A Functional Medicine Look at Hormone Labs

Have you ever been curious about how a functional approach to evaluating hormone levels differs from your local gynecologist, urologist, or primary care physician?

You may have been told your hormone levels were “normal” but you still feel tired, moody, anxious, depressed, or irritable…

Maybe you’ve packed on some weight unexplainably, and/or feel bloated more often than not...

Perhaps your hair texture has changed, is brittle, or it’s falling out! Ugh- the worst!!

Something in your gut is telling  you that your hormones are off but you were told the labs were “normal”- so what’s a deeper look really worth?

It’s priceless!

And although that may sound cliche, we know how frustrating it can be to not feel your best, want more, but not have the medical support to get there, let alone - what you’re missing out on in life by not feeling and performing better.

Hormones matter -deeply, which is why we take a deep dive and thorough approach. 

In this video, we take a detailed look at the hormone pathway so you can understand the how a functional approach and deep-dive into your hormone pathway can not just help you find the reasons you don’t feel well but help you correct them at their root. 

What you may be most surprised about is that the hormone production or pathway, actually begins with CHOLESTEROL! You need a total cholesterol (LDL+Triglycerides+HDL) of 135 to 145 mg/dL for adequate hormone production.

This is a reason that patients with an over restrictive diet, poor gut health, or people on cholesterol lowering medications like statins, often end up with low hormone levels, including low testosterone. 

From cholesterol we get pregnenolone, which is the precursor to Progesterone. These 2 levels are critical for women in balancing with estrogen and has more recently been shown to be important for men, particularly men with post-traumatic stress disorder.

Pregnenolone is more commonly tested in saliva or urine samples than regular blood work. The biggest symptom I hear people say with low pregnenolone is they describe feeling “Tired BUT Wired” - physically exhausted, but anxiety and wound up internally. This usually happens from again, low cholesterol, and/or an adrenal ‘steal’ effect that occurs with high or prolonged physical or emotional stressors. 

Progesterone aides in sleep, anxiety, menstrual regularity, mood, and fertility. It affects the brain and the uterus, supports the immune system, and is an anti-inflammatory as it relaxes smooth muscle. Progesterone holds the wrath of PMS in it’s hands and is the critical balance of estrogen when it comes to weight loss, fertility, and more. 

Although we typically think of progesterone as a female dominant hormone, having enough progesterone for men, improves sleep quality, mood, and prostate health. 

Both pregnenolone and progesterone can be replaced by compounded medications. Additionally, supporting adrenal health and supplements like chasteberry can increase progesterone. 

DHEA is a precursor to estrogens and testosterone. DHEA is often depleted by the adrenals looking to make more cortisol, as is also the case with Pregnenolone, natural age related decline, and medications, most commonly birth control pills.

Both men and women have 3 estrogens, each with slightly different roles in the body. 

What’s never checked by traditional medicine practitioners is estrone or E1 levels and is the most cancer causing estrogen. Estrone is usually picked up in part by environmental exposure such as herbicides and pesticides in food or plastics such as drinking bottles or food storage containers where you would be actually ingesting BPA found in plastics). It can also be found in skin care products or occur with birth control pills or other synthetic hormone medications. 

In cases where patients have a family or personal history of hormone related cancers like breast or prostate cancers, assessing urine metabolites can be very helpful in ensuring proper detoxification from hormones you naturally produce, or that are being supplemented. 

E2, Estradiol (a good estrogen that can be a problem whether high or low) is important for heart health and bone health as it supports elasticity in the heart arteries, lowers inflammation (if at optimal levels) and supports bone production, preventing osteoporosis. When low in women, this is what tends to cause day-time hot flashes, fatigue, memory loss, and much more.

E3 Estriol  (a weak and healthy estrogen that we don’t often check by blood work) but is a common cause of vaginal dryness, and aging skin in menopause. It can be best assessed through urine levels.  For women, estrogen should be in balance with progesterone. 

Symptoms of high estrogen or high estrogen in comparison to progesterone, for women,  can include water retention, fat accumulation especially in the hips, thighs, and abdominal areas, bloating, Premenstrual Syndrome (PMS), headaches, and many other symptoms.

Estrogen dominance is the root cause of endometriosis, heavy menstruation aka menorrhagia, PMS, uterine fibroids, dense breast tissue and causes an increased risk of endometrial and breast cancers. 

Testosterone is derived from DHEA and converts to estrogens. Testosterone is the critical hormone for men leading the way in their overall well-being, and is still important for women in terms of energy levels, mood, ability to maintain muscle mass, bone health, heart health, libido, and metabolism. 

Some men and women tend to convert to Dihydrotestosterone (DHT), naturally. Catching this excess flow from testosterone to DHT and treating it can reduce symptoms like cystic acne and hair loss or male-patterned baldness, excessive body hair (in women), and irregular menses particularly in cases where a female has high testosterone and found to have Polycystic ovarian Syndrome (PCOS). 

As you can see, the hormone pathway is intricate and detailed when properly evaluated. If you have symptoms that you think may be hormone imbalance, even if you’ve already been told your levels are “normal”, get a deeper, more detailed assessment of your hormones. 

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