Cortisol face? Adrenal fatigue? Hormone Balancing Elimination Diets?
Phew! Balancing hormones is the latest wellness trend on Tik Tok and Instagram. If you’ve fallen down this rabbit hole, you might come back scratching your head wondering why you’re suddenly taking 6 different supplements and spending half your paycheck on specialty foods at the natural grocery store.
As a dietitian who works with various hormonal conditions, including PCOS, Hashimoto’s, and hypothalamic amenorrhea, I’m used to getting a lot of questions about hormones and nutrition. But in recent years, the things my clients have been hearing about hormone health have gotten crazier and crazier. Hormone balancing is a certified trend, and wellness agents aren’t going to miss the opportunity to cash in!
Everyone (myself included) has done that thing where you google some vague symptoms and after reading a few articles you end up convinced you have cancer or some rare, incurable disease. With hormone health on social media, it’s the same. Symptoms such as fatigue, digestive discomfort, difficulty sleeping and weight changes may occur with thousands of health conditions, and sometimes it’s just a side effect of being human! But when the algorithm catches up with you, it’s easy to walk away convinced that you have a hormonal condition—and that the solution is a strict hormone-balancing diet.
What are hormones?
First, let’s talk about what hormones are. Hormones are chemicals that essentially act as messengers to help coordinate bodily functions. They have a wide range of functions, including the regulation of metabolism, reproduction, growth and development, mood and stress response, sexual function, and the sleep cycle. Actually, there are more than 50 different hormonesand many of them perform multiple tasks with roles in different systems.
Hormones and the organs that secrete them make up the endocrine system. Within the endocrine system, there are multiple “pathways” of communication. For example, the HPA axis is a pathway I talk about a lot with my clients. It is a communication pathway between the hypothalamus, pituitary gland, and adrenal glands that plays a role in regulating metabolism, digestion, reproduction, temperature regulation, and more. Hormones secreted by the hypothalamus “communicate” with the pituitary gland, which releases more hormones that “communicate” with the adrenal glands. When there is a disruption in the HPA axis, it can have an impact on all the different systems and functions that the HPA axis regulates.
Hormonal disorders can be caused when there is either too much or too little of certain hormones. For example, diabetes is caused by too little insulin, and PCOS is caused by too much androgen. This hormonal imbalance can be caused by many different things, from tumors in the endocrine glands to autoimmune conditions to malnutrition, which we’ll talk more about in this post.
Examples of hormonal conditions include:
hyper or hypothyroidism
diabetes
PCOS
Cushing’s syndrome
hypothalamic amenorrhea
graves disease
The best diet for balancing hormones is to eat enough food.
I covered some of the more disturbing hormone health wellness trends in this post, but even if you’re seeing a legitimate doctor to manage a hormonal condition, it’s not uncommon to receive restrictive diet advice. Whether it’s cutting carbs, eliminating gluten, or my personal favorite, “just lose weight!”, there’s a lot of pressure to limit your intake. In most cases, restrictive dietary advice is not justified – often by doctors, who have limited nutrition educationthey repeat the same misinformation you feed on social media. This useless and inaccurate advice can cause a lot of harm, not only to your relationship with food, but to your hormonal state itself!
That said, sometimes advice on cutting out something or going on an elimination diet can be helpful. For example, there is a lot of overlap between Hashimoto’s and celiac disease, and when someone has not been diagnosed with celiac disease and is on a gluten-free diet, they will definitely notice an improvement in their symptoms. Or if someone incorporates more physical activity and eats a little healthier in their effort to lose weight, they may notice an improvement in blood sugar levels as a result. I would argue that the improvement is most likely a result of behavioral changes rather than weight loss, but that’s another post! There are endless nuances to health, so if you’ve benefited from an elimination diet or intentional weight loss, I’m really glad you found something useful for you.
What really worries me is when “hormone balancing” nutritional advice causes someone to eat less than what their body needs*. This is where it gets really bad.
*When I say less than what your body needs, I don’t necessarily mean weight loss (although that can be a side effect) or an eating disorder. Eating less than what your body needs means you are taking in fewer calories (i.e. energy) than your body needs for all its bodily functions and physical activity. Also, this amount is probably a lot more than you think!
How undernutrition harms hormonal health
One fact I like to remind my clients is that hormones are made from amino acids (proteins) and lipids (fats). When you don’t eat enough, there is a lack of the building blocks needed to make hormones. This is one of the reasons why hormonal disorders are so common among people who struggle with eating disorders.
Another way in which hormonal health is affected by undernutrition is through metabolic suppression. Bodies respond to inadequate intake by lowering metabolic rate to conserve energy. Most people hear this and think that a lower metabolic rate = weight gain. While this may be a side effect, I want you to think beyond the potential impact on the scale and consider what it means for your body to lower its metabolic rate. It means your body slows down bodily functions, starting with things that are less immediately necessary. Think reproduction, regulating body temperature and building/strengthening bones.
If you’re not eating enough calories or a certain macronutrient, you’re also unlikely to meet your needs for essential vitamins and minerals. Deficiencies in nutrients such as vitamin D, iodine, B12 and essential fatty acids can play a role in hormonal conditions. Note that if you have a hormonal condition, I’m not telling you to go out and take large doses of any of these nutrients – some supplements may be beneficial, especially if you’re deficient, but it’s important to get guidance on this from a doctor professional.
Finally, dieting, disordered eating, and restriction are a huge stressor, both physiologically and psychologically. The stress of malnutrition activates the stress response (which is regulated by hormones), as does the psychological stress of constantly thinking and worrying about food!
Over the years, it’s been great to see how simply supporting clients in eating enough food can have such a huge impact on their hormonal health. I’ve had clients get their period after years of amenorrhea within just a few weeks of adding fat to their diet (not always that easy, but pretty cool when it is!). I’ve had clients who had to constantly change their thyroid meds due to fluctuations in labs finally have some stability. And I’ve had clients see huge improvement in their PCOS symptoms from eating enough food after years of being told to diet and lose weight.
I will also add that many times clients come to me suspecting a hormone condition (or have been told they have one by an alternative provider) and follow all kinds of restrictive dietary advice to balance their hormones. Through our collaboration, we often discover that they don’t actually have a hormonal condition – they’re just malnourished. Fatigue, poor digestion, hair loss, moodiness, difficulty sleeping and skin problems can be side effects of hormonal conditions, but they are also side effects of malnutrition!
How can I improve hormonal health with food?
This is a much more in-depth question than I can answer in one blog post, as there are different hormonal conditions that can benefit from different nutritional interventions. Even for the same situation, it is important to take an individualized approach. What is useful for one person may be harmful for another!
That being said, the foundation of nutrition therapy for all hormonal conditions is eating enough food. This means getting enough calories (ie energy), carbohydrates, fats and proteins and eating a variety of foods to ensure adequate intake of micronutrients. For most people, this involves a mental shift away from trying to eat as little as possible and towards sufficiency (see my hierarchy of nutritional needs for more on this).
I should also add that medication is often a huge part of treating hormonal conditions. In many cases it is necessary and much more effective than diet. People often want to treat hormonal conditions with diet rather than drugs, and while this is certainly a valid decision to make, it’s worth asking why. Do you feel ashamed about taking a medication because you “should” be able to manage it with food? Or is it a careful choice made after considering the potential risks, benefits and your own personal values and lifestyle?
If you struggle with a hormonal condition and are looking for flexible, non-diet support to manage your symptoms, reach out! Depending on where you live, we may be able to work with you virtually. Explore our practice philosophy and services page to learn more or check this database intuitive food dietitians in your area.
