The Hormone Symphony...

Dr. Shannon Evans, DO, IFMCP • February 15, 2020

Is Hormonal Imbalance a Cause of Your Symptoms?

Did you know that your adrenal health affects your thyroid health and sex hormones?


First of all, hormones are the body’s chemical messengers that travel through the blood stream to tissues and organs. Hormones affect may different processes in the body: metabolism, sexual function, mood, reproduction, growth & development.

Hormones are produced by the endocrine glands. Adrenals, thyroid, testes and ovaries are some of the endocrine glands.

Only a small amount of hormones are needed to cause a big change in your cells and your entire body! This is why it is so important to have all your hormones in balance. Too little or too much of a hormone can be very troublesome!


Let’s talk about the Adrenals…

These small triangle shaped glands are located on top of both kidneys. They are composed of two parts: cortex & medulla. The adrenals produce certain hormones that are important to help with regulation in the body’s metabolism, sleep/wake cycle, stress response and so much more!

Cortisol is one important hormone produced by the adrenals. Cortisol helps control the sleep/wake cycle and the body’s use of carbs, fats & protein. It also regulates blood pressure, increases blood sugar and can decrease bone formation. In individuals with healthy adrenals, cortisol is highest when the body wakes up and lowest at bedtime. Cortisol is also released during times of stress to help increase energy and handle emergency situations. For instance, if you are hiking in the woods and come across an angry bear, your cortisol should increase causing you to have more energy to get the heck out of dodge!

In this stressful world, most people are in constant stress mode causing the adrenals to work overtime. When individuals are constantly stressed, it wears down their adrenals and can cause adrenal dysfunction. It is important to let our bodies relax, rest and take a break!

DHEA is another important hormone produced by the adrenals. The ovaries and testes also produce a small amount. DHEA is the highest circulating steroid present in the body. On its own, DHEA is not biologically active. It can be converted into active hormones such as testosterone and estradiol. DHEA is an important source of estrogen for postmenopausal females. Production of DHEA increases from age 10, peaks during the 20s and slows down as the body ages. Studies show that low DHEA in males causes a decreased life span. Studies in females with low DHEA shows a low sex drive and osteoporosis.


How Do You Support Adrenal Health?


  • Self care! Eating a healthy, clean diet! Relaxing, resting and taking time for movement.
  • Eating foods with supportive nutrients:
      • B vitamins (co-factors for hormone production): B5, B6, Biotin & Folate: Proteins (fish, poultry, eggs, dairy products), leafy green veggies (spinach), beans & peas
      • Vitamin C: Broccoli, brussel sprouts, cauliflower, leafy greens, sweet potatoes, citrus fruits, berries
      • Magnesium: Almonds, spinach, cashews, peanuts, soy, black beans, avocados
      • Omega 3 fatty acids: Cold water fish (salmon, mackerel, tuna, herring, sardines), flaxseed, chia seed, walnuts
      • Zinc: Oysters, beef, crab & pork


What are some symptoms of Adrenal Dysfunction or Imbalance? Depending on whether the cortisol is too high or too low, individuals will experience different symptoms:


  • Low or high blood pressure
  • Difficultly falling asleep, staying asleep, or waking up
  • Trouble controlling blood sugar, either too low or too high
  • Fatigue
  • Feeling wired
  • Irritable



Let’s move onto the Thyroid…

The thyroid is a small butterfly-shaped gland located at the base of the neck. It maybe small, but it is vital to the body’s overall health and plays a huge role in how the body functions! The thyroid influences the function of the sex hormones, heart, brain, liver, kidneys, skin and gut to name a few…

How does the thyroid influence an individual’s cells, organs & body? It makes thyroid hormones. In order to make thyroid hormones, the thyroid needs nutrients. The thyroid mostly produces a hormone called T4 (thyroxine) and a small amount of T3 (triiodothyronine) that is made up of iodine and tyrosine (amino acid). T4 contains four iodine atoms and T3 contains three iodine atoms. The body mostly recognizes T3. So T4 needs to be converted to T3—which this conversion happens outside of the thyroid.

Some factors that can inhibit hormone production: stress, infection, trauma, radiation, medications, fluoride (antagonist to iodine), toxins (pesticides, mercury, cadmium & lead), and autoimmune disease.


How Does Adrenal Health Affect Thyroid Health?


  • Cortisol slows thyroid hormone production—too much stress, can cause too much cortisol release, leading to less thyroid hormones.
  • Prolonged elevation in cortisol can cause excessive estrogen, which can make the thyroid hormones the body has inactive (the thyroid hormones stay bound to thyroid-binding globulin, so the thyroid hormones are not free to bind to the cells in the body to activate the body’s cells)
  • Chronic stress causes inflammation, which can make the body’s immune system overactive & trigger autoimmune responses. An example of this is when the body’s immune system over reacts and starts making antibodies towards the thyroid gland.


How to Support Thyroid Health…


  • Support Adrenal Health!
  • Decrease exposures to toxins
  • Have a daily detox routine
  • Get rid of inflammation!
  • Make Gut Health a priority
  • Regular, enjoyable movement (this is also important for adrenal health)


Supportive Nutrients for Thyroid Health:


  • Iron: Oysters, white beans, dark chocolate, beef liver, spinach
  • Iodine: Seaweed, fish (cod or tuna), seafood
          • Iodine is very controversial to recommend, especially in hypothyroid patients. Here is my opinion on iodine: Iodine is essential to synthesize thyroid hormones. If you remember above, there are four iodine atoms in T4 and 3 iodine atoms in T3. Your body needs iodine in order to make thyroid hormones. Now everything needs to be in balance. So too much iodine or too little is a problem. I recommend, if you are going to supplement with iodine, check your iodine level first to see where you are at. The recommended standard for checking an iodine level is a 24 hour urine test—this can be a little difficult to accomplish for some individuals. If not able to obtain a 24 hour urine iodine level, check a one time urine test or perform a blood test.
  • Tyrosine: Eggs, fish, meats & beans
  • Zinc: Oysters, beef, crab
  • Selenium: Brazil nuts, fish (halibut, sardines, tuna), beef, turkey, chicken, rice, eggs
  • Vitamin A: Liver, fish oils, sweet potato with skins, spinach, carrots, broccoli
  • Vitamin D: The best source of Vitamin D is the sun! Foods containing vitamin D: cod liver oil, swordfish, salmon
          • Recommend every individual check their vitamin D level yearly. If vitamin D levels are too low or too high, an individual may need to check vitamin D levels more often. Most individuals need to supplement with vitamin D. If you live in a place that is colder during the winter and you are not spending much time outside or are covered up—individuals may need more vitamin D supplementation during the winter months. The only way to know is to check lab work!
  • Vitamin C: As mentioned above—broccoli, brussel sprouts, cauliflower, leafy greens, sweet potatoes, citrus fruits, berries
  • Vitamin E: Wheat germ oil, sunflower seeds, almonds, peanuts, beet greens, spinach, pumpkin, mango, avocado
  • Vitamin B2 (Riboflavin): Clams, salmon, chicken breast, beef liver
  • Vitamin B3 (Niacin): Beef liver, chicken breast, salmon
  • Vitamin B6: Chickpeas, beef liver, chicken breast, salmon


Supportive Nutrients for Hypothyroid (low thyroid) individuals:


  • Selenium 200-400 mcg daily
  • Zinc 15-30 mg daily
  • Vitamin D 2000 IU daily (Maybe more depending on the individual’s blood work)
  • Vitamin A 2000 IU daily
  • Iodine 150 mcg daily (Always important to evaluate baseline iodine level)
  • Iron 15-20 mg daily for menstruating females (Important to evaluate iron level with blood work)
  • It is important to talk with your doctor to see what supplements are right for you!


Symptoms of Thyroid Imbalance… There are so many symptoms that are tied to thyroid imbalance since thyroid health plays so many important roles for our overall wellbeing! Here are a few of the most common symptoms:


  • Fatigue
  • Constipation
  • Joint pain
  • Depression
  • Anxiety
  • Changes in skin
  • Brain fog



What about Sex Hormones?

Sex hormone production is controlled by the Hypothalamus-Pituitary-Gonadal (HPG) axis. The hypothalamus signals the pituitary and then the pituitary signals the testes and ovaries to produce sex hormones.


Let’s focus on Testosterone, Estrogens & Progesterone:

Testosterone: Can be produced by testes, adrenals & ovaries. Important for expression & maintenance of male sexual characteristics; sex drive in both males & females; metabolism & muscle mass. Testosterone can be sent down a different pathway to form estrogens.

Estrogen: Produced in the ovaries. Conversion of androgens (such as testosterone) to estrogen can occur in fat cells, bone & testes. Estrogen is important for development & maintenance of female sexual characteristics; energy balance, metabolism and prevents bone loss.

Progesterone: Produced in ovaries & adrenals. Has several important roles in the female reproductive cycle.



Thyroid & Sex Hormones…

The thyroid and sex hormones are always in communication. Both the thyroid and sex hormones are influenced by each other. So, if one system is dysfunctional, it will cause the other system to be dysfunctional.


  • Estradiol (estrogen): lowers the effectiveness of the thyroid hormone in the body (keeps the thyroid hormones in an inactive state)
  • Testosterone increases the effectiveness of thyroid hormone in the body to keep it readily available for use—this is one reason why testosterone is important for metabolism.


Adrenals & Sex Hormones…

Cortisol (which is produced by the adrenals) blocks the production of estrogen & testosterone. Cortisol also blocks the estrogen and testosterone that is already in circulation from binding to an individual’s cells. So, if an individual is constantly stressed and producing lots of cortisol, then the individual’s body is not able to make sex hormones or use the sex hormones it previously made!


Symptoms of Imbalanced Hormones…

Estrogen Dominant Symptoms: breast tenderness, fibrocystic changes, heavy periods, fat distribution in hips or thighs, anxiety, fibroids, endometriosis or symptoms suggestive of endometriosis and painful periods.

Lack of progesterone or imbalance between estrogen & progesterone: oral contraceptive use, anxiety, PCOs (polycystic ovarian syndrome), anxiety, hormone replacement of estrogen only, spotting before & after periods.

Testosterone Imbalance: acne, anger or aggressiveness, change in sex drive, hair growth or hair loss, and loss of muscle mass.


Helpful Foods for Hormone Balance:


  • Protein
  • Healthy fats
  • Vegetables & fruit. Rainbow of colors daily with goal of 10-13 (1/2 is one serving) servings per day. Heavy on the vegetables!
  • Organic, non-processed foods (certain herbicides & pesticides studied have shown to be endocrine disruptors & also cause inflammation)
  • Filtered water (especially if you have thyroid issues obtain filter that also filters out fluoride in drinking, cooking and bathing water)
  • Stay away from foods that cause you inflammation!


Foods that are NOT helpful for Hormone Balance:


  • Pesticide/herbicide ridden food
  • Inflammatory foods with lots of chemicals, additives & dyes
  • Soda
  • Caffeine
  • Alcohol



The Hormone Symphony: It becomes a master piece when all the different players (hormones, endocrine system, body) work together and have the right balance—not too much or not too little of anything!

If anything is out of balance, it can negatively affect the rest of the body, since the body works together as a whole, not separately!

In summary, to have a hormone symphony, instead of a hormone disaster, it is essential to have the proper nutrients, a healthy gut, a liver that is happy & at full speed on detoxing. It is also important to have a happy and balanced immune system with well functioning adrenals, thyroid and sex hormones that are working together.



Do you have symptoms of hormone imbalance and feel like your body needs help getting to optimal health? At New Beginnings Functional Medicine Clinic , Dr. Shannon Evans, DO, IFMCP is passionate about empowering, educating and partnering with patients to get to their optimal health! Call 970-305-0101 or email Staff@NewBeginningsFMC.com to schedule a complimentary 15 minute consult with Sara to see how Functional Medicine can get you to your optimal health!





References:

https://www.hsph.harvard.edu/nutritionsource/vitamin-e/

https://medlineplus.gov/hormones.html

https: ods.od.nih.gov/factsheet/Iron-HealthProfessional/

https://www.webmd.com/vitamins/ai/ingredientmono-1037/tyrosine

https://www.pathophys.org/sexhormones/

https://ods.nih.gov/factsheets/VitaminA-HealthProfessional/

https://ods.od.nih.gov/factsheets/Riboflavin-HealthProfessional/

https://www.hopkinsmedicine.org/health/conditions-and-diseases/adrenal-glands

https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/dehydroepiandrosterone-dhea

https://medlineplus.gov/bvitamins.html

https://medlineplus.gov/ency/article/002404.htm

ifm.org

https://ods.nih.gov/factsheets/Magnesium-HealthProfessional/

https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer/

https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120618/

Https://www.endocrinologyadvisor.com/home/decision-support-in-medicine/endocrinology-metabolism/effe...


By Dr. Shannon Evans, DO, IFMCP June 13, 2025
I am sure you know that diabetics pay close attention to their blood sugar or blood glucose levels. In my opinion, I think everyone should know if their blood sugar is balanced or not! First off, let’s talk about what your blood sugar level is: A blood sugar level or otherwise known as blood glucose is the amount of sugar or glucose in your blood. Sugar comes from carbohydrates in food and drinks you put into your body. Sugar or glucose is your body’s main source of energy. Your blood can carry sugar all over your body. Your liver can also release stored glucose, if your body needs some energy. How does your liver get glucose? Your liver can get the glucose you ate from your gut, specifically your intestines and then stores it. Your liver does so many important things and this is just one of many! What are the benefits to having a continuously balanced blood sugar level? •Great way to help with optimizing your health and healing your body! •Steady energy throughout the day. •Better focus and memory •Stable mood •Better sleep •Hormone balance including adrenals, thyroid and sex hormones •Stress resilience •Nervous system more balanced and less likely to be stuck in fight or flight mode •Organs functioning optimally •Optimal metabolism •Less inflammation •Improved immune function •Better resilience Testing to find out about your blood sugar level: 1- Finger stick test . You get a drop of blood from your finger, put the drop of blood on a test strip, then put the test strip in the glucose meter and within seconds you find out what your blood glucose is at that current point in time. 2- Lab draw taken from your vein . This also tells you at the current time what your blood sugar level is. This is more accurate than a finger stick test. 3- Hemoglobin A1c test . This can be obtained with a lab draw or finger stick test. This tells you what your average sugar level is for a 3 month period. What we are looking for with this test is how much sugar is hanging off of your red blood cells and this will give you a clue about your average sugar level for a 3 month period. For the typical person, your red blood cells last a total of 3 months in your body. 4- Continuous glucose monitor . You wear a sensor this is usually placed on the back of your arm for ~10-14 days to continuously measure your sugar level 24/7 using an app on your phone or a reader. What are the drawbacks to each test: 1-Finger stick test is not always accurate and is only giving you a one time snap shot of what your sugar level is doing currently. 2-Lab draw is pretty accurate but is also only giving you a one time snap shot of what your sugar level is doing currently. 3-Hemoglobin A1c test. It sounds like a great test because you are getting info about a three month period. But the problem is, you are getting the average, you are not seeing if there are highs or lows. 4-CGM (continuous glucose monitor). Not always accurate. Sensors sometimes malfunction. Certain things can throw off the readings such as going thru a metal detector, laying on your arm that has the sensor or being in a hot environment like a sauna, hot tub or bath. What is the best way to see if your blood sugar level is balanced? With the technology that is currently available, I am a big fan of continuous glucose monitors . This is a way we can get the most thorough data about what your sugar level is doing 24/7 for 10-14 days. You will be able to see if your blood sugar is actually balanced 24/7. This means you don’t want to see ups and downs. You want your blood sugar to be balanced—as close to a straight line as possible 24/7. You will also be able to see if certain foods raise your blood sugar. Guess what? In conventional medicine there is a list of foods that are suppose to increase your sugar level. What I have found partnering with patients and looking at their data from their CGMs is that every one is unique and an individual and responds differently to different foods. You will find out what foods increase your blood sugar levels. You will also be able to see how your body responds to simple and complex carbohydrates. For a lot of people, if you don’t have protein and some fat before eating carbs, this can also raise your blood sugar level and put your sugar level out of balance. The amount of carbs also matter. Some people can get away with eating more carbs than others. You will also get the answer about how much your body likes in terms of carbs. You will also get to see if you have any symptoms or your body feels a certain way, if you have low blood sugars or high blood sugars. In conventional medicine, there is a list of symptoms for low and a certain list of symptoms for high blood sugars—but guess what? You are an individual and unique, so your symptoms maybe different than what the “typical symptoms” are. If your body feels stressed, this also affects your blood sugar level. So if you get stressed or angry at someone, you will likely see your blood sugar level increase. If you are exercising too hard and it is too stressful on your body, you can also see an elevation in your sugar level. You may also not feel when you are high or low. What does having a balanced blood sugar look like based on the numbers? Conventional Medicine has outlined what the criteria is for blood sugar numbers that are in prediabetic range or diabetic range, which is helpful. My goal for you is to work towards optimal range for blood sugar levels and have a balanced blood sugar level 24/7, so your body can work optimal! Here is what I have found to be the best ranges for an optimal blood sugar level after working with patients over the years: Fasting blood sugar: 80’s to mid 90’s mg/dL. For some individuals, mid 70’s is optimal. After eating blood sugar or post prandial blood sugar level: I have found that the most optimized patients with a balanced blood sugar level increase their blood sugar no more than 10 mg/dL from their pre-meal blood sugar level. It is okay to have blood sugar level highest before bed even up to 100, since you will not be eating all night and don’t want your blood sugar level plummeting while sleeping. Studies are currently being conducted to figure out what the optimal levels of blood glucose levels should be. It has only been in the last few years that continuous glucose monitors have been available for non-diabetic patients, so as we learn more and continue to conduct more studies, eventually we will have better evidence and wisdom. What the current studies are showing is that optimal levels for fasting blood glucose should be less than 110 mg/dL and after eating the blood sugar should not increase more than 30 mg/dL from pre-meal blood sugar level. Just like everything in life, you don’t want too little or too much when it comes to your blood sugar level—you want it in balance! Are you concerned about your health or a loved one's health and not sure where to begin? Schedule a FREE 15 minute strategy call with New Beginnings. Schedule online or call 970-305-0101. References: https://my.clevelandclinic.org/health/diagnostics/12363-blood-glucose-test https://pmc.ncbi.nlm.nih.gov/articles/PMC5293555/ https://www.ncbi.nlm.nih.gov/books/NBK555976/ https://www.levels.com/blog/what-should-my-glucose-levels-be-ultimate-guide
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Dr. Shannon's Blog

By Dr. Shannon Evans, DO, IFMCP June 13, 2025
I am sure you know that diabetics pay close attention to their blood sugar or blood glucose levels. In my opinion, I think everyone should know if their blood sugar is balanced or not! First off, let’s talk about what your blood sugar level is: A blood sugar level or otherwise known as blood glucose is the amount of sugar or glucose in your blood. Sugar comes from carbohydrates in food and drinks you put into your body. Sugar or glucose is your body’s main source of energy. Your blood can carry sugar all over your body. Your liver can also release stored glucose, if your body needs some energy. How does your liver get glucose? Your liver can get the glucose you ate from your gut, specifically your intestines and then stores it. Your liver does so many important things and this is just one of many! What are the benefits to having a continuously balanced blood sugar level? •Great way to help with optimizing your health and healing your body! •Steady energy throughout the day. •Better focus and memory •Stable mood •Better sleep •Hormone balance including adrenals, thyroid and sex hormones •Stress resilience •Nervous system more balanced and less likely to be stuck in fight or flight mode •Organs functioning optimally •Optimal metabolism •Less inflammation •Improved immune function •Better resilience Testing to find out about your blood sugar level: 1- Finger stick test . You get a drop of blood from your finger, put the drop of blood on a test strip, then put the test strip in the glucose meter and within seconds you find out what your blood glucose is at that current point in time. 2- Lab draw taken from your vein . This also tells you at the current time what your blood sugar level is. This is more accurate than a finger stick test. 3- Hemoglobin A1c test . This can be obtained with a lab draw or finger stick test. This tells you what your average sugar level is for a 3 month period. What we are looking for with this test is how much sugar is hanging off of your red blood cells and this will give you a clue about your average sugar level for a 3 month period. For the typical person, your red blood cells last a total of 3 months in your body. 4- Continuous glucose monitor . You wear a sensor this is usually placed on the back of your arm for ~10-14 days to continuously measure your sugar level 24/7 using an app on your phone or a reader. What are the drawbacks to each test: 1-Finger stick test is not always accurate and is only giving you a one time snap shot of what your sugar level is doing currently. 2-Lab draw is pretty accurate but is also only giving you a one time snap shot of what your sugar level is doing currently. 3-Hemoglobin A1c test. It sounds like a great test because you are getting info about a three month period. But the problem is, you are getting the average, you are not seeing if there are highs or lows. 4-CGM (continuous glucose monitor). Not always accurate. Sensors sometimes malfunction. Certain things can throw off the readings such as going thru a metal detector, laying on your arm that has the sensor or being in a hot environment like a sauna, hot tub or bath. What is the best way to see if your blood sugar level is balanced? With the technology that is currently available, I am a big fan of continuous glucose monitors . This is a way we can get the most thorough data about what your sugar level is doing 24/7 for 10-14 days. You will be able to see if your blood sugar is actually balanced 24/7. This means you don’t want to see ups and downs. You want your blood sugar to be balanced—as close to a straight line as possible 24/7. You will also be able to see if certain foods raise your blood sugar. Guess what? In conventional medicine there is a list of foods that are suppose to increase your sugar level. What I have found partnering with patients and looking at their data from their CGMs is that every one is unique and an individual and responds differently to different foods. You will find out what foods increase your blood sugar levels. You will also be able to see how your body responds to simple and complex carbohydrates. For a lot of people, if you don’t have protein and some fat before eating carbs, this can also raise your blood sugar level and put your sugar level out of balance. The amount of carbs also matter. Some people can get away with eating more carbs than others. You will also get the answer about how much your body likes in terms of carbs. You will also get to see if you have any symptoms or your body feels a certain way, if you have low blood sugars or high blood sugars. In conventional medicine, there is a list of symptoms for low and a certain list of symptoms for high blood sugars—but guess what? You are an individual and unique, so your symptoms maybe different than what the “typical symptoms” are. If your body feels stressed, this also affects your blood sugar level. So if you get stressed or angry at someone, you will likely see your blood sugar level increase. If you are exercising too hard and it is too stressful on your body, you can also see an elevation in your sugar level. You may also not feel when you are high or low. What does having a balanced blood sugar look like based on the numbers? Conventional Medicine has outlined what the criteria is for blood sugar numbers that are in prediabetic range or diabetic range, which is helpful. My goal for you is to work towards optimal range for blood sugar levels and have a balanced blood sugar level 24/7, so your body can work optimal! Here is what I have found to be the best ranges for an optimal blood sugar level after working with patients over the years: Fasting blood sugar: 80’s to mid 90’s mg/dL. For some individuals, mid 70’s is optimal. After eating blood sugar or post prandial blood sugar level: I have found that the most optimized patients with a balanced blood sugar level increase their blood sugar no more than 10 mg/dL from their pre-meal blood sugar level. It is okay to have blood sugar level highest before bed even up to 100, since you will not be eating all night and don’t want your blood sugar level plummeting while sleeping. Studies are currently being conducted to figure out what the optimal levels of blood glucose levels should be. It has only been in the last few years that continuous glucose monitors have been available for non-diabetic patients, so as we learn more and continue to conduct more studies, eventually we will have better evidence and wisdom. What the current studies are showing is that optimal levels for fasting blood glucose should be less than 110 mg/dL and after eating the blood sugar should not increase more than 30 mg/dL from pre-meal blood sugar level. Just like everything in life, you don’t want too little or too much when it comes to your blood sugar level—you want it in balance! Are you concerned about your health or a loved one's health and not sure where to begin? Schedule a FREE 15 minute strategy call with New Beginnings. Schedule online or call 970-305-0101. References: https://my.clevelandclinic.org/health/diagnostics/12363-blood-glucose-test https://pmc.ncbi.nlm.nih.gov/articles/PMC5293555/ https://www.ncbi.nlm.nih.gov/books/NBK555976/ https://www.levels.com/blog/what-should-my-glucose-levels-be-ultimate-guide
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