What are hormones and why do they matter?
Hormones are chemical messengers, helping the various parts of our body communicate. Whether we are talking about triggering hunger, generating energy, using nutrients, repairing damaged cells, developing secondary sexual characteristics, or managing and adapting to stress, we are talking about hormones! Most hormones are made inside our bodies by endocrine glands, though certain specialized cells in other tissues may also produce and secrete hormones. Different tissue types may respond differently to the same hormonal signal and different concentrations of the same hormone may have different effects.
Maintaining optimum hormone balance for both men and women involves understanding nutrition's broad foundational role in endocrinology as well as each individual's unique nutrition needs.
Since women's bodies experience more frequent monthly hormonal fluctuations, we are often the ones struggling acutely with the consequences of hormonal imbalance. Some of the common diagnoses associated with hormonal imbalance in women include polycystic ovarian syndrome (PCOS), infertility, endometriosis, premenstrual dysphoric disorder (PMDD), fibroids, and fibrocystic breasts, to name a few. Many of these conditions not only impact immediate quality of life, but can be risk factors for long-term disease (1,2,3).
In 2015, the American College of Obstetricians and Gynecologists released a statement proposing that the menstrual cycle, especially in adolescents and young women, be treated as a clinical vital sign, alongside current clinical vital signs such as pulse, temperature, and respiration (4). This was due to the fact that menstrual irregularities, especially in young girls and adolescents, can be strong predictors of life-time disease risk.
Early warning signs
As a nation, we suffer from growing rates of obesity, heart disease, diabetes, cancer, and depression (5, 6). We also know that before the onset of an advanced chronic illness, there are often early shifts in hormones and other inflammatory processes that can behave as early warning signs. A diagnosis of PCOS, for example, often involves imbalances in luteinizing hormone (LH), follicular stimulating hormone (FSH), estrogen, progesterone, and androgens. However, these hormonal changes may eventually lead to more advanced metabolic disease, such as diabetes. The CDC states that more than half of women with PCOS develop type 2 diabetes by age 40 (7).
The hormonal symphony consists of many vital players, including thyroid hormone, cortisol, estrogen, progesterone, testosterone, DHEA, insulin, and many, many others. Your body's hormones are participating in a delicate physiological balancing act at all times. Imbalances in hormones may unfold over time and begin to compound, as early warning signs of disruptions go untended.
Inflammation and hormonal imbalance can occur over a short or long period of time as a result of improper nutrition.
The Role of Nutrition
What we eat directly affects many aspects of how and when our body makes hormones. What we eat will not only supply the cellular building blocks for our hormones, but will influence how certain hormones are released and used (8).
Many women suffering from hormonal imbalances such as those listed above are prescribed medications such as hormonal contraceptives or metformin. While these medications may offer some initial relief, they do not correct any underlying nutritional imbalances. Research has supported the strength of nutritional intervention over metformin therapy, for example, in the case of metabolic diseases such as diabetes (9). Failure to correct any underlying nutritional balance will ultimately fail to provide optimum metabolic support.
The Medical Nutrition Therapy (MNT) approach to addressing a wide variety of hormonal imbalances not only appreciates the science of metabolism as a whole, but has the capacity to affect multiple metabolic centers at once. This is the beauty of nutrition.
We know that different people will have different needs. Nutrition therapy may be customized to each individual with respect to one's unique nutrient imbalances, absorption capacity, and metabolic disease risk. Many medications, on the other hand, are not as easily tailored.
Some medications used to treat hormonal imbalances produce side effects. The current research, summarized in much of the literature and further discussed by the National Cancer Institute, suggests increased risks for breast, endometrial, and possibly even ovarian cancer when using the preponderance of hormonal contraceptives currently available (10). This information, along with the reports evaluating an increased prevalence of depression and intestinal microbiome changes and nutritional deficiencies (such as in certain B vitamins and magnesium) when taking many hormonal contraceptives, suggests that alternative therapies should first be considered.
(1) Bhathena RK. Insulin resistance and the long-term consequences of polycystic ovary syndrome. J Obstet Gynaecol. 2011; 31(2):105-10.
(2) Huo L, Straub RE. Risk for Premenstrual Dysphoric Disorder is Associated with Genetic Variation in ESR1, the Estrogen Receptor Alpha Gene. Biol Psychiatry. Biol Psychiatry. 2007 Oct 15; 62(8): 925–933.
(3) Gold B, Kalush F, Bergeron J, Scott K. Estrogen receptor genotypes and haplotypes associated with breast cancer risk. Cancer Res. 2004 Dec 15; 64(24):8891-900.
(4) Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Committee Opinion No. 651. American College of Obstetricians and Gynecologists. Obstet Gynecol 2015;126:e143–6.
(5) Shaw JE, et al. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010;87:4–14.
(6) R. Mojtabai, M. Olfson, B. Han. National Trends in the Prevalence and Treatment of Depression in Adolescents and Young Adults. PEDIATRICS, 2016; DOI: 10.1542/peds.2016-1878
(7) PCOS and Diabetes, Heart Disease, Stroke. Centers for Disease Control and Prevention website http://www.cdc.gov. Updated October 11, 2016. Accessed October 1, 2017.
(8) Marks V. How our food affects our hormones. Clin Biochem. 1985 Jun; 18(3):149-53
(9) Diabetes Prevention Program Research Group. Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. N Engl J Med 2002; 346:393-403
(10) Burkman R, Schlesselman JJ, Zieman M. Safety concerns and health benefits associated with oral contraception. American Journal of Obstetrics and Gynecology 2004; 190(4 Suppl):S5–22
About the Author
Heather Davis, MS, RDN, LDN, holds a master's degree in nutrition science and is accredited by the Academy of Nutrition and Dietetics as a registered dietitian nutritionist (RDN). She works as a clinical dietitian, educator, and medical writer specializing in neuroendocrine nutrition and advanced chronic disease medical nutrition therapy