A Naturopathic Approach to Hormonal Imbalance
Hormonal imbalance is an underlying factor contributing to numerous conditions seen by Naturopathic Doctors such as infertility, menopause, polycystic ovarian syndrome (PCOS), chronic fatigue, hypothyroidism, anxiety and depression. When addressing these conditions, it is important to employ our diagnostic skills and detailed questioning to determine the root of the hormonal imbalance. A proper intake will distinguish as to what hormones may be imbalance (for example, insomnia with heavy bleeding may indicate an estrogen excess, whereas insomnia with anxiety and PMS may indicate a progesterone deficiency). These subjective symptoms can be used in conjunction with specific laboratory testing, such as a serum or salivary hormone and thyroid panel (LH, FSH, estradiol, progesterone, DHEA, testosterone, TSH, free T3, free T4, reverse T3 and cortisol levels), salivary 4-point cortisol test, and 24-hour urinary collection (to determine hormonal metabolites). Serum or salvia samples should be taken on day 19 of a women’s menstrual cycle, and at least ten hours away from hormonal medications for the most accurate reading. Basal Body Temperature (BBT) recorded first thing in the morning at the same time every day is also an effective tool used in treating fertility, adrenal fatigue, and thyroid dysfunction(1).
Naturopathic Doctors recognize that everything in the body is connected. Based on this principle, we need to evaluate proper functioning of all other body systems when treating hormonal imbalances. The adrenal gland is at the top of the endocrine hierarchy, hence, adrenal function must be addressed first before treating thyroid or ovarian function (as the adrenals, thyroid, and ovaries work as a balanced triad)(2)). Digestive function needs to be addressed by diet journaling and/or IgG food sensitivity testing, as inflammation in the digestive tract will impact nutrient absorption and elimination of hormonal metabolites. Hair mineral analysis is an effective tool in evaluating a person’s nutritional status, providing valuable information as to what minerals/vitamins are deficient. Liver function needs to be addressed to ensure healthy cholesterol levels necessary for steroid hormone production and clearance of excess hormone metabolites. Before treating hormonal imbalances with bio-identical hormones or botanical medicine it is importance to drain the liver through homeopathic drainage or detoxification treatment, as a sluggish liver will impede and/or decrease the effectiveness of such treatments.
Naturopathic Doctors respect the delicate balance between the mind and body, where mental-emotional health is critical in determining strong physical health and vice-versa. Hence, stress is a crucial factor in hormonal treatment. High cortisol and/or catecholamine (such as epinephrine or norepinephrine) levels from prolonged and/or acute stressful periods, respectively, will lead to decreased thyroid and sex hormone levels(3). Inquiring about a patient’s stress levels and triggers, and stress coping mechanisms is integral to our patient’s health and our core beliefs as Naturopathic Doctors. By helping our patient’s alter their perception and stress levels (through mindfulness, relaxation techniques, acupuncture, cognitive behavioural therapy, homeopathics, etc) we can help them alter their hormone levels through their bodies’ own self healing power. And it is that, evoking the body’s own self healing power, that is one of the most powerful fundamental lessons we have learned as Naturopathic Doctors, graciously taught to us by our Naturopathic Elders.
1. Wilson GR, Curry RW Jr. Subclinical thyroid disease. Am Fam Physician. 2005 Oct 15;72(8):1517–24 Department of Community Health and Family Medicine, University of Florida Health Science Center, Jacksonville, Florida 32209, USA. firstname.lastname@example.org
2. Westmacott, Clare. The Adjuvant Use of Bio-Identical Hormone Therapy in Clinical Practice. 2016. Presented at the Association for the Advancement of Restorative Medicine in Toronto, ON.
3. Kirschbaum, C., Wüst, S., & Hellhammer, D. (1992). Consistent sex differences in cortisol responses to psychological stress. Psychosomatic medicine, 54(6), 648–657.