Healthy Hormone Support
The complexity of proper hormone balance for women—and men—can be aided by carefully guided lifestyle choices as well as supplements.
Hormone imbalances can occur in men and women of almost any age. A variety of factors can be related to these imbalances, including high insulin levels from diets high in refined foods and sugar, exposure to environmental toxins, high consumption of hydrogenated fats and a lack of physical activity leading to weight gain. Age is also a factor in reduced levels of hormones, creating feelings of imbalance in everyday pursuits.
In the book The Hormone Cure, Sara Gottfried, MD, a Harvard-educated gynecologist, listed her “greatest hits” of top hormone imbalances seen in her practice:
• High cortisol that causes a feeling of tiredness, but “wired,” which prompts the body to store fuel in places it can be used easily as fat, such as at the waist.
. Low cortisol (the long-term consequence of high cortisol), which can cause a feeling of exhaustion
• Low pregnenolone, which can cause anomia; low levels are linked to attention deficit, anxiety, mild depression, brain fog, dysthymia and social phobia.
• Low progesterone, which can cause infertility, night sweats, sleeplessness and irregular menstrual cycles.
• High estrogen, which can cause breast tenderness, cysts, fibroids, endometriosis and breast cancer.
• Low estrogen, which causes mood and libido to tank.
• High androgens, such as testosterone, which are among the top reasons for infertility.
• Low thyroid, which causes decreased mental acuity, fatigue, weight gain and constipation; long-term low levels are associated with delayed reflexes and a greater risk of Alzheimer’s disease.
Dr. Adam Killpartrick, DC, CNS with Suncook Valley Chiropractic and Functional Medicine in Pittsfield, NH, said to answer the question of top hormone concerns. “I’m going to put aside the obvious concern involving insulin and metabolic syndrome.This is especially vital for children these days,” he said. “But in terms of other hormonal imbalances, it’s difficult to isolate one hormone as being more important than other hormones, as they are all so intimately intertwined.”
However, in his practice he pays close attention to thyroid hormones and adrenal indexes, he said. “It’s been my experience that these hormones have a significant, farreaching effect on physiology. But in functional medicine, there are areas that need to be appreciated, including the testing that gives the most accurate, comprehensive visibility into the system. For many years, testing total cholesterol levels alone provided a doctor with a ‘hypothyroid’ diagnosis. Then TSH (thyroid-stimulating hormone) was the lone ranger used to determine thyroid function.Unfortunately, neither provides the insight needed to effectively support a patient with underlying thyroid dysfunction,” said Dr. Killpartrick, noting even subclinical hypothyroid has been associated with a significant increase in heart disease.“And when it comes to adrenal hormones, the constant and unrelenting stress people are under and the subsequent stress response contributes to an unhealthy increase in cortisol, which in turn contributes to everything from blood sugar issues to neurological dysfunction.”
According to Dr. Tina Rogers, ND, of Flow Health & Wellness in Kitchener, ON, Canada, the main causes for hormone disruption include poor diet, stress, liver congestion and pharmaceutical use, while the top hormonal concerns in her practice are PMS/painful period, infertility and menopause.
“The underlying causes for hormone disruption vary greatly from excess stress on the body, poor gut health, nutrient deficiencies and imbalances and toxicity issues such as BPA (bisphenol A),” added Dr. Killpartrick. “The bottom line is that the causes need [to be] isolated and addressed directly to provide the opportunity for the system to balance itself out.”
In infertility cases, both females and males require hormonal balancing, Dr. Rogers pointed out. “I think it is also important to stress the proper balance of hormones in males to prevent prostate cancer along with other issues that may affect the prostate.”
More About Men
Men’s hormone issues are emerging more as an issue in practice, noted Dr. Killpartrick.“Women’s hormone imbalances can be more complex and delicate, however, men still need to maintain balance between their sex, stress and metabolic hormones. And with regard to ‘man-o-pause,’ as some refer to it, testosterone levels gradually decrease over time, which can contribute to a number of physiologic issues with men,” he said, adding that this is why it is so important to administer the most appropriate testing methods to determine exactly where the problem lies“It’s not enough to assess free testosterone by itself, which is a great indicator of active hormone, but also the protein bound, to assess the production of the hormone.This helps pinpoint the area that needs the support.”
Dr. Kyl Smith, director of education for Texas-based Progressive Labs, noted that peer-reviewed science demonstrates that stress resulting in the elevation of the stress hormone cortisol is a major factor shown to decrease testosterone in otherwise healthy men.
Acting through the classic glucocorticoid receptor, stress-induced elevations in serum cortisol concentration directly inhibits testosterone production by Leydig cells in the testicles.1-3 For example, when male members of the ground crew of military aircraft were passengers on an acrobatic flight, they experienced acute anxiety that was accompanied by increased serum cortisol concentrations and decreased serum total testosterone concentrations.4 Similarly, young men about to board an aircraft for their first skydiving attempt (a purely psychological stressor) experienced an acute increase in cortisol concentration and an acute decrease in total testosterone concentration.5
In his book, The Testosterone Switch, Dr. Smith explained that a man suffering with low testosterone typically experiences mild to moderate fatigue, lethargy, tiredness or sapped motivation that just won’t go away. Men continually seek some form of artificial energy boost, such as caffeine, throughout the day to attempt to feel “normal,” he added.
Balancing Acts
According to Dr. Smith, the well-researched brain nutrient phosphatidylserine (PS) has been shown to reduce the stress response, decreases cortisol and increase testosterone in otherwise healthy men.
PS has been shown to attenuate (reduce) the endocrine responses to exercise or psychological stress. For example, daily supplementation with PS suppressed the spikes in serum concentrations of cortisol that accompanied cycling exercise in healthy, young, physically-conditioned men6-11, and that followed exposure to acute psychological stress in healthy young men and women.7-8 In a double-blind, randomized, placebocontrolled trial, healthy young men supplemented their diets with either placebo or PS.12 Compared to the lack of effect with the placebo, 10 days of dietary supplementation with PS significantly suppressed the cyclinginduced elevations in serum cortisol concentrations that were apparent in the men in the placebo group.12
In addition, pre-exercise serum total testosterone concentrations were on average 37 percent greater, and pre-exercise serum cortisol concentrations were on average 35 percent lower, after just 10 days of PS supplementation.12
Together, these findings6-12 indicate that supplemental PS interacts with neuronal cell membranes within the human brain to blunt the pituitary ACTH (adrenocorticotropic hormone) secretory response to hypothalamic stimuli, attenuating the secretion of cortisol at rest and during and after exercise,13 and releasing the testicular Leydig cells from cortisolemic inhibition of testosterone synthesis and secretion.
Dr. Rogers said to balance hormones she will often use various botanical medicines, acupuncture and nutrition. “I often put patients on a hypoallergenic or anti-candida diet. If the patient is estrogen dominant, I will ask them to increase foods with I3C (cruciferous veggies). If there is increased cortisol, I limit their grain/starch intake. Or if there are issues with the thyroid, I will limit goitrogenic foods,” she said. “The acupuncture that I use varies based upon each patient’s case. Supplements I use are often from Douglas Labs or MediHerb, and will contain a variety of different herbs from black cohosh to chaste tree.”
She explained that foods high in I3C promote a healthy balance of estrogen, and recommends avoiding foods that are goitrogenic prevent. Herbs such as chaste tree are a hormonal regulator and will balance the hormones, while black cohosh is a great hormone for menopause as it increases estrogen and decreases inflammation, which can help with joint pain that menopausal women often experience. “Acupuncture is great because it promotes release of endorphins and increases circulation,” she added.
Further, Dr. Rogers pointed to Michnovicz et al, who recorded that the consumption of foods high in I3C at the consumption of 6-7 mg/kg of body weight increases catechol production of estrogen (good estrogen), and thereby promotes proper amounts estrogen in the body and decreases the risk of breast cancer.
She also cited Ernst et al from the article “Treatment of PMS with a phytopharmaceutical formulation containing Vitex agnuscastus (chaste tree)” from Journal of Women’s Health & Gender Based Medicine in May
2000. Researchers recorded that of 1,634 patients using the extract of the fruit from chaste tree, 93 percent recorded a decrease in symptoms or complete elimination of symptoms.
Specific products Dr. Rogers said she finds useful for hormone balance include:
• Progestomend by Douglas Labs
• Estromend by Douglas Labs
• Testo Quench by Douglas Labs
• Estrium by Metagenics
• Chaste Tree by Medi Herb
• Wild Yam Complex by Medi Herb “Practitioners as a whole are working in a very similar manner when it comes to botanicals and nutrients (ashwaganhda, phosphatydlserine, B vitamins),” Dr. Killpartrick added. “However, there are more practitioners turning to adjunctive modalities to support the work they’re doing internally.”
Among these are cranial work, which can have a direct influence on releasing dural tension and any associated tension surrounding infundibulum, the stalk connecting the pituitary gland (the master hormone gland) to the brain. “This can impact the entire endocrine system from insulin levels to thyroid and adrenal hormone production,” he added. “In practice, I’ve seen both of these techniques have profound effects on glucose metabolism and A1c levels.
“Other research is promising involving the use of low-level laser with conditions such as Hashimoto’s thyroiditis,” Dr. Killpartrick continued. “These lasers are typically used by chiropractors for acute inflammation support but are increasing being employed for these more chronic conditions.And, of course, the research on High Intensity Interval Training and the effect on growth hormone and testosterone levels is changing how practitioners recommend physical exercise.”
In fact, along with eating a low glycemic, antioxidant-rich diet to build testosterone, Dr. Smith recommended patients exercise with intensity. “The immediate effects of one bout of intense exercise will improve insulin, glucose homeostasis, the ‘stress response’ and rates of hormone synthesis and secretion, ultimately increasing testosterone.” A warm up, he said, followed by 10 to 15 minutes of intense exercise in the form of interval training is all that’s needed to produce a healthy hormone response.
Dr. Gottfried offers modest, “hormonal success” weight-loss tips to her patients, since diet is heavily linked to hormonal balance.Some proven goals include:
• Modularize. Break a larger goal into small, concrete goals.
• Eat like your great-grandparents, who ate whole foods before the days of packaged food, fake butter and McDonalds.
• Cut out the white stuff, including refined carbohydrates, sugar, sugar substitutes, flour and gluten.
• Track food religiously. Every sip, every bite.
• Shift to less calorie-dense foods, such as apples and celery, instead of rich, sugary and calorie-dense foods like ice cream.
• Obtain counseling or coaching if needed for further accountability, to understand the root causes of eating issues, as well as for emotional support.
• Move more. Setting the goal to walk 10,000 steps daily will increase activity levels every day, even if you don’t make it to 10,000
References:
1 Fenske M. Role of cortisol in the ACTH-induced suppression of testicular steroidogenesis in guinea pigs. J Endocrinol. 1997;154:407-414.
2 Welsh TH Jr, Bambino TH, Hsueh AJ.Mechanism of glucocorticoid-induced suppression of testicular androgen biosynthesis in vitro. Biol Reprod.1982;27:1138-1146.
3 Hu GX, Lian QQ, Lin H, Latif SA, Morris DJ, Hardy MP, Ge RS. Rapid mechanisms of glucocorticoid signaling in the Leydig cell. Steroids.2008;73:1018-1024.
4 Leedy MG, Wilson MS. Testosterone and cortisol levels in crewmen of U.S. Air Force fighter and cargo planes. Psychosom Med. 1985;47:333-338.
5 Chatterton RT Jr, Vogelsong KM, Lu YC, Hudgens GA. Hormonal responses to psychological stress in men preparing for skydiving. J Clin Endocrinol Metab. 1997;82:2503-2509.
6 Monteleone P, Beinat L, Tanzillo C, Maj M, Kemali D. Effects of phosphatidylserine on the neuroendocrine response to physical stress in humans.Neuroendocrinology. 1990;52:243-248.
7 Benton D, Donohoe RT, Sillance B, Nabb S. The influence of phosphatidylserine supplementation on mood and heart rate when faced with an acute stressor.Nutr Neurosci. 2001;4:169-178.
8 Hellhammer J, Fries E, Buss C, Engert V, Tuch A, Rutenberg D, Hellhammer D. Effects of soy lecithin phosphatidic acid and phosphatidylserine complex (PAS) on the endocrine and psychological responses to mental stress. Stress. 2004;7:119-126.
9 Monteleone P, Maj M, Beinat L, Natale M, Kemali D. Blunting by chronic phosphatidylserine administration of the stress-induced activation of the hypothalamo-pituitary-adrenal axis in healthy men.Eur J Clin Pharmacol. 1992;41:385-388.
10 Fahey TD, Pearl MS. The hormonal and perceptive effects of phosphatidylserine administration during two weeks of resistive exercise-induced overtraining.Biol Sport. 1998;15:135-144.
11 Jäger R, Purpura M, Geiss KR, Weiß M, Baumeister J, Amatulli F, Schröder L, Herwegen H. The effect of phosphatidylserine on golf performance.J Int Soc Sports Nutr. 2007;4:23.
12 Starks MA, Starks SL, Kingsley M, Purpura M, Jäger R. The effects of phosphatidylserine on endocrine response to moderate intensity exercise.J Int Soc Sports Nutr. 2008;5:11 (doi: 10.1186/1550- 2783-5-11).
13 Singh A, Petrides JS, Gold PW, Chrousos GP, Deuster PA. Differential hypothalamic-pituitary-adrenal axis reactivity to psychological and physical stress. J Clin Endocrinol Metab. 1999;84:1944-1948.
Healthy Take Aways
. Reasons for hormonal disruption are varied, but can include stress on the body, poor gut health, nutrient deficiencies and imbalances, and toxicity issues such as BPA.
. Menfs hormone issues are emerging as an issue in practice.
. Herbal supplements for hormone balance in women should contain a variety of different herbs, from black cohash to chaste tree.
. Cranial work can have a direct influence on releasing dural tension and any associated tension surrounding infundibulum.
. Eating a low-glycemic, antioxidant- rich diet and participating in high intensity interval training can help build testosterone.
FOR MORE INFORMATION:
. Dr. Sara Gottfried, www.saragottfriedmd.com
. Dr. Adam Killpartrick, (603) 435-6600
. Progressive Laboratories, (800) 527-9512, www.progressivelabs.com
. Dr. Tina Rogers, (519) 749-3569
