Weather your planning on making babies or not paying attention to your hormonal health is essential for over all good health. Many functions in your body including, bone health, metabolism, stress response, mental health, digestive function and more are influenced by our wonderful and sometimes woeful hormones.
What happens when hormones are out of whack?
Many common health concerns today are connected to hormonal imbalance. Chronic conditions such as hashimotos thyroiditis, polycystic ovarian syndrome (PCOS), inflammatory disorders including endometriosis, amenorrhea (absence of period), Mood and mental health disorders, acne prone skin, weight gain and insulin resistance, metabolic disease, the list goes on.
Signs and symptoms that may indicate underlying hormonal dysfunction:
( In brackets are potential hormonal drivers)
Breast tenderness and swollen lymph nodes (estrogen dominance)
Fibroadenoma, a benign (non-cancerous) breast tumor from overgrown cells forming a mass.(estrogen dominance)
Slow detoxification or constipation (estrogen dominance, low thyroid)
High cholesterol (low thyroid, inflammation, insulin resistance)
Cold hands and feet (low thyroid)
Cramping, bloating and digestive upsets (gut flora imbalance, nutrient deficiencies, low progesterone)
Low libido or non-existent sex drive (low estrogen and testosterone)
Sugar cravings and blood glucose imbalances (insulin resistance, high testosterone, low progesterone, PCOS)
Headaches and mood swings (mineral deficiencies, dopamine, serotonin, gaba)
Weight gain, particularly around your middle (insulin resistance, high cortisol, low thyroid)
PMS symptoms (low or high estrogen/progesterone, inflammation)
Hair loss or thinning hair (low thyroid, high cortisol)
Acne or facial hair and excess body hair growth (insulin resistance, high testosterone, PCOS)
Fatigue, low energy and motivation (low cortisol, insulin resistance, low or high estrogen/progesterone, low thyroid)
Abnormal pap smears, heavy bleeding, painful menstruation (estrogen dominance, low progesterone)
Depression, hot flashes, vaginal dryness (low estrogen)
Cysts, infertility, bloating or fluid retention (low progesterone, insulin resistance)
Contributing factors that can lead to hormonal Imbalance
Inflammatory foods in the diet
Processed foods. Foods that have been changed in the lab. For example packaged food items that have many additives to enhance flavour, increase shelf life, add colour or create the right consistency.
Hydrogenated vegetable oils (canola, soybean, safflower, sunflower oil, margarine). These polyunsaturated seed oils and trans fats are highly inflammatory and can lead to hormonal imbalances and chronic health conditions. Processed oils are often added to packaged foods to increase shelf life of the product. Always read your labels as cleaver marketing will make a product appear like it is a healthy choice. A good example is olive oil spread (basically margarine), this appears to be healthy as olive oil is healthy. Sometimes these products even have a high health star rating. Do not trust these marketing ploys, read the label and you will discover that for example an olive oil spread ingredients are in fact Vegetable oils 60% (containing minimum 19% olive oil), water, salt, emulsifiers (471, 322 (from soy)), milk solids, preservative (202), food acid (270), colour (160a), flavour, vitamins A & D.
Sugar. Too much sugar, particularly refined sugar, sucrose and fructose increase inflammtion. Again read your labels, you may be surprised to find out how much sugar your breakfast cereal, flavoured yoghurt or fruit juice contain per 100 g. Not only does sugar encourage the growth of cancers, cause inflammation in the body, weight gain, diabetes and heart disease, excess sugar in our diet causes havoc to our hormones. In particular insulin sensitivity.
Hormones and antibiotic use in animal products can disturb our own hormonal balance and function within the body. Choose organic,grass fed/ free range and wild caught where possible.
Chemical use and pesticides on the foods we consume.
High carbohydrate intake. Carbohydrates are metabolised in the body as glucose. Excess carbohydrate rich foods = higher blood glucose levels and insulin resistance.
Not enough essential fatty acids in the diet, high omega 6 to omega 3 ratio (too many polyunsaturated, processed fats). Consuming an adequate amount of healthy fats in the diet is essential for hormone production and function in the body. Long term low fat diets have been linked to hormonal disruption, particularly in woman.
Long term use of Hormonal Contraceptives
Hormonal contraceptives prevent pregnancies by shutting down ovarian function and replace estrogen and progesterone with contraceptive drugs like ethinylestradiol and levonorgestrel. This can mask underlying hormonal imbalance and in some cases contribute to poor nutrient absorption leading to nutrient deficiencies
Prevent muscle gain and can contribute to weight gain and insulin resistance (5).
The oral contraceptive pill can interfere with your gut health reducing healthy microbiome.
Impaired absorption of zinc, vitamin C and B vitamins
Increase cortisol levels (stress response hormone)
Stress,high cortisol levels and the HPA axis
Stress in the body can compound due to multiple factors leading to a state of chronic stress. When we think of stress we often relate it to a mental state but there are many stressors that can contribute to increased cortisol levels in the body including infection, food sensitivities, toxic exposure, trauma and over exertion. Too much high intensity exercise is often an overlooked factor that can lead to a state of stress and inflammation in the body. Poor sleep is another contributor that is all too common and of course mental stress (work, school, financial burden, dysfunctional relationships, trauma, emotional stress). On going chronic stress leads to high levels of our stress hormones, cortisol, adrenaline and norepinephrine. When our body produces these hormones in excess, particularly cortisol our immune system can be supressed, we have an increased risk of insulin resistance leading to weight gain, and the function of brain communication from the hippocampus to our pituitary gland is disturbed (HPA axis) (6).
Our HPA- axis is the communication highway between the brain to our pituitary gland which is responsible for stimulating hormone production including FSH (follicle stimulating hormone) and less LH (lutenizing hormone) which are essential for ovulation. High cortisol levels decrease this important communication pathway and therefore can lead to anovulation and hormone imbalance.
Gut health dysfunction and poor nutrient absorption
Some common contributing factors include:
Low stomach acid can result in poor digestion of food, increased vulnerability to bacterial infection and stomach bugs. Medication use - such as PPI’s (proton pump inhibitors) often prescribed for reflux and can cause low stomach acid. This can lead to dysbiosis (imbalanced microbiome) by allowing opportunistic bacteria and parasites survive in the digestive tract.
Dysbiosis. Your intestines are filled with trillions of bacteria, fungi, and even some viruses, that are all working together to keep your system functioning correctly. This collection of important gut bugs are known as your microbiome. When disturbed, (ie antibiotic use, bacterial and parasitic infections) dysbiosis can occur leading to many health complications. A healthy microbiome plays an important role in over all health including hormone regulation. These good gut bugs when in balance work to signal glands in the body to produce more or less hormones (7).
Poor elimination and absorption due to digestive disorders. Constipation slows down the elimination of toxins including excess estrogen and burdens the liver. If you are the opposite and suffer from loose bowel movements you are often missing out on many of the essential nutrients that when absorbed efficiently contribute to hormone and mood regulation. Low absorption of vital nutrients such as zinc, magnesium, selenium, vitamin D and iodine can often occur with digestive disorders, all of which are vital for hormone production and for a healthy and fertile cycle.
Over burdened Liver
Poor liver function can lead to insulin resistance as well as impaired detoxification of excess estrogen from the body. The liver not only has to produce insulin to regulate blood sugar levels but also process and eliminate toxins from medications, environmental toxins and excess estrogen in order to maintain hormonal balance. All estrogen (including xenoestrogens) must be detoxified first by the liver and then the bowel. Exposure to Xenoestrogens (EDC’s), endocrine disrupting chemicals, can often contribute to symptoms and conditions related to excess estrogen. EDC’s are environmental toxins that mimic estrogen in the body. EDC’s are found in plastics, pesticides, perfumes, cleaning and skin care products. Other common contributors to poor liver function include: excess alcohol, caffeine and other toxic substances, including some medications and recreational drug use. Also often overlooked are toxic fumes from work place or environment e.g paints, cleaning agents, glues, petrol, diesel, ammonia, industrial fumes and strong fragrances.
How can I treat my hormonal imbalance naturally?
Often woman are put on an oral contraceptive pill to “regulate hormones”, a bandaid approach that is in fact masking the underlying issues, not addressing them. In some cases a hormonal contraceptive can be useful to give some symptom relief and of course in prevention of pregnancy. It should not however be a long-term solution to hormonal symptoms and in some cases it can even lead to post contraceptive hormonal dysfunction.
Nutrition and lifestyle play major roles in hormonal control. Although everyone has individual needs and should seek the guidance of a health care practitioner during the journey to hormonal balance below is a list of just some of the changes you can make to help assist in regulating hormones.
Reduce sugar!!
Refined sugar and fructose are not only inflammatory but also contribute to insulin resistance, both of these factors can disrupt our hormonal function. Consuming too much sugar can also disrupt our gut flora, encouraging bad bacteria to grow, increase food cravings and weight gain in some cases contributing increased levels of estrogen. Quitting sugar is not easy and it can often hide in foods you may think are healthy like, granola bars, sweetened yogurts, breakfast cereals. Fructose is the main culprit when it comes to increasing insulin. It is the sugar in table sugar (sucrose), honey, maple syrup, dried fruit, agave, fruit juice and dates. Whole fruit also contains fructose but is generally ok, unless you are managing severe insulin resistance. Whole fruit is metabolised slower due to its high fibre content.
Ensure Sufficient Protein intake
Protein keeps us feeling full helping to regulate blood sugar levels and therefore assists in maintaining a healthy weight. Aim to choose good quality protein from grass fed, organic and hormone free animal products. For vegetarians and vegans who are insulin resistant, getting sufficient protein intake without eating too many carbohydrate rich foods (eg legumes, pasta, lentils) can sometimes be a balancing act. To ensure adequate protein without eating meat, dairy or poultry, a vegetarian or vegan protein powder supplement can be helpful.
Include essential fats
Firstly eating fat won’t make you fat, gone are the days of a low-fat diet! We need a healthy amount of healthy fats to. provide the building blocks for your hormones, cells, and brain. Now this doesn’t mean you can go to town on a deep fried hot dog dripping in trans fats, that is the recipe for inflammation. In contrast, including the right types of good quality fat is essential for not only balancing hormones but good health in general. Fats to include :
Essential omega 3 fats – Salmon, mackerel, sardines, herring ( wild caught is best if you have access to buy it ), walnuts, hemp seeds/oil, chia seeds, avocado.
Saturated fats- Coconut oil (unrefined, cold pressed, organic), grass fed butter, lard and ghee. Saturated fats are solid at room temperature, are highly heat stable maintaining their structure under high temperatures Their stability at high temperatures makes them a healthier fat to cook with. Their slow release energy contributes to satiety, blood sugar and insulin control.
Eat lots of Veg
You do not have to be a vegetarian to eat a predominantly plant based diet. However filling your plate with plants that are high in antioxidants which help reduce inflammation and support detoxification. Animal products are an important source of protein, amino acids, vitamins and minerals but rather than the main event on your plate think of them as the side. Load up on non starchy cruciferous vegetables – cabbage, kale, brussel sprouts, broccoli, collard greens are high in natural fibre and contain many essential vitamins, minerals and antioxidant. They support digestive and liver function assisting in elimination of toxic load and excess estrogen. Non starchy veg are also lower in carbohydrate (glucose) and will not spike blood glucose levels like higher carbohydrate choices. Vegetables are a good source of prebiotic fibre feeding your good gut bacteria which is important to create balance in the body. Choose organic or spray free when possible, find the top offenders for pesticide and chemical use at www.ewg.org.
Eat fermented foods
Including fermented foods into your diet helps support healthy digestion and elimination Try including foods such as sauerkraut, kimchi and kefir. If you don’t already eat fermented foods start slow. Adding a small amount once a day will assist in balancing your gut microbiome, encouraging growth of good gut bacteria. This helps drive out the bad guys and has been shown to aid in nutrient absorption, hormone regulation as well as the production of mood boosting serotonin. Encouraging a healthy gut microbiome has also shown reduction in cravings for sugar which is often driven by bad gut bacteria (7).
Minimise wheat and dairy
For many simply avoiding dairy and gluten can significantly reduce inflammation in the body. The reduction in wheat and dairy in many has shown improvement in hormonal symptoms. For some, wheat is not an issue but for the majority of the population wheat triggers inflammation in the body that manifests in many ways, Including hormonal dysfunction, skin disorders, digestive issues, joint inflammation and mood disorders to name a few. Avoiding dairy has been shown to dramatically improve period pain, heavy periods, endometriosis symptoms, acne, and PMS (1). The lactose in dairy is often the culprit behind digestive symptoms as well as spiking blood glucose which can be a problem for those with insulin resistance and weight gain. Milk also naturally contains many hormones including testosterone, progesterone, insulin, and a potent growth hormone called IGF-1 A. For some this may contribute to hormonal imbalances. Dairy contains a protein call A1 casein which for some people can stimulation inflammatory cytokines. Hormonal symptoms related to a sensitivity to A1 protein include period pain, heavy periods (especially in teenagers), fibroids, endometriosis, acne, PMS. Some alternatives to try are goat or sheep milk products (because they contain A2 dairy), almond milk and coconut milk (2).
Get quality sleep and relaxation
Quality sleep may sound simple but so many of us do not get enough of it! For optimal hormone production your body needs quality sleep, 7- 8 hours of undisturbed sleep per night can do wonders. Sleep helps to support healthy HPA-axis (Hypothalamic - Pituitary - Axis) discussed above. Lack of sleep and high cortisol due to stress are often the culprits for HPA- axis dysfunction. Insulin sensitivity is also improved with adequate sleep.
Practice Sleep Hygiene: practicing sleep hygiene can include many things some are limiting caffeine, alcohol consumption and reducing noise, bright lights and stress before bed., sleeping in a dark, cool room may can assist in a restful sleep. Light exposure disrupts melatonin production, and cooler sleep temperatures have been shown to improve sleep. Disconnect from your device. Avoid scrolling through facebook and Instagram feeds at night and restrain yourself from having your phone or device in your bedroom. Limit screen exposure, or use devices that help shield blue light wave length at night ( this stimulates your brain making it hard to get to sleep) . If you have to be on your phone or computer in the evening then there are some apps that can be downloaded like the free F.lux app on your computer, phones, etc. If you don’t mind looking like Bono, then wearing amber tinted glasses in the evening may be an option to try. https://alifeofproductivity.com/flux-sleep-better/
Learn to relax on the regular. Breathing and meditation, practicing yoga, and spending time with friends who make you laugh all these things are great ways to relax. Relaxing is something that can sometimes be difficult particularly in a state of hormonal dysregulation and this is why it is all the more important to incorporate time to practice relaxation.
Address vitamin and mineral deficiencies through diet and supplement support where necessary
Eating a whole food diet with quality fresh vegetables, fruit and protein in essential to ensure adequate intake of essential vitamins and minerals Supplementation is only necessary in the place of dietary inadequacy. Some key players in hormonal function that are often depleted in a hormonal dysfunction picture include:
Magnesium: Regulates the stress response and supports your nervous system. It also works to help calm and regulate the HPA axis, can help reduce menstrual pain, headaches and insomnia and is often depleted in those with high cortisol levels. Adequate magnesium has also been shown to reduce insulin resistance (3). Food sources: almonds, cashews and Brazil nuts, dark leafy greens, bone broth, raw cacoa (dark chocolate). Fatty fish such as salmon and mackerel.
Zinc: Is an essential mineral for hormone production. It can do wonders in the treatment of hormonal symptoms as it is anti-inflammatory, Regulates the menstrual cycle, can improve symptoms such as acne and hirsutism (facial hair), supports thyroid function, ,dials down cortisol and the stress response. If supplementing always do so under the guidance of a practitioner Don’t take more than 80 mg for more than three months without speaking to a clinician because it can deplete copper. Food sources: Meat (particularly red meat) eggs, shell fish oysters are a high source. Vegan and vegetarian sources such as legumes including chickpeas, beans and lentils are not as well absorbed as animal products however heating, sprouting, soaking or fermenting plant sources of zinc like can increase this mineral’s bioavailability. Seeds are another great source of zinc, healthy fats and fibre. Try including hemp, pumpkin and sesame seeds into your daily intake.
Vitamin C: Supports immune function, inflammation and healing, assists in iron absorption and is essential for progesterone production, which helps to balance estrogen in the body. The human body cannot produce or store vitamin C. Therefore, it’s essential to consume it. Food sources: Berries, kale, broccoli, cauliflower, and kiwi fruit.
Vitamin B6 Vitamin B6 plays an important role in hormone regulation and is often depleted in those with digestive dysfunction, on a long-term vegan diet, hormonal contraceptive use and those under stress. Vitamin B6 is essential for synthesis of hormones in particular progesterone (often low in PCOS, endometriosis, perimenopause, mood disorders).This PMS regulating vitamin also promotes anti-inflammatory prostaglandins and detoxification and clearance of both estrogen and histamine (a common cause of PMS). Food sources: Nuts and seeds, poultry, salmon and tuna, chicken liver (think pate), sweet potato, avocado, banana, spinach. If you suspect your diet is in adequate in B6, Speak with a practitioner before supplementing as high doses above 50mg a day can cause nerve damage.
Regular exercise
Too much exertion such as over doing cardio or high intensity exercise, particularly if the body is already under stress can lead to hormone dysfunction by increasing cortisol as discussed above. However, getting the balance right has many benefits. Exercise improves insulin sensitivity in the muscles (4). Resistance training such as Pilates, body weight exercises and light to moderate weight training are proven ways to build and tone muscle without over stressing the body when considering regulating cortisol levels and hormonal balance, particularly in woman. Yoga, swimming, walking in nature, and surfing are also great options to reduce high cortisol, relax/increase mindfulness, build strength, fitness, control weight gain and all importantly increase your mood!
Get support
Regulating hormones and improving hormonal symptoms, for some can be as simple as making the above diet and lifestyle changes. However understanding what is the root cause of your dysregulation is best guided by a health professional such as a nutritionist, naturopath or integrative endocrinologist, who can refer you for appropriate pathology testing, take a detailed health history, ensure you are getting your required intake of macro nutrients vitamins and minerals and so much more to support you in your individualised journey.
It is important to remember that all health journeys are individual, if you have been diagnosed with the same condition as someone else, it does not mean that their treatment will be the same as yours, there is not a simple cookie cutter fix. Eating a whole-food diet and an abundance of green, leafy vegetables, avoiding and reducing processed foods, sugar, and alcohol in your diet is a good place to start. Working with a nutritionist to help guide you through this journey will help you find a diet that supports your health. You will learn to respect your body and listen to what it tells you about which foods and lifestyle choices are YOUR fit and which ones you need to give the boot.
My hope is that this long read has been beneficial to you or to someone you love!
Liss xx
References:
(1) Diary and hormonal acne https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2715202/
(2) Inflammation From A1 Milk https://www.larabriden.com/the-inflammation-from-a1-milk-is-mind-boggling/
(3) Magnesium for hormonal balance https://www.ncbi.nlm.nih.gov/pubmed/28392498
(4) Exercise reduces insulin resistance https://bmcsportsscimedrehabil.biomedcentral.com/articles/10.1186/s13102-018-0110-8
(5) The OCP use can lead to insulin resistance https://www.ncbi.nlm.nih.gov/pubmed/27538888
(6) Stress and the HPA axis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5666903/