Naturopathic Family Medicine, LLC

Both men and women can suffer from hormone imbalances, and knowing which hormones are out of balance allows us to remedy the situation. “Remedies” might include nutritional support, herbs, exercise, and/or bioidentical (natural) hormone prescriptions. Although there are others, here some of the most common hormone imbalances I test for and treat:

Thyroid hormone- Most often this hormone is too low, leading to symptoms of fatigue, feeling cold, weight gain or difficulty losing weight, hair loss, menstrual irregularity, high cholesterol, and swelling in the extremities, among other symptoms. Thyroid is tested via blood. I generally do a panel that includes TSH, free T3 and free T4 to give me the most information about thyroid function, and I often ask people to take their morning temperatures and record them as well. Ideally, TSH is between 0.8 and 2.5, free T4 is around 1.0 and free T3 is between 2.5 and 6.0; I treat if these numbers are off from these ranges (most conventional doctors will not treat unless TSH is over 4.0 or 5.0). Because natural thyroid hormone is so inexpensive and safe, I’ll often use it as a first-line therapy. Often I find that people benefit from Iodine supplementation, ingestion of natural sea salt, and avoidance of environmental chlorine and bromine that are known to disrupt thyroid function. Also, I almost always recommend treating the adrenal glands at the same time (generally with herbs), as adrenal function is intricately linked to thyroid function.

Cortisol (adrenal hormone)- Cortisol is our bodies’ “fight or flight” hormone produced in the adrenal glands. Cortisol can be either high, producing symptoms like insomnia and agitation, or low, producing fatigue and depression. Generally, cortisol becomes chronically high during periods of stress, either via emotional stress (like a high-powered job) or physical stress (like a chronic infection or an imbalance of one of the other hormones like progesterone or DHEA) and remains high until the glands burn out- producing a chronically low cortisol state (“adrenal fatigue”) which produces symptoms of tiredness and decreased motivation. Because cortisol fluctuates throughout the day (it should be highest in the morning and lowest at night), it is best tested by a series of saliva samples taken throughout one day. Disrupted cortisol patterns are generally treated by first treating the cause of the dysfunction (infection, work stress, low progesterone or DHEA), and then with supplements and herbs, and occasionally with natural cortisol hormone (hydrocortisone).

Steroid hormones- Estrogens, progesterone, pregnenolone, testosterone, and DHEA are some examples of hormones, sometimes called “sex hormones”, which can cause symptoms when they’re out of balance- in both men and women. For women, some examples of symptoms include overweight, insomnia, irritability, joint pain, hot flashes, irregular menses, vaginal dryness, PMS, hair loss or abnormal hair growth, headaches, endometriosis, polycystic ovaries, acne, fatigue, painful intercourse, breast tenderness, memory problems, low libido, osteoporosis or osteopenia, depression, decreased muscle strength, and water retention. Men generally complain of weight gain, fatigue, decreased muscle strength, and low libido. It is difficult to predict which hormones are high or low without testing. For example, hot flashes can be caused by low progesterone OR low estrogen (or imbalances in other hormones), and so I always prefer to test before prescribing treatments. Testing at my clinic is done through saliva or urine, which show the “free” or active hormones; blood tests are not as revealing as they reflect protein-bound, inactive hormone levels. Treatment for both men and women often include herbal support and bioidentical (natural) hormone prescriptions (most often sublingual or in the form of creams). Liver function and proper hormone metabolism are important areas that are assessed concurrently.

Insulin- Insulin is produced by the pancreas in response to increased blood sugar. Insulin can be either high or low, both fasting and after eating. Testing insulin via blood or saliva is most common, and can be done first thing in the morning before eating or after a meal. When I test for pre-diabetes or diabetes, I generally check blood for both fasting blood sugar and fasting insulin, and then ask the patient to eat a combination of high fat and high sugar and check both blood sugar and insulin one hour later. This lets me know how the pancreas is dealing with both sugar and fat intake. Recommendations are most often focused on herbal treatment, nutraceutical supplementation, dietary advice, and lifestyle modifications.