Common Hormonal Imbalances: The ‘Top Six’ That I See

As explained <a href=” http://”>here</a>, steroid hormones are involved in everything we do and have startling effects on our vitality, sleep patterns, mental health and libido. As far as systems go, you’ll struggle to find something in your body that is more vital than your steroid hormones.

If they are balanced, you are likely to feel great. However, the opposite is also true. While there are over 50 different steroid hormones that interact without one another in a delicate metabolic dance, there are several hormonal issues that I see regularly. Each comes with its own set of symptoms and each throws up different therapeutic requirements.

High Cortisol

There are few people in the Western world that, at one time or another, have not endured a spell of high cortisol. This is because this glucocorticoid is released in larger amounts when the body is under stress. The hormone actually helps us recover from stressors, stops us from wobbling in the face of challenges and replenishes our ‘valuable’ fat stores after the fight-or-flight response has kicked in. The problem is that this response evolved to be a transient effect, activated briefly every 4-5 days; many individuals are dealing with higher cortisol levels all day, every day.

High cortisol can induce weight gain, especially around the abdomen. It also can induce insulin resistance and suppress the immune system. People with high cortisol levels often feel that they have stressful lives but that they are ‘good at coping’, bar a little difficulty in getting to sleep and a very slight sensation of being permanently activated and ready-for-action.

Regular symptoms: mainly insidious but may see some unexplained weight gain or unrefreshing sleep.

Likely causes: psychological stress, irregular meals, chronic infections, poor quality sleep.

Therapeutic approach: remove stressors outlined above. Consider support with Vitamin C and/or Phosphatidyl Serine.

Low Cortisol

In most cases, low cortisol is the consequence of sustaining high cortisol for a long period of time. In a mechanism that shares parallels with the development of Type II diabetes, the cells that produce cortisol eventually become damaged through their excessive action and their ability to produce cortisol is affected. Occasionally, low cortisol is brought on through infections. Some bugs can affect the hypothalamus, part of the brain that regulates the behavior of the adrenals, and induces a chronic lower level of stimulation to this system.

Regardless of the cause, low cortisol leaves an individual unable to handle stressful situations the way they once did. It also is likely to leave them unable to regulate their blood pressure effectively and their sleep-wake cycle becomes disturbed. A key manifestation of this imbalance is that this lack of cortisol means that the body is constantly pushed into compensating and it does so by pumping out more adrenaline. The adrenaline causes a number of symptoms including early waking, jitteriness and hypervigilence.

Regular symptoms: hypoglycaemic symptoms, low blood pressure, low appetite upon waking, dizziness upon standing, frequent urination, increased startle reflex, jitteriness, anxiety, poor sleep patterns, poor concentration, no tolerance for stress.

Likely causes: sustained high cortisol for months/years, infections.

Therapeutic approach: support cortisol levels with Licorice Root, remove stressors that are affecting the adrenal glands.


Low DHEA can often occur just before the body slumps from high cortisol to low cortisol. This can happen when the body perceives an over-riding need for high cortisol levels, yet is lacking the base components to keep producing it. As a consequence, it develops a ‘clever’ trick which is to divert the hormonal precursors destined for DHEA production and instead send it down the cortisol pathway.  A classic case of ‘robbing Peter to pay Paul’. This solves one immediate problem, but at the cost of low DHEA.

DHEA is a very useful steroid for the brain in particular, nourishing the glial cells there and supporting good mood and mental acuity. It also supports the immune system and is the precursor to testosterone, estrogen and DHT. A low DHEA:cortisol ratio is associated with increased weight gain around the abdomen.

Regular symptoms: reduced mental ability, poor mood, low libido, noticeable increase in weight gain around the abdomen.

Likely causes: excessive stress (prioritizing cortisol production), low intake of saturated fat, adrenal dysfunction.

Therapeutic approach: remove stressors, restore dietary fat. Consider temporary support with DHEA supplements.

Low Testosterone

As one of the ‘end products’ in a long chain of steroid hormones, testosterone is often a victim of imbalances further up the chain. If it’s precursors (like DHEA) are affected, then it can become very difficult for the body to compensate and produce enough testosterone. Additionally, high cortisol levels will compete for binding at steroid receptors, meaning that what little testosterone there is may be blunted (this effect is compounded in men when you consider that increased stress at the hypothalamic level will actually suppress the stimulation of the testes, further exaggerating the issue).

It should therefore come as no surprise that, amongst the stressed-out, under-slept men in London, many are suffering from low testosterone levels. Testosterone isn’t just about sex drive and beating one’s chest; it also has a big role to play in feeling good and brain functions like spacial awareness. And while most of this is mainly seen in men, testosterone is also important for women too (albeit at lower levels).

Regular symptoms: impaired body composition, low sex drive.

Likely causes: low DHEA, low intake of saturated fat, excessive stress, excessive action of aromatase enzyme (converts into estrogen), excessive action of 5-alpha-reductase enzyme (converts into DHT).

Therapeutic approach: inhibit over-active enzymes with botanicals, reduce stress, ensure cortisol/DHEA levels are within range, increase dietary fat.

Low Progesterone

The most common imbalance in women is low progesterone. Symptoms include poor sleep, painful periods, disproportionate weight gain beneath the arms and around the hips/buttocks and, in some individuals, migraines. These symptoms are all caused by estrogen and can be lumped into the ‘estrogen dominance’ category. This often leads women to believe that they have high estrogen levels and, while this is sometimes true, it is more likely caused by low levels of progesterone. Progesterone and estrogen oppose one another’s actions and so, when the former is in short supply, the latter can run wild.

It is unusual to find low levels of progesterone without some obvious stress. This is where the ‘progesterone steal’ phenomenon comes in, and describes how the body prioritizes the production of cortisol and chooses to rob the reservoirs of progesterone in order to do so. While DHEA levels can be compromised in the same way (described above), progesterone is a much closer relative to cortisol – only 3 enzymatic steps away – and suffers much more as a result.

Regular symptoms: PMT, poor sleep, inability to ‘switch off’, weight gain beneath arms/around buttocks and thighs, feeling worse in the second half of the menstrual cycle.

Likely causes: stress, adrenal imbalance, low intake of saturated fat.

Therapeutic approach: ensure cortisol/DHEA levels are within range, increase dietary fat.


In a complex machine driven by over 50 different steroid hormones, there exists a remarkable range of potential imbalances. However, the good news is that the body’s impressive ability to regulate itself means that most of these are very temporary. For the rest of the time, when the above-listed patterns present themselves, there are time-tested protocols that we can use to restore optimum balance. Because of the pivotal role that steroid hormones play in every system in the body, these protocols offer affected individuals near-miraculous results and fantastic increases in symptoms, mental sharpness and  energy levels. Don’t leave it untreated!