There is more than one type of estrogen circulating through the body and even more metabolites of estrogen that can have effects on tissues of the body. Estradiol is the primary estrogen in women and is primarily produced in the ovary before menopause. After menopause, estradiol continues to be made in small amounts in the ovary and in much larger amounts in other fat tissues of the body such as belly, breast, hips and thighs. Estrogen is primarily produced from testosterone, also produced in the ovary, but can also be converted from estrone (a different estrogen), especially in menopause.
Progesterone is produced both in the ovary after ovulation, and in the adrenal glands. During pregnancy, it is produced in very large amounts by the placenta and is what is responsible for feeling sleepy during that time. It is actually a precursor for several other steroid molecules like cortisol, testosterone, and estrogen.
One of the most interesting aspects of progesterone is the fact that it helps balance the stimulating and growth effects of estrogen on cells. Progesterone can reduce the number of estrogen receptors on cells so that estrogen has less effect on that cell and it can inhibit the effect that estrogen has on activating DNA to make certain proteins, Because of this, it calms down tissues that have been stimulated by estrogen. This is what naturally happens to the endometrium every month during a woman’s menstrual period.
Progesterone is transported through the bloodstream attached to the protein albumin, so SHBG levels do not affect progesterone levels much. It is available in bio-identical forms in either oral capsule, or transdermal gels. There is some variation in the way that the gels are absorbed through the skin, and it can also be stored in fat tissue. When taken orally, it does get metabolized by the liver fairly quickly and has the side effect of making you sleepy. For this reason, it works very well at bedtime to help women with low progesterone levels to sleep well. There are also compounded preparations that can be given intravaginally as a cream which help protect the uterine lining (endometrium) without affecting levels in the rest of the body.
Although testosterone is the primary sex hormone found in men, it is also a very important hormone for women as well. Women have about one-tenth the level of testosterone when compared to men, but it carries out some very important functions. Testosterone works as a signal to increase production of red blood cells, it helps maintain muscle mass, and increases bone density. It also has significant effects on the brain to produce a feeling of well-being and vitality.
Some have called testosterone the “life-force hormone” and it does indeed contribute to motivation, libido, life energy, and striving. With low levels of testosterone, women can feel tired, sluggish, without any motivation, or even depressed. It has a role in sexual desire, but it is not the only factor affecting libido. Since it provides energy and motivation, a woman will feel more energized to carry out all activities if she finds them pleasurable or worthwhile, sex included.
In women, testosterone is produced in both the ovaries and the adrenal glands. It can either act directly on cells, or it can also be converted to estrogen. In the body, the majority of the testosterone produced becomes attached to sex hormone binding globulin (SHBG), a protein, which does not allow it to be active on cells and tissues. This means that only the “free” testosterone can act on the body. Because of this, factors that increase SHBG in the body will decrease a woman’s functional level of testosterone, such as birth control pills, high levels of thyroid hormone, and stress via cortisol. One other common culprit of low testosterone is alcohol, which encourages the body to convert testosterone to estrogen.
Keep in mind that all hormones are in constant communication with each other and that changing one will result in all the other hormones of the body reaching a new equilibrium. Whenever a person is evaluated for imbalances in testosterone, one must first see how the adrenals are functioning and balance the thyroid. If you want optimal levels of testosterone, it is important to get 7-8 hours of sleep per night, eliminate unnecessary stress, decrease alcohol intake to 1 drink per day or less, and make sure that you have appropriate Selenium and Zinc in your diet. Oftentimes, these two minerals need to be supplemented because of a decreased amount in our diet due to decades of soil erosion and mineral imbalances as a result of using fertilizers. All of these levels are easily measured and followed with simple lab tests.
Testosterone is the main sex hormone for men that increases significantly during puberty, and then decreases slowly starting in early adulthood for the rest of a man’s life. Testosterone is what is mainly responsible for the change in hair growth that happens at puberty, as well as an increase in size of a boy’s penis ad testicles, growing facial hair, and experiencing a deepening of his voice. Since testosterone is also known as the “life-force hormone,” it also contributes to motivation, vitality, and assertiveness.
In men, testosterone is produced mainly in the testes and the adrenal glands, although there are small amounts produced in other tissues as well. It encourages the growth of muscle mass, increases red blood cell production, increases bone density, and can increase oil production on the skin. Most testosterone produced (98%) is quickly attached to sex hormone binding globulin (SHBG), which is a protein that carries testosterone through the bloodstream. Once it is attached to SHBG, testosterone can no longer attach to target tissues or cells and so it is not active. Instead, there is a small percentage of “free” testosterone that is what interacts with testosterone receptors on target tissues and cells.
Levels of testosterone begin to decrease slightly after age 20 years old, then more pronounced after the age of 40. This explains why it becomes more difficult for men to keep a large amount of muscle mass in their later years as well as have a slight drop in sperm count as well. Although most men are concerned about problems with sexual functioning and desire, a normal drop in testosterone as men age does not always mean a decrease in desire or an inability to function. Usually there are several other factors involved.
Besides an overall decrease in testosterone over time, there is a considerable amount of variation in testosterone levels during the day and even during the seasons of the year. Many factors affect a man’s testosterone level as the body-mind work together to create the most efficient and balanced state for each individual. For the body to maintain muscle mass and have a high red blood cell count, it needs to use quite a bit of energy. When the environment is chronically stressful, threatening, or defeating, a man’s testosterone level will drop to conserve his energy for things that don’t take up so much energy and will not encourage him to risk himself in competition. Usually, a change of environment will help bring that testosterone to a new level.
In evaluating testosterone levels, one must take a few things into consideration. Since all of the hormones in the body are in a balance and constantly responding to changes, testosterone does not function alone. Before considering giving testosterone, one must find out what condition the adrenal glands are in and how they are responding to stress. This is the system that the body gives its first priority, and it will actually “pull” away from testosterone in order to make more stress hormones (cortisol) if it feels that need. Adrenal fatigue is a much more common cause of fatigue and weight gain in our society today than is low testosterone.
Next, the thyroid must be carefully evaluated since a low level of thyroid hormone will result in a low testosterone level. In men with decreased thyroid functioning, normalizing the thyroid hormone will increase testosterone levels without having to take testosterone. This happens because the body-mind gives priority to thyroid over testosterone and not the other way around. It is important to exclude any depressed thyroid functioning in order to properly balance all the hormones rather than try to supplement one while keeping the entire system skewed.
Not everyone with a low-range testosterone level has a problem. Different men have different sensitivity to testosterone based on their genetics that determine the efficiency of their testosterone receptors. This means that some men can get the same effect on their tissues and cells with a small amount of testosterone (efficient receptors) while other men will need higher levels of testosterone (inefficient receptors) just to get the same effect. It is important to look at the overall picture to really determine a need for testosterone replacement (loss of muscle mass, depression, loss of motivation, fatigue, anemia, loss of libido).
Testosterone plays an important part in sexual functioning, but is not the only determining factor of sexual desire or erection. There are many men in their 70’s and 80’s with plenty of libido and very low levels of testosterone, so we know that there are other factors at play. When it comes to loss of sexual desire, much more common causes are relationship dynamics, anxiety, chronic stress, or other lifestyle factors. Without addressing these first, changes in testosterone levels will not improve sexual desire significantly. Testosterone replacement is indicated for some men, but it is often a symptom of a larger problem, and not the problem itself.
One other very common cause of low testosterone, especially in men, is alcohol consumption. Alcohol causes the body to convert free testosterone to estrogen, so his levels of testosterone drop. If you want optimal levels of testosterone, it is important to get 7-8 hours of sleep per night, eliminate unnecessary stress, decrease alcohol intake to 1 drink per day or less, and make sure that you have appropriate Selenium and Zinc in your diet. Oftentimes, these two minerals need to be supplemented because of a decreased amount in our diet due to decades of soil erosion and mineral imbalances as a result of using fertilizers. All of these levels are easily measured and followed with simple lab tests.
Although estrogen is the primary sex hormone found in women, it is also a very important hormone for men as well. It is readily made from testosterone in several tissues of the body depending on the body’s needs. Estrogen is what is responsible for growth during childhood for both boys and girls, and the long bones continue growing until they receive the signal from estrogen to stop. In childhood, boy’s estrogen levels are very similar to girl’s. In adulthood, however, a man’s estrogen level is from about one fifth to one half of a woman’s estrogen level (hers vary quite a bit with her menstrual cycle).
Even in men, estrogen carries out some very important functions. It works to help protect the lining of blood vessels, it is needed along with testosterone for production of healthy sperm, it maintains strong bones in balance with testosterone, it contributes to sex drive, helps regulate the heart rate, and protects the functioning of the brain and memory. Estrogen also has been found to regulate body fat in men similarly as it does in women so that when estrogen levels are too low, the body starts to accumulate body fat, especially around the waist. Too much estrogen circulating, however, can decrease levels of free testosterone, cause men to gain weight around the hips and thighs, and have enlargement of their breast tissue.
Estrogen is carried through the bloodstream attached to a protein called sex hormone binding globulin (SHBG). This protein is produced in the liver depending on the amount of estrogen and testosterone floating around the bloodstream. Essentially, estrogens increase SHBG production (which lowers free estrogen levels) and testosterone decreases SHBG production (which increases free estrogen levels). Other factors can affect the amount of SHBG in the body such as insulin, which lowers production of SHBG and results in increased circulating estrogen.
There are two different receptors for estrogen found on cells throughout the body-mind, and the combination of these receptors determines what effect estrogen will have on a particular tissue. The alpha receptor produces mostly a stimulating effect on tissues, signaling them to grow and cells to divide. The beta receptor is found in higher quantities in bone, brain, liver, intestines, and skin and has more of a suppressive effect on tissues and cells. Normally, there is a combination of both alpha and beta activity going on throughout the body-mind to keep things balanced. Of note, the prostate gland has both estrogen-alpha and beta receptors and the balance of these may contribute to enlargement of the prostate as well as prostate cancer.
Estrogen can be synthesized from testosterone in several different tissues, but it is primarily the role of enzymes found in fat tissue. For this reason, the more fat a man is carrying, the higher his estrogen level will be. This is important not just for some unwanted side effects of estrogen already mentioned, but also the fact that estrogen can turn on and turn off hundreds of different genes in DNA to change how the body-mind operates and heals itself. The key is to have the estrogen levels within a healthy range – not too high, but not too low either.
One very concerning problem facing men today is the amount of xenoestrogens that they are exposed to on a day to day level. These are substances in the environment that attach to estrogen receptors in the body and can act like estrogens – some weak, and some strong. This means that a man could be getting an “extra daily dose” of estrogen-like substances that directly impact his health. Some of the sources of xenoestrogens include fat in meat and dairy products, pesticide residue on fruits and vegetables, common cleaning products (especially scented ones), plastic food containers and plastic-lined canned food, soaps, shampoos and lotions, cologne, hair dye, and vapors from plastic products such as in building materials, carpets, foams, flooring, etc. Unfortunately, xenoestrogens do not show up on lab tests. They are also stored in the fat tissue of the body, so can continue to have their effects for a long time after exposure. Obviously eating organic produce, eliminating or reducing dairy from the diet, and attempting to eat only grass-fed animals that were not exposed to pesticides or hormones would be a step towards reducing exposure to xenoestrogens.
Cortisol is a stress hormone that is secreted from the adrenal glands along with Adrenaline into the body in response to stress. Although Adrenaline is metabolized quickly in the body (a few minutes), cortisol hangs around in the bloodstream much longer (several hours) and affects many systems of the body. Since the body depends on cortisol for its survival, the first priority when there is a stress response will always be to make cortisol above everything else. For this reason, other hormones cannot be considered balanced unless cortisol is attended to first. If cortisol is secreted repeatedly throughout the day in response to stress, levels can build up in the body.
Cortisol functions to help balance the body and coordinate many different systems together. All of its functions are meant to help the body deal with stress, physical or psychological, real or imagined. In the short-term, cortisol helps balance blood sugar levels by making energy out of fat and protein. It forms a balance with insulin so that cells are not left without the glucose they need to function and keeps a person from becoming hypoglycemic. It also helps protect the cells from increased levels of insulin and helps regulate sodium and potassium levels in cells. Prolonged exposure to elevated levels of cortisol, however, can result in muscle wasting, protection of fat tissue, and bone loss.
One very important function of cortisol is that of keeping the immune system in check. When the body responds to some sort of trauma or infection, cortisol helps keep the immune response from getting out of control and damaging the body as well. When the body cannot produce enough cortisol, areas of inflammation often have more redness and swelling and take longer to heal. In contrast, too much cortisol can suppress the immune system so much that the body cannot properly defend itself and a person may get infections more easily.
Cortisol also plays a role in cardiovascular health. It helps regulate sodium and potassium balance in the cells of the heart muscle so that it helps control the force of contractions and helps regulate the heartbeat. It also works in balance with calcium and magnesium to help regulate blood pressure. Too little cortisol and a person could experience low blood pressure, while chronically high cortisol could increase blood pressure above normal levels.
The brain is also significantly impacted by cortisol. When cortisol is secreted in response to an acute stress, the brain can more easily capture snapshot memories in short-term memory. Cortisol levels help balance electrical activity in the brain and affect sleep and alertness. With too much cortisol, a person cannot sleep well and often wakes up early, they may feel anxious or agitated or also depressed, and their system for long-term memory becomes impaired. With too little cortisol, a person can feel moody or depressed, fatigued, and foggy in their thinking.
There are many things in our environment that raise our cortisol levels unnecessarily. Some of these are stress, caffeine, prolonged exercise, very low calorie intake or starvation, consumption of alcohol, and sleep deprivation. Many people routinely have one or more of these factors constantly in their lives, which is detrimental to the balance of cortisol and their overall health. During any of these states, the body produces an excess of cortisol, which also puts a great strain on the adrenal glands. If many of these stresses go on for years, the adrenal glands can fatigue and finally stop being able to produce proper amounts of cortisol.
In adrenal fatigue, the body does not produce enough cortisol, either for its normal functioning or in response to stress. This results in a pervasive sense of fatigue, illness, moodiness, forgetfulness, hypoglycemia, dehydration, and increased cellular stress. The key is to keep cortisol levels balanced – not too high, but not too low either. Adrenal fatigue is a very common condition in our modern day society and requires serious lifestyle changes to correct over time. There are also important dietary changes and supplements that can restore adrenal functioning.
Cortisol levels are best measured in saliva with an easy-to-use at home kit. These levels, along with the level of DHEA (which helps regulate cortisol) and a person’s symptoms can point out what stage of adrenal fatigue a person is in. Some simple interventions such as a few minutes meditating, abdominal breathing, or humming can help induce a relaxation response and decrease the body’s need for cortisol. These, along with cutting out those factors in your life that function to increase cortisol, can improve your overall health, help you regulate your mood and your weight, and even help prevent against illness and cancer.
DHEA is a steroid hormone made from cholesterol. It is mostly secreted from the adrenal glands, as well as some in the testicles and ovaries, and also in the brain. It functions as a precursor for testosterone and estrogen, but only in the target tissues and there does not appear to be significant conversion from DHEA to testosterone in the bloodstream. DHEA helps regulate the body’s level of cortisol in response to stress. It also has some direct actions on tissues of the body. Although it is in the androgen family, it actually has very weak androgenic activity in the body. Interestingly, it is the most abundant steroid that we have in our bodies, still some of its action remains a mystery.
Some studies have found that women may get a small increase in testosterone levels from DHEA supplements, no such increase was found in men. We do know that people who are depressed seem to have lower levels of DHEA, and that levels of DHEA seem to correlate with longer life and better heart health. DHEA can be seen elevated during the early stages of adrenal fatigue when the body is trying to crank out higher amounts of cortisol in response to stress. Once a person reaches a more advanced level of adrenal fatigue and can no longer produce a good cortisol response, it is only a matter of time before the DHEA production also falls off. When both cortisol levels and DHEA levels are below normal, then that person is at an advanced stage of adrenal fatigue.
DHEA is known to contribute to younger looking skin and may help improve thinking and memory as well. It boosts the immune system, helps you keep your weight down, and even helps you have good HDL levels. It helps you sleep better and helps you deal with stress more easily. If you have too little DHEA, you may have low energy, sluggishness, joint pain, and a reduced amount of hair under your arms, in your pubic region, or over your shins. A high DHEA may be a sign of adrenal fatigue or treatment-resistant depression. DHEA levels in comparison to cortisol levels can indicate in which state of adrenal fatigue a person is in.
Although DHEA supplements are sold over the counter, levels should be checked before attempting supplementation. All of the ways that a person naturally maintains good health also help to normalize DHEA levels. Those are good sleep for 7-8 per night, a diet that is not excessive in calories, more vegetables than animal products, good fats and a healthy amount of Omega-3’s, regular moderate exercise, laughter, and eliminating chronic stress. Another way to boost DHEA is to have an orgasm. There is an increase of DHEA just after orgasm, which is just another reason that you get that great post-sex glow!
The thyroid gland is the largest endocrine gland in the human body and the one that regulates metabolism and energy production. Except for the stress response and cortisol, the body-mind gives preference to the thyroid functioning above all other hormone systems. Because of this, it is important to rule out any problems with the thyroid whenever someone has a physical complaint that may indicate an hormone imbalance. In the United States, it is estimated that about one out of every seven people are suffering from low thyroid functioning, many who don’t even know it.
The thyroid gland is located in the front part of the neck and is controlled by the pituitary gland found at the base of the brain, and ultimately by the hypothalamus found in our limbic system. Depending on the needs of the body-mind and on the levels of hormones circulating through the body-mind, the brain sends signals to the thyroid to make thyroid hormone (T4). T4 is not actually an active thyroid hormone and must be converted to T3 in order to have its action on cells and tissues. T4 can also be converted to rT3 (reverse T3) that may function to block the action of T3 and slow the body down. Since a large quantity of rT3 can affect the body just as much as low T4, it is important to look for rT3 and see if it is the cause of symptoms when evaluating thyroid functioning.
In order to properly produce thyroid hormone, the body needs proper nutrients (Iodine, Iron, Selenium, Zinc, B2, B3, B6, Vit C, Vit D, and tyrosine). Things that cause the body stress will decrease production of thyroid hormone, or encourage the conversion of T4 to its inactive rT3 form. Some of these are stress, chronic infections, radiation, starvation, inflammation, fluoride or chloride. Supplementation with both Selenium and Zinc has been shown to increase conversion of T4 to its active T3 form.
There has been quite a bit of debate about what “normal” thyroid levels are, and the most frequently checked level is TSH (thyroid stimulating hormone) that is secreted from the brain to the thyroid. When this level is high, the thyroid is not producing functional thyroid hormone as it should and the brain is trying to get the thyroid to work harder. Many clinicians will say that a TSH level of 3.5 mIU/L or below is “normal”, but many studies have found that many people in the range of TSH from 2.5-3.5 mIU/L actually have thyroid dysfunction and would benefit from more specific testing and interventions to improve thyroid functioning.
Some of the symptoms of low thyroid function are fatigue, irregular periods, constipation, dry skin, brittle hair, weight gain, feeling cold, hair loss, muscle pain, swelling, or depression. Any of these symptoms should be an indication to have your thyroid functioning checked. Overactive thyroid is also problematic and can make people feel anxious, jittery, hot and sweaty, palpitations, blurry or double vision, difficulty sleeping, weight loss, loose stools, thinning skin, and muscle weakness. If it continues, a person may have bulging of the eyes which is irreversible. In extreme cases, a person may become psychotic, hallucinate, or become a suicide risk with overactive thyroid.
Thyroid functioning is also strongly tied to the production of testosterone and estrogen in the body. If thyroid levels are low, production of testosterone and estrogen are lower. Conversely, when thyroid hormones levels are high, this can also increase the amount of testosterone and estrogen. With these elevations, men may experience growth of breast tissue and women may have damaging effects from increased levels of stimulating estrogen. It is very important to insure healthy thyroid functioning whenever evaluating other hormones for imbalances or for supplementation.
Insulin is a hormone made in the pancreas which is secreted after eating to control blood sugar. The amount of insulin secreted is in proportion to the amount of the increase in blood sugar from each meal. When insulin levels rise, it signals the body to stop using fat for energy and get rid of glucose in the blood instead. It forms energy stores in muscle cells and promotes growth of muscles when in proper proportion with protein intake. It protects fat tissue by forcing fat cells to take in more fat and also increases triglyceride production. It is one of the body’s most important growth hormones and responds to each meal and the amount of carbohydrates, proteins, and fats eaten.
When the body cannot produce normal levels of insulin (Diabetes Type 1) or becomes resistant to the effects of insulin (Diabetes Type 2), then blood sugar levels can rise to dangerous levels that are toxic for the body. If blood sugar levels rise too high, a person could experience a diabetic coma and die. More commonly, diabetics have chronically elevated levels of blood sugar which over time damage their joints, their kidneys, their eyesight, their blood vessels, their nerve endings, and their immune system. The elevate blood sugar levels act as a poison on all the systems of the body-mind.
In our country, there has been a skyrocketing amount of Diabetes Type 2 as a result of changes in the Standard American Diet that has increased the amount of sugar in our foods many times over. Not only has it resulted in tremendous weight gain, but it puts people at risk for earlier death from many diseases and an increased risk of cancer. Not only should a person pay attention to the glycemic index of the foods they eat, but they must also consider the glycemic load of the entire meal (how much their sugar will go up in response to all the food they have in one meal). Most prepackaged and prepared foods have a considerable amount of sugar and should be avoided. Getting our society hooked on “convenience” foods and “fast” foods has resulted in a significant increase in chronic and debilitating illness. Sadly, most people have either forgotten how to cook their own meals or are convinced that it would be more time consuming or expensive, but this has been proven to be false.
Insulin is usually balanced in the body by cortisol, but their relationship is not as straightforward as that. When insulin levels are high, it heightens cortisol’s ability to store fat, even as it is decreasing levels of cortisol. Chronic elevated levels of cortisol can also make the body resistant to insulin, causing the body to try to secrete more insulin just to have the same effect. As you can imagine, stress can be a big player here since it increases cortisol and thereby affects insulin. When stress is chronic and high, a person will develop insulin resistance (Diabetes) and will store more fat tissue.
Insulin also has effects on sex hormones. When insulin levels are high, testosterone and estrogen levels also increase. This can be problematic when there is chronic elevation of insulin with increased cardiovascular risks for men, increase in breast tissue growth, and increased risk for breast cancer and prostate cancer. Women with PCOS (polycystic ovary disease) have both insulin resistance and increased testosterone. When a person is trying to balance their hormones, they cannot ignore insulin. This means that good dietary choices and healthy lifestyles decision will play a huge role in their hormone balance and overall health.