Hormone imbalances

Dopamine is our neurotransmitter for focus, motivation, reward and pleasure.

Levels of dopamine are influenced by levels of sex hormones such as estrogen, progesterone, and testosterone, as well as by stress hormones.

Testosterone

• Testosterone can increase dopamine synthesis: this may be relevant in schizophrenia, which particularly affects men
• Cognitive decline in schizophrenia is associated with higher testosterone levels

Estrogen

• Estrogen has a protective effect on dopamine receptors in the brain and can help to enhance overall dopamine levels
• This can help to explain gender differences in neuropsychiatric illness

Stress hormones

• Stress hormones such as cortisol are thought to affect dopamine levels
• Acute stress in late adolescence/early adulthood can trigger a dopamine release in the brain, the amount of which is correlated to the amount of salivary cortisolSinclair, D., Purves-Tyson, T. D., Allen, K. M. and Weickert, C. S. (2014). Impacts of stress and sex hormones on dopamine neurotransmission in the adolescent brain. [online] Psychopharmacology, 231 (8), pp. 1581-99. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3967083/ [accessed 9 Oct. 2017].
• It is postulated that the dopamine release triggered by stress can be addictive: it may cause people to seek out stressful situations in order to get what is known as a ‘dopamine rush’

Our neurotransmitter for mood, alertness, sleep and appetite.

Our serotonin levels are influenced by our sex hormones, especially estrogen.

• Evidence shows estrogen boosts serotonergic functioning
• This is especially relevant in postmenopausal women, where experiments show that estrogen reverses the effects of tryptophan depletion and can improve working memory and affective processing
  • Tryptophan is an essential building block for the production of serotonin

Glutamate is the most common excitatory neurotransmitter in the brain. It influences alertness, attention, memory and learning.

Estrogen facilitates the transmission of glutamate.

GABA is the neurotransmitter for calming down, relaxing and focusing. It is referred to as “nature’s tranquilizer”, but has the additional benefit of sharpening our thinking rather than making our brain fuzzy.Amen, D. (2013). Unleash the Power of The Female Brain. New York: Harmony Books, p. 101. Cass, H. and Barnes, K. (2008). 8 Weeks to Vibrant Health. Brevard, NC: Take Charge Books, p. 115. Reiss, U. and Zucker, M. (2001). Natural Hormone Balance for Women. New York: Pocket Books, p. 149, p. 228.

Sex hormones progesterone and estrogen impact GABA levels

• Estrogen can suppress the effect of GABA, whereas progesterone can support its effectBarth, C., Villringer, A. and Sacher, J. (2015). Sex hormones affect neurotransmitters and shape the adult female brain during hormonal transition periods. [online] Frontiers in Neuroscience, 9, p. 37. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4335177/ [accessed 9 Oct. 2017].
• Low progesterone levels can lead to low GABA levels, and cause anxiety and poor attention

The hormone osteocalcin inhibits GABA synthesis. However, it enhances the synthesis of monoamine neurotransmitters such as serotonin, dopamine and norepinephrine and serves an important function in cognitive function.Oury, F., Khrimian, L., Denny, C. A., Gardin, A., Chamouni, A., Goeden, N., Huang, Y. Y., Lee, H., Srinivas, P., Gao, X. B., Suyama, S., Langer, T., Mann, J. J., Horvath, T. L., Bonnin, A. and Karsenty, G. (2013). Maternal and offspring pools of osteocalcin influence brain development and functions. [online] Cell, 155 (1), pp. 228-41. Available at: https://www.ncbi.nlm.nih.gov/pubmed/24074871 [accessed 9 Oct. 2017].

Khrimian, L. N. (2017). The Role of Osteocalcin in the Regulation of Brain Development and Functions. PhD. Columbia University. Available at: https://academiccommons.columbia.edu/catalog/ac:208842 [accessed 15 Nov. 2017].

Oxytocin, the love and bonding neurotransmitter is also a hormone. It is released during an orgasm, breastfeeding and childbirth, but also during any affectionate interaction, especially between women. Magon, N. and Kalra, S. (2011). The orgasmic history of oxytocin: Love, lust, and labor. [online] Indian Journal of Endocrinology and Metabolism. 15 (Suppl3), S156-S161. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3183515/ [accessed 9 Oct. 2017].

Its release is enhanced by estrogen.Gottfried, S. (2013). The Hormone Cure. New York: Scribner, p. 75.

Oxytocin can help us feel calm, happy and connected.

Our neurotransmitter for memory, acetylcholine strengthens memory pathways and modifies synapses to enhance the encoding of memories. Hasselmo, M. E. (2006). The Role of Acetylcholine in Learning and Memory. [online] Current Opinion in Neurobiology, 16 (6), pp. 710-15. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2659740/ [accessed 9 Oct. 2017].

Loss of acetylcholine can cause memory problems, depression, anxiety, and disorientation.Talbott, S. M. (2007). The Cortisol Connection. 2^nd ed. Alameda, CA: Hunter House, p. 119. Low levels of acetylcholine have been linked to Alzheimer’s disease.Francis, P. T. (2005). The interplay of neurotransmitters in Alzheimer’s disease. [online] CNS Spectrums, 10 (11 Suppl. 18), pp. 6-9. Available at: https://www.ncbi.nlm.nih.gov/pubmed/16273023 [accessed 17 Oct. 2017].

Estrogens have been shown to be protective against Alzheimer’s when mixed with acetylcholinesterase, making estrogens a target for Alzheimer’s therapeutics. Simpkins, J. W., Perez, E., Wang, X., Yang, S., Wen, Y., & Singh, M. (2009). The Potential for Estrogens in Preventing Alzheimer’s Disease and Vascular Dementia. Therapeutic Advances in Neurological Disorders, 2(1), 31–49. http://doi.org/10.1177/1756285608100427

 

• Each individual is born with the unique ability to make varying levels of hormones, and to be more or less sensitive to these hormones and their fluctuations
• Environmental factors such as nutrition, sleep, exercise, stress levels, etc. can turn genes on or off, leading to a manifestation, or a repression, of these genes Gottfried, S. (2013). The Hormone Cure. New York: Scribner, p. 16.

Periods of extreme fluctuation in hormone levels are built into our life cycles, and our hormones are designed to fluctuate as we grow through these.

Puberty, pregnancy, and menopause are periods of severe hormonal fluctuations, which can greatly impact our moods.

As we age, our hormone levels tend to diminish. This can cause and/or exacerbate symptoms of hormonal imbalances.

Dr Sara Gottfried explains the importance of organ reserves, and how this is impacted by age. Organ reserve refers to the body’s natural ability to restore balance after trauma, pregnancy, a heavy workload or surgery. As we age, after 30, this reserve diminishes by 1% each year, meaning that we don’t just bounce back in the same way as we were able to do before. Gottfried, S. (2013). The Hormone Cure. New York: Scribner, p. 5. Cass, H. and Barnes, K. (2008). 8 Weeks to Vibrant Health. Brevard, NC: Take Charge Books, p. 125.

Perceived stress is one of the most potent contributors to hormonal imbalances.

Stress can be due to difficult socio-economic circumstances, psychological trauma, modern-day living, and negative thought patterns and beliefs.

Whatever the cause, chronic stress is one of the most proven ways to disrupt hormone balance, disrupting the HPA axis, and causing a cascade of other hormonal imbalances.

• High cortisol levels can dysregulate the Hypothalamic-Pituitary-Adrenal (HPA) axis, which is involved in our reaction to stress, trauma and injury
• A dysregulated HPA axis can cause further hormonal imbalances in thyroid and sex hormones

Stress due to difficult economic and environmental circumstances

Factors such as poverty, unemployment, difficult living conditions, etc. can cause extreme and/or chronic stress.

Stress due to difficult social circumstances

Difficult or damaging relationships, domestic abuse, loneliness and social isolation can cause extreme chronic stress.

Stress due to psychological trauma

Psychological trauma and abuse, whether in childhood or adulthood, can cause extreme chronic stress, and a chronically dysregulated HPA axis which can cause lasting and recurring hormonal imbalances.

Stress due to negative thoughts and beliefs

Negative thoughts and beliefs, which can be habitual, and may or may not be founded in reality, can cause a perception of acute, and/or chronic stress. This perception of stress will cause a physiological reaction, releasing stress hormones which disrupt hormonal balance, even though the stressor may be perceived, and the intensity of the stress response may far exceed the reality of the situation.

Indeed, whether you fear being chased by a mugger, or you are actually being chased by a mugger as you walk down the street – both will prompt a physiological response which will impact your hormonal balance.

 

Read more about the topics above and how they impact our mental health by clicking the links below:

• Difficult economic and environmental circumstances
• Difficult social circumstances
• Psychological trauma
• Negative thoughts and beliefs

One of the most important causes of hormone imbalance is poor nutrition. Poor diet, problem foods and beverages, blood sugar issues, etc. can all substantially contribute to hormone imbalance.

Problem foods and beverages

Problem foods and beverages can disrupt hormonal balance. These can include foods to which you may have an intolerance, which then cause inflammation and absorption issues, or they can be known inflammatory foods.

Dairy

• Dairy can be poorly tolerated usually due to casein, whey or lactose present in dairy products, leading to intolerance causing inflammation
  • Inflammation can increase stress hormones such as cortisol
• Milk, cheese and eggs have been shown to increase matrix metalloproteinase (MMK) which then drums up inflammation, which leads to higher androgens Gottfried, S. (2013). The Hormone Cure. New York: Scribner, p. 224.
• Cow’s milk can increase estrogen Gluck, M. and Edgson, V. (2010). It Must Be My Hormones. Camberwell, Vic.: Penguin Group (Australia), p. 70.
  • Dairy consumption after menopause correlates with higher estradiol levels Gottfried, S. (2013). The Hormone Cure. New York: Scribner, p. 171.

Gluten

• Gluten intolerance can interfere with the thyroid
• Extreme gluten intolerance, known as celiac disease, is a leading cause of hypothyroidism

There is a correlation between celiac disease and thyroid antibodies as manifested in Hashimoto’s disease.Ch’ng, C. L., Jones, M. K. and Kingham, J. (2007). Celiac Disease and Autoimmune Thyroid Disease. [online] Clinical Medicine & Research, 5 (3), pp. 184-92. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2111403/ [accessed 9 Oct. 2017].

• Gluten intolerance can cause inflammation of the small intestine and damage to its lining, causing malabsorption of nutrients from food and nutritional deficiencies which can then lead to hormonal imbalances Gottfried, S. (2013). The Hormone Cure. New York: Scribner, pp. 248-50.

Coffee

• Excess coffee consumption can increase levels of adrenaline and cortisol, thereby impacting the production of androgens

Alcohol

• Alcohol can negatively impact both estrogen and testosterone metabolism. Regular alcohol use may lead to an imbalance in these hormones

Refined carbohydrates and sugars

• High levels of sugar increase serum insulin and IGF-1 levels, both of which raise androgens and cause excess-androgen symptoms Gottfried, S. (2013). The Hormone Cure. New York: Scribner, p. 224.
• Sugar can increase the production of estrogen in the liver and can increase estrogen levels Gluck, M. and Edgson, V. (2010). It Must Be My Hormones. Camberwell, Vic.: Penguin Group (Australia), p. 70, p. 196.
• Women with PMS consume 275% more refined sugar than women who don’t have PMS Gottfried, S. (2013). The Hormone Cure. New York: Scribner, p. 147.
• Sugar lowers testosterone levels Amen, D. (2013). Unleash the Power of The Female Brain. New York: Harmony Books, pp. 107-8.
• Refined carbohydrates, such as sugar, can cause imbalances in stress hormones
  • Consumption of refined sugar can cause a surge in adrenaline, which lasts several hours after ingestion Holford, P. (2007). Optimum Nutrition for the Mind. London: Piatkus, p. 19.
• Refined carbohydrates can cause inflammation, which negatively impacts hormones
• Refined carbohydrates can cause gut dysbiosis, strengthening bad bacteria and reducing good bacteria. Dysbiosis may lead to elevated levels of a bacterial enzyme called Beta-glucuronidase. Beta-glucuronidase is capable of recirculating estrogens into the body causing elevated estrogen levels

Acidic diet

• An acidic diet, due to too much protein, too many refined carbohydrates, and not enough alkalizing vegetables and fruit, can be disruptive to hormonal balance
• Such a diet requires the body to release minerals, such as calcium and magnesium, to neutralise the acid in the blood, which can lead to demineralization and inflammation
• Inflammation, in turn, is correlated with higher cortisol production. Holford, P. (2007). Optimum Nutrition for the Mind. London: Piatkus, p. 58.

Dehydration

It is essential to stay well hydrated with water, as dehydration can increase cortisol and lower testosterone and other hormone levels.Talbott, S M. (2007). The Cortisol Connection. 2^nd ed. Alameda, CA: Hunter House, p. 76.

Blood sugar imbalances

Blood sugar imbalances can cause hormonal imbalances, mood swings, anxiety, irritability etc.

Blood sugar imbalances can be caused by skipping meals; eating too many refined carbohydrates (sugar, white flour), especially without protein and fat to slow digestion; eating foods with a high glycemic load can cause sex and stress hormone imbalances.Amen, D. (2013). Unleash the Power of The Female Brain. New York: Harmony Books, p. 97.

• Blood sugar imbalances can worsen estrogen dominance and reduce progesterone (your calming hormone) Gottfried, S. (2013). The Hormone Cure. New York: Scribner, p. 165.
• When blood sugar drops, it causes an increase in the stress hormones cortisol and adrenaline, and can lead to feelings of anxiety, panic, weakness, jitteriness, and irritability, etc. Vitti, A. (2013). Woman Code. New York: Harper Collins, p. 59. Gluck, M. and Edgson, V. (2010). It Must Be My Hormones. Camberwell, Vic.: Penguin Group (Australia), p. 115.

Read more about blood sugar imbalances.

Body Mass Index

A BMI that is either too high or too low can cause an imbalance in hormones.

Low BMI

• Women who suffer from Anorexia Nervosa or Bulimia, or high performance athletes can suffer from imbalanced hormones due to low BMI
• Lower body fat causes lower estradiol levels
• When a woman’s body fat is lower than 21% of total body mass, the hormonal control centres in her brain keep her from making enough estrogen to ovulate or to build up her uterine wall Gottfried, S. (2013). The Hormone Cure. New York: Scribner, p. 185.
• Low BMI can cause low progesterone
• Low BMI can raise cortisol Schorr, M., Lawson, E. A., Dichtel, L. E., Klibanski, A. and Miller, K. K. (2015). Cortisol Measures Across the Weight Spectrum. [online] Journal of Clinical Endocrinology & Metabolism, 100 (9), pp. 3313-3321. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4570173/ [accessed 7 Nov. 2017].

High BMI

Being overweight can wreak havoc on hormones, causing:

• Excess adipose tissue (obesity) can lead to hormone imbalance and inflammation
• Adipose tissue in excess is considered an active endocrine organ, as it capable of producing its own hormones, such as estrogen and pro-inflammatory factors
• Low grade inflammation caused by excess adipose tissue usually results in elevated levels of cortisol, Talbott, S M. (2007). The Cortisol Connection. 2^nd ed. Alameda, CA: Hunter House, p. 58. which can impact negatively on other hormones such as progesterone
• Insulin resistance
• Excess cortisol (released by fat cells)

How nutritional imbalances can impact our mental health.

Too little exercise can cause hormonal imbalance by lowering the production of various key sex, thyroid and adrenal hormones.

Too much exercise, in other words, exercise which is too intense or too often, can also cause an imbalance in hormones by increasing cortisol levels, which then can cause an imbalance in other hormones. Sato, K. and Iemitsu, M. (2014). Exercise and sex steroid hormones in skeletal muscle. [online] Journal of Steroid Biochemistry and Molecular Biology, 145, pp. 200-5. Available at: http://europepmc.org/abstract/med/24704257 [accessed 9 Oct. 2017].

How lack of appropriate exercise can impact our mental health.

Toxic pollution from the air, water, household products and cosmetics, etc. can have a profoundly disruptive effect on our hormones:Amen, D. (2013). Unleash the Power of The Female Brain. New York: Harmony Books, p. 93.

• These hormone-disrupting chemicals are known as “endocrine disruptors”
• Particularly potent endocrine disruptors are xenoestrogens — toxic compounds often found in plastics and other petrochemicals which mimic estrogens in the body and are especially disruptive to hormonal balance Hyman, M. (2008). The UltraMind Solution. New York: Scribner, pp. 166-71.
• Tobacco and recreational drugs can all impact hormonal balance

How toxicity can impact our mental health.

Getting 8 hours of sleep every night is essential to hormonal balance:

• Sleep deficiency will throw your hormones out of balance as it raises cortisol and reduces melatonin
• High cortisol, in turn, can reduce the production of pregnenolone, the mother hormone from which all other hormones are made
• The production of cortisol may take precedence over the production of sex hormones such as progesterone Leproult, R. and Van Cauter, E. (2010). Role of Sleep and Sleep Loss in Hormonal Release and Metabolism. [online] Endocrine Development, 17, pp. 11-21. Available at: https://www.ncbi.nlm.nih.gov/pubmed/19955752 [accessed 9 Oct. 2017].

How poor sleep can impact our mental health.

Lack of contact with nature and natural light can affect our circadian rhythms and our stress levels, leading to multiple hormone imbalances.

How lack of nature and natural light can impact our mental health.

Cortisol levels should peak in the mornings (6-8 am), then gradually starts to drop around 11 am through the day, preparing the body for bed as the sun goes down (prompting the release of melatonin, the sleep hormone).

In people that work night shifts, the pattern of cortisol levels is reversed, suggesting the timing of cortisol release is linked to daily activity patterns.(2017) You and Your Hormones from the Society for Endocrinology. Cortisol. [online] Available at: http://www.yourhormones.info/hormones/cortisol/ [Accessed 16 Oct. 2018].

When we are jet-lagged or we work night shifts, our body clocks take a while to adapt to our new clocks, which can create hormonal imbalances and sleep issues.

Inflammation can lead to higher androgens.Gottfried, S. (2013). The Hormone Cure. New York: Scribner, p. 224.

In a vicious circle, lower estrogen can lead to inflammation by causing a rise in inflammatory cytokines and interleukins. Au, A., Feher, A., McPhee, L., Jessa, A., Oh, S., & Einstein, G. (2016) Estrogens, inflammation and cognition. Frontiers in Neuroendocrinolgy 40, pp. 87-100, Available at: https://www.sciencedirect.com/science/article/pii/S0091302216300024; http://www.aikenbellamagazine.com/2016/11/02/connection-hormone-imbalance-inflammation/

How inflammation can impact our mental health.

• Constipation prevents the natural detoxification of hormones, and can cause a build up of excessive estrogen

Amen, D. (2013). Unleash the Power of The Female Brain. New York: Harmony Books, p. 93. Hyman, M. (2008). The UltraMind Solution. New York: Scribner, pp. 166-71.

How gut issues can impact our mental health.

Synthetic hormones, which are exogenous to us (meaning that they are not manufactured by our bodies but come from outside), also disrupt our natural hormone balance, sometimes intentionally.

• Hormones from the food supply such as in dairy and meat.Hyman, M. (2008). The UltraMind Solution. New York: Scribner, pp. 166-71.
• Contraceptive pill Amen, D. (2013). Unleash the Power of The Female Brain. New York: Harmony Books, p. 111.
• Synthetic hormone replacement therapy (SHRT)
• Bio-identical hormone replacement therapy (BHRT)

In addition, certain prescription drugs can influence hormone levels. For example, certain antidepressants, a few high blood pressure medications and opioids can affect testosterone levels and other hormone levels.(2017). Can prescription medications affect testosterone levels? [online] International Society for Sexual Medicine. Available at: http://www.issm.info/education-for-all/sexual-health-qa/can-prescription-medications-affect-testosterone-levels [accessed 10 Oct. 2017].

The removal of ovaries and uterus will have a very disruptive impact on hormonal balance.

I have seen so many patients whose ovaries (and uterus) have been removed unnecessarily. Unfortunately some women have very strong negative emotional reactions to what has happened to them. Anger, depression, and a sense of mourning are just some of the emotions women may experience after having a hysterectomy (removal of the uterus) or total hysterectomy (removal of the uterus and ovaries) (..) The unnecessary removal of the uterus and/or ovaries is not only detrimental to health but also to emotional wellbeing.Gluck, M. and Edgson, V. (2010). It Must Be My Hormones. Camberwell, Vic.: Penguin Group (Australia), p. 56.