Hormonal Imbalance

My approach

First step running a thyroid hormonal panel: TSH, T3, T4, free T3, reverse T3 and thyroid antibodies. In addition, it is important to get the accurate DHEA, DHEA-s, E1, E2, E3, Progesterone, Testosterone, SHBG, cortisol.

Here is a list of medications that affect thyroid function and absorption:

Iron, calcium, aluminum hydroxide, colestyramide, sucralfate, raloxifene, phenobarbital, phenytoin, carbamazepine, rifampin, rexinoids, methimazole, beta blockers (propranolol), glucocorticoids, dopamine agonists, metformin, lithium, iodide, amiodarone, iron, acid blockers.

How does other hormones influence the thyroid hormone? Yes!

All hormones in the body play a domino effect on the each other. For example estrogen will increase the amount the thyroid binding globulin the body produces.

  • Estrogen dominance will decrease the conversion of T4 to T3.
  • Adrenal fatigue will decrease T3 and T4.
  • Excess cortisol suppresses TSH

 

What leads to hypothyroidism? Toxins

Toxins: organophosphates pesticides, Hexachoorbenzene, radiation, dental x-rays, heavy metals, Soy diets, Brassicas, Lifestyles, medication (Amiodarone, Theophyline, Betablockers)

Avoid: chlorine, fluorine, bromine

Detoxifying the thyroid

Finding the root cause why thyroid is malfunctioning in either producing too much or too little hormones is very important.  The best approach is detoxifying the thyroid and then nourishing the thyroid so this gland is able to produces its own necessary supplies of hormones.

 Reducing the stress

Under the stress body stops converting T4 into T3 (active hormone)

Nourishing the thyroid

Deficiencies leading to hypothyroidism: in vitamin A, B12, vitamin E, selenium, iodine, zinc, iron

Thyroid gland requires minerals and nutrients as building blocks for making its own hormones and function properly. Thyroid gland uses these building-blocks to make the thyroid hormones on its own. The thyroid hormone T4 (thyroxine) needs to be converted to the active form T3 (triiodothyronine) which enters in every cells and this conversion requires in its biochemical substrate all these minerals and nutrients. In addition, thyroid needs to be balanced out with hypothalamus, pituitary and adrenal as part of HPA axis for better function.

How the hormones influence each? And why need to synchronize?

Estradiol – If symptoms/signs of estrogen deficiency are problematic, consider estrogen re placement (assuming no contraindications) balanced with natural progesterone.

Progesterone– need to balance or buffer the effects of estradiol.  In women NOT supplementing with progesterone the postmenopausal level is expected to be less than 1 ng/ml. In postmenopausal women supplementing  with estrogens, progesterone therapy is often helpful in preventing symptoms of estrogen imbalance when the progesterone/estradiol ratio  is optimal (100 – 500).

Testosterone level is highest during youth and drops steadily with age.   About half of the testosterone is produced by the ovaries and their removal (oophorectomy) results in a precipitous drop in circulating testosterone and an increase in symptoms of androgen deficiency. Symptoms/signs most commonly associated with low testosterone include: low libido, incontinence, vaginal dryness, fatigue, memory lapses, depression, and bone loss.  Testosterone is an anabolic hormone essential for creating energy, maintaining optimal brain function (memory), regulating the immune system, and building and maintaining the integrity of structural tissues such as skin, muscles, and bone.

SHBG (Sex Hormone Binding Globulin) is a protein produced by the liver and released into the bloodstream in response to increasing levels of estrogens. SHBG is a relative index of overall exposure to any form of estrogens (endogenous, pharmaceutical – ER T , xeno – estrogens – pollutants).  As the estrogen levels increase there is a proportional increase in SHBG in healthy individuals.

Excess thyroid medication, or hyperthyrodism, is also associated with elevated SHBG. High insulin (insulin resistance), high androgens, and high glucocorticoids (cortisol) lower SHBG, all of which increase the bioavailability of estradiol and the likelihood of estrogen dominance symptoms. In the circulation, SHBG binds about 37 percent of estradiol, while the remainder binds to albumin; less estrone (1 6%) and very little estriol (1%) bind to SHBG. Many of the synthetic estrogens, such as ethinyl – estradiol used in oral contraceptives show little binding affinity for SHBG, rendering them more bioavailable and potent than estradiol.

DHEAS is highest during the late teens to early twenties and the n declines progressively  with age to the lower levels of the range in healthy men and women. Expect DHEAS to be in the high reference range until the mid – twenties, the mid – range during the thirties to early fifties and in the lower normal range thereafter. Low age – related DHEAS is often associated with low testosterone (DHEA  is a testosterone precursor) and symptoms of androgen deficiency (fatigue, depression, low libido, loss of muscle mass, bone loss, memory lapses). Symptoms of androgen deficiency may be caused by low age – related DHEAS. Consider DHEA therapy if DHEA  and/or testosterone are lower than age – expected levels.

Cortisol– If symptoms of adrenal imbalance are problematic consider testing cortisol in saliva 4x throughout the day to determine if levels remain within normal range, or fluctuate erratically , throughout the day (more likely associated with symptoms characteristic of cortisol imbalance.

 

 

Nutrigenetic approach to health testing sample:Practitioner Appendix – Hormone Panel