The Ovary-Thyroid-Adrenal Connection
There is a direct relationship between the ovaries and the thyroid gland. Next to the thyroid, the ovaries contain the greatest concentration of iodine in a woman’s body, so when iodine is deficient, you will feel the effects in both the ovaries and the thyroid. Most importantly, the ovaries have receptors for thyroid hormones, which play a role in the development of the egg and during conception.
Too much thyroid hormone activity may increase estrogen receptor function (leading to Estrogen Dominance) and too little thyroid hormone activity on the ovaries can create menstrual problems (such as PMS) and infertility. If your thyroid levels are low (i.e. Subclinical Hypothyroidism), this could have huge implications for your estrogens, as well as the functioning of your reproductive system and sex drive. Conversely, too much estrogen (Estrogen Dominance) inhibits thyroid hormones, and too much cortisol, as we will see shortly, causes too much estrogen.
The Adrenal-Ovary Connection: Cortisol and Progesterone
Cortisol and progesterone compete for the same receptor sites on the cells in your body. When you are under stress, cortisol levels go up, which can cause an abundance of cortisol to monopolize the receptor sites that should be served by progesterone. So while the body may be producing progesterone at normal levels (and indicate this on a blood test), the progesterone is not able to do its job because cortisol is filling all the receptors. Subsequently, excess cortisol (caused by excess stress) leads to depleted levels of progesterone. Cortisol also reduces your ability to clear excess estrogens from your body through your liver.
It is important to understand that progesterone is a precursor hormone, that is, it is used as a starting point for other hormones, including cortisol, DHEA, testosterone, and even the estrogens. Therefore, when you are experiencing chronic stress, as in the case of adrenal burnout, your body is pumping out cortisol to the detriment of progesterone, throwing off the delicate balance of your sex hormones. In particular, estrogen and progesterone act together to create a harmonic balance; if estrogen is too low, then progesterone comes to the rescue by converting to estrogens. If there is too much estrogen, you need more progesterone, or the clearance of excess estrogen to keep these two hormones in balance. With stress reducing the ability of progesterone to connect with its receptor sites, and stress also creating more estrogen, it is easy to see how it can quickly cause an imbalance in this delicate hormonal symphony. Cortisol reduction through stress management is imperative for hormone balancing.
The Adrenal-Thyroid Connection
The thyroid and adrenals influence many of the same functions and profoundly impact each other. Because they are so interconnected, you often cannot effectively treat one without ensuring the health of the other. In most cases, it is recommended to first begin treating the adrenals before the thyroid. The reason behind this is simple: the thyroid is the master metabolism gland – by ramping up its production without first supporting the adrenals, you are effectively kicking the adrenals when they are already down. This can lead to even worse adrenal depletion and worsen symptoms.
Cortisol, one of the key stress hormones, is essential to healthy thyroid function. In adrenal burnout where cortisol levels are elevated, your body attempts to conserve energy by lowering thyroid function (Hypothyroid), and the associated ovarian hormonal imbalance follows. Furthermore, stress uses up important nutrients (such as selenium and magnesium), depriving the thyroid of what it needs for hormone production, as well as, what it needs to protect itself from inflammation. Stress also inhibits the ability of your body to convert inactive thyroid hormone (T4) into its active form (T3) and inhibits the ability of the active form to get into your cells. Cortisol also makes the thyroid hormone receptors on your cells resistant (i.e. less sensitive) to the active form of thyroid hormone, so cells are unable to uptake thyroid hormone and it cannot do its job within the cells to activate the thyroid’s many functions in your body and brain.
Cortisol is necessary for thyroid hormone to work well, and thyroid hormones are needed for cortisol to do its job.
Adrenal Burnout and the Immune System
When you are in a chronic state of stress, your inflammatory cell production increases. Your body is staying prepared for all possible threats, including those that could require fast activation of your immune system. This over activates your immune system increasing your risk of developing inflammatory reactions – for example, eczema, food intolerance, and allergies. Chronic low-grade inflammation can also be responsible for fatigue, weight gain, brain fog, migraines, low blood pressure, anxiety and panic attacks, cognitive function changes, insomnia, aches and pains, depression, and conditions such as chronic fatigue syndrome, fibromyalgia, and PMS.
Over time, your immune system can become confused by mixed messages of being told to fight an infection when no infection is present. This can turn your body’s immune defenses from friend to foe, leading to autoimmune conditions in which the immune system begins to attack your own cells and organs. A rebound effect can eventually occur whereby elevated cortisol, which suppresses inflammation, can inhibit your infection-fighting responses so much that you become more vulnerable to infections – so you get sick more often than normal, or have trouble fighting off infections such as colds, flu, or bronchitis. It also makes you more susceptible to infection with, or reactivation of certain viral infections – particularly Epstein-Barr virus, which may cause severe fatigue and is considered a possible “stealth” cause of autoimmune conditions.
Nutritional Recommendations for Balancing Hormones
The most fundamental connection between diet and hormones is that consuming excess refined flours and refined sugars disrupts hormonal balance. Insulin, the hormone released to usher sugar into the cells (which also tells the cells to store fat), plays a critical role in hormonal balance – particularly balance between estrogen and progesterone. Refined flours and sugars cause excess amounts of insulin to be released into your body, then insulin triggers your fat cells to store the excess glucose for later (in other words, this leads to increased fat storage and weight gain). Your fat cells are a site of estrogen production and release; therefore, excess refined flour and sugar leads to fat storage which can lead to too much estrogen.
Breakfast sets the stage for the entire day. If breakfast consists of foods that produce a slow and steady increase in blood sugar (such as proteins, healthy fats, fiber and, low-GI carbohydrates), the blood sugar fluctuations from later meals will not be as pronounced and food cravings will be diminished (particularly for sweets or dense carbs). As an example, if you were to eat an omelette and greens for breakfast, your blood sugar levels will rise gradually and will remain stable for a few hours (usually 3-4 hours), providing you with a stable energy source. If, on the other hand, you were to eat boxed cereal, a bagel, doughnut, or a cookie for breakfast, your blood sugar will spike followed by a crash, setting you up for an energy pattern of ups-and-downs throughout the day, cravings for unhealthy foods (generally sweets and high-GI carbs), and an out-of-control appetite. This, in the long-run, can lead to weight gain and hormonal imbalance.
The timing of when you eat is also critical. Eating small amounts of low-GI foods, coupled with a protein and healthy fat, every 2-3 hours is more effective in keeping blood sugar (and, by extension, your hormones) stable and balanced than eating larger meals less frequently. In other words, the standard “three meals a day” concept is not effective at balancing blood sugar and hormones. Instead, try 5-6 smaller meals, or 3 meals with 2-3 snacks at regular intervals throughout the day. These small frequent meals or snacks of low-GI foods provide a steady stream of energy, reduce stress, and result in less fat storage – therefore contributing to hormonal balance and a leaner body!
Going back to cortisol, the spikes and crashes of blood sugar puts stress on the body which, in turn, leads to an overproduction of cortisol. As we have seen above, cortisol has the net effect of depleting progesterone, leading to an imbalance of estrogen-progesterone - generally characterized as “Estrogen Dominance”.
Herbal Recommendations for Hormonal Balance
It is important to understand that any holistic program to address hormonal balance will usually take around 3 months to notice significant change - patience and managing your expectations will be key. You will most likely not notice changes immediately, or even within your first menstrual cycle. This is completely normal and to be expected. It took years for your body to develop a state of hormonal imbalance, and it will take some time to recover. Try incorporating the following herbs into your hormone-balancing routine:
Chaste Tree Berry (Vitex) is the herb of choice for hormonal balance. It improves estrogen-progesterone balance, addresses symptoms of Estrogen-Dominance (such as symptoms of PMS, depression and irritability, bloating, breast tenderness, cravings, etc.) and helps to regulate menstrual cycles. It also helps to ease symptoms of menopause (including hot flashes, vaginal dryness and sleep issues).
Try in tincture form 1 dropper full in a splash of water first thing in the morning, away from other medications or supplements. For persistent or aggressive symptoms, you can increase this dose to up to 3 times per day.
Turmeric is profoundly anti-inflammatory and also helps to reset cortisol, especially when it is elevated due to stress.
Try adding 1 tsp of dried turmeric to smoothies, soups, stews, curries or as a veggie seasoning, or try making golden milk or turmeric tea.
Cinnamon not only tastes great but it has benefits for digestion and helps to lower blood sugar and improve insulin resistance.
Try adding ½-1 tsp to your smoothies, low/medium GI pancake or muffin recipes, or golden milk/turmeric tea.
Maca is a gentle, safe, and nourishing tonic herb for restoring cortisol balance. As a result it helps to balance estrogen and progesterone as well. It is also very useful in supporting menstrual and menopausal symptoms.
Try adding 1 tsp to your smoothies or tonics or in capsule form.
Supplement Recommendations for Hormonal Balance
Indole-3-Carbinol (I3C) helps to clear excess estrogens, particularly harmful xenoestrogens and estrogen metabolites. I3C helps ease PMS symptoms, protect against estrogen-dominant cancers, and is effective at keeping the balance of healthy estrogens in the body while supporting liver hormone function. It also helps support estrogen function in fat cells.
Try 150-300 mg per day.
D-Glucarate helps detoxify excess estrogens and protects the body from the negative effects of toxic estrogen-metabolites which are produced by the liver. It is also a powerful fat-flushing nutrient as well as able to reduce total triglyceride levels (thus reducing the risk of cardiovascular disease and helping the body metabolize fats).
Try 150-300 mg per day.
Diindolylmethane (DIM) is a powerful metabolizer of estrogen and studies have shown that it supports a healthy balance of the estrogens and their metabolites. It can help with estrogen-dominant conditions as well as symptoms of PMS and menopause.
Try 150-300 mg per day.
Gamma Linoleic Acid (GLA) is a beneficial omega-6 fatty acid found in evening primrose, borage, and black currant seed oils. GLA is converted, through several steps, into prostaglandins which are hormone-like substances.
Try up to 4000 mg of borage oil or up to 8000 mg of evening primrose oil per day.
Lifestyle Recommendations for Hormonal Balance
Probably the most important component to adrenal recovery is sleep!
Set the stage for a good night sleep by: avoiding caffeine after 2pm, enjoying light exercise for 20-30 minutes daily (but not within 3 hours of bedtime), avoid alcohol and eating within 3 hours of bedtime, and skip fluids within 2 hours of bedtime if you typically wake up in the night for trips to the bathroom. Also skip daytime naps.
Make your room a sleep sanctuary by using your bed for sleep, sex, and reading only. Keep it cool (generally around 68F), use blackout blinds and/or an eye mask to block out light as well as a white noise machine or ear plugs to filter ambient noise.
Power down from all electronics at least one hour before bed. Instead, read an inspirational book, do some yoga, meditate, do some deep breathing, or listen to relaxation or guided visualization recordings.
Let out your stressors/worries one hour before bed to avoid ruminating on them when your head hits the pillow. Journaling is a great opportunity to release stressors, practice gratitude, and focus on positive moments.
Take a warm bath. Adding Epsom salts and essential oils such as lavender can be wonderfully relaxing and prep your body for sleep.
Reset your circadian rhythm by getting up at the same time every day (ideally no later than 7am), and getting to sleep at the same time each evening (ideally, no later than 10-11pm)
Do not over-exercise. While getting daily physical activity is important for maintaining good health, over-exertion, particularly when you are already in a state of chronic stress, puts additional stress on your adrenals which leads to excess cortisol production (and by extension, further hormonal imbalance). While HIIT and crossfit are all the rage, these exercise modalities are not the best choice for healing from hormonal imbalance.
Try instead brisk walks, yoga, Pilates, or swimming. Yoga, and twisting poses in particular, can be incredibly nourishing to the nervous system, generating inner peace and calm, and reducing stress.
Deep breathing triggers neurons in your brain which tell your body it is time to relax.
Try deep breathing (belly breaths)or alternate nostril breathing, sends a message to your brain to calm down and relax – lowering your stress response, cortisol production, and bringing your hormones into balance. Try this breathing exercise:
Exhale completely through your mouth
Close your mouth and inhale quietly through your nose for a count of 4
Hold your breath for a count of 7
Exhale completely through your mouth for a count of 8
Repeat another 3 times
Meditation can bring awareness, harmony, and peace to life. Practicing meditation regularly will allow you to enjoy increased relaxation and greater energy.
Try the following meditation practice:
Sit comfortably in a chair with your feet flat on the ground, or lie on your back (you may elevate your head if you need extra support)
Allow yourself to survey your surrounding environment – what you see, hear, smell, and feel
Now close your eyes and turn your attention inward and relax your muscles
Observe the movement of your thoughts, emotions, and desires
Bring your attention to your breath, clearing your mind of other thoughts
If your mind wanders, simply acknowledge the thought, then bring your attention back to your breath; do not judge yourself or your thoughts
Through this internal observation, you are being cleansed of external distractions
Enjoy this meditation for as long as you like, ideally for a minimum of 5-15 minutes daily, preferably early in the morning