A Functional Medicine Perspective

Hormonal imbalances can cause of a host of serious health problems, including inflammation, metabolic syndrome, adrenal fatigue, sexual dysfunction, obesity, diabetes, osteoporosis, heart disease, hypertension, dementia and more. While many things can cause an imbalance in our hormones, the good news is we can often fix these imbalances without medications. It is not a result of bad luck; it’s due to bad habits that many of us fall in to as we rush through our busy days. We know the schedules we keep don’t allow for much time to take care of ourselves. But, without a conscious decision to make some changes to what we eat and drink, how much movement and activity we get daily, and to ensure we have adequate time to rest and sleep, we will continue to be frustrated by our lack of energy and increasing struggle to keep up with the pace of our lives, while staying positive and productive.

The path to real healing starts when you decide you need to know “Why?” Why do you feel lousy or out of balance? What is causing the symptoms?

Crossing Back to Health offers Functional Medicine in St. Louis

Hormones - a Functional Medicine Approach

When you figure out what creates the imbalances – and treat the underlying problem – you find a true solution. Functional Medicine facilitates the diagnosis and treatment process, in that it identifies and treats the underlying cause(s) which creates balance and improves symptoms.

Most of us are living life completely out of balance. Unfortunately, after a time, we come to accept the symptoms of imbalance as “normal”.

Because various hormones allow communication from one organ or region of the body to another, they enable appropriate response to stress and keep the body in a homeostatic balance. For instance, a hormone in the brain (ACTH) triggers cortisol production in the adrenal gland in response to stress. The cortisol then feeds back to the brain to slow down the production when there is enough or the stress has subsided. It sounds simple when we focus on one hormone, however our bodies produce many hormones and each hormone interacts with the others, creating shifts that can be challenging to balance.

When talking about hormones, think of a symphony with many players, all working together to create a cohesive sound. When things are in tune, the result is beautiful harmony. But, if any one part is out of synch, the result is disjointed and the result sounds chaotic. Hormones work in a similar fashion, and can be influenced by physiological stress, disrupting the entire network.

Hormones may be categorized into three groups for better understanding.

  • Adrenal Hormones: Provide a critical foundation for developing and maintaining overall health and well-being. Sustained elevations of cortisol from chronic stress may lead to hyperglycemia, insulin resistance, central obesity, hypertension, hyperlipidemia, memory impairment, altered thyroid function and alterations in sex hormones. Proper functioning of the adrenals is also foundational for normal thyroid and sex hormone production.
  • Thyroid Hormones: TSH which is produced in the hypothalamus stimulates the production of T4 which then needs to convert to T3, the active thyroid hormone. This conversion is dependent upon key nutrients, when deficient lead to low thyroid symptoms. The immune system can interfere with normal thyroid function by producing autoantibodies producing the most common form of hypothyroidism “Hashimoto’s Thyroiditis”. Thyroid dysfunction may occur due to stress and inhibition of TSH from cortisol (adrenal influence).
  • Sex Hormones: Imbalances in estrogen, progesterone, and testosterone are common around menopause, “perimenopause” and andropause, and can cause a host of symptoms. This imbalance also causes increased risk of heart disease, osteoporosis, dyslipidemia, immune dysfunction and hormone dependent cancers. Evaluation of the hormones provides insight into the production and elimination of sex hormones, providing an opportunity to support the biologic process and reduce risks.

Symptoms often related to hormone imbalance include:

  • Low energy, even after sleep
  • Hypertension
  • Hot flashes and night sweats
  • Weight gain – especially midline
  • Bloating
  • Brain fog or poor memory
  • Headaches, including migraines
  • Irregular periods or PMS
  • Tired all the time or overwhelmed
  • Sleep difficulties or insomnia
  • Low sex drive
  • Vaginal dryness
  • Constipation
  • Salt craving
  • Depression
  • Mood imbalance
  • Infertility
  • Poor wound healing
  • Easy bruising
  • Hypoglycemia
  • Fibromyalgia
  • Craving sweets
  • Adult onset diabetes
  • Bone loss or osteoporosis
  • Water retention
  • Frequent infections
Functional Medicine's approach to Hormones

Hormones may be evaluated using a variety of methods:

  • Saliva testing – especially for cortisol and DHEA – stress hormones
  • Urine testing – a complete evaluation can check stress hormones, sex hormones and mineralocorticoids.
  • Blood testing – thyroid, autoantibodies, insulin, lipids, inflammatory markers, oxidative stress markers, toxin levels, IgE & IgG allergy testing, nutrient levels etc.
  • Genetic testing – helpful to evaluate individual tendencies that impact production and breakdown of hormones which guides the approach.
  • Nutrient assays – evaluates nutritional needs to support hormone production.
  • Stool studies – looks for gut related issues and source of potential inflammation.
  • Dietary History – helps to identify foods that may be creating inflammation and hormone imbalance.

Controversies and disagreements abound regarding:

  • how to diagnose and measure hormonal function and dysfunction;
  • how to address safety concerns when prescribing HRT including the form, application and dosage; and
  • When and how to include lifestyle, diet, nutritional and botanical treatments.

When evaluating and treating hormone imbalances, there is an order of priority which starts with the adrenals, followed by thyroid, and finally sex hormones. Frequently a patient may believe they need hormone replacement therapy, when testing shows the adrenal function is deficient and the sex hormones are normal or even elevated.

Functional Medicine


Functional Medicine in St. Louis

By testing properly, we identify the root cause and restore function to the whole system with improved overall outcomes and safety. Because the Functional Medicine approach looks upstream and applies dietary modifications, nutritional supplements, and other lifestyle changes before considering HRT, the need for HRT can often be minimized or avoided.

It is important to also consider the production, transport, conversion, distribution, interactions with other hormones, cell sensitivity to the hormone signal, detoxification and excretion of the hormones.

There’s a lot going on in this complex system! Hormone production is influenced by inflammation, nutritional deficiencies, over exercising, obesity, genetic patterns, malnourishment, oxidative stress, insulin resistance and chronic infections. Because of this influence an evaluation may include markers for inflammation, oxidative stress and metabolism, nutrient levels, genetic testing, and evaluation for chronic infections.

The Right Diet Becomes Your Number-One Reset Button


The first step involves removing the bad stuff. We all know the main culprits – sugar, caffeine, alcohol, stress, and lack of exercise all contribute to a variety of health issues. Imbalances in your hormones are triggered by bad food. If you eat sugar, you’ll produce more insulin, more estrogen, and more testosterone. Dairy and gluten are often triggers for inflammation and hormonal imbalances. Xenobiotics or environmental chemicals like pesticides in our food can act like powerful hormone disruptors and trigger our own hormones to go out of balance.

After removing the bad stuff, replace it with good stuff. Eat a whole, real, unprocessed, organic, mostly plant-based diet with organic or sustainably raised animal products. When you focus on this type of diet, you minimize intake of xenoestrogens, hormones, and antibiotics. Taking simple steps like choosing organic food and drinking filtered water can significantly benefit hormone balance.

Other Strategies to Balance Your Hormones

Supplement wisely. Fish oil and additional vitamin D and B vitamins help balance hormones. Take these in addition to a good multivitamin and mineral with sufficient calcium and magnesium. Probiotics, antioxidants and phytonutrients (vitamin E, resveratrol, curcumin, n-actetyl cysteine, green tea, selenium), and the anti-inflammatory omega-6 fat (GLA or gamma linoleic acid) can help balance hormones.

Exercise. When you exercise, you have less PMS and other problems. Find something that you love to do, and commit to your improved health. Running, long walks, weight training, dance, or any other form of movement that you enjoy can provide significant benefits to your hormones as well as your stamina and energy levels.

Reduce stress. Chronic stress can trigger or exacerbate hormonal imbalances. The key here becomes finding something that works for you to reduce stress. Try meditation, yoga, qi gong, nature or find a creative outlet.


Get Enough Sleep. Insufficient sleep can adversely impact PMS, menopause, and other conditions. Getting eight hours of quality, uninterrupted sleep every night is one of the best things I can think of to balance hormonal levels.

Reduce or eliminate alcohol. Alcohol, even red wine, will impact hormone balance.

Let’s work together!

It would be a privilege to work with you to improve your health and overall well-being. By determining the underlying causes of your symptoms, we can find the most beneficial plan for you. Contact us today to learn more!