This is a continuation of a previous post. You can read the first half here.
The Body’s Prioritization System
Your body is smart. It constantly has to make decisions and tradeoffs based on priorities. The body will always prioritize keeping you alive today. And thank goodness it does: our body can kick in with adrenaline and cortisol (stress hormones) when it needs to so we can survive. Historically, this would only have happened occasionally for very short periods of time, specifically emergency situations, like being chased by a giant moose. In our modern lifestyle, we are chronically stressed. It may be from high sugar intake, which taxes the adrenals, or food sensitivities, or toxic exposure, or psychological stress from grief. This is where problems start to happen: chronic stress throws off the delicate hormone orchestra. Through a series of pathways, stress inhibits reproductive function.
The Pregnenolone Steal
To understand how the orchestra can get out of harmony, we need to look at a concept called the “pregnenolone steal”, a chronic stress response within the body. Our adrenal glands make a lot of stress and sex hormones: DHEA, cortisol, aldosterone, testosterone, estrogens, and progesterone. These all come from a precursor called pregnenolone, which itself comes from cholesterol. (A lot of terminology here, but stick with me!) When the body is stressed, the hypothalamus (the hormone regulating “general” in the brain) tells the adrenal glands to keep making cortisol – and a lot of it. The body has to get these building blocks from somewhere, so it starts “stealing” nutrients that would be used to build other essential hormones! Instead of converting the pregnenolone into all of those stress and sex hormones above, the body uses it to make just cortisol.
Your body isn’t wrong! It’s trying to keep you alive. Cortisol isn’t in itself bad: it actually has anti-inflammatory properties. But over time, chronic, high levels of cortisol from an ongoing stress response lead to a lot of problems. It is the balance that matters.
The Effects of Ongoing Stress
Chronic elevated cortisol can lead to insulin resistance (IR). IR is when the cells no longer “listen” to the message of insulin telling them to take in glucose. The pancreas then has to work harder to produce even MORE insulin, effectively giving the message “louder.” When the liver becomes overloaded with toxins, it can’t conjugate excess hormones for elimination (think of it like bagging up the garbage to be taken away by the garbage truck), so we get a buildup of excess hormones. The adrenals get stressed out having to produce so much cortisol. The imbalance of hormones can lead to all kinds of problems: estrogen dominance in men and women (uterine and ovarian cancers, cysts and fibroids), high androgens in women (PCOS), thyroid metabolism defects, adrenal exhaustion, and on and on. Because the endocrine system is a delicate system, imbalances often manifest as infertility. But, by managing our body’s stress response as part of a foundational approach with nutritional therapy, we can bring balance back to the hormones and restore our fertility.
Figuring Out What Your Stressors Are
The sooner you can identify and then remove or mitigate the stressors in your life, the sooner you can bring balance to your hormones and restore your fertility. Here are some major stressors (many may surprise you!):
- Refined sugars and a high glycemic diet (this is the biggest one!)
- Coffee and other stimulants
- Stressful life situations: the grief and stress of TTC (trying to conceive), a job you hate, the morning commute
- Digestive compromises (leaky gut, infection, food allergies/intolerances)
- Nutritional weaknesses (lacking in nutrients necessary for function)
- Disease/other pathologies
How to Remove or Mitigate These Stressors
Making changes to the foundational aspects of health, plus implementing some lifestyle changes, can make a world of difference.
- Reduce sugar intake (even natural sugar): We talked a bit about this in Part 1. Doing a sugar detox is one of the best ways to do a reset and teach your body to use fat as its main fuel source (which it prefers doing). Reducing sugar intake is the best way to give your adrenals, pancreas and liver a well-deserved break. Don’t drink juice! Natural sugar is still sugar.
- Eat enough of the right kinds of food: Limiting calories can be viewed by the body as a stress response. Make sure you are getting plenty of good fats so you feel satisfied and satiated, and good quality animal proteins so your body can build good hormones. 1200 calories is NOT ENOUGH. Make sure you eat a properly prepared, nutrient-dense diet so you have all of the right nutrients for function.
- Get good sleep: Make sure you get at least 8 hours of sleep a night. Exposure to blue light tells your brain that it’s daytime and time to be awake. Limit bright light exposure (computer/phone screen) an hour before you go to bed, and purchase a pair of amber-tinted/blue-blocker glasses to wear in this time. This will help signal to your body that it’s time to make melatonin to make you sleepy. Getting good sleep is not optional. It is crucial.
- Exercise gently: Chronic cardio is not the answer here: running, doing the elliptical, and spin classes will all exacerbate the body’s stress response. Getting outside in the daylight early in the morning for a gentle walk will help you set your proper circadian rhythm. Yoga is wonderful for putting your body in “rest and digest” mode rather than “fight or flight.”
- Meditate: Implement a daily meditation, even if it’s only 5 minutes a day. Don’t worry if you don’t know how to meditate. The Calm and Headspace apps are excellent for guided meditation in different time blocks.
- Identify food allergies/intolerances: A 30 day elimination diet and reintroducing foods one by one, tracking how you feel with each one, is the best way to discover underlying food sensitivities. Lab tests are notoriously unreliable and test only one arm of the immune system at a time. The most common ones are grains (especially gluten-containing ones), dairy, eggs, corn, soy, nuts, and nightshades (the family of plants tomatoes, bell peppers, egg plant, and chilis belong to).
- Deal with chronic infections: If you suspect you might be dealing with a chronic infection, such as Candida (yeast), SIBO (small intestinal bacterial overgrowth), or parasites (much more common than you think!), work with a practitioner to sort this out.
- Reduce exposure to toxins: This is a huge topic that could fill another blog, but some basics are switching to more natural alternatives to home and body care, reducing EMF exposure (turn off wifi and set your phone to airplane mode at night), and be vigilant at fighting mold.
- Get tested for heavy metals: Genetic mutations such as MTHFR can mean the body can’t detox effectively, such as clearing heavy metals like mercury and lead. A buildup of these can lead to all kinds of problems and affect fertility. Work with a functional medicine practitioner who understands methylation pathways on this one.
The Problem with Hormone Replacement Therapy
If people have got a chronic stress response going on in the body, they probably have an imbalance of hormones in the body. The adrenals are tired overproducing cortisol to keep up with the demands required. The people might think they should add do some bio-identical hormone therapy so they can get a higher amount of the desired hormones that they want. The problem is that if the “pregnenolone steal” has been “plasticized” — that is, remembered by the body, like a trail used many many times through a forest, or a well-worn groove in a road — when those precursor hormones come in, the body says, “Great! More materials to make cortisol!” And this is exactly what we don’t want, for all the reasons outlined above. So, adding in hormones without first TESTING for hormone levels can actually have the exact opposite effect of what you want, or create a new problem.
- Giving hormones squelches the body’s natural HPT/PT (Hypothalamus/Pituitary) negative feedback loop that says, “Okay, that’s enough hormone; you can stop now.” The brain doesn’t see any need to produce any more on its own: that hormone is coming in exogenously anyway!
- Just like in insulin resistance where the cells no longer “listen” to the “message” of insulin, the body can begin to ignore the message of this new hormone, as well, which results in a symptoms of deficiency even when there’s an excess of the hormone in the body.
- Giving DHEA, progesterone and pregnenolone can exacerbate high cortisol levels.
- Giving testosterone to men can increase DHT and estrogen levels.
- Giving estrogen to women with insulin resistance can increase already high testosterone levels.
- DHEA, progesterone and pregnenolone can exacerbate high cortisol levels.
- Giving estrogen can exacerbate estrogen dominace, which is at the root of most female cancers, uterine and breast fibroids, and ovarian cysts.
Instead of band-aid solutions and symptom-chasing, it’s better to work on underlying causes and to restore hormone balance that way. Work from a foundational approach: getting a properly-prepared, nutrient dense diet, making sure digestion is good so we can absorb our nutrients, managing our blood sugar by reducing sugar intake and upping fat intake, getting the right kinds of fats, and making sure we’re adequately hydrated. A Nutritional Therapy Practitioner is skilled in helping you to address these foundations and build a prioritized plan based on your own bio-individuality. By doing this, you can work towards restore your own hormone balance, feel better, have clearer skin, better libido, and best of all, regain your fertility.