Addressing Hormonal Imbalances
Hormone Support
Hormonal imbalances are not so easy to spot. Natural practitioners help reveal symptoms and successfully address them with supplementation.
When most of your clients or patients think of overall health/wellness and a sense of vigor, they believe it’s due solely to a healthy immune system. And yes, of course, they are right. However, they should become aware that their hormonal (endocrine) status also plays a significant role in securing homeostasis and a great sense of well-being and energy. Humans produce approximately 50 hormones via 12 glands of the endocrine system, creating a delicate and complex endogenous environment that can easily be affected by multifarious factors.
Sara Gottfried, MD, author of the New York Times best-selling books, The Hormone Reset Diet and The Hormone Cure, explained that hormones act similar to text messages in the body sent from any of the multiple endocrine glands (thyroid to gonads to fat tissue) through blood to target cells throughout the body. Each gland synthesizes certain hormones that have specific jobs. “Overall, the system is quite complex with multiple feedback loops, such as the Hypothalamic-Pituitary-Adrenal-Thyroid-Gonadal axis, she said. “A good example of a key hormone is progesterone, sent from the ovary or adrenals to the brain to metabolize into allopregnanolone, which modulates the GABA (gamma amino butyric acid) receptor and creates a sense of calm. Hormones drive one’s interests through the neuro-hormonal axis—they influence neurotransmitters, and by extension, behavior, emotion, the immune system and how food is turned into fuel.”
Dr. Gottfried added that when hormones are working in balance—neither too high or too low— the person feels his/her best. However, she compared, “when they are imbalanced, they become the mean girls in high school, making life miserable.”
As Holly Lucille, ND, RN described, “The endocrine system plays one of the most important roles in health and homeostasis as it is the web that allows the hormones that it houses communicate and deliver messages throughout the entire body.”
Dr. Laurie Steelsmith, a naturopathic physician and acupunturist, agreed, noting that human hormones have a significant role in health and vitality; hormones exert an impact in every cell and can have profound effects on mood, behavior, mental clarity, sexuality and sense of well-being. As a common example, she offered, is hormonal imbalance in women, who will feel symptoms associated with premenstrual syndrome (fatigue, cramps, irritability, food cravings), heavy or painful periods and lack of well being; more extreme may be more easy/quick weight gain, low moods/depression and difficulty sleeping. Mismanaged stress will exacerbate this.
Even in individuals who are mostly healthy, hormonal secretion and action can be greatly impacted by numerous modern lifestyle factors. A person who proactively eats a nutritious diet, ensures he/she obtains six to eight hours of quality sleep, limits alcohol intake and exercises will keep his/her endocrine system functioning optimally. Yet as practitioners, you know that such a person is uncommon. Although your patients and clients endeavor to live “healthier,” there remain many other factors not so easily controlled.
In the 1990s, Dr. Joseph Collins, clinical advisor, for Pennsylvania-based Douglas Laboratories began providing personalized care of menopause-aged women based on the type of menopause they were experiencing (documented in his book, Discover Your Menopause Type). After many years of prescribing bioidentical hormone replacement therapy (BHRT), and working with other patients who were not satisfied with BHRT prescribed by others, he realized that “replacement” was not adequate and that something else needed to be addressed. Exploring herbs, he found that many functioned to balance specific hormonal pathways; some acted as phytoestrogens, others as phytoandrogens and others as phytoprogestogens, in addition to herbs that helped control excessive testosterone and increased thyroid function.
“Just as I had found that each menopause-aged woman had unique and specific needs to allow her to function at her best, I realized that each hormone had specific needs to help it function at its very best,” he explained. “Some of these needs were helping the hormone receptors listen to the hormone and overcoming hormone resistance, improving hormone production, and improving hormone function by acting like the hormone. After many years of research and clinical practice, I started creating what are now recognized as ‘Hormone Specific Formulations,’ my motivation fueled by the team at Douglas Labs. While the popularity of BHRT was telling people to replace their hormones, they agreed with me that we also had to repair them.”
When it comes to women, said Dr. Steelsmith, “those who burn the candle at both ends, don’t get enough sleep, grab fast food on the run will go from hormonal harmony to hormonal havoc, often ending up with more intense PMS symptoms, weight gain, and heavier and more painful periods.” High-stress lifestyles and the habits they create (as described above), are a chief creator of “hormonal havoc.” And this is frequently not identified by your client/patient as a source of feeling poorly or not being able to get rid of those pesky extra pounds in the middle, even when good health exists.
The necessity to be instantly responsive to business and personal lives via mobile devices, keeping on very tight schedules, dealing with social media demands all have been added to working to pay bills and save, and taking care of one’s family, home and vehicles. This increases a sense of anxiety, which causes the adrenal glands to release adrenaline (a short-lived hormone) and cortisol. Dr. Steelsmith explained, “Over time, in women, high cortisol can create hormonal imbalance. It does this through many mechanisms but most notably through its ability to impact ovulation and the release of progesterone. It can lead to infertility, and a decreased ability to balance your progesterone and estrogen levels.”
Dr. Gottfried added that when one’s cortisol level is constantly high, this causes increased cravings for sugar and carbs, which in turn increases belly fat. Further, 50 percent of people with elevated cortisol experience depression. Additionally, achieving less than seven hours of sleep a night can affect cortisol levels; and she pointed out that only 6 percent of the population “does well” with shorter sleep durations. Getting seven to nine hours of sleep keeps cortisol levels even keel, “which prevents the muffin top and accelerated aging.”
Relatedly, there have been some news reports that an increasing number of women are indulging in wine to relax from a hectic lifestyle, but Dr. Gottfried pointed to excessive alcohol intake as another enemy of healthy hormones: it raises both cortisol and estrogen levels, creates poor sleep, and can lower metabolism by more than 70 percent. Asking women patients/clients about their alcohol-relaxation habits may help and Dr. Gottfried suggested they refrain completely from alcoholic intake for a minimum of two weeks twice yearly. Further, many women overdo it with exercise, thinking “the more the better,” and this also can throw a spanner in the works. Over-exercising can create a surge of cortisol. If this is the case, “Stop exercising so hard in an obsessive desire to burn calories—and start exercising smarter,” she advised.
Diets that are heavily in favor of processed foods, sugars and refined carbs, and alcohol, will severely impair metabolism. Dr. Gottfried explained that when a client or patient cannot lose weight trying the conventional methods, her metabolism “is broken, and 99 percent of broken metabolism is related to hormonal misfires.” Because hormones are involved in nearly all factors affecting weight gain and loss—how and where fat is stored, cravings/appetite/food addictions and gut flora, changing diet can correct these hormonal misfires to help get back on a healthy metabolism track. Outside influencers, called endocrine disruptors (EDs), additionally have significant impact on hormonal activity. These include a wide variety of man-made chemicals found in building materials and products, as well as xenoestrogens, which Dr. Gottfried described as “hijacking natural hormones, having reproductive and developmental consequences. In a typical day, Americans are exposed to more than 700 endocrine disruptors. These nefarious chemicals can affect men by causing gynecomastia (enlarged breasts), reduced sperm count, and increased risk of developing prostate cancer. In girls, they cause early puberty onset, and in women, they can affect pap smears and increase the risk of developing breast cancer. In all humans, EDs can inhibit thyroid function.
“I think the modern day influences on the endocrine system are remarkable,” said Dr. Lucille. “The chronic, confounded, compounded stressors along with xenobiotics and electromagnetic fields all take their toll causing imbalances in the endocrine system.”
Because your client or patient may come to you with symptoms such as exaggerated PMS, fatigue, inability to lose weight, etc., these conditions that are affecting quality of life may indeed be caused by hormonal imbalance and insufficiency. Hormonal imbalances may be obscure, and difficult to pinpoint. “Each case is different and symptoms are different for each individual and hormonal imbalances often overlap with other diagnosis like candida infections, anemia, chronic viruses,” said Dr. Lucille. Because common symptoms include fatigue, weight gain, sleep disturbances and blood sugar imbalances, she advised, it is very important is for the practitioner to have good clinical acumen and marry the clinical presentation along with the history and any confirming labs to determine best course of action. “Often, I will use a 24-hour urine hormone metabolite test through Genova Diagnostics to see the overall hormone web picture.”
Dr. Gottfried has been taking care of hormonal patients for 25 years, and she still performs tests even though she can now predict which hormones are out of balance; thus she emphasizes that natural practitioners perform tests as well. Because women tend to be more complicated when it comes to hormonal imbalances, she suggests using her clinical questionnaires found in The Hormone Cure, which identify and reveal the top seven hormonal imbalances, as well as blood testing of thyroid, fasting glucose and insulin, IGF-1 and dried urine testing. Women patients/clients who complain about not being able to lose weight or control weight gain, should be given the questionnaire from The Hormone Reset Diet, which will identify which of the seven metabolism hormones (estrogen, insulin, leptin, cortisol, thyroid, growth hormone, testosterone) are out of balance or insufficient.
“Men are less likely to have problems with the hypothalamic-pituitary-adrenal-thyroid-gonadal axis, and so I start with a focus on their testosterone-to-estrogen ratios,” she advised. “For those whose issue is depression, it’s the same game plan. About half of people with depression have cortisol dysregulation, and about 20 percent have problems with thyroid.”
Obesity in men and women is typically associated with alterations in hormone metabolism, pointed out Dr. Collins. “If the hormone changes did not cause the obesity, then obesity will cause a change in hormones. So at least 35 percent of the population has some kind of hormone problem. In America, that is over 100 million people. Since many people with hormone problems are not obese, I expect it is even higher than that, possibly 125 to 150 million.”
Recommended Protocols
After review about lifestyle factors as mentioned above, Dr. Steelsmith emphasized several botanical supplements that can help support his/her body while in transition. One of her favorite supplements that supports women’s health is Asensia, which features chaste tree berry. “It has helped thousands of women support their ability to ovulate through the herbs’ action on the pituitary gland. It can help to balance estrogen and progesterone levels in a woman’s body thus impacting PMS and decreasing heavy or painful periods in many cases. It also affects prolactin levels, which in turn, decreases the breast and nipple tenderness associated with premenstrual syndrome.”
Another herb Dr. Steelsmith likes to support women’s endocrine systems is Rhodiola rosea—a type of ginseng that not only boosts the adrenal glands’ ability to respond to stressors, but also has positive effects on serotonin levels.
To help regain men’s hormonal health, lifestyle changes are paramount in restoring that balance,” she said. “In addition, using Chinese ginseng can positivity impact testosterone levels through its affects on the adrenal glands and cortisol levels.”
When you identify adrenal related issues in men and women, Dr. Lucille suggested one of her favorite formulas—Adrenaplex from EuroMedica, which combines adrenal extract along with supporting nutrients and adjunct hormones like DHEA and pregnenolone. “It is an ‘all in one’ type of product that allows me the room to add additional things to the plan and not disturb the patient’s chance for adhering to the protocol due to too many supplements,” she explained.
In Dr. Gottfried’s practice, she sees quite a few individuals with high cortisol-related issues, low estrogen issues and problems stemming from low thyroid. Prior to recommending specific supplements, she also addresses lifestyle habits including a whole-foods diet and adopting stress management techniques.
For excessive circulating cortisol, Dr. Gottfried recommends the following: 500 mg vitamin B5, which seems to inhibit hypersecretion of cortisol during high stress; 750 to 1,000 mg vitamin, which has been shown to lower cortisol release in surgical patients and children in high stress situations; 400 to 800 mg phosphatidylserine, which also lowers cortisol release and can help improve mood when stress exists; 250 to 400 mg L-theanine, which may reduce stress without sedative effects, and 4 g fish oils, which a study showed was the optimal dose for lowering morning cortisol levels in men and women after six weeks.
Low estrogen is a condition that can be addressed through diet and supplementation. Diet wise, flaxseeds, which contain lignans, are highly recommended, as lignans are a major class of phytoestrogens. Dr. Gottfried elaborated that one study showed that eating two tablespoons of flax seeds twice per day (approximately 30 grams total) for six weeks reduced hot flashes—a key symptom of low estrogen—by half, and diminished the intensity by 57 percent. “Other great ways to combat low estrogen include eating pomegranate, rhubarb, and Shatavari Ghee (a clarified butter that is part of an ayurvedic diet),” she added. For low estrogen, she recommends maca, shown to increase estradiol in menopausal women, magnesium and red ginseng, found to decrease hot flashes on the Kupperman Index and the Menopause Rating Scale.
When a patient or client has low functioning thyroid, she recommends minerals as the thyroid is “sensitive to copper and zinc, which must remain in proportion; an imbalance in these two elements can result in hypothyroidism.” She also recommends vitamin A, at 5,000 IU daily, selenium, iodine and iron; low iron levels can cause hair loss and hypothyroidism.
In Dr. Collins’ viewpoint, cellular health is a priority as hormones, which act as messengers, tell cells what to do. As such, he said that this requires a high-grade multivitamin, omega-3 EFAs and probiotics. Diet should include low-glycemic fruits and vegetables, proteins and no processed foods.
Douglas Labs provides a unique line of botanical supplements, Hormone Specific Formulations that includes eight products with a ninth soon to be added. Each is an herbal combination specific to the hormone the formulation is designed to support.
The line includes: AdrenoMend, which supports all the homeostasis regulatory systems affected by stress; EstroMend, which controls estrogen metabolism without raising estrogen levels; EstroQuench, which helps inhibits the conversion of testosterone to estrogens by supporting endogenous aromatase inhibitor function; ProgestoMend, which will increases production of progesterone or improves progesterone function.; TestoGain, which helps increase the production of testosterone and/or increase the functions of testosterone; TestoQuench for Men, which helps to control excessive testosterone; TestoQuench for Women, which decreases excessive testosterone production in women; and ThyroMend, which supports the seven key functions required for ultimate thyroid health.
Hormonal imbalances and insufficiencies are not so easily spotted, but taking the time to test and uncover when they do exist is the first step in helping patients and clients on the road to feeling much better. In some cases, they can then be able to lower or even eliminate some pharmaceuticals they are taking to address some of their lifestyle issues. As with the immune system, when the endocrine system is functioning optimally, sound health for the long-term is more assured.
For More Information:
Douglas Laboratories, (800) 245-4440, www.douglaslabs.com
Sara Gottfried, MD, www.saragottfriedmd.com
Holly Lucille, ND, RN, www.drhollylucille.com
Dr. Laurie Steelsmith, www.drsteelsmith.com
