The hormone dance

The word “hormone” may automatically make you picture an angry, pimply teenager. For most people, hormones really only mean estrogen and testosterone. To think only about our sex hormones, is to leave out the interplay of all hormones across the entire system (our body.) There are many other hormones that are important for optimal health and our ability to respond to life events. Key players are thyroid hormone, cortisol, insulin, and estrogen (yes for men too).

Hormones are the body's communication system, like text messages, that are released from certain glands and organs in response to the environment. Despite what many people believe, hormones rarely go rogue, but are the logical downstream result of adapting to an environment where our survival wasn’t always guaranteed. Hormones tell the rest of the body what it should do based on the lifestyle choices we make. No hormone acts alone, they shift constantly is a pulsatile fashion and interact even with each other to give the body maximum flexibility in responding to a dynamic and evolving environment. This is key for survival. Without a quick response to stressful stimuli, we would not have survived very long. Shifts in hormone levels, action, and excretion moves the body’s natural states from resting to reaction. Hormones can control whether we are fertile or not, digest food or not, rest or run, or even fight infections or allow an overgrowth. To maintain the ability to rapidily shift from one state to the other, the body will keep lots of hormones in circulation, but only about 1 to 5% is unbound and available to do work. Hormones are extremely powerful and even small fluctuations too high or too low can have negative consequences.

Hormones are released by 5 major glands and tissues connected along an axis called the HPATG axis. HPATG stands for the hypothalamus and pituitary, which contains both neural and immune tissue; and the adrenals, thyroid and gonads, which contain only endocrine tissue. Endocrine means the tissues release their various hormones directly into the bloodstream. Some hormones are controlled by the pathway they affect like blood sugar influencing insulin and glucagon release from the pancreas.

The hypothalamus is the seat of control and releases hormones along neurons connecting directly to other glands, primarily the pituitary, which secretes releasing hormones in response to neural stimulation (our thoughts, emotions, and environment.) They hypothalamus can sense current hormone levels like thyroid hormone and inhibit the production of more. It is our reaction to our environment that causes a stimulatory or inhibitory response. Releasing hormones from the hypothalamus act on the pituitary gland which release stimulating hormones that bind to receptors on the adrenal, thyroid, and gonadal tissue.

“Life is about 10% what happens to you and about 90% how you react to it.” Charles Swindoll

Whether the stimulus is real or imagined (negative self-talk, ruminating on the past, or worrying about the future) our hypothalamus responds in a very real way, resulting in changes from our mood, immunity, stress, weight, energy, and fertility.

The hormone dance floor

Picture a very crowded dance floor. When one hormone does the electric slide they either stop and stare or join in for dance. There are 2 common dances that are important for overall metabolic health as well as reproductive health. Metabolically, there are 4 common hormones that are key to regulating energy production from foods and responding to stressful stimuli, which also affects metabolism. Insulin, glucagon, cortisol, and thyroid hormone increase or decrease protein synthesis, increase or decrease the formation of glycogen (the storage form of sugar) and glucose use, and increase or decrease the storage of fat in the form of triglycerides or fatty acid breakdown for energy use. Reproductive health dances includ estrogen, testosterone, progesterone and prolactin but is also influence by the metabolic dance of insulin, cortisol, and thyroid hormone. These two dances are not truly separate at all and this can be a common dynamic for women, especially those who are struggling with blood sugar imbalances and mood imbalances.

The dance masters

Cortisol is considered the master regulator because it can make other hormone receptors more sensitive and shift the body into a more catabolic state. It can slow metabolism all by itself and even increase blood sugar levels. It also affects the balance of the sex hormones by upregulating or downregulating their production. Cortisol is released by the adrenal glands in response to stressful stimuli. High cortisol levels are linked to many chronic diseases such as diabetes, high blood pressure, infertility, and diabetes. Cortisol is essential for survival, but chronicaly high levels result in a dysregulation of all the other hormones as well as an inability to be in resting, thriving, and healing state of being.

Insulin is not inherently bad, but is often vilified because of it’s role in the metabolic dysregulation seen in those with diabetes. We have to have insulin to get fuel, in the form of glucose, into literally every cell in the body except red blood cells. The problem with insulin comes from our dietary choices that spike insulin levels over a period of 10–30 years, causing our cells to become resistant to its effects. Increases in insulin levels can also affect our sex hormone dance by shifting hormone biotransformation to a more androgen dominant state, as seen in PCOS in women. The cause here is not female sex hormones gone rogue, but the body's natural response to an environment of caloric excess in the form of sugar. The body is well equpped to handle temporary shifts, but when the demands on the body are skewed 90% of the time then hormones must adjust to keep us alive.

Balance is essential

Hormones typically have a very short half life. This makes sense, we only want a temporary shift in response to an immediate event in our environment and the the body must go back to it’s resting state. Hormones must be chemically broken down or inactivated from the blood through the liver during phase 1 and phase 2 detoxification to allow the body to acheive a resting state. Some hormone metabolites (intermediate compounds) can have very potent effects. Estrogen is a great example of hormone imbalances occuring from poor phase 1 and 2 detox resulting in cancerous compounds that can lead to breast and uterine cancer. Even chronic constipation (poor phase 3 detox) can shift estrogen levels higher because estrogen can be reabsorbed in the colon and into the bloodstream from there.

Liver overload from too many medications and an imbalance in the intestines from particular microbial species can lead to high estrogen levels and symptoms of estrogen dominance. Adipose tissue is an endocrine tissue and can even produce estrogen and cortisol outside of normal HPATG control, meaning no negative feedback loop. The liver produces proteins that bind to hormones and keep blood levels under control. Thyroid binding globulin and sex hormone binding globulin act as carrier molecules for hormones. The liver responds to rises in estrogen and thyroid levels for example, and will increase or decrease binding globulin levels.

Insulin resistance can cause the liver to decrease SHBG. Why? Because the liver needs energy (glucose) to function and insulin resistance decreases fuel avaiable to liver cells. So increasing insulin can cause an increase in free estrogen. A decrease in thyroid function will result in similar dysfunciton. Cortisol is bound as well and cortisol levels rise in the blood, the proteins that bind to cortisol become saturated and a higher percent is free and avaiable to attach to receptors. Cortisol binding globulin can also transport progesterone, but not if it is saturated with cortisol. You can see how one level of dysfunction with a particular hormone creates effects further downstream through the action or inactivation of other hormones. Balance is critcal for all hormone function.

Receptor function is often forgotten

Hormones can’t have an effect if they can’t reach the cell in question or if the receptor is blocked. Think of it as a key (the hormone) and a lock (the receptor.) They have to fit just right to open the door.

Receptors can be located within the cell’s outer membrane like insulin receptors or within the cell and within the wall of the nucleus. Binding of a hormone to the receptor triggers a cascade of reactions that affect the funciton of the cell. Often it is activation of a certain enzyme or change to genetic expression which results in protein production. Other molecules can bind to the receptors and cause similar effects as the hormone (phytoestrognes found in food or xenoestrogens found in chemicals like skincare) or impair the receptor and block the hormone from attaching. Drugs often act in this way. In fact, endocrine disrupting compounds like BPA can actually change the shape of the receptor. Damage to the cell membrane can create receptor dysfunction. Omega 3 and 6 imbalance, age related damage, poor antioxidant function and certain drugs such as cholesterol medications are known causes of receptor dysfunction. Cholesterol medications are a real triple whammy. Cholesterol is a vital molecule that our body must have to thrive. Steroid hormones and sex hormones are produced from cholesterol, as well the antioxidant Co-enzyme Q10. Cholesterol also makes up part of the cell membrane.

Small stimulus, big changes

Hormones are highly variable and can be affected quite easily by stress. Not just mental stress from thoughts and emotions, but physical stress like food and toxins. Crap food not only can looks like a toxin or foreign invader, but also doesn’t contain nutrients and increases stress on the body. Foods can overtly contain hormones (dairy and beef) and have direct endocrine effects like phytoestrogens, which can bind to estrogen receptors. Even small amounts of endocrine disrupting chemicals found in skincare and plastics can mimic look enough like estrogen to cause a downstream affect. Eating food like dairy, gluten, and soy can be highly inflammatory for many people, increasing cortisol production and impacting thyroid hormone conversion within the cell.

The whole picture

The hormone picture is way more complicated than one single lab marker shows. Often times traditional doctors and nurses only know how to recognize over deficiencies and to not address the complex interplay between master hormones like cortisol and insulin and sex hormones like estrogen and testosterone. The whole hormone picture involves thinking of each hormone as one piece of the larger puzzle and when one goes array we must ask ourselves what are we doing and what are we asking our body to do in response to the environment in which we are living. If you have unaddressed hormone issues like insulin ressitance and PCOS, it will not magically resolve with medications and magic. True hormone balance and healing requires prioritizing food, stress reduction, exercise, sleep and even positivity and mindfulness. The hypothalamus is always listening and alert, ready to send a group of powerful messages to the entire body.