Diagnosing Hormone Dysfunction
Most people have not been taught much when it comes to hormone health and function. We learn estrogen is the female hormone, testosterone is the male hormone, and for those with thyroid issues, you might know something about TSH. Yet the world of hormones is not simple and when looking at hormone dysfunction through a functional medicine lens, we inspect hormones from different angles using the mnemonic PTSD, which we’ll explain below.
Hormones are communicators. In the body, messages are sent and received between different parts of our anatomy. The transportation of these messages around the body happens through hormones. There are multiple categories of hormones including sex hormones (ie. estrogen, progesterone, testosterone, DHEA), thyroid hormones (TSH, Triiodothyronine (T3), Thyroxine (T4)), stress hormones (epinephrine, norepinephrine, cortisol, aldosterone), and metabolic hormones (ie insulin, leptin, ghrelin). All of these hormones are designed to do different jobs and carry different messages around the body. As functional medicine practitioners, we can measure these hormones and then view the results thinking about four different aspects: Production, Transportation, Sensitivity, and Detoxification (PTSD).
P is for Production of hormones. We consider how the natural processes in your body are working to produce specific hormones.
- If production is low, we think about conservative natural ways that increase production. This may include tailored nutrients that have been shown to support production.
- An example of this is low thyroid hormone. Before jumping right to recommending thyroid hormone, we consider nutrients that could be deficient and therefore affect thyroid hormone production such as iodine and selenium.
T is for Transportation. With transportation we consider how the hormone is moving around the body.
- Transportation of the hormone can determine how much is available to be utilized by our tissues. We may see normal levels of hormones on lab work but if that hormone is too available, there may be too much of an effect on the tissue. Hormones are all about balance!
- An example of this is when we see normal estrogen levels, but the patient is experiencing estrogen dominance symptoms. Upon closer inspection the doctor notices the protein that transports estrogen in the body is low. This means there are higher levels of free hormone in the body which can interact with estrogen sensitive tissues like the uterus or breasts leading to negative changes.
S is for Sensitivity. We have to consider how sensitive your cells are to the specific hormone’s signal.
- If your cells are not sensitive to the communication coming from the hormones, there is dysfunction that needs to be addressed.
- An example of this is insulin. Insulin is a hormone that acts as the key to unlock our cells so that sugar or glucose can get in. When our cells become less sensitive to the insulin, our body then has to make more insulin to get the sugar into the cell. This is essentially what is occurring in a body that is pre-diabetic or type 2 diabetic.
D is for Detoxification. This is where we look at how hormones are eliminated from the body once they’ve done their job.
- If we have increased levels of hormone in the body, it may be from increased production or from an impaired or reduced ability to get rid of the hormone. If we are unable to metabolize and remove hormones from our body, they recirculate which can lead to higher levels of that hormone in our bodies. This is why it is so important to have daily bowel movements and to engage in body movement that is strenuous enough to break a sweat.
- Using estrogen as an example again, if you are having issues with methylation, you won’t be able to remove estrogen from the body efficiently. Estrogen needs to be methylated in order to be metabolized and eliminated.
We value high quality, comprehensive labs that give us specific information about what is happening with your hormones. The test we recommend will depend on the hormones you and your doctor need information on. If you are looking at stress and sex hormones, a DUTCH test would be more precise for you, whereas a cardiometabolic panel would be supportive for learning about metabolic hormones and a comprehensive thyroid panel would give precise information for thyroid hormones. If you are ready to find out more about your hormone function and how it may be causing your symptoms, please reach out to our office. We are ready to take a comprehensive look with you and explore paths to move you toward better functioning!