7 Hormone Imbalances That Could Explain Your Fatigue, Moodiness & Weight Gain
Your hormones are the messengers of your body. Each hormone sends specific instructions to every organ and helps determine your mood, energy levels, weight, temperature, digestion, and many other aspects of your health. And yet, we don't often appreciate hormones until they aren't working well.
The major endocrine glands that make those hormones are your brain (hypothalamus and pineal and pituitary glands), thyroid, parathyroid, adrenals, pancreas, reproductive glands (ovaries and testes), and gastrointestinal tract.
With hormones, it's all about balance. As Goldilocks lamented, they can't be too high or too low; they have to be just right. Otherwise, imbalances can cause myriad health issues.
Mainstream medicine typically runs basic labs for hormone health. If your labs don't come back "normal," you're typically given a synthetic hormone cream or pill that could have side effects. If those labs come back "normal" and you're still experiencing symptoms, you may be told you're either depressed, just getting older or need to lose weight.
Functional medicine wants to find out the root cause of patients' hormonal symptoms as well as support the body's natural mechanisms for healthy hormone balance.
Here, I'll go over some of the most common hormone problems that I see in patients, and that you may be going through right now. I'll also explain which labs you may want to consider asking your doctor about:
1. Cortisol
Our adrenal glands secrete several hormones, and one of them is cortisol, your body's main stress hormone. Adrenal fatigue happens when there’s an imbalance in this cortisol rhythm: Cortisol is high when it should be low, low when it should be high, or always high or always low. Adrenal fatigue is really a dysfunction of your brain’s communication with your adrenals — not the adrenal glands themselves. Because adrenal fatigue is mainly a brain stress problem, the solution focuses on minimising chronic stressors.
What You Might Experience:
- You're slow to start in the morning
- Cravings for salty or sugary foods
- Low sex drive
- You're fatigued in the afternoon but get a "second wind" in the evening
- Can't stay asleep
- Dizziness when standing up quickly
- Afternoon headaches
- Blood sugar issues
- Chronic inflammation
- Nails are weak
- Often moody
- Difficulty losing weight
The Labs: I run a 24-Hour Adrenal Stress Index, a salivary test that tracks your cortisol levels and HPA (brain-adrenal) axis quality.
2. Thyroid
Every cell of your body needs thyroid hormones to function healthily. There are many underlying thyroid problems that won't show up on standard labs. For example thyroid conversion issues, thyroid resistance or autoimmune attacks against the thyroid (Hashimoto’s or Graves' disease).
What You Might Experience:
- Feeling tired
- Feeling cold in your hands, feet, or all over
- Requiring excessive amounts of sleep to function properly
- Weight gain, even with a low-calorie diet
- Difficult, infrequent bowel movements
- Depression or lack of motivation
- Morning headaches that wear off as the day progresses
- Outer third of eyebrow is thin
- Thinning of hair on scalp
- Excessive hair falling out
- Dry skin
- Mental sluggishness
The Labs: Mainstream medicine typically just runs TSH and T4 (inactive thyroid hormone) to determine thyroid hormone dosage. A functional medicine thyroid panel involves looking at many other labs such as Free and Total T3 (active thyroid hormone), Reverse T3, and thyroid antibodies to rule out autoimmune thyroid problems.
3. Estrogen
The ratio of the three forms of oestrogen — estrone (E1), estradiol (E2), estriol (E3) — is important for both women and men. Some research has linked imbalances in oestrogens to increased mortality rates in those with heart disease as well as the progression of some cancers.
What You Might Experience With Not Enough Oestrogen:
- Vaginal dryness
- Night sweats
- Painful sex
- Brain fog
- Recurrent bladder infections
- Feeling lethargic
- Depression
- Hot flashes
What You Might Experience With Too Much Oestrogen:
- Feeling puffy and bloated
- Rapid weight gain
- Breast tenderness
- Mood swings
- Heavy menstrual bleeding
- Feeling anxious and/or depressed
- Migraine headaches
- Have had cervical dysplasia (abnormal pap smear)
- Insomnia
- Brain fog
- Gallbladder problems
- Weepy and emotional
The Labs: A full blood and salivary female hormone panel, including all oestrogen isomers.
4. Progesterone
Both men and women need healthy progesterone balance. Progesterone helps to balance and neutralise the effects of excess oestrogen. Without optimal progesterone, oestrogen becomes harmful and out of control (oestrogen dominance).
What You Might Experience:
- PMS
- Insomnia
- Unhealthy looking skin
- Painful breasts
- Stubborn weight gain
- Cyclical headaches
- Anxiety
- Infertility
The Labs: A full blood and salivary female hormone panel.
5. Testosterone
In both men and women, low testosterone is something that I commonly see in practice. Low testosterone in women has been linked in some studies to low sex drive, heart disease, and breast cancer. One study found that men with low testosterone had a greater rate of death.
What Women Might Experience With Too Much Testosterone:
- Acne
- Polycystic ovary syndrome (PCOS)
- Excessive hair on the face and arms
- Hypoglycemia and/or unstable blood sugar
- Thinning hair
- Infertility
- Ovarian cysts
- Mid-cycle pain/cramping
What Women Might Experience With Not Enough Testosterone:
- Weight gain
- Fatigue
- Low sex drive
What Men Might Experience:
I often see the over-conversion of testosterone to oestrogen in men. Men don't produce estrogen-like women but convert it through a process called aromatization. Excess activity of the enzyme aromatase can cause low testosterone and high oestrogen in men resulting in:
- Erectile dysfunction
- Low sex drive
- Weight gain
- Irritability
- Breast enlargement
The Labs: Blood and saliva testosterone and DHEA panel.
6. Leptin
Your fat cells aren’t just some unsightly nuisances that jiggle and make clothes not fit; they’re actually an intelligent part of your endocrine (hormonal) system. Fat cells produce a hormone called leptin.
One of the leptin’s jobs is to tell your brain to use the body’s fat stores for energy. Leptin resistance occurs when leptin is not recognised by the body, specifically the hypothalamic cells of your brain. Your body then thinks it’s in starvation mode, which makes it want to store more fat.
What You Might Experience:
- You’re overweight
- You don't lose weight easily
- You have constant food cravings
- You’re stressed out
The Labs: Serum leptin.
7. Insulin
Just like leptin resistance, insulin resistance is not a hormonal deficiency but a hormonal resistance pattern. Most people know insulin resistance when it comes to type 2 diabetes, but insulin resistance is also seen in many people who have not progressed to the full-blown diabetic disease.
This pre-diabetic metabolic syndrome is marked by this resistance to insulin. This means your body is producing insulin but your body is not using it properly. The problem here is that insulin is a fat-storing hormone, which makes weight loss an uphill battle for many.
What You Might Experience:
- Cravings for sweets
- Irritableness if meals are missed
- Dependence on coffee
- Become lightheaded if meals are missed
- Feel shaky, jittery, or having tremors
- Agitated, easily upset, or nervous
- Poor memory
- Blurred vision
- Fatigue after meals
- Eating sweets doesn't relieve sugar cravings
- Waist girth is equal or larger than hip girth
- Frequent urination
- Increased thirst and appetite
- Difficulty losing weight
The Labs: Serum insulin, c-peptide, fasting blood sugar, and HgbA1c.
The Bottom Line: Because the body is all interconnected, if you have one hormone problem, you might have other ones as well. In other words, to say you have only one of these seven issues might be oversimplification — it could be all of these issues or a combination of some of these. It's important to work with your health care provider to find out what hormone issues might be at play.