Hormones Down?

May 11, 2011 No Comments by Scott Isaacs MD

Hormonal balance means that the body is functioning at its best.  But what can happen if this balance gets off track?  Having a hormone problem means that your hormones are too high, too low or just don’t work right.

The most common type of hormone problem is low hormone levels.  When hormone levels are low, there can be a multitude of symptoms, depending on which hormone is low.  Low thyroid hormone, called hypothyroidism, affects about 23 million Americans.  The word “hypo” means low, or not enough.  The word “hyper” means high or too much.  (So, hyperthyroidism means too much thyroid hormone.)

As an endocrinologist, I see patients with low thyroid hormone levels frequently.  It is one of the most common hormonal problems.  There are so many symptoms you can experience as a result of the low hormone levels, like gaining weight, feeling cold or having dry skin.  There are many other symptoms as well, but the point is that because thyroid hormone is responsible for the general functioning of the body, having low thyroid hormone levels means a general slowing down of the body’s function.  Metabolism slows, leading to feeling tired and gaining weight.  The body’s engine does not burn as hot, making you feel cold.  The heart slows down causing a slow heart beat.  The bowels slow down causing constipation.  The brain slows down causing memory loss and slow thinking.  The good news is that hypothyroidism is easy to fix.  You can take thyroid hormone in pill form, replacing the body’s deficiency, restoring normal body functions.

One hundred years ago, this simple “cure” with an easy to take pill was considered a medical breakthrough, saving millions of lives.  Today, we take it for granted, but I like to take a step back to appreciate the miracle of this cure, in just a simple pill.  Originally, thyroid hormone replacement came from ground up animal thyroid glands.  It was a simple, but innovative discovery.  Today, ground thyroid glands are still used as a form of thyroid hormone replacement, although the majority of patients with hypothyroidism take a synthetic form of the hormone known as levothyroxine, which is sold under the brand names Synthroid, Levoxyl or Levothyroid.

Another hormone that can go low is insulin.  Insulin is necessary for proper blood sugar levels, and when insulin is low, blood sugar rises—the result is diabetes.  In fact, low insulin levels cause a particular type of diabetes known as “type 1 diabetes” or “insulin dependent diabetes.”  (Type 2 diabetes is caused by resistance to insulin, insulin not working properly, which I will talk about in a later article.)  Fixing insulin deficiency is the same as the thyroid, people with type 1 diabetes take shots of insulin to replace the deficiency.  And, just like thyroid hormones, originally insulin came from animal glands.  Today, most insulin is synthetic, made in a factory, but it works the same as naturally-produced human insulin.

Another example of a hormone deficiency is menopause, a naturally process that occurs in all women.  In menopause, the ovaries gradually make less and less of the hormone estrogen.  Interestingly, some women experience terrible symptoms of menopause like hot flashes and mood swings where other women have no symptoms.  Endocrinologists are still trying to figure out why this happens.  Women who have severe symptoms of estrogen deficiency take estrogen replacement to restore their levels to that of a younger woman.  Unlike replacing thyroid hormone for hypothyroidism or insulin for diabetes, taking estrogen in menopause is usually done as temporary solution.  This is because endocrinologists believe that having lower estrogen in menopause is natural, and raising estrogen levels in the older woman to be like that of a younger woman is unnatural and can lead to problems down the road like breast cancer or blood clots.

So having low hormones is not always that simple.  Most of the time, low hormones are treated with hormone replacement, but in some cases, leaving the hormones low is your best bet.


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