Saul Marcus, ND - Naturopathic Doctor

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15. Blood sugar, estrogen and hormonal balance

The thyroid and hormonal balance

Hormones are chemical messengers produced by one part of the body to tell some other part what to do. Thyroid hormone, is just one of many others including insulin, cortisol, estrogen, progesterone and testosterone. There are many other hormones, but these are amongst the most important.

Usually, we only think of one hormone at a time. Thyroid symptoms indicate a thyroid problem. Blood sugar symptoms means there is an insulin problem. Symptoms around sexual function indicate a sex hormone problem. And high stress means a cortisol problem. This simple model may help medical students learn about hormones, and is good for books that convince you that if just your thyroid hormone, or if just your testosterone was normalized, you would feel fine, but the hormonal system really does not work like this.

In real life each these four systems affects the other three in a complex balance game. Basically, when one hormone goes up, another goes down to compensate. This continues until a patient becomes so sick, that almost all of these hormones go down.

insulin, cortisol, estrogen, protesterone, testosterone and thyroid hormone are all in balance.

The pancreas, insulin and blood sugar

Junk food, or foods high in sugar stimulate the pancreas to release insulin. Insulin's job is to lower blood sugar, by moving it into cells to be used for energy, or stored for later use. We store sugar for energy in two ways. Sugar can be converted to fat, or in the liver as glycogen. Fat is a long term energy reserve. Glycogen is more easily used, and is the first place we our body goes for energy when we have not eaten for a few hours. [84]

Cortisol is insulin's counterpart. Among many other functions, cortisol takes sugar stored in the liver (glycogen) and puts it into the blood stream. To keep things simple, insulin lowers blood sugar, and cortisol raises blood sugar.

This is what may sound confusing at first. When insulin goes up to lower blood sugar, cortisol goes up as well. It may sound odd. Why would the body raise cortisol, which increases blood sugar, at the same time insulin is going up to lower blood sugar?

The answer is in the very complex way the body precisely regulates itself. Too much insulin will lower blood sugar too much. This is called hypoglycemia (low blood sugar) . So when insulin goes up, cortisol goes up a little also. This is not to raise blood sugar, but to make sure insulin does not drop blood sugar too much.

As reviewed in section 14, high cortisol decreases thyroid hormone. In a healthy diet, the moderate ups and downs of cortisol as it helps regulate blood sugar is not going to effect thyroid function. However, high carb, high sugar diets send insulin and blood sugar surging up and down all day. This affects both cortisol and ultimately thyroid hormone as well. [85]

Therefore, as part of normalizing thyroid hormone function naturally, it's essential to have a good diet and keep blood sugar in an acceptable range.

The sex hormones

The three most well known sex hormone are estrogen, progesterone, and testosterone. Although we often think that estrogen and progesterone are female hormones and testosterone is a male hormone, women and men have both.

Of these three hormones, it is estrogen that has a profound effect on thyroid hormone. Estrogen is carried in the blood by a protein called "sex hormone binding globulin." Higher levels of estrogen will increase binding protein and this is associated with less active thyroid hormone. [86]

Excessive levels of estrogens in women and men are epidemic in our society.

Three common causes of high estrogens are:

1) Xeno-estrogens. Many synthetic chemicals, (especially plastics) mimic estrogen. These synthetic xeno-estorgens are much more powerful than the estrogen made in the body, and there are currently no tests for them. The best way to eliminate xeno-estrogens is to avoid them, by reducing exposure to toxins, and never heating food in plastic. Plastics are full of these compounds, which when heated, will leak into food.

2) Poor liver function. If the liver is sluggish, and unable to get detoxify estrogens out of the body, estrogens will accumulate. This is true for both estrogens made by our own body (endogenous estrogens) and estrogens we have made outside of our bodies (xeno-estrogens).

3) Weight gain. Fat cells have an enzymes called aromatase. Aromatase converts testosterone into estrogen. Therefore, obesity can contribute to high estrogen, low thyroid hormone and low testosterone.


Sleep deprivation has been shown to decrease T4 and T3, but not TSH. Therefore, sleep problems may contribute to symptoms of hypothyroidism, yet not change TSH labs. [88]

There are various reasons why people don't sleep well, but one major reason is related to stress and cortisol. Normally cortisol is highest in the morning, and goes down during the day until it's lowest point when we go to bed. Under high stress cortisol may remain high until the evening, preventing sleep.

Long term stress may cause insomnia through a slightly different way. Often people are tired all day long, get energy at night, or wake about 2-3AM. Instead of having high cortisol all day long, they have a deregulation of cortisol. It is too low during the day making them tired, but goes up late or night, preventing them from sleeping. This kind of insomnia can be helped by taking supplements during that day that help raise cortisol, and supplements at night that keep cortisol down. In my practice I use seri-phos (phosphoralated serine) to help people sleep if their cortisol is too high. The supplement phosphatidyl serine can also help as well, but is unfortunately very expensive.

in addition to taking supplements for sleep, it's important to look at the diet, lifestyle and the overall hormonal picture to get to the root cause of the problem. Is insomnia caused by cortisol deregulation, anxiety, neurotransmitter imbalance or something else. And depending on what is causing insomnia some supplements are going to work and others wont.