Hormones: messengers of Health and Disease

These key signalling molecules run across every system of the human body, regulating our physiology and driving us to health or disease.

What are hormones?

Hormones are chemicals released by the endocrine system into the bloodstream to regulate the function of specific cells, tissues or organs. Hormones are considered the most important chemical messenger of the body due to their role in regulating the function of cells and organs.

Hormones are also highly specific, thanks to the presence of protein receptors in the cells they target. These receptors recognise and bind to the hormone and start a cascade of biochemical reactions aimed at specific biological tasks. 

When the optimal hormone level is altered, a condition called hormonal imbalance can occur, leading to a broad range of symptoms. Common symptoms associated with hormonal imbalances include insomnia, fatigue, weight gain, hair loss, or mood swings.

Fortunately, hormonal imbalances are, in most cases, fully reversible conditions. Understanding the symptoms associated with hormonal imbalances and the treatments available to address them is an important first step to improving your health.

What are hormonal imbalances?

Hormones are highly specific and highly effective. Hence, any alterations to the optimal delivery of the right amount of a hormone can have potentially serious health effects. In other words, hormone imbalances can be defined as any alteration to the normal and optimal delivery of any given hormone. Too much or too little of any given hormone can potentially have serious effects on the function of a specific part of your body.

Hormones and endocrine glands – hormones are secreted by endocrine glands, which are specialised organs found across the body. Hormones are part of the endocrine system.

In practice, the endocrine system is a network of glands found across the body, and some of the key components of this system include:

Located at the base of the brain, and it produces various hormones, including anti-diuretic hormone (ADH), corticotropin-releasing hormone (CRH), gonadotropin-releasing hormone (GnRH), growth hormone-releasing hormone (GHRH, oxytocin, and prolactin-releasing hormone (PRH).

Located in the middle of the brain, it produces the hormone melatonin.

Located below the brain, it produces thyroid-stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), follicle-stimulating hormone (FSH), and luteinising hormones (LH).

located in front of the neck, below the larynx (voice box), the thyroid produces triiodothyronine (T3) and thyroxine (T4). The parathyroid glands release a hormone called parathyroid hormone (PTH).

Located in the upper part of the chest, it produces thymosin

Located on top of each kidney, it makes and releases corticosteroid hormones and epinephrine

Located behind the stomach, produces insulin and glucagon

Produce estrogen and progesterone.

Produces testosterone.

hormones and the brain diagram

What do hormones do?

At the heart of optimal body function is the balanced secretion, distribution, and function of all hormones. Due to their widespread distribution, their ability to travel through the bloodstream, and the communication pathway they establish with the nervous system, hormones influence a wide range of functions in the body. Broadly, the function of hormones can be grouped into these categories:

Hormones can influence both structure and function in our body. For example,

  • Progesterone, a female sex hormone mostly released in the ovaries, has been shown to have neuro-protective qualities by preventing the release of harmful free radicals by microglia (a type of cell found in the central nervous system) and by stimulating myelin production. Myelin is an essential component needed for efficient communication between neural cells. From a functional perspective, ovarian hormone supplementation has been shown to affect mood and certain cognitive functions, like working memory.
  • Hormones also influence our body’s natural circadian rhythms, the inner workings of our body that regulate our sleep-wake cycle. Several hormones, such as melatonin, cortisol, gonadal steroids, prolactin, thyroid hormone and growth hormone (GH), have been shown to have daily oscillations, meaning the levels of these hormones in our body change throughout the day. Other hormones, such as insulin, leptin, ghrelin and adiponectin, are called nutrient-sensitive hormones. They also oscillate on a circadian basis, but their release is partially regulated by environmental stimuli, such as feeding time and light-dark cycles.
  • Hormone function generally follows a feedback loop system. For example, endocrine glands react to hormonal changes in the blood, similarly to how a thermostat reacts to temperature changes. Endocrine glands rely on the presence or absence of hormones in the blood to activate hormone secretion. In other words, if there are low levels of hormones circulating in the blood, the endocrine glands make more, increasing blood hormone levels. Likewise, if blood hormone levels are too high, the glands stop producing hormones, leading to lower blood hormone levels.

What are symptoms of hormonal imbalances?

Some key symptoms associated with hormonal imbalances include:

Altered hormone levels can affect our sleeping patterns. Different factors can alter the optimal level of hormones. For example, in women, going through pregnancy, menstruation or menopause can affect hormone balance and lead to difficulties sleeping.

Alteration to optimal levels of hormones like estrogen, progesterone and testosterone may contribute to depression and anxiety symptoms. Even panic attacks have been linked to hormonal imbalances. One study suggests that excessive levels of the hormone orexin can lead to panic attacks, while suboptimal levels can lead to narcolepsy.

Changes from normal hormone levels have been associated with weight problems, particularly in women. Low estrogen levels, associated with menopause, is associated with gaining weight. One form of estrogen called estradiol is known to decrease during menopause. This hormone helps regulate metabolism and body weight, and low levels are associated with weight gain.

Hair loss has been associated with hormonal imbalances through the role of hormones like testosterone. More specifically, levels of dihydrotestosterone (DHT) are associated with hair loss. Skin conditions like acne are also influenced by hormonal imbalances, particularly involving hormones like testosterone, androgen, and possibly, progesterone.

Excessive levels of progesterone can lead to tiredness and feeling sleepy, whereas reduced thyroid hormone or estrogen levels can lead to low energy levels.

Hormones like estrogen and progesterone have been linked to irritable bowel syndrome (IBS). These hormones may act as a trigger for IBS symptoms.

Low testosterone levels are associated with reduced interest in sex.

While symptoms like anger, irritability, mood swings, depression, and anxiety are associated with premenstrual syndrome (PMS), hormonal imbalances are an important factor, especially for hormones like estrogen.

What causes hormonal imbalances?

Different factors can cause alterations to optimal hormone levels. The endocrine system itself can be challenged by many factors, which lead o hormonal imbalances and altered function of different systems. Some of these factors include aging, pregnancy, certain environmental factors, genetics and certain diseases and medications. For example,

  • Aging – as we age, damage to cells or tissue can affect the optimal production of hormones, hormone metabolism and function, and the body’s natural rhythms, such as the menstrual cycle.
  • Some common conditions associated with hormonal imbalances include:
    • Chronic stress
    • Underactive or overactive thyroid (hypothyroidism)
    • Diabetes
    • Cushing syndrome
    • Certain cancers, such as pituitary tumours
    • Infections
    • Injury or trauma
    • Stress
  • Environmental factors – certain compounds found in the environment, called endocrine disrupting chemicals (EDC), can interfere with the normal function of the endocrine system.

While the conditions below may be initially caused by hormonal imbalances, having the conditions can also lead to further hormonal imbalances:

  • diabetes (type 1 and type 2)
  • diabetes insipidus
  • hypothyroidism, or an underactive thyroid
  • hyperthyroidism, or an overactive thyroid
  • hyperfunctioning thyroid nodules
  • thyroiditis
  • hypogonadism
  • Cushing syndrome, or high levels of cortisol
  • congenital adrenal hyperplasia, which causes low levels of cortisol and aldosterone
  • Addison’s disease

Many causes of hormonal imbalance are exclusive to women and include:

  • menopause
  • primary ovarian insufficiency, which is also known as premature menopause
  • pregnancy
  • breastfeeding
  • PCOS
  • hormone drugs such as birth control pills

Generally, it is important to address hormonal imbalances promptly, as the more a hormonal imbalance persists, the longer the disruptive effect on the body, and the harder it becomes to address and fix the problem.

But, before any hormonal problem can be addressed, it is important to identify the causes and mechanisms causing the imbalance. Supplementing a deficient hormone is only a temporary solution if the problem is a malfunctioning organ, which will continue to deteriorate.

The Australian Centre for Functional Medicine’s central goal is to prevent the onset of a disease. To prevent a hormonal imbalance, we first aim to fix the underlying factors driving the imbalance. This is the only way forward to a permanent cure of your health problems.

11 signs and symptoms of hormonal imbalances

Hormone imbalances can lead to conditions like insomnia, fatigue, weight gain, hair loss, or mood swings, among many others. Some important symptoms of hormone imbalances include:

Sleep disturbances negatively impact hormonal rhythms and metabolism and are associated with obesity, insulin insensitivity, diabetes, hormonal imbalance, and appetite dysregulation. Insomnia and other sleep alterations can also directly affect the function of the hypothalamic-pituitary-adrenal (HPA) axis, the body’s key response system against stress. Read more about the effect of poor sleep on the HPA axis here. Another important hormone related to sleep is melatonin. Melatonin levels rise during nighttime and influence factors such as body temperature and blood pressure, as well as binding to receptors involved with reduced nerve activity and muscle relaxation.

About 13% or over 3 million Australians suffer from an anxiety-related condition. Women are particularly affected due to alterations to the optimal function of estrogen during menstrual cycles, pregnancy, or menopause. Recent findings on the role of hormones in anxiety include,

  • One review reported that estradiol and progesterone supplementation administered during menopause was significantly associated with cognitive and affective benefits.
  • A review on the function of estrogens confirms the important roles of these hormones in modulating anxiety-like behaviours in both human and animal models.

Hormones can influence a person’s ability to gain or lose weight. For example,

  • One review discussed the link between abdominal obesity and high cortisol levels, as well as the role of stress and glucocorticoids in controlling food intake and energy expenditure. A key finding is that cortisol responsiveness to stress may serve as a marker to identify people at risk of weight gain and subsequent obesity.
  • Following a poor diet, one lacking nutrient-dense foods alongside a stressful lifestyle can lead to unhealthy weight gain, in part mediated by altered hormone function.
    • One recent review study showed that regular consumption of highly or ultra-processed foods, like packaged bread, cookies, savoury snacks, candy, ice cream, breakfast cereal, and pre-prepared frozen meals, is linked to obesity and related cardiometabolic outcomes.
    • A recent review highlights the important role of stress as a driver of obesity. Stress is known to:
      • interfere with cognitive processes such as executive function and self-regulation;
      • affect behaviour by inducing overeating and consumption of foods that are high in calories, fat, or sugars;
      • decreases levels of physical activity and sleep quality
      • triggers physiological changes in the hypothalamic-pituitary-adrenal axis, which is an important regulator of multiple metabolic functions.
      • can stimulate the production of biochemical hormones and peptides such as leptin, ghrelin, and neuropeptide Y.
    1.  

Hormone imbalances are also involved with more complex conditions, such as alterations to the so-called gut-brain axis. This bi-directional communication pathway connects the gastrointestinal tract (GIT) and the brain. Read more about the gut-brain axis Some of the key components of the gut-brain axis include the vagus nerve, the sympathetic nervous system, the endocrine and immune systems, as well as the gut microbiota. Alterations to the functioning of this system can lead to conditions like:

  • Bloating
  • Constipation
  • Diarrhea
  • Nausea
  • Defective intestinal permeability
  • Inflammatory bowel disease
  • Obesity
  • Mental health (anxiety and depression)
  • Metabolic disorders and other problems.

Acne is caused by three key factors: excessive production of sebum, accumulation of dead skin cells in pores and excessive growth of the skin bacteria Propionibacterium acnes. Excessive levels of androgens can influence sebum production, leading to acne. In fact, new acne treatments are now using drugs targeting androgens. Learn more about our modern functional medicine approach to acne here.

This common condition can affect anyone, even when following a healthy diet and getting sufficient rest. For example, excessive levels of progesterone can cause sleepiness and underproduction of thyroid hormone can lower energy levels. A comprehensive evaluation of your hormone levels may be the best first step to help us diagnose hormonal imbalances.

Altered functions of the thyroid gland (Hypothyroidism, hyperthyroidism, and parathyroid disorder) can lead to conditions like dry hair or hair loss. Stress can directly affect hair loss through the involvement of the hormone cortisol. Cortisol can target and damage hair follicles, leading to hair loss. Androgens—such as testosterone (T); dihydrotestosterone (DHT); and their prohormones, dehydroepiandrosterone sulfate (DHEAS) and androstendione (A), are all considered key factors in hair growth. These hormones act on specific intracellular androgen receptors located in hair follicles, as described in this recent review.

Low Sex Drive or Premenstrual syndrome (PMS) – changes in hormone levels can affect sex drive in both men and women. In women, estrogen levels can lead to less interest in sex and cause dry vaginal problems. Other problems associated with low estrogen levels include infertility, hot flashes, and mood swings. Changes in hormone levels in women can be caused by menopause or pregnancy. In men, low levels of testosterone can lead to a low sex drive.

Two key hormones have been associated with muscle and joint weakness: testosterone, estrogen, and hormones produced by the thyroid gland.

  • Testosterone and estrogen – Muscle weakness has been associated with low serum testosterone levels, which usually occurs as men age. In females, estrogen has also been linked to age-related muscle strength loss, but these results are less conclusive.
  • Hypothyroidism – malfunction of the thyroid gland can lead to sub-optimal production of two key hormones produced by the thyroid gland: Triiodothyronine (T3) and Thyroxine (T4). Low levels of these two hormones are associated with impaired function of muscle cells. For example, thyroxine (T4) deficiency can lead to a reduced mitochondrial oxidative capacity, abnormal glycogenolysis and an insulin-resistant state of the cell.

Abnormally high levels of blood pressure, commonly known as hypertension, can occur due to hormonal imbalances. For example, altered hormone production by these endocrine glands has been associated with hypertension:

  • Pancreas – optimal function of the pancreas is important for keeping an optimal hormonal balance. People with diabetes, for example, have problems with their pancreas, which does not produce enough insulin. As a consequence, the body cannot process glucose, leading to high levels of this sugar in the blood, which is responsible for most of the common problems associated with diabetes.
  • Adrenal glands – conditions associated with altered levels of hormones produced by the adrenal glands include Primary aldosteronism, Congenital adrenal hyperplasia, Chrousos syndrome, Cushing syndrome, Hyperdeoxycorticosteronism and Hydroxylase deficiency, among others.
  • Parathyroid glands – conditions associated with altered levels of hormones produced by the parathyroid glands include hyperparathyroidism.
  • Pituitary glands – conditions associated with altered levels of hormones produced by the pituitary glands include Acromegaly, Cushing disease, Secondary hyperaldosteronism, and renovascular hypertension.
  • Thyroid glands – conditions associated with altered levels of hormones produced by the thyroid glands include hypothyroidism and hyperthyroidism.

Altered cortisol levels can lead to high blood pressure and abnormal inflammatory responses. Some symptoms associated with altered cortisol levels include:

  • Moon face – this condition occurs when extra fat builds up on the sides of the face. The condition can be related to obesity but can also occur due to Cushing’s syndrome.
  • Cushing’s syndrome – this is a hormonal disorder caused by excessive levels of blood cortisol. Cortisol normally helps regulate blood pressure and blood sugar and reduces inflammation. But when there are excessive levels of this hormone, as in the case of Cushing’s syndrome, all other biological systems are thrown off balance, leading to symptoms like:
    • A rounded, rosy face (moon face)
    • Weight gain, especially in the upper body
    • A fat pad in the upper back or base of the neck
    • Thinning skin that is easy to bruise
    • Acne
    • Tiredness
    • Weak muscles
    • High blood pressure
    • High blood sugar levels
    • Depression and anxiety
    • Osteoporosis
    • Kidney stones
    • Sleep problems
    • Extra hair growth on your body and face
    • Irregular periods
    • Low sex drive and problems having an erection
    • Decreased fertility
  • weight gain, mostly around the midsection and upper back
  • weight gain and rounding of the face
  • acne
  • thinning skin
  • easy bruising
  • flushed face
  • slowed healing
  • muscle weakness
  • severe fatigue
  • irritability
  • difficulty concentrating
  • high blood pressure
  • Headache

 

Altered levels of cortisol can occur due to a combination of different factors, such as stress, abnormal pituitary or adrenal gland function, certain cancers, medication side effects, or high estrogen levels.

Hormone imbalances and health at AUSCFM

At AUSCFM, we follow a modern and evidence-based approach to diagnosing and treating pathologies associated with hormonal imbalances. We are on top of current research involving the role of hormones in human health. We employ leading diagnostic testing technologies to hormonal imbalances, as well as other markers of health. Our DUTCH hormone test, for example, provides a comprehensive assessment of key hormones and metabolites. This test informs clinicians about key physiological aspects of your body, such as cortisol and melatonin function, levels of dehydroepiandrosterone, cortisol metabolites, six organic acids and levels of sex hormones. To learn more about the DUTCH hormone test, see our article.

Based on our DUTCH hormone test results, we can identify evidence of hormonal imbalances that may be driving your symptoms. The results of this test, for example, can reveal an altered function of the HPA axis. The Hypothalamic-pituitary-adrenal (HPA) axis is part of the endocrine system and a key regulator of homeostatic processes, influencing immune function and our stress response. To learn more about the HPA axis, see our recent article.

In addition to hormone health, we employ advanced testing that targets six additional gut pathologies. Taken together, the results of these seven tests will give us a comprehensive view of the factors influencing a patient’s health and will help us design personalised treatment strategies.

In parallel, getting an in-depth understanding of your current health and lifestyle, including the diet you follow, can help clinicians identify the root of your problems. Working closely with your practitioner and health coach, you can resolve the underlying cause of hormone imbalance with a personalised plan, including changes to your nutrition, lifestyle, and stress management practices.

If you are experiencing health problems that could be explained by hormonal imbalances, start by registering to

References

  1. Nussey S, Whitehead S. Endocrinology: An Integrated Approach. Oxford: BIOS Scientific Publishers; 2001. Chapter 1, Principles of endocrinology. Available from: https://www.ncbi.nlm.nih.gov/books/NBK20/
  2. McEwen BS. Endocrine Effects on the Brain and Their Relationship to Behavior. In: Siegel GJ, Agranoff BW, Albers RW, et al., editors. Basic Neurochemistry: Molecular, Cellular and Medical Aspects. 6th edition. Philadelphia: Lippincott-Raven; 1999. Chapter 49. Available from: https://www.ncbi.nlm.nih.gov/books/NBK20431/
  3. Ali SA, Begum T, Reza F. Hormonal Influences on Cognitive Function. Malays J Med Sci. 2018 Jul;25(4):31-41. doi: 10.21315/mjms2018.25.4.3. Epub 2018 Aug 30. PMID: 30914845; PMCID: PMC6422548.
  4. Barth C, Villringer A, Sacher J. Sex hormones affect neurotransmitters and shape the adult female brain during hormonal transition periods. Frontiers in neuroscience. 2015 Feb 20;9:37.
  5. Kim TW, Jeong JH, Hong SC. The impact of sleep and circadian disturbance on hormones and metabolism. Int J Endocrinol. 2015;2015:591729. doi: 10.1155/2015/591729. Epub 2015 Mar 11. PMID: 25861266; PMCID: PMC4377487.
  6. Clapp M, Aurora N, Herrera L, Bhatia M, Wilen E, Wakefield S. Gut microbiota’s effect on mental health: The gut-brain axis. Clin Pract. 2017 Sep 15;7(4):987. doi: 10.4081/cp.2017.987. PMID: 29071061; PMCID: PMC5641835.

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