See supplements and herbal recommendations for sleep support and insomnia in the Herbs and Supplement section.
Exercising with HPA Axis Dysregulation
You want to feel good and energized after exercise. Pushing yourself while struggling with HPA Axis Dysregulation will only worsen your symptoms. You can still exercise in alignment with each cycle phase, but you’ll want to modify exercises during the first half (follicular and ovulatory) and avoid high impact cardio, at least until your HPA Axis heals. Focus on walking, gentle yoga, or pilates. When I struggled with dysregulation, my favorite exercise was to stream p.volve™ videos and still is, to this day. They’re low-impact, but you can feel the burn.
HORMONE IMBALANCE AND DEPRESSION
I want to touch on the mental and emotional aspect of not only HPA Axis Dysregulation, but hormone imbalance. When I was at my lowest point and extremely frustrated with being tired, lacking the brain power to concentrate and feeling deeply sad for no reason, my emotions brought out the worst in me. Because my progesterone, estrogen, and cortisol levels were so low, my mood was also very low. Little things would send me into a downward spiral, and I was always living on the verge of an emotional breakdown.
The weepiness and sadness factor of hormone imbalance are real. This is serious and can adversely affect your relationships, especially with your significant other, close family members, and friends. These people can be there to give emotional support but, as much as it sucks, they can’t fix you or your hormones. I was self-sabotaging by starting unnecessary arguments, bringing up every little thing that annoyed me, and blaming my problems on everything and everyone but myself. I was incredibly sad and depressed but didn’t realize it until I started healing and the dark clouds slowly lifted. Sometimes, when we are in the thick of sadness, we are unable to see the gravity of its effects on us and those around us.
I wanted to share my experience to show the link between hormone imbalance and depression. I don’t think it’s talked about enough, and many women are left in the dark when it comes to the root cause of their depression and anxiety.
At one point I considered antidepressant and anxiety medication but having the knowledge that my low mood was brought on by low hormone levels was enough motivation for me to choose a natural healing route. I’m not against medication because I know it is absolutely necessary for some people. But in my case, I knew that medication wouldn’t address my underlying hormone imbalances or HPA Axis Dysregulation and would only prolong my healing and create a reliance on medication.
If you are experiencing symptoms of depression, talk to your doctor and request to have a full blood and hormone panel done to see if it reveals an underlying hormone imbalance, nutrient deficiency or gut issue. If so, you’ll clue into what’s happening in your body that may be contributing to your sadness and anxiety. If you want to avoid using antidepressants or use them as a last resort but don’t know where to start with natural healing, try the Happy Hormone Method for at least three months, and see if your symptoms subside or lessen.
Refer to my supplement recommendations and alternative treatment options for depression and anxiety.
THE ROLE OF YOUR THYROID
Menstrual problems are closely linked with thyroid conditions. Your thyroid is a butterfly-shaped gland located on the front of the throat. The largest of all the endocrine glands, it acts as your internal thermostat and master of metabolism by regulating body temperature, hunger, and energy expenditure. Out of the estimated 20 million Americans suffering from some type of thyroid disorder, more than half of them don’t know their thyroid has been causing the hair loss, weight gain or inability to lose weight, mood imbalance, or depression.
The thyroid produces two main hormones, T3 (triiodothyronine) and T4 (thyroxine). These hormones stimulate calorie burn and metabolic processes like detoxification, digestion, and ovulation. They also influence mood regulation, cognitive function, sex drive, energy levels, sleep quality, and more. Undiagnosed thyroid disorders can majorly affect your life. The two most common disorders are hypothyroidism and hyperthyroidism.
SIGNS OF A SLUGGISH THYROID: HYPOTHYROIDISM
Hypothyroidism is the more common condition and signifies an underactive thyroid that’s not producing enough thyroid hormones. Hypothyroid symptoms can include:
□Low basal metabolic rate which leads to unexplained weight gain or difficulty losing weight (even with a healthy diet and exercise)
□Puffy face or puffy eyes
□Eyelid twitching
□Dry skin (mostly on the scalp)
□Itching inside the ears
□Cracked heels
□Cold feet and hands
□Hair loss or thinning hair
□Fatigue
□Depression
□Anxiety
□Brain fog
□Forgetfulness
□Sweaty palms
□Swollen neck
□Constipation
□Muscle weakness or stiffness
□Chronic headaches
□Slowed heart rate
□Exhaustion
High amounts of stress, iodine or zinc deficiency, and toxicity can also contribute to hypothyroidism.
SIGNS OF A OVERACTIVE THYROID: HYPERTHYROIDISM
Hyperthyroidism is less common and refers to an overactive thyroid gland, producing too many thyroid hormones. This increases the body’s metabolism and causes bodily functions to speed up. Symptoms include:
□Feelings of nervousness
□Anxiety
□Irritability
□Insomnia
□Extra bowel movements or diarrhea
□Racing heartbeat or heart palpitations
□Heat intolerance
□Excessive sweating
□Shortness of breath
□Dizziness
□Itching
□Hives
□Muscle weakness
□Bulging eyes
□Unexplained or sudden weight loss
□Fatigue
□Appetite change
□Vision change
□Thin or brittle hair
Graves disease, taking too many tablets of the T4 hormone, or having lumps on the thyroid can all contribute to hyperthyroidism.
Thyroid conditions often involve menstrual cycle problems as well, like heavy or light menstrual bleeding, miscarriage, postpartum depression, multiple periods per month, anovulatory cycles, and hypersensitivity to hormonal shifts throughout your cycle.
If you’re curious about having your thyroid tested, ask your doctor to do a comprehensive thyroid panel that includes TSH, Free and Total T4, Free and Total T3, Reverse T3, thyroid antibodies, TPO Ab, and Thyroglobulin Ab (to rule out autoimmune thyroid problems).
See more for thyroid support in the Herbs and Supplement section.
HORMONE TESTING
The only way to truly know what is going on with your hormones is to have your levels tested. However, you want to make sure they are being tested accurately and optimally before your doctor determines you are “normal” when you don’t quite feel right. These labs are important because they will provide a baseline assessment and comparison for the future. Looking up symptoms, blindly guessing, and making your own protocol is not recommended (symptoms often appear similar for different imbalances, conditions, or deficiencies), and you may end up wasting money on unnecessary supplements that could worsen your hormone health or prolong the healing process.
There are a few different ways to go about testing. Traditionally, hormone testing is done via a serum (blood) test but, these days, we can use a serum (blood) or dried blood spot (for at-home testing), saliva, dried urine, or a combination of all three to get the full picture. You’ll want to take an additional test in three months to track progress, and every 6-12 months
after.
SERUM (BLOOD) TESTING: This is the most widely accepted and accessible way to test hormones in the conventional medical world, through your gynecologist or primary care practitioner. Serum is accurate for testing peptide hormones (like FSH, LH, prolactin, insulin, and thyroid hormones) as well as the sex hormone binding globulin (SHBG) and nutrient markers, but it’s not good at predicting the bioavailability of sex hormones or providing a full picture of cortisol throughout the day. This is because serum tests only provide the total hormone levels circulating in your blood at that one moment, rather than the free (active) levels. This may cause your results to appear “normal” when in reality the majority of your hormones may be bound and therefore, inactive. It also becomes problematic because your hormone levels fluctuate throughout the month and it’s ideal to have a comprehensive overview of every hormone ratio throughout your monthly cycle. Testosterone is an exception, as it can be tested in both total and free forms, providing a full picture.
DRIED BLOOD SPOT TESTING: This is an at-home form of collection where you prick your finger and place blood drops on a filter card. Once dry, blood spot cards are stable for shipment and storage. The dried blood format equates to serum blood testing. Its advantage over serum is that it eliminates the need for a complete blood draw and can be done from the comfort of your home.
SALIVA TESTING: This is a non-invasive form of testing that’s accessible for at-home testing or naturopath patients. While it’s hard to spit that much saliva into a plastic tube, it’s great for those who are scared of needles or blood. It can also provide more accurate cortisol readings, as serum testing can reflect falsely high cortisol if patients are afraid. Since saliva is easier to collect, this form of testing provides multiple snapshots in time to see the bigger picture for specific symptoms of hormone excess or deficiency. For example, cortisol can be measured multiple times per day (morning, noon, afternoon, and night) and sex hormones can be measured throughout the month rather than just at one moment in time. Saliva testing is valuable because it looks at the free (active) levels thereby allowing us to see the availability of hormones at the cellular level, but it won’t provide complete levels.
DRIED URINE TESTING (THE DUTCH TEST): DUTCH stands for Dried Urine Test for Comprehensive Hormones. It’s an advanced assessment form of hormone testing that uses urine samples on filter card collection strips. It is the gold standard way of measuring adrenal, sex steroid hormone by-products and their respective metabolic pathways. By gauging how your body metabolizes hormones, it reveals the types of estrogen you are making, which shows how at-risk you are for certain estrogen-dependent cancers such as breast, ovarian, and uterine. Additionally, it’s the most common method for testing brain neurotransmitters. What makes this test stand out from the blood tests ordered by your doctor or the saliva test from your naturopath is this: every piece of information you collect from other forms of testing can be collected with a single DUTCH test.
Because it is a more in-depth assessment, I recommend finding an expert (like a naturopath or functional medicine practitioner) who can understand and interpret the results and determine the next steps for treatment. While a conventional doctor may be able to understand your results, they most likely will not know how best to help you using alternative treatment methods.
Not every woman needs to take this advanced form of testing, especially if you are only experiencing mild symptoms. But for the woman who is very symptomatic, has already had blood or saliva testing done and still doesn’t have answers, has a hormonal condition (like PCOS or endometriosis), is having trouble getting pregnant, or simply wants a complete, in-depth look into how her body is functioning, then the DUTCH test would be the best way to get specific answers.
For other women who have mild symptoms but want to check in with their body, I recommend doing a combined serum and saliva test through your doctor or naturopath or doing an at-home testing kit.
Note: If you are on hormonal birth control, then hormone testing results will be inaccurate. Wait three months after stopping birth control to start any testing.
Home Testing Kits
These tests can be ordered online or through a practitioner and done at home (always search online for coupon codes before buying tests), but a doctor or naturopath should review your results. Why do at-home testing? Unless your doctor thinks there is something wrong, they can’t order a standard hormone test and bill your insurance. At-home testing is one way around that.
DUTCH DRIED URINE TEST: See above (dutchtest.com)
FLOLIVING WOMEN’S HEALTH TESTING KIT THROUGH EVERLYWELL: This easy testing kit uses dried blood spots and saliva collections throughout your cycle. Results are available within days via an online dashboard. FloLiving offers a 30-minute follow-up phone consultation. You can also print your results and present them to your doctor or naturopath (everlywell.com).
ZRT LABORATORY: This lab provides numerous home testing kits using dried blood spot, saliva, or a combination for hormone balance, but they must be ordered through a practitioner. Providers can be found on their website (zrtlab.com).
NATUROPATHIC DOCTORS
I recommend meeting with a gynecologist or naturopathic doctor who is willing to explore natural solutions using a whole-body approach. Sometimes, it takes meeting with a few medical professionals and expanding your team to find the answers you want and need. Getting a second or third opinion never hurts, especially if you feel uncomfortable with your doctor’s recommendations. Use the American Association of Naturopathic Physicians website to find a naturopath near you (naturopathic.org).
LAB TESTS WITH YOUR DOCTOR OR NATUROPATH
If you forego at-home tests and prefer to visit your doctor or naturopath, be sure to ask for the full hormone panel test that includes estrogen, progesterone, FSH and LH, as well as a full thyroid hormone panel, including TSH, T3, T4, and reverse T3. Most doctors will only want to test TSH, so make sure to ask for the full panel. If you have a 28-day cycle, it’s best to have the tests taken on day three (for estrogen) and days 19-22 in the middle of your luteal phase (for progesterone).
You’ll also want a complete blood panel. This will look at key nutrient biomarkers, anemia, red blood cell status, and more. The test can be done at any time of the month, and it will indicate any nutrient deficiencies you might have.
WHILE CHATTING WITH A FRIEND ABOUT her new cleaning service for her home, she said their service was detailed and thorough, but she couldn’t smell the “clean” smell when they were done. I pointed out that they might be using natural products because it’s toxic for people to use chemicals all day. It made me think about how disconnected we are from natural smells, and how accustomed we’ve become to synthetic, toxic fumes on store shelves (just walking down that aisle gives me a headache).
I know that synthetic “clean” smell very well, and I used to think it made my space feel cleaner, too. What I didn’t realize was how toxic this was to my endocrine system, and how detrimental it was to my hormone health (and most likely contributed to my acne).
ENDOCRINE-DISRUPTING CHEMICALS
Using toxic bleach and harsh cleaning products leaves a harmful, lingering residue for you, your family, and your pets. There are plenty of non-toxic ways to disinfect, clean, and freshen your home using natural ingredients. That way, you don’t have to worry about breathing in toxic fumes, staining your clothes with bleach, or burning your hands from chemicals. Natural products are better for the environment, too.
Cleaning supplies aren’t the only culprit when it comes to toxins. Before you walk out your front door in the morning, you’re exposed to over a hundred endocrine-disrupting chemicals on average. These chemicals come from hand soap, laundry detergent, dryer sheets, hair products, body wash, body lotion, skin care, makeup, nail polish, deodorant, perfume, air fresheners, candles, scented sprays, cleaning products, and unfiltered tap water. Not to mention the chemicals used in dry
cleaning services, lawn care services, salons and spas, building materials, farming, agricultural practices, the plastics in reusable containers and flame-retardants used on fabrics for furniture, rugs, and curtains. Most of these chemicals are not tested for their effects on human health because of how the U.S. regulates toxic chemicals.
You may be rolling your eyes because you’ve heard these chemicals are only harmful in high doses but picture this: you wake up and start getting ready for work. First, you brush your teeth with a conventional toothpaste made with triclosan and artificial sweeteners. You hop in the shower, and use body wash containing sulfates, parabens, and fragrance. You shampoo and condition your hair with more sulfates, parabens, and fragrance. Then you get out of the shower and apply a body lotion with polyethylene glycols (PEG’s), mineral oil and fragrance, and roll on deodorant with aluminum, and then lather on face serums, moisturizers and makeup with more chemicals. Maybe you add some hair products and a spritz of perfume. Your body has just been overloaded with toxic substances before you even start your day, and this may happen several times per week. When you think about all of the environmental chemicals and pesticides in foods we encounter daily, it’s no wonder our natural detoxification and elimination systems are overloaded.
These toxins may be fine in small amounts, but when you use them every single day, it becomes a much larger dosage. We now know that consistent low dose exposure in amounts thought to be acceptable are affecting hormone balance, and can also impact fertility and pregnancy.
The Happy Hormone Guide Page 3