Welcome to our hormone series! We hear all the time that people are curious about hormones, but their complexity makes understanding them a bit difficult. Because of this, we wanted to do a multi-part series covering some of our major hormones and how they interact with each other. We’ll start with cortisol and progesterone. Follow along for more!

The human body is big, complicated, and extremely interconnected. Hormones are the signals our bodies use to communicate. Hormone balance is essential for maintaining and regulating your body’s systems. Your hormones all follow certain cycles of creation, usage, metabolism, and elimination. When one or more steps in the cycle are problematic, a domino effect can occur and cause a myriad of functional issues within the body’s systems. This results in symptoms like irritability, weight gain, acne, and painful or irregular periods in females.

Nutrition and Hormone Signaling

Nutritional factors can either help balance hormone levels or disturb them. For example, having consistent intake of selenium, iodine, and iron help to balance thyroid hormones.

While environmental factors can affect hormone levels, we must also consider how they may impact hormone sensitivity. Some nutrition patterns can lead to our cells developing resistance to certain hormones; others may make them more sensitive. For example, some nutrition patterns could lead to rigid cell membranes, which can cause insulin resistance.

Another example of diet affecting hormone sensitivity can be observed in the case of leptin, a hormone released from adipose (fat) tissue. Excess leptin (caused by excess fat) has been shown to disrupt cells’ leptin receptor pathways by overstimulating them. In other words, the more fat tissue is present, the more leptin is produced, so the more leptin receptors are bombarded. When the leptin cannot be received but is continuously produced, levels of environmental leptin will increase and continue to overstimulate cell receptor pathways in a vicious cycle called “leptin-induced leptin resistance” that can lead to obesity.

Beyond nutritional factors, our hormone balance can be affected in other ways. Our bodies metabolize hormones the same way they do food. If these metabolic pathways are hindered, this will lead to imbalances.

In functional medicine, hormone imbalance issues are approached with the Institute for Functional Medicine’s (IFM’s) mnemonic device “PTSD”. By identifying where the dysfunction is coming from, we find the areas where we can intervene. 

“P” stands for Production, as in how much of the hormone is synthesized. 

“T” stands for Transport, referring to the interaction of hormones with other cells and how they are distributed. 

“S” stands for Sensitivity, which is the level of resistance a cell has to a hormone signal.

“D” stands for Detoxification- how well the body metabolizes and eliminates hormones.

Cortisol:

Unlike most hormones, which are made primarily of protein, cortisol is a steroid hormone made from cholesterol and therefore more similarly resembles fat. Cortisol is produced in the adrenal glands, which are small organs located just above our kidneys. The adrenal glands are also responsible for the production of adrenaline, noradrenaline, and DHEA (which is a precursor to a couple other hormones).

Cortisol functions on a diurnal cycle, which is one that occurs every 24 hours. It spikes at the beginning of the day upon waking and provides you with energy and alertness. Throughout the day, cortisol levels decrease until they are at their lowest point at the end of the night, allowing you to relax for bedtime.

All hormones have effects on systems in the body, not just one process. This is why maintaining their rhythm/cycle is so important. Cortisol connects the brain and adrenal glands in a system that is mainly responsible for our body’s stress response. The hypothalamus in the brain uses a hormone to signal the pituitary gland to produce another hormone that signals the release of cortisol (yet another hormone). You can see how the intricate relationship between all of our hormones would cause a domino effect when one or more is knocked out of balance.

What does it do?

Have you ever used hydrocortisone cream or heard of someone getting a cortisone injection? These medical interventions utilize cortisol’s anti-inflammatory properties to treat inflammation locally. Cortisol also plays a role in metabolism, raises blood sugar, regulates blood pressure, supports bone health, impacts mental health, and as we already discussed, maintains a healthy sleep-wake cycle.

What affects cortisol levels?

Acute and chronic stress can cause fluctuations during cortisol’s daily cycle. Anything from losing a loved one to driving in traffic can cause an impact. Stress does not need to be external, though. Internal stress factors include injuries, inflammation, microbiome imbalances, over-exercising, and exposure to toxins. This strong relationship led to cortisol’s nickname “the stress hormone”.

The internal stress factors I mentioned can be largely impacted by diet. Caffeine is known to raise cortisol levels and keep the body in a state of fight or flight, which can also increase inflammation in the body. (Check out this blog to read more about caffeine and cortisol.) Studies have suggested a link between increased cortisol levels and a Western diet consisting of saturated fats, simple sugars, and less fiber.

When an abnormal growth is present on the adrenal or pituitary gland (both components of the cortisol production system), extremely high levels of cortisol can result. This condition usually results in Cushing’s disease over time. Addison’s disease results from the exact opposite: extremely low levels of cortisol over time due to autoimmunity.

Functional medicine practitioners regularly test cortisol levels and identify and remove disruptors by learning about their patients’ individual situations.

Progesterone

Progesterone is a steroid hormone made from cholesterol, just like cortisol. It is calming, anti-inflammatory, and sleep-promoting. Its balance is more of a concern for females than males because of its importance during the second half of the menstrual cycle.

Progesterone is produced in the ovaries after ovulation. Its job is to maintain the thick uterine lining created by estrogen during the first half of the cycle and keep the uterus ready for pregnancy. If the egg isn’t fertilized after ovulation, progesterone levels drop and trigger menstruation (the shedding of the thick uterine lining). Progesterone is not created without ovulation.

Low Progesterone

Low levels of progesterone can cause symptoms such as PMS, anxiety, fatigue, low fertility, low libido, and migraines. Causes of this condition could include stress, age, estrogen dominance, insulin resistance, polycystic ovary syndrome (PCOS), and inflammation.

At Dr. Autoimmune, we use the wonderful and comprehensive DUTCH test to monitor hormone levels. Contact us using the form at the bottom of this page if you are interested in pursuing this test. We use natural methods to increase progesterone levels, such as enriching the diet with zinc-rich foods and supplementing with magnesium, vitamin B6, and herbs. Check out this case study to read a bit about an actual patient’s experience with hormone testing and how it helped with her case.

The Progesterone-Cortisol Connection

You may have noticed that stress can impact the production of both cortisol and progesterone, but in opposite directions. Stress increases cortisol production, but decreases progesterone production. Why is this?

Cortisol follows the HPA-axis (hypothalamus-pituitary-adrenal axis), and progesterone follows the HPO-axis (hypothalamus-pituitary-ovary axis). When the hypothalamus perceives stress, it makes a decision to prioritize survival over reproduction and decreases the production of reproductive hormones. It is a mechanism our bodies created in order to avoid becoming pregnant during times of famine or war.

Progesterone also plays an important role in balancing estrogen, another sex hormone. Stay tuned for Part 2 where we will dive into this relationship and the concept of estrogen dominance!

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    Ian really knows A LOT about thyroid problems! His knowledge and confidence convinced me to make the lifestyle changes -including no gluten, no sugar, and more exercise-that are essential to healing hormonal imbalances and to staying well. Several months later, I feel stronger, more energetic, and am happier than I have felt in a long time. Many thanks for all your help!

    - Anonymous

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