CHAPTER 13
N IS FOR NEUROHORMONE DEFICIENCIES
BOOST THE SYMPHONY OF A YOUTHFUL MIND
Low thyroid doesn’t kill you, it just makes you wish you were dead.
RICHARD AND KARILEE SHAMES, THYROID MIND POWER
ANITA: BRAIN FOG, WIRED, AND TIRED
Anita, 38, a second-grade teacher and a mother of three, loved teaching and felt that both her family and her career were growing better every year. But in 2016, out of the blue, she started feeling sad and tired, wired and forgetful; no matter how hard she tried, she couldn’t shake her negative feelings. Troubled by disrupted sleep, she started drinking more coffee to boost her energy, but it made her feel more anxious. In addition, she became sensitive to loud sounds, which made teaching little children hard, and she started having afternoon headaches.
When Anita came to Amen Clinics, one of the first things I did was check her important health numbers via lab testing. It turned out her TSH (thyroid-stimulating hormone) was high, and her T4 (the active form of thyroid) was low. She also had very high levels of thyroid antibodies: They were over 1,000; a normal level is less than 35. Having such a high level of thyroid antibodies is associated with an autoimmune condition called Hashimoto’s thyroiditis; it appeared that Anita’s body was attacking her own thyroid tissue. Her level of vitamin D —essential to the health of the thyroid gland —was low, as was her Omega-3 Index. Anita’s SPECT scan showed overall low activity, which is common in hypothyroidism.
ANITA’S BRIGHT MINDS RISK FACTORS AND INTERVENTIONS
BRIGHT MINDS |
ANITA’S RISK FACTORS |
INTERVENTIONS |
Blood Flow |
Low blood flow seen on SPECT |
Treat thyroid |
Retirement/Aging |
||
Inflammation |
Low Omega-3 Index |
Omega-3 fatty acids |
Genetics |
Family history of thyroid disease |
|
Head Trauma |
||
Toxins |
||
Mental Health |
Thyroid-related anxiety |
Thyroid medication |
Immunity/Infection Issues |
Low vitamin D |
Vitamin D3 supplements |
Neurohormone Deficiencies |
High thyroid antibodies |
Thyroid medication, zinc, L-tyrosine |
Diabesity |
||
Sleep Issues |
Disrupted sleep |
Sleep strategies |
We used the BRIGHT MINDS approach with Anita, which included prescribing thyroid medication, putting her on an elimination diet (many people with thyroid issues are sensitive to gluten), and adding the nutraceuticals L-tyrosine, omega-3 fatty acids, zinc, and vitamin D3. These treatments made a big difference in helping her memory, energy, and mental stability. After three months, Anita told me that she felt back to her old self.
HORMONES: IT’S ALL IN THE BALANCE
When your brain, adrenal glands, sex organs, pancreas, and thyroid gland work together, they produce just the right amounts of hormones: chemical messengers that control many of the body’s basic functions. This symphony of hormones can be affected by many factors, both inside and outside your body. When they are working in concert, you feel great. When any of these organs is out of sync, however, you can feel awful. Problems start when too much or not enough of one hormone (or several) is produced, which can throw off the delicate balance.
You can experience two types of problems when your hormones are out of balance:
- uncomfortable symptoms that can begin to change how you think, feel, and act, affecting your quality of life;
- an increased risk of illness, such as depression, Alzheimer’s, heart disease, osteoporosis, diabetes, and certain cancers.
Communication between hormones and the brain is strongly two-way: The brain produces signals that trigger the release of hormones, and hormones from other parts of the body also influence the brain. When thyroid activity is low, for example, as it was for Anita, brain activity is typically low as well. That’s why an underactive thyroid often leads to depression, irritability, and brain fog.
Meet the hormone “family”
There are hundreds of hormones in the body that affect the brain. To keep this discussion practical, I am going to show you how to optimize seven of the most important ones:
- thyroid
- cortisol
- DHEA
- estrogen
- progesterone
- testosterone
- insulin (see chapter 14, page 228)
Thyroid: the energy regulator
The thyroid —a small, butterfly-shaped gland located in your lower neck —produces three main thyroid hormones: TSH, T3, and T4. These hormones are among the most influential in your body, and all have to be in the right balance to keep your brain and body healthy. Too little of any thyroid hormone (hypothyroidism) makes you feel like a slug; you just want to lie on the couch all day with a bag of chips. Everything works more slowly, including your heart, your bowels, and your brain (because the thyroid gland drives the production of many neurotransmitters that run the brain, including serotonin, dopamine, and GABA). SPECT scans of people with hypothyroidism show overall decreased brain activity, which often leads to depression, cognitive impairment, anxiety, and brain fog. More than 80 percent of people with low-grade hypothyroidism have impaired memory function.[490] One-third of all depressions are directly related to thyroid levels being too high or too low.
An overactive thyroid, or hyperthyroidism, is also a problem, because it makes everything in your body work too fast. It can feel like you’re in overdrive —you feel jittery and edgy, as though you’ve had way too much caffeine.
Common Symptoms of Thyroid Lows and Highs
|
|
|
Thyroid problems can occur at any time in a person’s life, though women are especially prone to problems after having a baby —usually within six months of the birth. During pregnancy, certain parts of the immune system relax so that immune cells and antibodies will not reject the baby’s placenta, which is attached to the mother’s uterus. This is why many women with thyroid problems feel that pregnancy is the best time of their lives, as it calms those issues. After the baby is delivered, however, everything changes: The placenta detaches and parts of the immune system that were turned down to prevent early rejection of the placenta now surge back.
Postpregnancy is not the only vulnerable time for women’s thyroid issues. An estimated one in four postmenopausal women has a thyroid imbalance. Nearly 45 percent of people over 50 have some degree of thyroid gland inflammation, according to Ridha Arem, MD, editor of the journal Thyroid. Dr. Arem suggests that minor thyroid problems cause more disability in the elderly population than in the young, who have greater reserves of thyroid function.[491]
Tens of millions of men and women —5 to 25 percent of the world’s population —are thought to have thyroid problems. And these issues seem to be increasing: The authors of Thyroid Mind Power report that “the last 40 years have witnessed a massive increase in the amount of hormone-disrupting synthetic chemicals finding their way into our air, food, and water. . . . The most sensitive and highly susceptible of human tissues turned out to be the thyroid gland.”[492]
Most thyroid issues are autoimmune, which means that the body is attacking itself. This may be due to environmental toxins that are stored in our bodies, food allergies (to gluten and dairy products in particular), or something in the air we breathe. For this reason, many physicians consider the thyroid to be the so-called “canary in the coal mine,” alerting us to the dangers of ingested toxins.
Factors that inhibit thyroid production include
- excess stress and cortisol production
- selenium deficiency
- deficient protein
- excess sugar
- chronic illness
- compromised liver or kidney function
- cadmium, mercury, or lead toxicity
- herbicides or pesticides
- oral contraceptives
- excessive estrogen production
Cortisol and DHEA: our lady of perpetual stress
The adrenals, a pair of triangle-shaped glands that sit atop your kidneys, are critically involved in your body’s reaction to stress. The adrenals produce the hormones adrenaline, dehydroepiandrosterone (DHEA), and cortisol, which are released in the well-known fight-or-flight response. Here is how it works: Let’s say you’re hiking through the woods with your children when you see a mountain lion; immediately, your adrenals start producing adrenaline and the other hormones that will give you the burst of energy you need to either fight the lion or pick up the children and run.
The problem is, your body doesn’t differentiate among the various kinds of stress you experience. Whether it’s physical stress at the sight of the mountain lion or mental stress caused by your raging teenager or catty coworkers, your body reacts the same way, pumping out those chemicals. But when you run away from the mountain lion, your body processes the chemicals and gets them out of your system. This is not the case when you get stressed over the way your coworker looked at you; all you can do is return to your office or cubicle and stew. That leaves a dangerous cocktail of chemicals surging through your body until every one of them is finally metabolized.
In today’s world, you’re likely faced with that kind of psychological stress on a daily basis. You wake up to a blaring alarm, and the first thing you do is check your e-mail to see what people are demanding of you. On the way to work you get stuck in bumper-to-bumper traffic or sardined on a delayed train and arrive late to face a slew of impossible deadlines. Later your son’s school calls to tell you that he has been getting into fights. On and on it goes, and if you are not addressing your stress, your poor adrenals keep pumping out cortisol and other chemicals that can overwhelm your body.
When cortisol is chronically elevated, blood sugar and insulin levels also rise. And your brain doesn’t fare well. Serotonin, the calming brain chemical, drops, leading to anxiety, nervousness, or depression. Food cravings increase, your sleep is disturbed, and your health can spiral out of control. Chronic exposure to stress hormones has been shown to kill cells in your hippocampus, a major memory center in the brain, especially when DHEA is also low. If the stress continues for months and years, the adrenal glands finally just get tired. When they do, we call it adrenal fatigue, the point at which your body doesn’t have the resources it needs to deal with all that daily pressure. You can barely get out of bed in the morning or make it through the day.
You could also be getting fat. Adrenal fatigue leads to an especially dangerous buildup of fat in your abdomen. Not only do you ruin your chances of having a flat belly, but you’re at greater risk of cardiovascular disease and diabetes. Low cortisol also promotes inflammation, affects immune function, and alters blood sugar control and sex hormone production. When the adrenals are busy making stress hormones, they divert your stores of DHEA, which would have eventually been converted to sex hormones.
Lately, doctors have been seeing patients with adrenal fatigue more frequently. A big reason is that so many of us are skimping on sleep. The human body needs about seven to eight hours every night, and if it doesn’t get it, your system automatically goes into a stressed state. When you self-medicate to counteract the lack of sleep, you just make things worse. Drinking coffee or caffeinated energy drinks to keep yourself awake adds to the stress load. An alcoholic beverage in the evening to quiet down after all that caffeine may be a temporary fix. But once the alcohol wears off, it puts your body into another stress response that wakes you up at two in the morning and keeps you from being able able to fall back to sleep, ensuring you will need more caffeine to face the next day. Now you’re in a never-ending cycle of stress that exhausts your adrenal system and keeps you operating on the edge, never at your best.
Common Signs of Adrenal Fatigue
Tami Meraglia, MD, an integrative medicine physician in Seattle who sees many stressed-out people, wrote to tell me what advice she gives her patients:
My patients have an aha moment when I explain the difference between stress, lack of stress, and doing things that repair the damage and inflammation created by stress. Most patients think that going home and “relaxing” is healing the stress from the day. It is not. That is merely the lack of stress, if you are lucky. My patients see results when they actively engage in activities like the meditation exercises on your online site (www.brainfitlife.com) to heal and rejuvenate the damage done by the stress of that day. I remember asking my dentist when I was 11 years old if I had to floss all my teeth. He told me only the ones I wanted to keep. I think meditation is similar. Stress damages our health every day. You only need to meditate on the days when you want to heal that damage.
Estrogen and progesterone: the female sex hormones
ESTROGEN: BRAIN FOG ANTIDOTE
Two of the major hormones that drive a woman’s menstrual cycle are estrogen and progesterone. They affect many systems in the body, including the skeletal and cardiovascular systems, as well as the brain. And they are not found only in women. Men have these hormones, too, only in much smaller amounts —unless they have significant abdominal obesity, which turns healthy testosterone into unhealthy, cancer-promoting forms of estrogen. (In lectures, I often ask why we have so many pregnant men in our society . . . guys, it’s time to deliver the baby!)
A woman’s menstrual cycle reflects the natural rise and fall of estrogen and progesterone during a typical 28-day cycle. When everything works correctly, estrogen rises and falls in a gentle rolling motion twice during that time frame, while progesterone rises and falls once. The chart on the following page shows the cycle of estradiol, one of the key forms of estrogen, and progesterone.
Healthy levels of estrogen help women feel good, thanks in part to its involvement in the production of serotonin in the brain. Too much estrogen makes you anxious and irritable, like a wet cat; too little makes you depressed and confused. It’s the natural rise and drop in estrogen that affects mood. Problems can worsen during perimenopause and menopause, when estrogen levels wane. Critical thinking, short-term memory, and other cognitive functions are also eroded with the loss of estrogen production.
There are three different kinds of estrogen: estrone (E1), estradiol (E2), and estriol (E3). The health of your liver, gut, and adrenals determines which types of estrogen hormones are made. That’s one reason why getting healthy is critical to all of your body’s systems, including your brain.
- Estrone (E1), the main estrogen women’s bodies make after menopause, is implicated in breast and uterine cancer. Before menopause, women make all three estrogens plus progesterone. After menopause, the levels of E2, E3, and progesterone drop drastically, and their health-protective effects are lost. It’s not surprising that the majority of breast cancer cases occur in postmenopausal women. Obese women are at higher risk because fat turns healthy testosterone and estradiol into estrone.[493] Alcohol consumption also increases estrone, which could be the reason there is an association between alcohol intake and breast cancer.[494] Eating excess sugar, taking the antacid cimetidine or birth control pills, smoking, hypothyroidism, and pesticide exposure also increase estrone production.
- Estradiol (E2), the strongest estrogen, helps a female think clearly. It is produced in the ovaries and has many protective effects, including maintaining bone density, improving growth hormone production and cardiovascular function, keeping blood from getting sticky, supporting cognitive function and mood, and improving the lipid profile. Too much estradiol can be associated with estrogen-related cancers, but deficiencies can lead to osteoporosis, heart disease, dementia, and other diseases of aging.
- Estriol (E3) is the weakest of the three estrogens and has a protective role in breast tissue. It is believed to protect vaginal tissue too. Estriol helps reduce hot flashes in women, protects the urinary tract, and plays a role in retention of bone density. One compelling study showed that taking estriol can reverse brain lesions in women with multiple sclerosis.[495]
Common Symptoms of Estrogen Lows and Highs
LOW ESTROGEN |
EXCESS ESTROGEN |
|
|
|
PROGESTERONE: NATURE’S VALIUM
The other major hormonal player in a woman’s menstrual cycle is progesterone. It helps to prepare the uterus for implantation with a healthy fertilized egg and supports pregnancy. If no implantation occurs, progesterone levels drop, and another cycle begins.
However, progesterone, like estrogen, is much more than a sex hormone. Its receptors are highly concentrated in the brain. Progesterone protects your nerve cells; supports the myelin sheath that covers and protects neurons; and can enhance the effect of GABA, the brain’s main relaxation neurotransmitter. I like to think of progesterone as the relaxation hormone. It makes you feel calm and peaceful, and it encourages sleep. It’s like nature’s Valium, only better, because instead of being addictive and making your brain fuzzy, it sharpens your thinking. It has also been shown to help with brain injuries by reducing inflammation and counteracting damage.
Progesterone increases during pregnancy, which is why pregnant women often feel great. Some women with hormonal issues, in fact, feel so much better during pregnancy that they will deliberately get pregnant over and over again to feel normal. Progesterone is low for the first two weeks of the menstrual cycle. It then follows a rolling-hill pattern during the second half of the cycle, rising and falling along with estrogen. A drop in progesterone means the loss of the relaxation hormone. Calmness gives way to anxiety and irritability. Sleep is disturbed. Thinking becomes a bit fuzzy. Along with estrogen, progesterone plummets right before menstruation starts, and for some women, that’s when the bottom falls out.
Common Symptoms of Low Progesterone
Big fluctuations in progesterone can occur in a woman’s late thirties and forties, making her feel anxious and out of sorts. A progesterone cream is often very helpful when used under the care of an experienced health-care provider.
Progesterone production can drop with low levels of thyroid hormone; the use of antidepressants; chronic stress; deficiencies in vitamins A, B6, or C; zinc; and a diet high in refined sugar.
The Pill: What Women Need to Know
THE BEGINNING OF A NEW PHASE: PERIMENOPAUSE
By the time women reach their thirties or forties, their hormones start undergoing another change as their bodies prepare to leave their childbearing years. It doesn’t happen overnight. For eight to ten years before entering menopause (when your menstrual cycle ends completely), women go through a period of adjustment known as perimenopause. Most women don’t think about being in perimenopause until their estrogen levels have fallen to the point where they experience hot flashes and night sweats, the most common symptoms. But by the time hot flashes arrive, they’ve probably been going through perimenopause for up to 10 years.
These years of adjustment can be difficult. The hormone system works less efficiently, and the once (relatively) gentle ups and downs in hormone levels can give way to estrogen spikes followed by a crash right before a period begins. The result may be severe PMS symptoms, even in women who have never experienced them before. When estrogen levels decline during the menstrual cycle, perimenopause, or menopause, short-term memory suffers and crying spells and depression are more likely. Women may forget where they put their house keys or what they came to the grocery store to pick up. Low levels of estrogen can also make women more sensitive to pain. All of these symptoms are exaggerated with the more erratic hormonal shifts of perimenopause as the effect of going from estrogen dominance to withdrawal becomes more pronounced. It isn’t fun for anyone, and it can make women feel as though they are literally losing their minds.
To stay on top of the changes, it is a good idea for women to get their hormone levels checked at about age 35 to have a baseline and rechecked every two to three years thereafter. This is much better than waiting —as many women we see in our clinic have done —until they are ten years into the process, have already put on an excess 35 pounds, and are on antidepressant and anti-anxiety medications. Intervening earlier in the process can help avoid a lot of problems. (See “Prescription to Reduce Your Neurohormone Risk,” page 219, for healthy strategies to improve your hormonal balance.)
NOT YOUR GRANDMOTHER’S MENOPAUSE
Menopause just isn’t what it used to be. My grandmother Marcella, my father’s mother, whom I adored, was an old woman in her fifties and sixties. She was overweight and often appeared tired and out of breath. She died at age 62. Contrast her with my mother, who at 85 remains vibrant and active. She still plays golf and is often at the mall with one of my sisters, daughters, or nieces. Today many women in menopause are at the peak of their careers and social lives.
Technically, menopause is the one-year mark after the last menstrual period. Since estrogen and progesterone have fallen to very low levels, women no longer benefit from their protective qualities and are more vulnerable to conditions such as osteoporosis, heart disease, stroke, and Alzheimer’s. When estrogen levels go low, so does blood flow to the brain, which is associated with depression, anxiety, insomnia, weight gain, and problems with concentration and memory.
 |
It is even more critical after menopause to take brain health seriously, as your brain’s reserves of tissue and function have declined. |
As I have said throughout this chapter, sex hormones are critical for brain health. Studies of women who had complete hysterectomies (with ovary removal) showed that without hormone replacement, they had double the risk of Alzheimer’s disease. Recently, researchers studied the brain scans of women who were either on or off hormone replacement.[498] Over a period of two years, the women who did not take hormones showed decreased activity in the posterior cingulate gyrus, an area of the brain that is one of the first to die in Alzheimer’s disease. Those who took replacement hormones showed no reduced activity in that area of the brain.
This is consistent with a prospective study of more than 3,000 women that showed women on hormone replacement therapy (versus those who weren’t) scored significantly better on tests of verbal fluency, working memory, and psychomotor speed.[499] The researchers found no evidence that hormone therapy needed to be initiated close to menopause to have a beneficial effect on cognitive function in later life; they also found that it may decrease the risk of dementia even in women with the APOE e4 gene. In a 20-year follow-up study of 230,000 women, long-term self-reported postmenopausal estrogen replacement was associated with a 47 percent reduced risk of Alzheimer’s disease.[500]
Testosterone: it’s not just a guy thing
Most people think of testosterone as the male hormone. That’s true in the sense that an infusion of testosterone during a critical time of fetal development creates the male brain, and another at puberty leads to the deepening voice, facial hair, and many other features we associate with maleness. But females have testosterone too (just as males have some estrogen). In both men and women, testosterone helps protect the nervous system and wards off cognitive impairment, depression, and Alzheimer’s disease. It also seems to protect cells from inflammation, which some researchers believe is why men (who naturally have more of the hormone) are less susceptible than women to inflammatory diseases like rheumatoid arthritis, psoriasis, and asthma, and even why men suffer less from depression.[501] Men who have low testosterone are more likely to suffer from chronic pain, which is more common in women.
Although testosterone is very important to the health of men’s brains, energy, strength, motivation, and sex drive, it’s unwise to overdo it. Excessively high testosterone levels are associated with lower empathy and a high sex drive, which could be the prescription for having an affair, getting divorced, and losing half your net worth. For these reasons, I like to keep my male patients in the high-normal range.
A new analysis of medical records from two large hospital systems has shown that men taking testosterone-lowering therapy for prostate cancer were almost twice as likely to be diagnosed with Alzheimer’s disease in the years that followed than those who didn’t undergo the therapy.[502] If you elect this type of treatment for prostate cancer, make sure to do everything else you can to keep your brain healthy.
CHECKUP FOR NEUROHORMONE DEFICIENCIES ISSUES
Lab tests
After age 40, be sure to undergo yearly testing of the following hormones for men and women. Note that each lab determines what readings fall in the normal range, so ask for a lab’s standards if they don’t provide them.
- Thyroid panel (blood test): If you have symptoms, don’t settle for just a TSH test, which measures your thyroid-stimulating hormone. TSH levels can be normal even when you have an undiagnosed thyroid problem. Instead, insist that your doctor order all of the following:
- TSH: Anything over 3.0 is abnormal and needs further investigation.
- Free T3: Active thyroid; see the normal ranges for the individual laboratory you use.
- Free T4: Inactive thyroid; see the normal ranges for the individual laboratory you use.
- Thyroid antibodies
- thyroid peroxidase (TPO) antibodies
- thyroglobulin antibodies (TG); see the normal ranges for the individual laboratory you use.
An important note: While thyroid tests can be helpful, your doctor should treat you, not the blood test. I’ve seen too many hypothyroid patients who haven’t been treated because their thyroid numbers were low but “within normal limits.” That’s a little like saying a vitamin D level of 31 is normal (the normal range is 30 to 100). I have never wanted to be at the bottom of any class I was in. How a patient feels and functions (e.g., low energy, constipation, dry hair, dry skin, poor cognition, body temperature) is more important in assessing thyroid function than using arbitrary normal ranges on blood tests. All of the above tests could be normal and someone could still have a problem.
- Liver function tests: Ninety-five percent of T4 is “activated” in the liver, so having a healthy liver is essential. See chapter 10, page 157, for more on these tests.
- Ferritin level: Ferritin is like the bus that drives active T3 into the cells; ferritin needs to be above 50 for this to occur. See page 88 for more on this test.
- Cortisol (saliva): This is best done four times, at intervals throughout the day (to track your daily cycle): when you first wake up, around lunchtime, around dinnertime, and just before you go to sleep. Ideally, your cortisol levels are high in the morning (to wake you up) and taper off slowly during the day and evening, allowing you to fall into a restful sleep at night. When cortisol levels are too high, you feel wired. When they are too low, you feel exhausted, spacey, or sluggish.
- DHEA-S (blood test): Normal blood levels of DHEA-sulfate can differ by sex and age.
Typical normal ranges for females:
- Ages 18–19: 145–395 mcg/dL (micrograms per deciliter)
- Ages 20–29: 65–380 mcg/dL
- Ages 30–39: 45–270 mcg/dL
- Ages 40–49: 32–240 mcg/dL
- Ages 50–59: 26–200 mcg/dL
- Ages 60–69: 13–130 mcg/dL
- Age 70 and older: 17–90 mcg/dL
Typical normal ranges for males:
- Free and total serum testosterone (blood test): Having an optimal level of testosterone is important for your health and well-being. Too much can cause behavioral problems, such as aggression, but too little is associated with depression, poor memory, and low libido.
Normal levels for adult males:
- Total testosterone (280–800 nanograms [ng]/dL; 500–800 ng/dL is optimal)
- Free testosterone (7.2–24 picograms [pg]/mL; 12–24 pg/mL is optimal)
Normal levels for adult females:
- Total testosterone (6–82 ng/dL; 40–82 ng/dL is optimal)
- Free testosterone (0.0–2.2 pg/mL; 1.0–2.2 pg/mL is optimal)
- Estrogen and progesterone for women: These levels can be measured in blood or saliva. Women who have menstrual periods are usually tested on day 21 of their cycle; postmenopausal women can be measured anytime. See the normal ranges for the individual laboratory you use.
PRESCRIPTION TO REDUCE YOUR NEUROHORMONE DEFICIENCIES RISK
The Strategies
- Love your hormones. To have a great brain, you have to care about the health of your hormones. Make optimizing them a priority, and your life will be much happier.
- Limit the bad; expand the good. To keep your hormones healthy, it is critical to avoid or limit anything that hurts or diminishes them, including smoking (which lowers the age of menopause),[503] stress, processed food, too much sugar, high amounts of unhealthy fats, wheat, lack of sleep, excessive caffeine, more than a few glasses of alcohol a week, and obesity.[504] To expand the good, engage in these healthy behaviors: exercise, lift weights, get adequate sleep, eat a healthy diet, and manage your stress.
- Steer clear of endocrine disrupters. Pesticides are known to cause hormonal imbalances, and some pesticides have been shown to act as endocrine disrupters, interfering with the body’s natural hormone systems and causing an array of health problems.[505] (See chapter 10, pages 158–159, for more on how to avoid these chemicals.)
- Use hormone supplements and medications wisely. When possible use bio-identical hormones, as they mimic the molecular structure of the hormones your body makes. Bio-identicals generally have fewer side effects.
The Nutraceuticals
- L-tyrosine to support thyroid function
- Zinc to help support healthy testosterone levels
- DHEA can be taken over the counter but is best done under the supervision of your health-care professional. Generally, I start patients on 10 mg and go up from there, depending on what each individual patient needs. DHEA is usually well tolerated, but there can be some unpleasant side effects, like acne and facial hair, due to the tendency of DHEA to increase testosterone levels. These can be avoided by using a specific metabolite of DHEA called 7-keto-DHEA, which is more expensive but may be preferable in some cases. The dose of 7-keto-DHEA is typically 50 to 100 mg.
- Diindolylmethane (DIM) is a phytochemical found in cruciferous vegetables like broccoli and cauliflower. It shifts estrogen metabolism to favor the friendly or harmless estrogen metabolites.[506] DIM can significantly increase the urinary excretion of the “bad” estrogens in as little as four weeks.[507] The typical dose of DIM is 75 to 300 mg per day.
- Omega-3 fatty acids (fish oils) contain eicosapentaenoic acid (EPA), which laboratory studies show helps control estrogen metabolism and decrease the risk of breast cancer.[508]
- Calcium D-glucarate, a natural compound found in fruits and vegetables like apples, brussels sprouts, broccoli, and cabbage, inhibits the enzyme that contributes to breast, prostate, and colon cancers. It also reduces the reabsorption of estrogen from the digestive tract. The dose for calcium D-glucarate is typically 500 to 1,500 mg per day.
- Probiotics help maintain healthy intestinal flora and hormone levels.
Key Vitamins, Minerals, and Herbs for Hormone Balance
TO SUPPORT MULTIPLE (OR ALL) HORMONES
ESTROGEN (FEMALES)
PROGESTERONE (FEMALES)
TESTOSTERONE
THYROID
CORTISOL
DHEA
The Foods
AVOID (OR LIMIT):
- Sugar and simple carbohydrates cause unfriendly flora to grow in the GI tract and disrupt estrogen metabolism. These foods also raise blood sugar and insulin levels, adversely influencing sex hormone balance.
- Protein from animals raised with hormones or antibiotics. Instead look for grass-fed, hormone-free, antibiotic-free organic beef and chicken; they are richer in omega-3 fatty acids, which will reduce inflammation and help your hormone receptors to function properly. Also eat organic vegetables, fruits, nuts, seeds, beans, and grains.
- Processed foods
- Gluten
- Soy protein isolate
- Excitotoxins, substances that can kill neurons, including MSG, aspartame, hydrolyzed vegetable protein, sucralose, and “natural flavors” (these often contain MSG)
- Foods and drinks that lower testosterone levels, including soy, licorice, and spearmint tea
CONSIDER ADDING:
- Fiber-rich foods, including those that contain lignin: green beans, peas, carrots, seeds, Brazil nuts.[509] Lignin binds harmful estrogens in the digestive tract so they can be excreted in the feces rather than be reabsorbed. Dietary fiber also improves the composition of intestinal bacteria so the body can excrete harmful estrogen metabolites. It also decreases the conversion of testosterone into estrogens, maintaining a healthy testosterone level.
- Hormone-supporting spices: garlic, sage, parsley, anise seed, red clover, hops (see below)
- Eggs. Many hormones are made from cholesterol, so make sure you have enough cholesterol in your diet.
- Testosterone-boosting foods: pomegranates, olive oil, oysters, coconut, brassicas (including cabbage, broccoli, brussels sprouts, cauliflower), whey protein, garlic
- Estrogen-boosting foods: soybeans, flaxseeds, sunflower seeds, beans, garlic, yams, foods rich in vitamins C and Bs, beets, parsley, aniseed, red clover, hops, sage
- Thyroid-boosting (selenium-rich) foods: seaweed and sea vegetables, brassicas, maca
- Progesterone-boosting foods: chasteberry, plus magnesium-rich foods: See chapter 5, page 77.
- Zinc-rich foods to boost testosterone: See chapter 12, page 200.
- Prebiotic- and probiotic-rich foods: See chapter 7, page 107.
PICK ONE HEALTHY BRIGHT MINDS HABIT TO START TODAY
- Get your hormones tested on a regular basis.
- Avoid hormone disruptors, such as BPA, phthalates, parabens, and pesticides.
- Avoid animal protein raised with hormones or antibiotics, which can disrupt your hormones.
- Eat more fiber (to eliminate unhealthy forms of estrogen).
- Lift weights to boost testosterone.
- Limit sugar.
- Take zinc to help boost testosterone.
- Take cortisol-reducing supplements, such as ashwagandha (which also supports the thyroid).
- For women, make sure to optimize estrogen for overall brain health.
- Consider hormone replacement when necessary.