Ask Dr. Brandi Anything: How do I know if my hormones are out of whack?

Dear Dr. Brandi – How can I tell if my hormones are dysregulated?

Hormones play a big role in our lives.They impact our behavior, energy, appetite, and relationships. Most of us are aware that hormone levels change throughout our lives, and they even fluctuate monthly with menstrual cycles. Often, women are told they are “hormonal” which implies that they have a problem rather than experiencing a normal fluctuation in the endocrine system. A need for hormone regulation is not as common as women have been made to believe it is, and lab testing is the best way to assess your hormone levels.

There are, however, four common conditions – PCOS, Thyroid disease, Adrenal Insufficiency, and Type II Diabetes – that warrant a closer look at hormone regulation:

  1. Polycystic Ovary Syndrome (PCOS) – PCOS is a common cause of female infertility. Symptoms include: abnormal hair growth, acne, weight gain, and insulin resistance. There are often high levels of androgen hormones that can result in many of these symptoms. If possible, talk to your first-degree biological relatives about any fertility challenges to see there is a pattern of PCOS in your family – there is some evidence that PCOS risk is higher in women who have a family history. Tracking your periods is a great way to understand if you might be at risk for this endocrine condition. PCOS is not the only cause of infrequent periods, but it might be time to ask your doctor more questions.
  2. Thyroid Disease – While this condition affects 0.3% of the population, it’s more prevalent in women. Common symptoms of hypothyroidism include fatigue, weight gain, cold sensitivity, hair loss, depression, and infrequent periods. Hyperthyroidism symptoms include: hyperactivity, mood swings, anxiety or nervousness, lethargy, difficulty sleeping, muscle weakness, and diarrhea Along with a thorough assessment of your symptoms, a TSH test from your doctor is the definitive way to diagnose thyroid disorders. While being female, having low iodine intake, and being of African descent are all risk factors for thyroid dysfunction, most physicians do not recommend standard screening for thyroid disease until after age 60. Keep in mind supplements found in health stores that purport “Thyroid Support” cannot replace thyroxine which can only be prescribed by a physician.
  3. Adrenal Insufficiency (Addison’s Disease) – This condition is rare. Symptoms include: nausea, vomiting, diarrhea, irritability and depression, low blood sugar or hypoglycemia, and joint pain. Recent online advertisments have encouraged self-diagnosis of adrenal dysfunction. However adrenal insufficiency can only be diagnosed with an ACTH test, and again, the condition is uncommon.
  4. Diabetes – The hormone insulin tremendously affects weight, mood, and energy. High blood glucose levels can lead to insulin resistance which means it’s more challenging for glucose to enter cells where needed. As insulin resistance worsens, the pancreas increases the amount of insulin it releases until cells take up insulin. Controlling your blood glucose levels is crucial to improving insulin resistance and overall pancreatic function.

We recognize that common symptoms like weight gain, depression, hair loss, and fatigue might lead to concerns about hormone imbalance. It’s crucial to talk to your doctor about these symptoms. There are many other factors that could be causing these symptoms. Advocate for yourself if you believe your symptoms are not being addressed. Be careful of supplements and diagnostics that purport they can address your “hormonal imbalance.” Hormone disorders are confirmed only by lab tests that are correlated with symptoms. You’ll want to work with your doctor and an endocrinologist to address any concerns.

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  • Brandi Sinkfield

    Dr. Brandi, is a Board-Certified Anesthesiologist, who was inspired by her mother, a registered nurse who graduated with a degree in information technology. Through tough love and support from her father, extended family, and friends she attended Case Western Medical School and received her M.D. She completed residency training at Cleveland Clinic and dual fellowship training at Stanford Anesthesiology in Perioperative Management and Digital Health. Growing up she experienced the lack of transparency, shame and secrecy surrounding women’s health and body confidence driving her to imagine a pathway for her own daughter and other women to access information that empowers them and inspires confidence.