If you’ve ever spent time Googling symptoms like fatigue or mood swings or are interested in optimizing your health, you’ve almost definitely come across “hormone imbalances ” being a factor that can keep you from feeling your best. But what is a hormone imbalance and which ones should you be looking out for?
Keep reading to learn about the most common hormone imbalances, what causes them, and how Parsley Health approaches hormonal imbalance treatment.
According to Carolyn Krieg, DO , an internal medicine physician specializing in functional medicine at Parsley Health, to understand what causes hormone imbalances you first have to understand the endocrine system. “Our endocrine system is the system in our body that produces hormones,” she says. You’ve got multiple endocrine glands all over your body, including the ovaries, adrenals, and testes. The ovaries and testes produce sex hormones, like testosterone and estrogen, and the adrenals produce stress hormones, like cortisol .
In the case of a hormonal imbalance, the hormone production in one of these glands goes awry. And unfortunately, when one hormone is thrown out of balance, it can affect others. Indeed, one of the most important things to know about the endocrine system is that “the hormones that are produced from each of those glands are very interrelated,” says Dr. Krieg. This means that a cortisol imbalance can contribute to an estrogen imbalance and vice versa. “One hormone imbalance can quickly become a snowball effect of different hormones getting knocked out of whack,” says Dr. Krieg.
Because your hormones are so interconnected and control nearly every system and process in the body, the symptoms can be wide-ranging, and a lot of this depends on the exact type of hormonal imbalance you may have. While there are many different types of hormonal imbalances, modern life puts us all most at risk for developing a few specific ones. Here, Dr. Krieg explains the most common hormone imbalances she sees in her office and some of the top causes of those hormonal imbalances.
“In women, estrogen dominance is basically when estrogen is higher than progesterone,” says Dr. Krieg. That can mean either that estrogen is high and progesterone is normal or estrogen is normal and progesterone is too low. “This can occur for many reasons but obesity, stress, and exposure to xenoestrogens are some of the most common causes of hormonal imbalance,” continues Dr. Krieg. If this is the first time you’re hearing the word xenoestrogens, they are man-made chemicals that mimic estrogen in your body. This can lead to estrogen buildup that your body can’t detox at a fast enough rate, which “causes symptoms such as severe PMS , painful and heavy periods, mood swings, anxiety , migraines, breast tenderness, endometriosis, fibrocystic breasts, uterine fibroids, water retention, and bloating ,” says Dr. Krieg.
We often make the mistake of thinking that hormone imbalances only occur in women, but sex hormone imbalances—and any imbalances for that matter, happen in men too. (While imbalances like low testosterone in women can occur, it’s much less common.) According to Dr. Krieg, hormone imbalances in men are becoming increasingly more common. “We’re seeing low testosterone levels in younger and younger men,” she says. Typically, testosterone levels naturally decline as you age, but experiencing this drop in testosterone earlier in life is typically due to lifestyle factors. Interestingly, one of the root causes of “low-T” is actually too much estrogen, which can be a result of chronic stress, obesity, too much alcohol, and again, too many xenoestrogens from the environment. “This causes problems like gynecomastia [swollen male breast tissue] and low libido,” explains Dr. Krieg.
The thyroid glands are another important endocrine gland to know about. “The most common thyroid imbalance is when the thyroid starts to function suboptimally,” says Dr. Krieg. This is something called hypothyroidism, the symptoms of which include fatigue, unexplained weight gain, and mood changes. (To learn more about the most common thyroid signs and symptoms, read this .) According to Krieg, the thyroid is very sensitive to stress, toxins, and also micronutrient depletion. “If you don’t have enough iodine, selenium, zinc, B2, C, A, D, or magnesium it can set you up for a thyroid issue,” she says. Nutritional deficiencies like this can often happen if you’re eating a diet high in processed foods, not getting enough variety in your diet, or have another underlying condition that impairs nutrient absorption.
As we learned earlier, our stress hormone cortisol is produced by the adrenal glands. Producing cortisol isn’t a one step process; in fact, it requires a complex series of events and a lot of intricate communication between the brain and the adrenal glands. When we are under chronic stress for a prolonged period of time, the delicate cascade of communication can get interrupted. Your body’s Hypothalamic-Pituitary-Adrenal Axis (HPA axis), responsible for releasing stress hormones, stays activated, so your body releases excess cortisol. Prolonged stress on the HPA axis may also lead to insufficient production of cortisol. Symptoms of a cortisol imbalance include chronic fatigue, weight gain and weight loss resistance, and cravings for caffeine, sugar, and carbs.
You’ve probably heard of insulin but you might not know that it’s actually a hormone. Insulin is produced by the pancreas and its main job is to regulate glucose in the body. It does this by helping glucose from the blood enter our cells so that we can turn glucose into usable energy.
But if you consistently consume excess sugar, are chronically stressed, and don’t exercise enough, you may be setting yourself up for an insulin imbalance. All these factors cause chronically high blood sugar, which can lead insulin production to malfunction. This can cause high blood sugar, pre-diabetes, and eventually, Type 2 diabetes. Common symptoms of insulin imbalance include an inability to concentrate, dizziness, sweating, headaches, and blurred vision.
Testosterone is a hormone most commonly associated with men. But women have testosterone, too, and one of the most common hormone imbalances in women is testosterone that is too high. According to Dr. Krieg, this can occur for many reasons but the most common underlying factor is insulin resistance. “When someone develops insulin resistance, the body produces more insulin as a response; and this higher insulin state causes the ovaries to produce more testosterone,” she explains. You may have heard of high testosterone before, probably as it relates to polycystic ovarian syndrome, or PCOS . As Dr. Krieg explains: “PCOS is considered a hyperandrogenic state, meaning you have high levels of androgen hormones like testosterone but also DHT, DHEA, and androstenedione.” High levels of testosterone and other androgen hormones cause symptoms like oily skin, acne , facial hair, and male-pattern baldness. That said, according to Dr. Krieg, you don’t always have to have high testosterone to have PCOS. “I prefer to say we typically see high testosterone with PCOS, but I have actually seen normal testosterone in women with high levels of the other androgens,” she explains.
Parsley Health approaches hormone imbalance treatment from a holistic perspective, which means advanced hormone testing to figure out exactly what’s going on, medication if it’s necessary, and a personalized lifestyle plan that will help correct the underlying causes of hormone imbalance. If you suspect you have a hormone imbalance, it’s best to work closely with a practitioner to determine the best course of action.
That said, there are some general suggestions that will help with any of the five most common hormone imbalances above.
How? Well, you’ll notice that there’s one factor that connects all five of the most common hormone imbalances above — and that factor is stress. More specifically, chronic stress.
“Stress is really the thing that pings each of these systems and connects everything,” says Dr. Krieg. Because of the overarching impact of stress, she almost always centers her hormone balancing lifestyle suggestions around stress reduction. “I would suggest relaxation practices like meditation , focusing on getting proper sleep , and I might suggest a group of herbs called adaptogens, which help support the adrenal glands,” says Dr. Krieg. (If you want to learn more about adaptogens, read this .)
A healthy diet is another critical aspect of l hormone imbalance treatment, but especially sex hormone imbalances like estrogen dominance or low testosterone. “Certain foods will help you reduce your exposure to xenoestrogens and support estrogen detox,” says Dr. Krieg. She suggests opting for organic foods, which will contain fewer endocrine-disrupting chemicals. She also suggests opting for clean cosmetics and cleaning products and avoiding all plastic water bottles and food storage containers. “Instead, opt for stainless steel and glass,” she explains.
According to Dr. Krieg, you can benefit from eating estrogen-detox supporting foods. Two great ones are ground flaxseeds and cruciferous vegetables. “I will also often suggest a B complex and vitamin C for antioxidants,” says Dr. Krieg. Together, all of these lifestyle suggestions help increase your resilience and can even treat hormone imbalances.
If you’ve been diagnosed with a hormone imbalance, or suspect you might have one, it can feel overwhelming. The endocrine system is incredibly complex and one problem can easily lead to another. The good news is that by focusing on decreasing chronic stress and improving nutrition, you can put your body back on a path to hormonal harmony.
Gretchen Lidicker is a writer, researcher, and author of the book CBD Oil Everyday Secrets: A Lifestyle Guide To Hemp-Derived Health & Wellness. She has a masters degree in physiology and complementary and alternative medicine from Georgetown University and is the former health editor at mindbodygreen. She's been featured in the New York Times, Marie Claire, Forbes, SELF, The Times, Huffington Post, and Travel + Leisure.