H is for hormones!

Hormones are the main messengers of the body. They tell the body what to do, how to do it and when. It could be a message that boosts up your energy so you can meet that deadline at work, one that tells your body to release an egg, or one that gets you in the mood for love.  Hormones link one system to another and permit parts of the body to communicate with one another. One hormone greatly impacts another and hormones are in delicate balance.  Once you get to the root cause and fix hormone related problems, health can be dramatically improved.

In this post we’ll go through each hormone, their roles, signs of deficiency or excess and a few treatment options!

Hormones related

Hormones are intricately related.

Cortisol

Our first hormone, cortisol, comes from the adrenal glands and is essential for many metabolic and immune functions. It’s the hormone our body uses to deal with stress and can be chronically elevated due to physical, psychological, chemical or environmental stress.   One of the first things I do with every patient is assess their cortisol.  Are you someone whose tired in the morning and has a tough time getting going? Do you get wired at night if you stay up past 10pm? Are you emotionally unstable if you don’t keep your blood sugar controlled with regular meals? Having a tough time losing weight? Suffer from insomnia? These are all signs that your cortisol is out of wack. Naturopathic doctors assess your cortisol two ways and both are important.

Wired and tired

Firstly, we collect urine for 24 hrs to assess total cortisol and its metabolites in your urine.  This tells us if your cortisol is way to high or too low.

Second, we assess the pattern of cortisol through-out the day.  Patients take a salivary sample of cortisol 4 times a day. Saliva is actually a very useful indicator of health since it contains free and therefore active hormones, as compared to hormones in the blood which are bound to receptors.

Normal depicted in green

Normal depicted in green

Cortisol is suppose to be higher in the morning when you wake and then decrease to its lowest concentration at night.

Signs of elevated cortisol

  • Food allergies, environmental sensitivities, muscle and skin breakdown, PMS, diabetes, obesity, mood disorders, chronic fatigue, infertility, bone loss, high estrogen, low progesterone, low growth hormone, aging due to lower levels of the anti-aging hormone DHEA, high blood pressure and poor memory.

If you think you may be a candidate for adrenal testing, take the test below.

http://www.diagnostechs.com/Pages/StressEvaluationTest.aspx

What can you do?:

  • Yoga/meditation/stress reduction
  • B vitamins, vitamin C
  • Rhodiola, ginseng, ashwaghanda to build you up
  • Magnesium and/or phosphatidyl serine to bring you back down at night.

DHEA

DHEA increases muscle, improves immune function, is associated with anti-aging and is the precursor to all other hormones, especially testosterone and estrogen. DHEA levels peak in our early twenties,  and then, unfortunately decrease from then on.  High levels of cortisol greatly deplete DHEA.

Symptoms of DHEA deficiency

  • Fatigue, loss of stamina, low sex drive, memory decline, muscle weakness/wasting, loss of bone mass and sleep problems to name a few.

What can you do?:

  • DHEA is a fantastic hormone, but currently its illegal for canadians to prescribe. It’s readily available in the states as an over the counter prescription.
  • Try increasing levels naturally with magnesium, Relora and Puncture Vine (Tribulus)

Thyroid hormone

Thyroid function and adrenal function go hand in hand. Cortisol greatly impacts how the thyroid functions and  is one of the main causes of hypothyroidism. The thyroid sits in the throat and releases active thyroid hormones (T4 which converts to T3) in response to TSH with help from its percursors tyrosine, selenium and iodine.  The thyroid controls metabolism, energy, bone turnover and heat regulation among many other things.  Up to 90% of your thyroid hormone is bound in the blood and only a small amount circulates as free physiological T4 and T3.  It’s important to measure these active free hormone levels, in saliva or in the blood.  Ask for a free T3 and T4 if your doctor suspects you have hyper or hypothyroid issues, don’t settle for a TSH only.

You may be suffering from an under-active thyroid if you have:

  • A goiter, or swollen thyroid, anemia, a metal taste, anxiety, fatigue, constipation, cracking/dry skin, depression, edema, hair loss, palpitations, low body temperature, cold extremities, a slow pulse and weight gain.
The thyroid affects weight gain and loss.

The thyroid affects weight gain and loss.

What can you do?:

  • Avoid goitrogens, which deplete iodine: turnips, cabbage, mustard, soy, peanuts, pine nuts, millet
  • Doctors often prescribe Synthroid which contains T4. Some people will benefit form T4, but most will not be able to convert T4 to T3 and will continue to suffer with symptoms.
  • I prefer dessicated thyroid hormone which contains bioidentical T4 and T3.
  • Thyroid precursors: Selenium, Iodine , zinc, B-vitamins and Tyrosine
  • Animal glandulars (Whole thyroid gland from another animal)
  • Bladder wrack (Fucus versiuclosus)

Estrogens

Estrogens, cortisol and thyroid hormone greatly affect one another.  Elevated cortisol, leads to high estrogen and when estrogen is high, hypothyroidism commonly occurs. There are three main forms of estrogen in the body: Estrone (E1), Estradiol (E2) and Estriol (E3). Each has different degrees of interaction with estrogen receptors making them relatively strong or weak estrogens.  Estrone is formed in the liver from precursor hormones such as androgens, DHEA and progesterone. Estrone remains high after menopause since it isn’t synthesized in the ovaries, is a strong estrogen and is often called “bad” estrogen since one of its metabolites is associated with increased rates of cancer.  Estradiol is produced by the ovaries from cholesterol, its main role is to build the uterine lining during the second half of the menstrual cycle.  It is also a relatively strong estrogen. Finally, estriol is a weaker estrogen, is secreted in high amounts during pregnancy to protect the fetus from estradiol and does not cause abnormal cell growth in the breasts and uterus and thus is not linked with cancer risk. Estrogen becomes deficient during menopause when the ovaries are no longer capable of producing estrogen. There is however some estrogen left from adrenal production, and fat storage

Signs of estrogen deficiency include:

  • Brain fog, painful intercourse, urinary tract infections, vaginal dryness, night sweats and thinning of the vaginal wall.

What can you do?:

  • Many herbs are helpful in menopausal symptoms that are due to low estrogen: Black cohosh, Chaste berry, Red clover, Sage and Alfafa.
  • Supplementing estrogen is very popular after menopause, however its imperative that the RIGHT estrogen is given in a safe form. I recommend topical estrogen only and insist patients are on supplements which help prevent estrogen conversion into cancer causing metabolites.
  • Furthermore I assess liver function in these patients prior to beginning supplement and carefully monitor serum levels of estradiol once supplementation has begun.
  • I like Biest, a combination of estriol (80%) and estradiol (20%) applied topically.

chaste

Too much estrogen can cause several issues in both women and men. For starters its associated with cancer risk, can generate endometriosis, fibroids, obesity, hypothyroid, lumpy breasts, heavy periods and more. One of the main culprits associated with high estrogen are something called xenoestrogens.  These are estrogen mimickers that wreak havoc on your entire endocrine system.

Common sources include:

  1. pesticides
  2. beef
  3. dairy
  4. cosmetics (especially parabens)
  5. plastic
  6. cleaning chemicals
  7. fabric softeners
  8. farmed fish
  9. hair dye

You may have high estrogen if you experience:

  • Acne, anemia, depression, endometriosis, fatigue, fluid retention, irritability, PMS, weight gain, irregular/long or short periods.

What can you do?:

  • Avoid xenoestrogens
  • Consume brassica rich foods like broccoli or foods that are rich in DIM or indole 3-carbonate (I3C).
  • Supplement with calcium d glucarate.

Progesterone

There are receptors for progesterone in the brain, skin, thyroid, blood vessels, breasts, bone and more. Although its main roles are to shed the uterine lining during menses and maintain the placenta during pregnancy, the relative levels of progesterone in the body compared to estrogen is extremely important for good health. Progesterone deficiencies are very common.  This is because progesterone is used to synthesize cortisol.  Given our stressful lifestyles many of us are using progesterone to make cortisol.

Symptoms of low progesterone include:  

  • Anxiety, insomnia, abdominal fat, depression, a poor ability to deal with stress, headaches and miscarriages.

What can you do?:

  • Protect your progesterone with Dong Quai and Turmeric
  • Detoxify and clear estrogen with I3C, DIM, calcium-d glucarate and liver support.
  • Another great option is either oral or topical bioidentical progesterone. I like prometrium.

natural-micronised-progesterone-100mg-200mg-400mg-softgel-250x250

Testosterone

Important for both males and females, testosterone builds muscle, affects skin health/tone, bone health, heart function and sex drive.

Low levels of testosterone have been linked with:

  • Depression, obesity, osteoporosis, low libido, skin aging and heart disease.

What can you do?:

  • Avoid  pesticides, plastics and xenoestrogens
  • Chill out! When the body needs more cortisol less testosterone is made from their common precursor (cholesterol). When this happens it is known as pregnenolone steal.
  • Increase zinc and fiber
  • Inhibit testosterone conversion to estrogen with aromatase inhibitors like resveratrol, chamomile, passionflower and red clover.
  • Enhance testosterone with Tribulus terrestis, Maca root and Damiana (Turnera diffusa)

Final thoughts

I recommend all patients have a complete hormone work-up if they aren’t experiencing optimal health.  A salivary panel can assess estrogen, testosterone, DHEA, progesterone and cortisol.  Once the results are in, dietary, supplement, botanical and pharmaceutical recommendations will be tailored to you to give you back your life and your health.

Biodentical replacement (BHRT) and balancing hormonal health are an important part of a naturopathic practice.

We are living a lot longer these days and quality of life needs to be addressed.  I think the best way to ensure we are living both longer and happier lives is to address endocrine health.

Bet these guys are on DHEA and have cortisol under control!

Bet these guys are on DHEA and have cortisol under control!