A Jangle of Hormones

ARE YOUR HORMONES ALL A ‘JANGLE’?

It would be rare to meet a woman today who has never had some type of hormone problem.  Problems with periods, the menstrual cycle, PMS, menopause and fertility are an almost universal experience in developed countries now and they are becoming increasingly severe.  As a result, more radical hormone treatments and surgery for hormonally related illnesses are increasing.

To illustrate this, I will share with you part of one of my patients’ story.  I’m sure numerous readers will identify with this. 

Jenny was very anxious to make an appointment.  On the phone she said “my hormones seem all over the place, I have to do something quickly as I feel I will go mad!” 

Here is some of what Jenny had to say at our first appointment –

“I think my hormones must be all out of balance because I feel so awful.  I feel so tired all the time, so tired that sometimes I can’t seem to get out of my own way.  I need a lot of sleep but never feel any benefit from it and feel exhausted when I wake each morning.  I know I might feel better if I exercised and that could help me lose some of the weight I’ve put on, but I don’t have any energy or motivation for exercise or anything or anyone.  My poor husband!  I have zero libido and before each period I get so bloated, uncomfortable, emotional and irritable that I feel like a mad woman.  Then when my period does finally come it is so heavy and painful these days I don’t know what to do with myself.”

Jenny is typical of so many women I see in my practice, presenting with reproductive difficulties and conditions associated with hormonal imbalance.  My aim is always to thoroughly assess what is going on underneath all those symptoms, work out what is actually causing the imbalance and then take steps to recreate the natural balance.

What are Hormones Exactly?

Produced by organs as diverse as specialised glands such as adrenal glands and ovaries to ordinary fat cells, hormones are of many types. They are proteins synthesised from cholesterol and transported throughout the body via the bloodstream continually bathing our tissues to trigger activity in sites distant to their origin.  Our cells have receptors on their membranes that are sensitive to particular hormones to which they then react.  Thus the health of cells, the sensitivity of the receptors and the quantity of hormone being produced will determine the reaction. 

So basically hormones are the chemical messengers that make things happen in our bodies. 

They co-ordinate the biochemical activity of all our cells and create the day-to-day changes that determine what actually happens within our body systems controlling all metabolic processes, development, growth, reproduction and behaviour.

The Hormonal Orchestra

To help understand the endocrine (hormonal) system, think of it as somewhat like an orchestra with each gland or hormone being represented by a particular section of the orchestra.    In an orchestra each section is affected by and has an effect on all of the others so if any are out of time, out of tune, too loud or too soft, all the others will be trying to compensate to ensure the music sounds right. 

So it is with your hormones too.  All are interrelated and profoundly affect each other. A change in the level of any hormone (artificially or naturally) will produce a cascade of consequences affecting everything else.

 But there is also a natural rhythm, like music our various hormones rise and fall, creating different “tunes” and “tones” over a day, months and years.

Hormone imbalances are a major health concern and affect millions of men and women worldwide.  As in Jenny’s case, they can have an extremely debilitating effect on physical & emotional health and impact greatly on quality of life for so many.

What Causes Hormone Imbalances?

In very simple terms hormone imbalance occurs –

A)  Because the basic substances & nutrients our bodies require to produce hormones and that allow our body cells to respond properly to them are not sufficiently available and

B)  Numerous environmental issues e.g. environmental & medically prescribed synthetic hormones & chemicals, pollution, heavy metals, stress & anti-nutrients have an adverse effect on the way the hormones are produced.

Testing for Hormone Imbalance

There are several different ways of assessing hormone levels and function.

Traditionally hormone levels have been assessed mainly by blood testing.  These tests are usually done once and only give indication of hormone levels in the blood at that particular point in time.  This is not always the best method of assessing hormone balance.  An example of this would be testing the levels of sex hormones in women which fluctuate widely throughout a menstrual cycle.

In some cases only one measurement is used to assess function and balance.  For example Thyroid Stimulating Hormone (TSH) is used commonly to assess thyroid status but will not give a full picture.  It may only be out of range if there is actual thyroid disease.  TSH is just one of around eight parameters required to fully assess thyroid function.

As well, simply taking your basal body temperature on waking (first 2 weeks of menstrual cycle for women) is a fairly good and very easy assessment of how your thyroid hormones are actually functioning and impacting on your life.  You can do this yourself at home.  One would expect a normal basal body temperature to be between 36.4°C and 36.6°C.  If yours is significantly above or below this consult your practitioner for further assessment.

Your ‘Urinary oestrogen metabolites’ is a different but extremely valuable way of assessing the effect of oestrogen in your body.  If oestrogens are not metabolised properly in the liver, the type of end products (oestrogen metabolites) can promote the development of hormonal disease states such as endometriosis, uterine fibroids, excessively heavy menstrual bleeding, uterine cancer, breast cancer and prostate cancer in men.  Poor oestrogen metabolism can also block the conversion of thyroid hormone into the active form and could be an underlying factor in thyroid dysfunction.

Salivary hormone assessment has been in use now for some time and is considered more accurate than blood but is not yet commonly used by mainstream medicine.

Saliva is considered to be equivalent to the tissues of your body and measures the biologically active or ‘free’ hormones. i.e. measures the actual effect your hormones are having on your body and the level of hormones that your body is actually using.  Blood tests on the other hand measure both the active and inactive forms of hormones all in the one measurement so can give you quite a different reading regarding their effects.

The important advantage for salivary hormone assessment is that it is not at all invasive (all you have to do is spit some of your saliva into a little tube!).  As well, you can easily measure hormones multiple times throughout the day to check the normal daily variations (e.g. cortisol a stress hormone which has a specific daily pattern) or, for women, easily test multiple times throughout the menstrual cycle to check normal cyclic variations.

I hope that this helps you “look outside the square” with regard to assessing your hormone balance.