A Functional Medicine Guide to Naturally Balanced Hormones
Hormones are vital to our mood, our sleep, our motivation and well-being. And imbalances in hormones can cause apathy, poor exercise recovery, insomnia, and a lack of drive (yes, sex drive, but also more generally lowering our motivation).
I recently enjoyed an excellent podcast, Huberman Lab Podcast #67 with Dr. Kyle Gillett on hormone health, which prompted me to write this blog post..
The podcast is about three hours long, and at some points they get into some pretty nuanced discussions that I found interesting. But if you don’t have the time, I wanted to summarize a few of the key concepts that resonated with me and add a few of my own thoughts.
How balanced are your hormones?
For premenopausal women, it’s often pretty easy to have a sense of hormone balance because menstrual cycles and symptoms around menses give us a lot of clues. If we suffer from severe cramps, premenstrual breast tenderness, and mood swings, then estrogen dominance might be at play. If menstrual cycles are irregular or absent for prolonged periods, then our hormone levels might be too low.
But for women who do not have a menstrual cycle, whether post menopausal, due to a hysterectomy, or for men, we have to be a little more astute in determining if hormonal imbalance is at play.
The Six Pillars of Hormone Health
As presented by Dr. Gillett on this podcast these six foundational pieces strongly influence hormone health for both women and men. Understanding these pillars in the context of your own health can help you make small changes to optimize your own hormones.
Diet
Exercise
Stress and Stress Optimization
Sleep
Sunlight and Nature
Spirit
Let’s look at each of these in a little more detail.
Diet for hormone health
The first pillar Dr. Gillett addresses in the context of hormone health is diet. This is hugely individualized with the aim of improving metabolic flexibility (which I wrote about in detail here) and using diet to maintain optimal body weight.
A few guidelines to help you get started with a healthy diet:
Remove or minimize any added sugars.
Healthy carbohydrates like sweet potatoes, winter squashes, legumes and gluten free grains, as needed depending on your activity level and metabolism.
Adequate protein favoring grass fed and grass finished meats, free range poultry, wild caught low mercury seafood like salmon and sardines, and chicken and duck eggs.
Lots of healthy fats, including olive oil and olives, avocado, butter or ghee from grass fed cows, and coconut oil.
Since diet is so individualized, how do you know if you’re on the right diet?
Use regular blood work to look at fasting levels of glucose, insulin, and hemoglobin A1c (approximating your average glucose over the past two to three months), along with a lipid panel to include triglycerides. Sometimes a few other markers can be helpful, but those are the basics. A functional medicine doctor can help guide the appropriate labs and develop a customized diet plan based on your results and goals.
Exercise for optimal hormone health
I would give almost equal importance to diet and exercise in the setting of hormone health. However, I want to think of exercise here as movement. So even if you’re not able to include more formal exercise into your current routine, then just think about movement during the day, whether taking the stairs instead of the elevator, parking your car further from the entrance, or just spending a few extra minutes playing with your dog. Even if you can include a 45 or 60 minute exercise session it’s still important to move throughout your day.
In thinking about exercise for improving healthspan, a few components to include:
Cardiovascular exercise for about 180 minutes each week, favoring a moderate intensity where you could still hold a conversation but just barely (you may also hear this called Zone 2). And throw in a few sessions of high intensity interval training (HIIT) with bursts of all out effort.
Strength training, both upper and lower body, aiming for at least 30 minutes three to four days each week. Supporting and maintaining our lean body mass (i.e. muscle) helps to improve metabolic flexibility, hormone balance, and improves healthspan.
Mobility training to support balance and moving well. (Note that this is more important for longevity than hormone health, so I’ve just included it here for completeness.)
Stress and stress optimization
Because our hormones extend beyond just sex hormones, we can’t think about sex hormones in isolation. Importantly, we need to think about the hypothalamic-pituitary-adrenal (HPA) axis, and even further, the hypothalamic-pituitary-thyroid-adrenal-gonadal axis (even if it is quite a mouthful).
The hypothalamus and pituitary gland are in the brain, and they send signals to the rest of the body to indicate whether we are in danger or whether we are safe and can rest and relax.
So our perceived stress influences our physiology, which we certainly all know from experience. And part of how our physiology is influenced is through the hypothalamic and pituitary signaling to our thyroid gland (influencing thyroid hormone production), to our adrenal glands (affecting cortisol output), and to our ovaries or testes (guiding production of sex hormones). And these are all interconnected through various pathways.
We can summarize this by saying cortisol, our primary stress hormone which is produced by the adrenal glands, can influence our sex hormones. So the more we can work to balance our stress (or perceived stress), calm and settle our nervous system, and support healthy cortisol, then the better balance we will see in our sex hormones.
Tips to reduce stress (or perceived stress) throughout your day:
Slow, rhythmic, diaphragmatic breathing
Spend time in nature
Humming, or making an “om” sound can help calm your nervous system
Sleep and your hormones
It’s really difficult to overemphasize the importance of sleep. Prioritizing and improving sleep can improve hormone balance, insulin sensitivity (i.e., how well you can tolerate carbohydrates), and lower feelings of anxiety.
And importantly, sometimes hormonal imbalances can cause sleep disruption. In particular, some women struggle with sleep around menopause because of lowered progesterone levels. Starting progesterone replacement with a functional medicine doctor can dramatically improve sleep.
Somewhat similarly with men, low testosterone levels can impair sleep. But we also need to be aware that when starting testosterone replacement therapy (TRT) there is an increased risk of sleep apnea, and occasionally within the first month or two of starting TRT we see a hyper-sympathetic response that can disrupt sleep.
If your not sleeping well, a few ideas to consider:
Create a consistent sleep schedule
Limit or avoid blue light (such as from your phone or TV screen)
Avoid caffeine late in the day
Skip alcohol before bed (though alcohol might help you fall asleep, it actually disrupts your natural sleep cycles)
Try having your last calorie intake two to three hours before bed
Try lowering EMF exposures overnight, such as turning your Wifi off and removing all electronics from your bedroom
Sunlight and nature
Most people have been told getting too much sun is dangerous for your skin. And while too much midday sun can cause harm if you reach the point of burning, getting appropriate sunlight every day is actually really good for you. Going outside and sitting in the sun first thing in the morning is not only a pleasant way to start your day, but it also sets off a cascade of hormones that normalize your circadian rhythm (making it easier to fall asleep that evening).
According to a 2017 study, people who are exposed to sunlight in the morning sleep better at night and feel less stressed and depressed than people who don’t get morning sunlight.
In addition to the sun’s positive impact on our hormones, spending time in nature can lower stress hormone levels and calm your nervous system.
Body, mind, and spirit connection
I like that Dr. Gillett included this in his discussion of hormone balance, more so in the general context of well being. He acknowledged that spirit or spirituality may look different for everyone, from religious to atheist to more general feelings of spirituality. It’s a beautiful reminder that our physiology and well being is affected by so much more than the sum of the parts.
Even if we are doing all the right things for our physical body, we cannot truly heal if our mind and spirit are living in a toxic place.
How a functional medicine doctor can help
If you believe you have hormonal imbalances, either mild symptoms or a diagnosed condition, it can be helpful to work with an integrative and functional medicine doctor to understand how these 6 pillars are affecting your health. In addition to providing you with nutrition and lifestyle guidance to improve health, we can also use comprehensive testing and look at hormone replacement therapy and targeted supplements when appropriate
To get relief from the symptoms associated with hormonal imbalance, call or book an appointment with us here.