Reverse Hormone Imbalances

PART TWO

Table of Contents

Female: Potential Treatment and Lifestyle Factors for Consideration with High Testosterone Levels

Testosterone
Normal Testosterone with High Androgen Symptoms.
Overall Considerations: 

 

  • Look into potential insulin dysregulation (in serum check glucose, fasting insulin, HA1C, C-Peptide)

 

Low Testosterone Symptoms but High 5a-Reductase Symptoms: 

 

  • Blocking 5a-Reductase production could make any low Testosterone symptoms worse. (15) This is only done through the use of medications.
High Testosterone Symptoms: 
 
  • Consider blocking 5a-Reductase to relieve those particular symptoms. 
  • Evaluate Adrenals
  • Consider Polycystic Ovarian Syndrome (PCOS)
  • Spearmint tea may lessen some high symptoms.
  • Blood sugar support. (Ex: Inositol, Berberine, Alpha Lipoic Acid)

 

Normal Testosterone with Higher DHEA With Low Testosterone Symptoms: 
  • With low Testosterone symptoms, the lowering of DHEA may not be advised. 
  • Evaluate blood sugar regulation, possible insulin, and cortisol regulatio

Testosterone Imbalances in Males

Potential Root Causes of Testosterone Imbalances in Men:

 Lifestyle and Aging Causes of Low Testosterone

  • Natural aging
  • Low fat and low cholesterol diets
  • Sleep apnea or chronic sleep disturbances
  • Diabetes or blood sugar dysregulation
  • Excess body fat around the midsection/obesity
  • Very low body fat levels
  • Increased aromatization (Ex: high body fat levels)
  • Overuse of testosterone supplementation
  • Zinc deficiencies
  • Environmental toxin exposure (EDCs)
  • Marijuana use or THC supplemental use
  • Alcohol consumption
  • Low antioxidant diet (Ex: Lack of plants and colors)

  Medical and Functional Causes of Low Testosterone

  • Certain medications (anabolic steroids, glucocorticosteroids like prednisone, opioids, Accutane and anti-androgens)
  • Low thyroid function or hypothyroidism
  • Hyperprolactinemia (aka high prolactin usually caused by tumors)
  • High Levels of Sex Hormone Binding Globulin (SHBG)
  • Leptin resistance
  • Unidentified pituitary or hypothalamic diseases
  • Hypogonadism caused by testicular surgery
  • Previous testes infections
  • Reduced blood flow to testes
  • Autoimmune conditions specific to the Leydig cells in testes
  • Radiation or chemotherapy
  • Brain Injury/Traumatic Brain Injury (TBI)

  Potential Causes of High Testosterone

  • The use of resistance training or HIIT
  • Low Sex Hormone Binding Globulin (SHBG) – results in high free testosterone
  • Pharmaceutical use of testosterone therapy, Clomiphene and or HCG
  • Supplemental use of Human Growth Hormone (HGH) 

Men: Potential Treatments and Lifestyle Factors for Consideration with Testosterone Imbalances

For Low Testosterone – Overall General Care Ideas

 

  • Lab Testing: Make sure hypothyroidism, elevated prolactin levels, diabetes or prediabetes are not present.
  • Evaluate LH/SHBG in the blood for pituitary dysfunction.
  • Confirm that no opioid/steroid use is not taking place or was not used recently.
  • Rule out excessive alcohol consumption, or high rates of EDC toxicant exposure. 
  • Overall Considerations: depending on the symptoms Tribulus, Maca, Tongkat Ali, fenugreek, zinc, Withania, mucuna, Eurycoma longifolia, Testosterone Replacement Therapy (TRT). 
  • High SHBG: consider supplemental boron.

 

*** Only TRT will directly raise testosterone levels, all others listed above may indirectly raise testosterone through a secondary means such as reducing inflammation, slowing down aromatization, lowering stress  or providing the raw materials for testosterone production but please take note that the scientific data is very weak on all of the above substances.

 

If Estradiol is High and Testosterone is Low

 

  • Address inflammation, belly fat, high insulin levels, and BPA exposures.
  • Certain pesticides and EDCs can increase Estradiol. (16)
  • Use supplements or medications to block the aromatase enzyme.
  • Work on liver health, primarily phase 1 metabolism pathways and the healthy methylation for the excretion of estrogens. (see above)
  • Consider aromatase inhibitors such as resveratrol, pomegranate,  mangosteen, green tea extract (EGCG), quercetin and chrysin.

 

If DHEA is Low and Testosterone is Low

 

Low DHEA may be worth addressing with DHEA supplementation, however, the conversion of DHEA into significant amounts of testosterone usually does not take place with men; it tends to convert into estrogens more often. Based on that fact monitor estrogen closely if using supplemental DHEA. (22)

 

  • High stress will also deplete DHEA, therefore assess cortisol levels and incorporate stress management techniques. 
If 5a-Reductase Symptoms are High

 

  • Investigate potential insulin dysregulation.
  • Address inflammation in the body.

 

Normal Testosterone with Low Testosterone Symptoms

 

  • Look at cortisol for elevations and dips. If present, then incorporate stress management techniques.
  • Consider the low Testosterone treatments from above.
  • Address any inflammation or insulin resistance. 
  • Assess testosterone to estrogen balance.

Cortisol Imbalances in Males and Females

Cortisol: Potential Root Causes of Cortisol Imbalances in Males and Females

   Low Cortisol

  • Cortisol suppressing medications (glucocorticosteroids, opioids, Accutane and antidepressants but there are more)
  • Chronic pain and inflammation
  • Pituitary or hypothalamic dysfunction
  • Head trauma
  • Chronic infections
  • Hypothyroidism (low)
  • Non-classical congenital adrenal hyperplasia 
  • Sleep dysregulation 
  • Surgeries involving the adrenal glands 
  • Addison’s disease (autoimmune condition)

The Health Coaches Guide Helping Clients Balance Their Hormones

Want to Learn How to Distinguish Between High and Low Cortisol Symptoms?

 

   High Cortisol

  • Cortisol supplementation 
  • Adrenal Glandular supplementation
  • Obesity
  • Low carbohydrate diet
  • Acute stress 
  • Acute inflammation 
  • Acute pain 
  • Acute infections 
  • Blood sugar and insulin dysregulation 
  • High caffeine consumption 
  • Hyperthyroidism (high)
  • Cushing’s syndrome or disease (tumor-causing high cortisol secretion)

Potential Treatments and Lifestyle Improvements for High and Low Cortisol

Low Cortisol

For patients with low cortisol production, consider all root causes first. Following that clients may benefit from the following treatment options:

 

  • Anti-inflammatory diet: remove gluten, dairy and refined sugars, eat an array of colorful produce and include healthy fats and complex carbohydrates at every meal.

 

  • Circadian rhythm improvements: Encourage sunlight when waking or through the use of full-spectrum light boxes (10,000 LUX) and the appropriate night time sleep routine, no screens 2 hours before bed and sleep in complete darkness. 

 

  • Adaptogenic support: such as Rhodiola, Ashwagandha (Withania) Eleuthero (Siberian Ginseng), short term use of Panax Ginseng (Korean Ginseng), Maca, Cordyceps and CBD. 

***There is little to no clinical research available regarding the use of adaptogens in terms of raising low cortisol levels. 

 

High Cortisol 

 

For clients who are showing signs of high cortisol symptoms, making the required lifestyle changes primarily by reducing stress will play the biggest role and have the largest impact. 

 

The additional lifestyle and supplemental options may also give some support: 

 

  • Reduce inflammation
  • Identify and eliminate infections
  • Address insulin resistance
  • Calming support supplements: used as a standalone or in combination blends including GABA support, 5-HTP, L-theanine, magnolia, Relora, Seditol, chamomile, milky oat seed, passionflower, phosphatidylserine (Enerphos), and Maca. 
  • Calming Adaptogenic support that includes combinations of ashwagandha, Rhodiola, Cordyceps, Schisandra, bacopa and holy basil (tulsi).

With High Morning Cortisol and or High Morning Anxiety Symptoms: 

 

  • Improve night time sleep hygiene.
  • Get in some morning sunlight within 30 minutes of waking. 
  • Address/remove the cause of any anticipated start of the day stress.
  • Keep blood sugar levels stable throughout the night (protein/fat snack before bed).
  • Focus on calming support, meditation, breathwork, and or vagal tone stimulation, especially within 30 minutes of waking.

 

Considerations if Nighttime Cortisol is High or if High Anxiety Symptoms Exist 

 

  • Address inflammation, blood sugar, and or acute stressors. 
  • Work on circadian rhythm improvements.
  • Vagal tone stimulation activities* 
  • Consider the use of calming support at night including phosphatidylserine, Magnesium, L-theanine, GABA, CBD oil, Lavela WS, Magnolia, and Relora

 

* Stimulating vagal tone creates a slight increase in heart rate when inhaling and a decrease of heart rate during the exhale. Deep diaphragmatic breathing with a long and slow exhale stimulates the vagus nerve which slows the heart rate and blood pressure, and is a good tactic to use during times of high stress and anxiety. (2) Humming, gargling, singing loudly are all activities that stimulate the vagus nerve in the same way as well.

Learn How Cortisol Imbalances Affect Testosterone and Estrogen Production.

 

The Health Coaches Guide Helping Clients Balance Their Hormones

Case Study: Maria

Let’s now attempt to put some of what we learned on this page in to action and look at a specific case study example of a classic hormonally imbalanced client. In doing so, I want you to  attempt to identify what are some of the biggest red flags that are present with this client and how you can help her in dealing with them. After that let’s detail what the long term journey should look like so that the client is better enabled to adhere to any new plan set forth for the long haul.

Meet Your New Client Maria

  • Suffers from night sweats and migraine style headaches around her period.

 

  • Irregular menstrual cycles, some months they are 20 days other months they can be as long as 37 days.

 

  • When her periods do come they are not heavy in terms of the menstrual flow.

 

  • High levels of daytime fatigue are present almost every day.

 

  • Bloating is a problem and it has no discernable pattern. It also appears to be getting worse over the past several months.

 

  • Anxiety  is present all throughout the month.

 

  • Suffers from Insomnia. Frequently wakes up, several times per night to use the restroom and then has trouble falling back asleep.

 

  • Has gained over 20 pounds in the past year, mostly around her belly area despite the fact that she has been dieting.

 

  • More and more hair loss seems to be coming from the top of the head region.

 

  • Has constant sugar cravings but at the same time claims to have a very low threshold to eating sugar and or alcohol. She gets blood sugar imbalances rather quickly and claims to have been this way for over 10 years now.

 

  • Exercise routine entails a treadmill version of cardio, 3-4 days per week, strength training 1 time per week and yoga, 2 times per week. She makes the statement that sometimes she feels very depleted after exercise, especially after her cardio days.

 

  • 4 days a week she works as a massage therapist, where she is on her feet almost all of the day.

 

  • She has 2 school-aged boys and a supportive husband but her husband works late most nights, so the kids are mostly her responsibility.

 

  • Regularly takes Tylenol for headaches and Ibuprofen for pain.

 

  • She has good friends and a strong social support circle but does not see them very much due to her busy schedule.

 

  • She says that she always feels hungry.

 

  • She has a low tolerance for skipping meals and claims that her blood sugar drops and that she gets shaky and snappy quickly.

 

  • Insomnia started around the birth of her 1st child, who is now 7.

 

  • She was anemic during pregnancy but is not now.

 

  • Her most recent labs came back with a TSH at 4.0 – Which was not flagged by her doctor.

 

  • Her Ferritin was at 68 and Vitamin D came back 29

Now playing the health detective role as a health coach, how would you help Maria reach her goals and get over her slump. It is safe to say that there are several red flags that appear to be contributing to Maria’s problems. However, there are also several things that can be easily put in play that will help her eliminate those red flags and help move her in the right direction towards reaching her goals and ultimately feeling better. How would you as a coach guide Maria or help her in not feeling so lost with regards to her health?

REFERENCES

Do Client Hormonal Problems Confuse You?

The Health Coaches Guide to Helping Client’s Balance Their Hormones

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Reverse Hormone Imbalances (Part One)

Do Client Hormonal Problems Baffle You? Do you have a hard time visualizing how all of the many hormones interact in the body? The odds are pretty high that your clients are currently receiving or acting on horrible hormonal advice that if they are listening to may just be undermining all of your hard work with them.