Your thyroid is a gland located behind your Adam’s apple. Its job is to produce thyroxine (T4) and triiodothyronine (T3) which are the hormones that control your metabolism. This process of transforming the food you eat into energy can result in (T)erminator-like symptoms where you begin to feel inhuman.
Think of the story of the tortoise and the hare. Hypothyroidism occurs when the thyroid is under-producing these hormones and can lead to Hashimoto’s thyroiditis. Hyperthyroidism occurs when too many hormones are being produced and can lead to Graves’ disease. Balance is the key to keeping your body running well.
If you are a woman, you know how much our hormones can take over and drive us either straight and narrow, or straight into a truck depending on stress, menstruation, food or environmental triggers. Men are not immune from thyroid disorders. Women tend to have higher instances with thyroid disorders, generally after menopause. Regardless of gender, autoimmune-related thyroid conditions are on the rise.
An early sign of thyroid irregularity is weight gain or loss. Since your thyroid can control your energy, it’s no wonder your weight can be affected. Rapid weight gain can be an indicator of low thyroid hormone function, while weight loss can be triggered by an overactive thyroid gland.
Fatigue
Just like weight gain, fatigue or excessive tiredness can be a sign of hypothyroidism or low thyroid function.
Brain fog
Thyroid hormones are directly related to the health of your brain neurons. There are only two things that every single cell in the body has a receptor for: thyroid hormones and vitamin D. It’s no wonder that vitamin D status influences thyroid function and your immune system.
Intolerance to heat or cold
Your circulation is affected if your thyroid is not functioning properly. This could present as feeling chilled or cold. If you notice that your hands and feet are particularly cold, this could be a symptom or sign of hypothyroidism. Alternatively, you might always run warm or experience hot flashes.
Poor quality hair skin nail
A slow thyroid can cause dry skin, hair loss,and brittle or ridged nails caused by follicle cycling. Sometimes slow and steady does not always win the race.
Digestive problems
Leaky gut and gastrointestinal discomfort are most often connected to thyroid dysfunction. Constipation is caused by a sluggish metabolism (lower thyroid hormone), while loose stools could be a symptom or a hyperactive thyroid.
Insomnia
When your hormones are out of whack, everything seems to follow suit. Whether your thyroid is over- or under-producing, you can have disrupted sleep from nervousness, be up with frequent urination, or experience night sweats.
Anxiety/depression
Hormones are the major players in mood regulation. They influence the neurotransmitters which cause imbalances in serotonin and dopamine. Thyroid imbalances cause inflammation, and when the hormone production is interrupted, it can affect proper blood flow to the brain.
Changes in your voice
An underactive thyroid can cause thickening of the vocal cords or swelling from the inflammatory changes.
Hormonal fluctuations
Your thyroid can directly affect your sexual function. From irregular periods to difficulty with sexual performance or enjoyment, your thyroid dysfunction may be a contributor.
The Thyroid-Autoimmune Connection
Are you aware that more than 90% of thyroid conditions are autoimmune? Unfortunately, most conventional doctors do not have the education or information about this connection. This can be incredibly frustrating!
What if you are taking thyroid medication but still experiencing these symptoms? Commonly, providers are not taught how to look at chemistry and physiology, but do prescribe medication for your symptoms. We at Dr. Autoimmune addresses the systems that run the symptoms, diagnose your particular imbalances with comprehensive blood chemistry, and create a customized care plan for you!
If you suspect your thyroid is the culprit of any of these symptoms, Dr. Autoimmune can help. We test specifically for all 8 thyroid markers. We have worked with close to 3,000 thyroid clients and have an 85% success rate! Call us at 303-882-8447 or fill out the form below today to see if your thyroid needs support.
Are you ready to overhaul your COVID symptoms? Finding relief at the end of a very long, arduous fight can be resolved with proper diagnostics and support. Getting to the root cause of your aches and pains is just what Dr. Autoimmune ordered.
What is long COVID?
Current research is conflicting, but it appears continuing symptoms could persist 1-3 months after infection, or even longer. The virus can trigger inflammation in various systems in your body, creating one or more symptoms.
If you have tested positive, or know you were exposed and have new or persisting symptoms from the the list below, your inflammation could be getting the better of you. Unfortunately these symptoms are so common that one research article indicated 52% of 16-30 year olds had symptoms at 6 months post-infection. These are some of the symptoms associated with long COVID:
Neurological:
Insomnia
Headaches
Fatigue
‘Brain fog’
Anxiety/depression
Memory impairments
Pain syndromes
Lung / Pulmonary:
Reduced lung capacity
Wheezing / gasping / unable to get full breath
Chest pain / tightness
Cardiac:
Palpitations
Abnormal heart rhythm
Clotting abnormalities
Gastrointestinal:
Abdominal pain
Nausea
Weight loss
Constipation
IBS
Endocrine:
Elevated insulin
Fatigue after meals
Shaky, lightheaded or ‘hangry’
Why me?
Long COVID thrives on immune system weaknesses! There are multiple reasons why some experience long symptoms, while others are unscathed. Contributing factors may include age, obesity, inflammatory markers, and insulin resistance (IR). IR is when your cells resist insulin and can no longer use glucose for energy. This can cause sugar cravings after meals, weight loss resistance, and fatigue.
One of the common symptoms of long COVID, loss of smell and taste, may indicate that the brain is resistant to insulin and therefore not getting enough fuel. Insulin resistance can lead to neurodegeneration (conditions like Parkinson’s and Alzheimers). Correcting insulin imbalances often lessen or eradicate symptoms.
How do we control insulin resistance?
Functional medicine might be the answer to your blood sugar handling issues. Assessing inflammation in the body is the first step for determining if your problem is systemic and what the root cause may be. Commonly, the culprit is in your gut. Imbalances in your microbiome have a profound effect on all of your bodily systems. Hormone imbalances can have a similar impact. Could cortisol and stress dysregulation be causing sleep disturbances, leading to insulin resistance? A resounding yes!
Dr. Autoimmune can help!
We have seen a dramatic increase of long COVID cases hauling their way through our practice. For many, autoimmunity was triggered or exasperated by the virus. Our proprietary process of diet, supplementation, lifestyle strategies and therapies can change your life. We have even seen cases that are now two years old improve or remiss!
Call us today and find out how our New Patient Exam process can help your health soar.
In Part 1 of this series we covered cortisol, progesterone, and their relationship. Though the vast majority of hormones are made of protein, both of these are steroid hormones made of cholesterol. Estrogen is another steroid hormone. It is the main female sex hormone, but it also plays an important role in male bodies.
Estrogen: The Breakdown
Estrogen is responsible for most of the physical changes in the female body related to reproduction. It stores fat in certain areas leading to ‘curviness’, plumps skin, and grows the breasts and pubic hair in females. It also has other important functions such as improving immunity and memory, strengthening bones, controlling cholesterol levels, and maintaining a balanced mood.
Estrone (E1) = the only estrogen produced after menopause
Estradiol (E2) = main estrogen in females of reproductive age
Estriol (E3) = produced during pregnancy
The two main sex hormones (hormones involved in reproduction) in females are progesterone and estrogen. As we discussed before, progesterone dominates the second half of the menstrual cycle, maintaining the thick uterine lining to prepare for pregnancy. That thick uterine lining exists thanks to estrogen, who dominates the first half of the cycle. Here is that visual again to refresh your memory:
A Finicky Relationship
One of the most common hormonal imbalances seen in females is between progesterone and estrogen. This imbalance is known as estrogen dominance. In males, this presents as an imbalance between testosterone and estrogen. Even though estrogen does important things like keeping bones strong, the key to balanced health is balanced hormones! One of progesterone’s most important roles is to balance out estrogen after it gets ramped up during the first half of the menstrual cycle. When estrogen levels in the body are too high, you risk developing estrogen-related cancers and experience a range of symptoms.
Because estrogen dominance describes the relationship between estrogen and progesterone, there are a few ways it can present. Estrogen levels could be normal, but if progesterone levels are low, you have estrogen dominance. The opposite can result in the same: If progesterone levels are normal, but estrogen levels are high, you have estrogen dominance.
Symptoms of Estrogen Dominance
If you menstruate, you may have experienced some (or all) of these symptoms. Though they are common in our society, they are likely the result of a hormone imbalance that you can get under control with proper nutrition and supplementation and the help of a functional medicine practitioner.
Females:
Heavy or irregular periods
Water retention and swelling
Breast tenderness and breast changes
Headaches or migraines
Weight gain
Mood swings
Painful periods
PMS symptoms
Fertility challenges
Hypothyroidism
Sugar cravings
Uterine fibroids (benign growths around or in the uterus)
Estrogen is created in the ovaries/testes, adrenal glands, and fat tissue. In normal amounts, it keeps our bodies well balanced. However, high amounts of fat tissue can result in extra production of estrogen, which in turn encourages more fat storage. This cycle can lead to unwanted weight gain. On top of that, estrogen has been shown to discourage the breakdown of fat cells, especially in the midsection (hips and waist).
Estrogen dominance over time can lead to more serious health issues, such as heart attacks, breast or ovarian cancer, blood clots, and stroke.
Estrogen and autoimmunity
Estrogen is known to be an immune-enhancer, whereas androgens and progesterone are immune-suppressors. This is an important piece of information for people living with autoimmune diseases such as Hashimoto’s thyroiditis, rheumatoid arthritis, and multiple sclerosis. Autoimmune diseases manifest when one’s immune system is overactive and starts to attack the body’s own tissue. In this case, having estrogen continue to ramp up your immune system is going to cause further damage. This is the reason that about 78% of people with autoimmune diseases are women.
What causes estrogen dominance?
High estrogen levels can be partially hereditary, but it can also be caused (or triggered) by external sources such as hormonal contraceptives, some antibiotics, and other medications, including the popular hormone replacement therapy used to ‘treat’ menopause symptoms. Other factors that contribute are gut dysbiosis, a low fiber diet, and alcohol consumption. The most common mechanism we see in clinical practice is estrogen dominance due to insulin resistance. When insulin is spiking to control blood sugar this creates fat cells and fat cells secrete more estrogen. This in turn alters the ratios of hormones and can increase inflammation which impacts all areas of the body. As this continues it’s almost like a train gaining steam without brakes. The estrogen dominance then facilitates inflammation which in turn causes more insulin resistance (and on and on…).
Another cause of estrogen dominance can be polycystic ovary syndrome (PCOS), which we mentioned in Part 1 as a cause of low progesterone levels. PCOS can be caused by high levels of androgens (male hormones). Symptoms can include acne, facial hair or male pattern baldness in females. PCOS may be manageable through proper nutrition. One group of researchers studied women with PCOS and found that by decreasing the amount of refined carbohydrates in their diets, insulin sensitivity could be induced. Insulin sensitivity, being the opposite of insulin resistance, can help increase levels of progesterone and therefore decrease levels of estrogen.
Insulin resistance promotes the enzyme aromatase, which converts androgens to estrogen. It also inhibits sex-hormone-binding globulin, resulting in more free estrogen. We’ll talk more extensively about insulin resistance in part 3 of this series.
Excess fat, stress, impaired digestion and detoxification pathways, and external estrogen copy-cats such as xeno- and phytoestrogens can also lead to increased levels of estrogen. The body metabolizes hormones and gets rid of them through detoxification pathways. When these processes aren’t functioning properly (or genetic alterations are present), estrogen will remain in the body for long periods of time.
Xenoestrogens are synthetic, man-made chemicals that resemble estrogen and act on estrogen receptors in the body. They are found in things like plastics, cosmetics (we absorb up to 60% of what we put on our skin!), and birth control pills. Phytoestrogens on the other hand, come from plants and have less of an impact (though still an impact!) on the body’s natural estrogen levels. Soy is the most common culprit in this family of estrogen disruptors.
What’s next?
The functional medicine approach to all hormone imbalances is represented in the pneumonic “PTSD”. Let’s apply it to estrogen!
Production:
Estrogen is made in multiple places, but we can have the most control over our fat tissue. This does not mean that you need to eat less. Our bodies need to be nourished! Exercise and proper nutrition will help us control excess fat buildup.
We can limit our exposure to external estrogen-like chemicals. Choosing clean cosmetics and organic foods is one way to reduce our intake of xenoestrogens. Avoiding foods like soy can reduce our intake of phytoestrogens.
Transport
More available estrogen as a result of dysregulated transportation pathways can lead to estrogen dominance.
Sensitivity
A cell’s sensitivity to a hormone may have an impact. For instance, a cell with a rigid membrane may not allow for estrogen to enter. When estrogen receptors are defective, it can result in an estrogen resistance condition and therefore more free estrogen.
Detoxification
If detoxification pathways are not functioning optimally and estrogen isn’t being excreted at a normal rate, that leaves more of it to cause an imbalance. We can provide our bodies with nutrients that support healthy digestion and a healthy liver for detoxing.
If you suspect you may have estrogen dominance, you should consider meeting with a practitioner who understands how to identify root causes and will work with you to create a personalized plan for balancing your hormones. Contact us using the form below to get started!
Stay tuned for Part 3 of our hormone series, where we will dive deeper into another very common hormone imbalance: insulin resistance.
Contact us:
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!
Your thyroid is a gland located behind your Adam’s apple. Its job is to produce thyroxine (T4) and triiodothyronine (T3) which are the hormones that control your metabolism. This process of transforming the food you eat into energy can result in (T)erminator-like symptoms where you begin to feel inhuman.
Think of the story of the tortoise and the hare. Hypothyroidism occurs when the thyroid is under-producing these hormones and can lead to Hashimoto’s thyroiditis. Hyperthyroidism occurs when too many hormones are being produced and can lead to Graves’ disease. Balance is the key to keeping your body running well.
If you are a woman, you know how much our hormones can take over and drive us either straight and narrow, or straight into a truck depending on stress, menstruation, food or environmental triggers. Men are not immune from thyroid disorders. Women tend to have higher instances with thyroid disorders, generally after menopause. Regardless of gender, autoimmune-related thyroid conditions are on the rise.
An early sign of thyroid irregularity is weight gain or loss. Since your thyroid can control your energy, it’s no wonder your weight can be affected. Rapid weight gain can be an indicator of low thyroid hormone function, while weight loss can be triggered by an overactive thyroid gland.
Fatigue
Just like weight gain, fatigue or excessive tiredness can be a sign of hypothyroidism or low thyroid function.
Brain fog
Thyroid hormones are directly related to the health of your brain neurons. There are only two things that every single cell in the body has a receptor for: thyroid hormones and vitamin D. It’s no wonder that vitamin D status influences thyroid function and your immune system.
Intolerance to heat or cold
Your circulation is affected if your thyroid is not functioning properly. This could present as feeling chilled or cold. If you notice that your hands and feet are particularly cold, this could be a symptom or sign of hypothyroidism. Alternatively, you might always run warm or experience hot flashes.
Poor quality hair skin nail
A slow thyroid can cause dry skin, hair loss,and brittle or ridged nails caused by follicle cycling. Sometimes slow and steady does not always win the race.
Digestive problems
Leaky gut and gastrointestinal discomfort are most often connected to thyroid dysfunction. Constipation is caused by a sluggish metabolism (lower thyroid hormone), while loose stools could be a symptom or a hyperactive thyroid.
Insomnia
When your hormones are out of whack, everything seems to follow suit. Whether your thyroid is over- or under-producing, you can have disrupted sleep from nervousness, be up with frequent urination, or experience night sweats.
Anxiety/depression
Hormones are the major players in mood regulation. They influence the neurotransmitters which cause imbalances in serotonin and dopamine. Thyroid imbalances cause inflammation, and when the hormone production is interrupted, it can affect proper blood flow to the brain.
Changes in your voice
An underactive thyroid can cause thickening of the vocal cords or swelling from the inflammatory changes.
Hormonal fluctuations
Your thyroid can directly affect your sexual function. From irregular periods to difficulty with sexual performance or enjoyment, your thyroid dysfunction may be a contributor.
The Thyroid-Autoimmune Connection
Are you aware that more than 90% of thyroid conditions are autoimmune? Unfortunately, most conventional doctors do not have the education or information about this connection. This can be incredibly frustrating!
What if you are taking thyroid medication but still experiencing these symptoms? Commonly, providers are not taught how to look at chemistry and physiology, but do prescribe medication for your symptoms. We at Dr. Autoimmune addresses the systems that run the symptoms, diagnose your particular imbalances with comprehensive blood chemistry, and create a customized care plan for you!
If you suspect your thyroid is the culprit of any of these symptoms, Dr. Autoimmune can help. We test specifically for all 8 thyroid markers. We have worked with close to 3,000 thyroid clients and have an 85% success rate! Call us at 303-882-8447 or fill out the form below today to see if your thyroid needs support.
Are you ready to overhaul your COVID symptoms? Finding relief at the end of a very long, arduous fight can be resolved with proper diagnostics and support. Getting to the root cause of your aches and pains is just what Dr. Autoimmune ordered.
What is long COVID?
Current research is conflicting, but it appears continuing symptoms could persist 1-3 months after infection, or even longer. The virus can trigger inflammation in various systems in your body, creating one or more symptoms.
If you have tested positive, or know you were exposed and have new or persisting symptoms from the the list below, your inflammation could be getting the better of you. Unfortunately these symptoms are so common that one research article indicated 52% of 16-30 year olds had symptoms at 6 months post-infection. These are some of the symptoms associated with long COVID:
Neurological:
Insomnia
Headaches
Fatigue
‘Brain fog’
Anxiety/depression
Memory impairments
Pain syndromes
Lung / Pulmonary:
Reduced lung capacity
Wheezing / gasping / unable to get full breath
Chest pain / tightness
Cardiac:
Palpitations
Abnormal heart rhythm
Clotting abnormalities
Gastrointestinal:
Abdominal pain
Nausea
Weight loss
Constipation
IBS
Endocrine:
Elevated insulin
Fatigue after meals
Shaky, lightheaded or ‘hangry’
Why me?
Long COVID thrives on immune system weaknesses! There are multiple reasons why some experience long symptoms, while others are unscathed. Contributing factors may include age, obesity, inflammatory markers, and insulin resistance (IR). IR is when your cells resist insulin and can no longer use glucose for energy. This can cause sugar cravings after meals, weight loss resistance, and fatigue.
One of the common symptoms of long COVID, loss of smell and taste, may indicate that the brain is resistant to insulin and therefore not getting enough fuel. Insulin resistance can lead to neurodegeneration (conditions like Parkinson’s and Alzheimers). Correcting insulin imbalances often lessen or eradicate symptoms.
How do we control insulin resistance?
Functional medicine might be the answer to your blood sugar handling issues. Assessing inflammation in the body is the first step for determining if your problem is systemic and what the root cause may be. Commonly, the culprit is in your gut. Imbalances in your microbiome have a profound effect on all of your bodily systems. Hormone imbalances can have a similar impact. Could cortisol and stress dysregulation be causing sleep disturbances, leading to insulin resistance? A resounding yes!
Dr. Autoimmune can help!
We have seen a dramatic increase of long COVID cases hauling their way through our practice. For many, autoimmunity was triggered or exasperated by the virus. Our proprietary process of diet, supplementation, lifestyle strategies and therapies can change your life. We have even seen cases that are now two years old improve or remiss!
Call us today and find out how our New Patient Exam process can help your health soar.
In Part 1 of this series we covered cortisol, progesterone, and their relationship. Though the vast majority of hormones are made of protein, both of these are steroid hormones made of cholesterol. Estrogen is another steroid hormone. It is the main female sex hormone, but it also plays an important role in male bodies.
Estrogen: The Breakdown
Estrogen is responsible for most of the physical changes in the female body related to reproduction. It stores fat in certain areas leading to ‘curviness’, plumps skin, and grows the breasts and pubic hair in females. It also has other important functions such as improving immunity and memory, strengthening bones, controlling cholesterol levels, and maintaining a balanced mood.
Estrone (E1) = the only estrogen produced after menopause
Estradiol (E2) = main estrogen in females of reproductive age
Estriol (E3) = produced during pregnancy
The two main sex hormones (hormones involved in reproduction) in females are progesterone and estrogen. As we discussed before, progesterone dominates the second half of the menstrual cycle, maintaining the thick uterine lining to prepare for pregnancy. That thick uterine lining exists thanks to estrogen, who dominates the first half of the cycle. Here is that visual again to refresh your memory:
A Finicky Relationship
One of the most common hormonal imbalances seen in females is between progesterone and estrogen. This imbalance is known as estrogen dominance. In males, this presents as an imbalance between testosterone and estrogen. Even though estrogen does important things like keeping bones strong, the key to balanced health is balanced hormones! One of progesterone’s most important roles is to balance out estrogen after it gets ramped up during the first half of the menstrual cycle. When estrogen levels in the body are too high, you risk developing estrogen-related cancers and experience a range of symptoms.
Because estrogen dominance describes the relationship between estrogen and progesterone, there are a few ways it can present. Estrogen levels could be normal, but if progesterone levels are low, you have estrogen dominance. The opposite can result in the same: If progesterone levels are normal, but estrogen levels are high, you have estrogen dominance.
Symptoms of Estrogen Dominance
If you menstruate, you may have experienced some (or all) of these symptoms. Though they are common in our society, they are likely the result of a hormone imbalance that you can get under control with proper nutrition and supplementation and the help of a functional medicine practitioner.
Females:
Heavy or irregular periods
Water retention and swelling
Breast tenderness and breast changes
Headaches or migraines
Weight gain
Mood swings
Painful periods
PMS symptoms
Fertility challenges
Hypothyroidism
Sugar cravings
Uterine fibroids (benign growths around or in the uterus)
Estrogen is created in the ovaries/testes, adrenal glands, and fat tissue. In normal amounts, it keeps our bodies well balanced. However, high amounts of fat tissue can result in extra production of estrogen, which in turn encourages more fat storage. This cycle can lead to unwanted weight gain. On top of that, estrogen has been shown to discourage the breakdown of fat cells, especially in the midsection (hips and waist).
Estrogen dominance over time can lead to more serious health issues, such as heart attacks, breast or ovarian cancer, blood clots, and stroke.
Estrogen and autoimmunity
Estrogen is known to be an immune-enhancer, whereas androgens and progesterone are immune-suppressors. This is an important piece of information for people living with autoimmune diseases such as Hashimoto’s thyroiditis, rheumatoid arthritis, and multiple sclerosis. Autoimmune diseases manifest when one’s immune system is overactive and starts to attack the body’s own tissue. In this case, having estrogen continue to ramp up your immune system is going to cause further damage. This is the reason that about 78% of people with autoimmune diseases are women.
What causes estrogen dominance?
High estrogen levels can be partially hereditary, but it can also be caused (or triggered) by external sources such as hormonal contraceptives, some antibiotics, and other medications, including the popular hormone replacement therapy used to ‘treat’ menopause symptoms. Other factors that contribute are gut dysbiosis, a low fiber diet, and alcohol consumption. The most common mechanism we see in clinical practice is estrogen dominance due to insulin resistance. When insulin is spiking to control blood sugar this creates fat cells and fat cells secrete more estrogen. This in turn alters the ratios of hormones and can increase inflammation which impacts all areas of the body. As this continues it’s almost like a train gaining steam without brakes. The estrogen dominance then facilitates inflammation which in turn causes more insulin resistance (and on and on…).
Another cause of estrogen dominance can be polycystic ovary syndrome (PCOS), which we mentioned in Part 1 as a cause of low progesterone levels. PCOS can be caused by high levels of androgens (male hormones). Symptoms can include acne, facial hair or male pattern baldness in females. PCOS may be manageable through proper nutrition. One group of researchers studied women with PCOS and found that by decreasing the amount of refined carbohydrates in their diets, insulin sensitivity could be induced. Insulin sensitivity, being the opposite of insulin resistance, can help increase levels of progesterone and therefore decrease levels of estrogen.
Insulin resistance promotes the enzyme aromatase, which converts androgens to estrogen. It also inhibits sex-hormone-binding globulin, resulting in more free estrogen. We’ll talk more extensively about insulin resistance in part 3 of this series.
Excess fat, stress, impaired digestion and detoxification pathways, and external estrogen copy-cats such as xeno- and phytoestrogens can also lead to increased levels of estrogen. The body metabolizes hormones and gets rid of them through detoxification pathways. When these processes aren’t functioning properly (or genetic alterations are present), estrogen will remain in the body for long periods of time.
Xenoestrogens are synthetic, man-made chemicals that resemble estrogen and act on estrogen receptors in the body. They are found in things like plastics, cosmetics (we absorb up to 60% of what we put on our skin!), and birth control pills. Phytoestrogens on the other hand, come from plants and have less of an impact (though still an impact!) on the body’s natural estrogen levels. Soy is the most common culprit in this family of estrogen disruptors.
What’s next?
The functional medicine approach to all hormone imbalances is represented in the pneumonic “PTSD”. Let’s apply it to estrogen!
Production:
Estrogen is made in multiple places, but we can have the most control over our fat tissue. This does not mean that you need to eat less. Our bodies need to be nourished! Exercise and proper nutrition will help us control excess fat buildup.
We can limit our exposure to external estrogen-like chemicals. Choosing clean cosmetics and organic foods is one way to reduce our intake of xenoestrogens. Avoiding foods like soy can reduce our intake of phytoestrogens.
Transport
More available estrogen as a result of dysregulated transportation pathways can lead to estrogen dominance.
Sensitivity
A cell’s sensitivity to a hormone may have an impact. For instance, a cell with a rigid membrane may not allow for estrogen to enter. When estrogen receptors are defective, it can result in an estrogen resistance condition and therefore more free estrogen.
Detoxification
If detoxification pathways are not functioning optimally and estrogen isn’t being excreted at a normal rate, that leaves more of it to cause an imbalance. We can provide our bodies with nutrients that support healthy digestion and a healthy liver for detoxing.
If you suspect you may have estrogen dominance, you should consider meeting with a practitioner who understands how to identify root causes and will work with you to create a personalized plan for balancing your hormones. Contact us using the form below to get started!
Stay tuned for Part 3 of our hormone series, where we will dive deeper into another very common hormone imbalance: insulin resistance.
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!
