Communication in the body is achieved via molecules called hormones which are secreted by cells in one part of the body, which travel throughout the blood stream and impact on distant cells, organs or systems. Hormones (including oestrogen, progesterone, insulin, cortisol and thyroxine) impact on mood and behaviour, energy levels, growth, menstrual cycle, immune system, appetite, weight gain.
Hormonal imbalance may result in hypothyroidism, polycystic ovary syndrome (PCOS), endometriosis, pre-menstrual syndrome, menopause, fibroids, infertility, pregnancy, diabetes and insomnia.
Anxiety, mood swings, low mood or depression may be profoundly impacted by your genetic make-up, the type of food you eat, the ratio of protein to carbohydrates in your diet, neurotransmitter and hormone levels and gut health.
Adrenal Gland Hormones
Cortisol is a hormone which helps us respond to stress for example e.g. emotional/physical stress, missed meals/poorly balanced meal ratios of carbohydrates to protein.
Cortisol function includes:
- Reducing inflammation
- Maintaining blood sugar levels
- Regulating the immune system
- Regulating the hormonal system
- In chronic stress or when we have insufficient nutrients to support adrenal function, the adrenal glands may fatigue and reduce cortisol production. Reduced cortisol output can lead to fatigue, mood swings, hormone imbalance, chronic inflammation and reduced immunity
DHEA is a hormone made in the adrenal glands from cholesterol. Cholesterol can also be converted to pregnenolone, to make oestrogen or testosterone. In situations of chronic stress DHEA is converted predominantly to pregnenolone, then further converted to progesterone, which is then converted to cortisol.
Chronic stress leads to depleted levels of progesterone and less availability of cholesterol for DHEA and oestrogen/testosterone production (i.e. hormone imbalances). See figure 1 below for abnormal steroid hormone pathways.
Female hormone imbalance may lead to PMS, tender breasts, fibrocystic breasts, endometriosis, polycystic ovaries, fibroids, infertility, PMS, mood swings, irritability, depression, anxiety, water retention, period pain, heavy periods. Oestrogen dominance is associated with premature bone loss and increased risk of breast cancer.
Male sex hormone imbalance may lead to low sex drive, erectile dysfunction, breast enlargement, breast milk production, infertility, irritability, anxiety, loss of muscle tone, loss of body hair, general weakness and 'fuzzy' thinking.
Adrenal function (male and female hormones and cortisol production) may be supported by:
- Eating regularly (see diet plan)
- Avoiding stimulants/ alcohol/sugar/predominantly carbohydrate meals
- Increasing quality protein and foods containing vitamin C (peppers, strawberries, broccoli, brussel sprouts, cauliflower etc.
- Adequate intake of magnesium obtained from almonds, brazil nuts, flaxseed and pumpkin seeds, and Vitamin B5 obtained from avocado, sweet potato, chicken, turkey, and broccoli
- Reducing stress levels
- Reducing sugar intake
- Increasing fibre intake (to aid in detoxification of female hormones)
- Reducing oestrogens from the environment e.g. non organic foods which are sprayed with pesticides and herbicides (which are essentially contraceptives), tap water, plastic food storage containers, cling film, oral contraceptives, cosmetics and toiletries
- Thyroxine and Hypothyroidism
The thyroid gland is a small gland which sits at the front of the neck which is responsible for the production of a hormone called thyroxine (T4 and T3) which increases metabolic rate in the body and affects nearly every organ. It regulates fat and carbohydrate metabolism, respiration, body temperature, brain development, cholesterol levels, the heart and nervous system, blood calcium levels, menstrual cycles, skin integrity etc [Canaris 2000]. Lack of thyroxine (or hypothyroidism) can lead to symptoms of:
- Weight gain
- Goitre (enlarged thyroid gland)
- Low mood/depression
- Insomnia/sleep disturbances
- Intolerance to temperature extremes
- Hair loss
- Lack of sex drive
- Dry skin and hair
- Loss of outer third of the eyebrow
Hypothyroidism may elevate blood pressure, cholesterol levels and inflammatory chemicals (IL6) which in turn may increase risk of cardiovascular disease
Hypothyroidism is often undiagnosed as many of the symptoms are put down to getting older. Your G.P may test your levels of thyroid stimulating hormone, free T4 and anti-thyroid peroxidase to assess thyroid function.
Causes of hypothyroidism
- Hypothyroidism is commonly caused by Hashimoto’s thyroiditis (an autoimmune condition), or
- Medications for other conditions e.g. lithium, amiodarone, Interleukin 2 and interferon-alpha
- Conditions such as sarcoidosis which causes inflammation of the thyroid gland and abnormal growths in the gland
- Pituitary gland dysfunction which affects secretion of thyroid stimulating hormone
- Genetic abnormalities
What increases your risk of hypothyroidism?
- Family history of hypothyroidism or autoimmune disease
- Increasing age (50+) and being female
- Being pregnant, post-natal and menopausal
- Hormone imbalance elevates thyroid binding globulin. Thyroid hormones that are bound to thyroid binding globulin (TBG) are deactivated which may decrease levels of T4 and T3 available to the body
- Oral contraceptive pill and oestrogen replacement therapy
- Chronic stress-inflammatory chemicals may reduce conversion of T4 to active T3
- Chronic inflammation
- Blood sugar imbalance
- Poor gut health-inflammation in the gut triggers production of the stress hormone cortisol which reduces production of T3
- Lack of beneficial gut bacteria - healthy gut bacteria helps with production of an enzyme called intestinal sulfatase which aids conversion on inactive T4 to active T3
- Pathogenic gut bacteria reduces TSH levels and reduces the ability of thyroxine molecules to attach to thyroxine receptor sites
What may help improve your condition?
- Supporting gut health with a nutrient rich diet, dealing with pathogenic gut bacteria and probiotic/digestive enzymes supplementation if necessary
- Reduce stress levels where possible
- Balance blood sugar levels
- Diet and supplementation which supports thyroid function and thyroxine production e.g. Iodine, selenium, Vitamin D and B12
- Maintaining a healthy weight
- Regular exercise
Thyroxine therapy prescribed by your GP may not always reduce your symptoms. Doctors prescribe the throxine in its T4 form. T4 needs to be converted to T3 form in the gut and liver to perform its action in the cells. This is reliant on a healthy gut and an enzyme called 5’ deiodenase enzyme. Some people have a genetic variance which means this enzyme is much less efficient which affects their ability to use the thyroxine medication that they are taking and their symptoms persist even though blood tests show that their T4 levels are adequate. This genetic variance may be tested for by performing a genetic test called the DIO11 test.
Foods which may interfere with absorption or effectiveness of thyroid medications are caffeine, goitrogens (from raw cruciferous vegetables such as cabbage, broccoli, brussel sprouts, and cauliflower), soya, fibre, calcium/chromium and high dose flavonoid supplements.
Testing hormones and neurotransmitters
Adrenal hormones, sex hormones, and neurotransmitters are functionally interconnected. Changes in sex hormones and adrenal hormones can lead to neurotransmitter imbalances. In turn, neurotransmitter imbalances can affect hormone function.