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One of the major areas that I focus on with my clientele is hormone balance. So many of the major symptoms of ill health are tied to the function of these critical chemical messengers. Mental clarity, memory, energy, weight control, sleep, happiness, bone strength, digestive function not to mention sexual health and reproduction are all intimately tied to the balance of this complex symphony.
What is surprising to me is just how many of my patients have serious hormone problems. I’m seeing it in both men and women and it is starting to show up in teenagers. If it seems like you’re noticing more and more people you know with hormone issues, you are correct.
The hormonal system is very complex with over 50 different hormones and pre-hormones that are all interconnected and constantly changing in an attempt to regulate us with our environment. Most of these hormones are secreted in very small amounts. A little goes a long way. Almost all of these hormones function in a negative feedback loop.
Negative feedback loops are like a thermostat in your home. There is a temperature sensor in the room or hallway that communicates with the heater. When the temperature gets above or below the desired set point, the thermostat tells the heater to turn on or off.
If your room is cold there are several things you could do. I suppose you could just put on a sweater. But doesn’t it make sense to first figure out what caused the room temperature to drop? What questions could you ask? Is the window open? Is the thermostat battery dead? Did someone reset it?
Literally just this morning I had a patient say to me, “hey I need to talk to you about my recent experience. My wife made us both appointments with a doctor who specializes in hormones. They did a blood test and told me that my testosterone was too low and then they wanted to stick a pellet full of testosterone in me. Something felt not quite right with that so I thought, I’m going to ask Dr. Duggar about this.”
Why is it then that we have become so enamored with replacing hormones when a blood test shows that they are below the optimal range? Is that always the right thing to do?
It seems that more and more people are learning that our modern living is causing hormonal havoc and they are turning to specialty clinics that have people do a simple blood test to confirm hormone levels and then if they are low, they prescribe bioidentical hormone replacement. These clinics are being advertised all over.
This sort of approach is very helpful for those people who have lost the ability to make the necessary hormones. It was born out of the model of dealing with menopausal women whose estrogen and progesterone levels plummet after they stop ovulating. But now we seem to have taken this model and applied it across the board. Any level that is low regardless of the age or situation of the patient is simply prescribed a replacement. Why is this done?
Because it is quick and simple. Usually, you can make a person feel better within a short amount of time.
Why do we assume that the body just can’t make hormones anymore? Does a 30 year old man with low testosterone need a shot? Does everyone with low thyroid levels need to be on a prescription of thyroid?
I submit that this approach is shortsighted. Remember, hormones are the end products of a long cascade of biochemical reactions. If there is a shortage at the end of the line, the problem lies upstream. Just replacing the hormone doesn’t solve the upstream problem. In fact, due to negative feedback, it is likely to downregulate production!
Even in circumstances where replacement is PART of the equation, it must be paired with a comprehensive approach to address the context.
So, let’s build out a more comprehensive approach together.
First, we’ve got to think about what might drive hormone production down. There are a lot of potential causes but let’s start with environmental factors.
Here are some really scary findings from a 2017 study by Shanna Swan, a reproductive epidemiologist at Mount Sinai’s Icahn School of Medicine, highlighted in her book “Count Down”.
- Between the years 1973 to 2011, human males sperm counts have dropped by 59.3%
- A significant portion of the population won’t be able to conceive children without technical assistance by the year 2050.
- This decline in sperm count is the result of dangerous man-made “endocrine-disrupting chemicals” (EDCs) that are now everywhere in our environment.
- Swan notes that humans already meet 3 of the 5 criteria for an endangered species.
Endocrine disruptors, which are widespread in plastic products, are similar in structure to natural sex hormones such as estrogen, thereby interfering with their normal functions — and more.
According to Pete Myers Ph.D., the future of humankind could ultimately be at risk:
“Your hormones have been hijacked. Your body’s astonishing, finely calibrated signal system — a system that controls everything from your weight to your fertility to your mood — has been scrambled by loosely regulated chemicals manufacturers use in a myriad of ways including in consumer products.
These hijackers — known to scientists as ‘endocrine-disrupting chemicals’ — are threatening our existence as a species. Driving this problem are chemical companies focused only on cheap plastics and regulators unwilling to do anything about it.”
In addition to the dramatic decrease in male sperm counts and concentrations and their overall lowering levels of testosterone, we are seeing a corresponding increase in female fertility problems ranging from miscarriages and birth defects to a decline in egg quality and quantity.
In some parts of the world, the average twenty-something woman is less fertile today than her grandmother was at age 35. This is a really huge problem!
Examples of EDCs:
- Bisphenol A (BPA) – found in food can linings and cash register receipts
- Phthalates – found in plastics (PVC products, vinyl shower curtains) and cosmetics (perfumes, nail polish, lotions)
- Flame retardants, solvents, lubricants (PCBs, PBBs, and PBDEs)
- Pesticides (sprayed on conventional fruits and vegetables), insecticides
- Heavy metals – cadmium, lead, arsenic, mercury
This 2015 report also linked EDCs to reproductive health issues, hormone-related cancers, prostate disorders, thyroid disease, and neurodevelopmental issues. The truth is, we all live in an ever-increasing toxic environment. More than 80,000 chemicals are introduced into the world each year. We are exposed to pesticides, herbicides, chemical solvents, xenobiotics, and industrial chemicals of all kinds through the food we eat, the water we drink, and the air we breathe. These toxins accumulate in our bodies and contribute to the total toxic load that can cause a variety of health problems. Keep in mind that our indoor environment is likely more toxic than our outdoor environment.
This information is sobering, isn’t it? What sort of world are we leaving for our children and grandchildren? I don’t even know what sort of effect you or I can make on this massive environmental collapse but we can make a difference in our own homes and families by following some basic principles.
Tips to Help Avoid EDCs:
- Eat organic produce (join your local CSA or ask your grocer to stock organic)
- Buy free-range, organic meats to reduce exposure to added hormones and pesticides
- Buy products available in glass containers rather than plastic or cans when possible
- Store food in glass containers, especially if reheating in the microwave
- Cookware: replace non-stick pans with glass, ceramic, stainless steel, or cast iron
- Drink filtered water
- Use a showerhead with a filter
- Avoid products labeled with “fragrance,” including air fresheners, as this catch-all term may include phthalates commonly used to stabilize the scent and extend the life of the product.
- Use glass baby bottles instead of plastic. Breastfeed exclusively for the first year, if you can, to avoid plastic nipples and bottles altogether.
- Cash register receipts are heat printed and often contain BPA. Handle the receipt as little as possible and ask the store to switch to BPA-free receipts.
- Avoid fabric softeners and dryer sheets; make your own to reduce static cling
What about other factors?
Physical and mental stress can play a huge role in creating hormone dysfunction. Chronic states of stress drive up our levels of cortisol and lower the functioning of thyroid hormones and over time can eventually lead to imbalances in estrogen, progesterone, and testosterone. Evolutionarily speaking, it isn’t very important to reproduce when you are under threat so there is a priority to getting into a safe situation before the body really cares about reproductive hormone health.
Another hormone that has a profound effect on all of the others is insulin. When our blood sugar is out of control and we tend to become resistant to the effects of insulin and we over convert our testosterone into estrogen. I’ve seen this time and again in patients who have low testosterone and have been put on a testosterone shot but who have an underlying problem with high stress and a poor diet. All of that excess testosterone just gets converted into more estrogen and they are still in the same boat they were in before.
So what is the take-home point here?
Remember that hormones are all interrelated. If any hormone level is lower than it should be, the state of the entire system needs to be considered.
Working on diet and lifestyle solutions will often create the context for the body to produce more normal levels of hormones so long as the gland hasn’t been destroyed or gone dormant in the case of menopause.
Eating a balanced diet that controls blood sugar and insulin levels. I think paleo, low carb or even ketogenic diets could be considered here. Smart supplementation can be implemented to make sure that specific pathways related to hormone function are supported.
I’ll also throw the use of herbal medicine into this category. There are some amazing herbs that can be used to support hormone health. In my opinion, this should be the first line of therapy in nearly all cases.
Exercise. I don’t even know if I could enumerate all of the mechanisms by which exercise contributes to improved production, metabolism, and cell receptor function of hormones.
Sleep. This is absolutely critical to resetting the circadian rhythms of the body. Specifically helping to balance cortisol rhythms.
According to a study published in the International Journal of Endocrinology in 2015,
“The regulation and metabolism of several hormones are influenced by interactions between the effects of sleep and the intrinsic circadian system; growth hormone, melatonin, cortisol, leptin, and ghrelin levels are highly correlated with sleep and circadian rhythmicity. Sleep disturbance,…negatively impacts hormonal rhythms and metabolism, [and] is also associated with obesity, insulin insensitivity, diabetes, hormonal imbalance, and appetite dysregulation.” 1
We all want our hormones balanced at the right levels that help us feel young and vital. That is a great goal. But let’s make sure that we’re willing to look at this problem holistically and address the lifestyle factors that are interfering with normal hormone function. I believe that that will dramatically reduce the need for hormone replacement and maximize our overall health.
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