for those dealing with hormone imbalances – thyroid problems, and adrenal fatigue (HPA-axis dysfunction) in particular.
For people with adrenal fatigue, I’ve found that intermittent fasting isn’t always the best choice when treating circadian rhythm dysfunctions. Women can also be more sensitive to IF because they have a higher amount of the protein kisspeptin which can contribute to menstrual irregularity, poor metabolism, and infertility. Not to say that intermittent fasting is completely out of the question for those with these specific hormone imbalances, but it may require a lot more modification and monitoring.
However, intermittent fasting takes center stage when it comes to healing insulin resistance. Studies have linked (13) intermittent fasting with increased metabolism and lower insulin resistance. (14) Make sure to still work with your doctor to monitor your progress as your glucose stabilizes.
And if you thought you’d have to worry about hunger while intermittent fasting, think again! Fasting actually positively affects your hunger hormone, ghrelin which improves brain dopamine levels. (16) Just one more example of the gut-brain axis connection!
Hormone Supporting Recipes
These three elixirs are among my favorite tools to use for hormone imbalances: one for thyroid, one for adrenal, and one for sex hormone health. Drink up and heal your hormones!
Every cell of your immaculately designed body needs thyroid hormones to function properly, so it’s no surprise that thyroid problems can have widespread symptoms, from weight gain, digestive problems, and hair loss (including, strangely, the outer third of your eyebrows) to brain fog, and depression. Here’s a yummy smoothie I designed to boost thyroid health:
Thyroid Booster Smoothie
- 1 cup full-fat coconut milk
- 1 cup mixed greens
- 1 cup organic frozen berries
- 1 avocado
- 1 stick of celery
- 1 scoop collagen protein
- 2 tablespoons dulse flakes
- 1 tablespoon maca powder
- 1 tablespoon extra-virgin coconut oil
- 2 Brazil nuts
Blend all ingredients in blender.
What’s it doing? To make healthy hormones you need healthy fats, so bring on the coconut milk, oil, and avocados. Green leafy vegetables facilitate healthy methylation, which we all need for healthy hormone production. Brazil nuts are packed with selenium, which your body uses to make the enzyme (5′ deiodinase) to convert your inactive thyroid hormone T4 into the active T3. Seaweeds like dulse flakes are rich in iodine, which is the raw material for making thyroid hormone. Maca powder helps to stabilize hormone levels, and celery is a great food medicine for healing the gut, which is also needed for optimal thyroid hormone levels.
If you have a low sex drive or struggle with depression, anxiety, and stubborn weight gain, you shouldn’t rule out a sex hormone imbalance. The delicate balance of estrogen isomers (E1, E2, E3) as well as the way they balance with progesterone and testosterone are crucial for feeling (and looking) like yourself. Here is a warm elixir to heat up your sex drive and balance those hormones:
Sex Hormone Boosting Elixir
- 2 cups full-fat coconut milk
- 1 teaspoon cacao powder
- 1 teaspoon shilajit powder
- 1 teaspoon mucuna pruriens powder
- 1 teaspoon raw honey
- 1/2 teaspoon cinnamon
- Blend ingredients well in a blender.
- Pour into a saucepan and heat for 3 to 5 minutes over medium heat until warm.
What’s it doing for me? In addition to the hormone-building healthy fats of coconut milk, cacao, shilajit, and mucuna pruriens have all been traditionally used to balance sex hormones and serve as potent aphrodisiacs. Enjoy!
If you are exhausted and irritable, or if you get an afternoon energy slump but often get a “second wind” at night and then sleep poorly, check the state of your adrenals. Adrenal fatigue happens when your brain and adrenal glands aren’t communicating well (due to issues with the brain/adrenal cnnection, or HPA axis). Chances are, you probably have too-high or too-low levels of the stress hormone, cortisol. Or you are experiencing unstable roller-coaster cortisol levels throughout the day. It’s time to put an end to the chaos! Try this herbal iced tea to cool off your stress and bring more Zen to your adrenals:
Refreshing Adrenal Balancing Iced Tea
- 1 teaspoon ashwagandha powder
- 1 teaspoon rhodiola powder
- 1 teaspoon holy basil powder
- 1 teaspoon cinnamon
- Pour 1 to 2 cups of hot water over herbs.
- Let steep for 15 minutes.
- Pour over ice.
How to make the most of these superfood drinks
You can give your body the best foods in the world, but if your day is filled with stress, you will be sabotaging your efforts at hormone health. Amplify the power and purpose of these three drinks by creating a ritual of serenity around drinking them. Find a quiet time in your day, maybe before the day starts in the morning or in the afternoon when you get home. Turn off your phone, dim the lights, close the door, and be silent and calm as you sip on any of these nourishing beverages. By bringing mindfulness to this practice, you will nourish your soul as well as your body. Also, because your hormones all influence one another, be holistic and try all three, rotating one per day throughout the week.
As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe.
- Jankowska EA, Rozentryt P, Ponikowska B, et al. Circulating estradiol and mortality in men with systolic chronic heart failure. JAMA. 2009;301(18):1892‐1901. doi:10.1001/jama.2009.639
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- Glaser RL, Dimitrakakis C. Reduced breast cancer incidence in women treated with subcutaneous testosterone, or testosterone with anastrozole: a prospective, observational study. Maturitas. 2013;76(4):342‐349. doi:10.1016/j.maturitas.2013.08.002
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BY DR. WILL COLE
Dr. Will Cole, IFMCP, DNM, DC, leading functional medicine expert, consults people around the world via webcam and locally in Pittsburgh. He received his doctorate from Southern California University of Health Sciences and post doctorate education and training in functional medicine and clinical nutrition. He specializes in clinically researching underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. Dr. Cole was named one of the top 50 functional medicine and integrative doctors in the nation and is the best selling author of Ketotarian and The Inflammation Spectrum.