Hormones 101 & The Functional Medicine Approach to Hormonal Balance

What are hormones? 

Hormones are our body’s chemical messengers.  They are produced in different tissues and released into the bloodstream to communicate information to other body parts. Quantities of each hormone fluctuate in response to the environment both within and outside of the body.  Each hormone, in a “just right” amount for the circumstance, provides specific instructions to each organ impacting how that organ functions.  For this reason and many others, hormones play an essential role in mood regulation, metabolism, weight management, energy, focus, fertility, sleep, gastrointestinal function and much more. 

Integrative and functional approaches to hormone balance 

The functional medicine approach emphasizes integrative and individualized evaluation and treatment of hormone imbalances.  Via this approach we seek to find and treat the underlying (and often hidden) “root causes” of disruptions in hormone levels.  This might include disruptions in sex hormones (such as estrogen or testosterone), thyroid hormone, or the stress hormone, cortisol.  Signs of hormone imbalance vary depending on which hormones and organs are involved.  Symptoms such as fatigue, acne, disrupted sleep, anxiety, weight fluctuations, and mood symptoms are common  Given that all the body systems are interconnected, imbalance in one hormone may disrupt other levels and related functions throughout the body. 

We seek to identify and correct the source(s) of the problem which might include chronic stress, nutrient deficiencies, poor diet, gut dysfunction including disrupted microbiome, and environmental toxins, to name a few.  We start our analysis with a comprehensive evaluation of each person’s history and life journey, assessment of lifestyle factors, lab work and advanced testing such as micronutrient analysis, comprehensive stool testing for gut microbiome/gut health assessment, food sensitivity, and heavy metal testing if appropriate. Then we use an evidence-based integrated approach to treatment that may include therapeutic lifestyle interventions (i.e. therapeutic diets, exercise, sleep, and stress management), as well as targeted supplementation and medication if indicated.  This allows us to uncover the causes concurrently with symptom management. 

Common hormone imbalances 

Cortisol 

Function: The adrenal glands secrete cortisol (the body’s main stress hormone) in response to stress. This is the body’s “fight or flight” response, and it can occur when faced with a perceived threat (thought/emotion) and actual threat (physical danger).  Although cortisol is an essential hormone for survival, chronic activation of the body’s stress response system has an overall negative impact across body systems.  

Symptoms: Cortisol receptors are present in most body tissues, which explains why cortisol imbalance can impact almost every organ and cause an array of symptoms. An individual may experience cravings for salty or sugary foods, difficulty waking in the morning, difficulty with falling asleep or staying asleep, feeling “wired but tired,” and weight loss resistance. Cortisol imbalance may also cause disruption in the rhythm of cortisol production which alters the release of melatonin, thus negatively impacting the body’s sleep-wake cycle.  This adversely affects sleep depth, duration, and overall quality, along with loss of the beneficial properties of adequate melatonin which provides antioxidant support for immune health and is anti-inflammatory. 

Thyroid 

Function: Nearly every tissue of the body utilizes thyroid hormone which plays a vital role in regulating metabolism, body temperature, growth, energy, heart rate, menstruation, and nail/hair growth.  

Symptoms: Common symptoms associated with thyroid dysfunction often reflect inadequate thyroid hormone levels and may include fatigue, cold hands/feet, weight gain, weight loss resistance, constipation, dry skin, weak nails, brain fog, and hair loss. 

 Estrogen & Progesterone 

Function: Estrogen influences more than female reproductive health as it plays a role in cardiovascular, bone, and cognitive health for all people. For women, estrogen levels naturally fluctuate during the menstrual cycle, eventually declining during perimenopause and menopause.  The ovaries no longer produce much estrogen during this time; however a form of this hormone is still produced from fat tissue. Progesterone is a hormone in women essential to balance estrogen. In addition to its role in reproductive health, it influences cognitive function, mood, and sleep. Just like estrogen, it naturally fluctuates during the menstrual cycle and declines in perimenopause and menopause. 

Symptoms: Estrogen dominance is a term that refers to a form of estrogen imbalance represented by symptoms of excessive estrogens in the body. Symptoms in women may include irregular, painful, or heavy periods, bloating, breast swelling/tenderness, acne, headaches/migraines, weight gain, and mood changes. It can also occur in men causing symptoms such as low libido, fatigue, weight gain, gynecomastia [growth of breast tissue in men] and infertility.  A decline in estrogen, as seen in perimenopause and menopause may cause weight gain, night sweats, mood changes, decreased libido, frequent urinary tract infections, vaginal dryness and poor sleep. Symptoms of low progesterone may include irregular periods, headaches, weight gain, mood changes such as anxiety or depression, hot flashes, and shallow or disrupted sleep.  

Testosterone 

Function: Testosterone levels naturally decline with age, however, a discussion with a clinician can help you determine what is appropriate for you. Normal testosterone levels support energy, sleep, decreased fat and increased muscle mass, sexual function/libido and cardiovascular health.  

Symptoms: Low testosterone symptoms include low libido, brain fog, fatigue, erectile dysfunction, weight gain/difficulty losing weight, changes in mood, sleep disruption and loss of lean muscle. In women, low testosterone is also associated with fatigue, anxiety, low libido, brain fog, thinning hair, bone loss and muscle weakness. Excess testosterone in women is associated with hair growth, blood sugar imbalance, acne, PCOS, thinning hair, infertility, and irregular menstruation. 

Take Action: Functional Medicine Consults 

Are you interested in working with our clinicians to address your own hormonal balance?  Synergy offers its members functional medicine consultation appointments and related education/coaching with our certified practitioners. Consults always include a comprehensive discussion and evaluation with a clinician, and specialized testing if indicated. Ask our team or talk to your physician about whether this may be helpful for you.