The Master Hormones
Many people think their adrenal, thyroid or sex hormones or other hormone imbalances are primary problems. I used to think this way but found hormone treatments to be of limited help and often harmful. Master hormones include insulin and neuro-transmitter stress hormones: ATP, serotonin, dopamine and norepinephrine/epinephrine. If overweight, master hormones include leptin, adeponectin and other treatable hormone problems. Occasionally, acetylcholine or GABA are significant problems as well.
The most important ones for most people are insulin, ATP, serotonin, dopamine and norepinephrine (but also leptin, adeponectin and others if overweight). These hormones regulate appetite, weight, glucose, the immune, circulatory, nervous, digestive, endocrine (hormonal) and many other systems and organs.
Think about the flight or flight sympathetic nervous system responses we read about. It’s a primary response, designed to release glucose (via insulin, glucagon and norepinephrine responses) and serotonin, dopamine, norepinephrine or epinephrine. Most authors and clinicians skip all this and recommend secondary hormone treatments based on faulty logical. Thyroid hormones, DHEA, cortisol or sex hormones are not primary responses and are controlled by the neurotransmitter stress hormones or affected by insulin and glucose levels (and leptin, adiponectin and others if overweight).
When neurotransmitters, particularly ATP, serotonin, dopamine and norepinephrine, are balanced due to daily stress, poor diet or other treatable problems, it potentially disrupts all other hormones until treated properly. When serotonin, dopamine or norepinephrine are not high enough, appetite increases, potentially leading to weight gain, leading to abnormal insulin, glucose and carbohydrate metabolism, which further disrupts serotonin, dopamine and norepinephrine which disrupts other hormones. When norepinephrine is not high enough or blocked, low glucose or insulin imbalances disrupt hormones and other neurotransmitters. This becomes an endless cycle that cannot be stopped with diabetic drugs, anti depressants, anti anxiety drugs or hormone treatments (in most cases).
40% or more of Type 2 diabetics experience hypoglycemia but don’t recognize the symptoms or their clinicians dismiss it and they become more blunted to the symptoms as their norepinephrine goes lower and lower over time, leading to silent complications. This commonly happens with many diabetic drugs, metformin and insulin. Most clinicians do not believe in hypoglycemia, unless the levels are so low to require hospitalization or emergency measures.
All obese patients have insulin resistance, as do many overweight people, with affects other master hormones, especially leptin and adiponectin. Many normal weight people have pre-diabetes or low glucose, which affects master and secondary sex hormones.
These cycles can be stopped with education, lifestyle changes, adjusting drugs and using specialized amino acid and other supplements. Drugs for depression and anxiety may deplete amino acids necessary for synthesis of neurotransmitters. We have treatment programs to educate you about abnormal insulin and glucose. We have programs to increase ATP, serotonin, dopamine, norepinephrine and other neurotransmitters.
Synthetic or “natural” hormone treatments tend over time to become ineffective, cause side effects or suppress the pituitary or hypothalamus, relieving symptoms but potentially causing silent progressive problems (unless tested and treated). Hormone treatments often deplete serotonin, dopamine or norepinephrine, rapidly (where the patient quickly notices anxiety, depression, weight gain or other symptoms) or silently and slowly (where the patient doesn’t realize it’s happening).
Standard glucose testing often does not diagnose insulin imbalances or misses pre diabetes. We do not encourage home glucose testing. It’s either done incorrectly, not provided to us for management, fooling patients and practitioners into complacency. A four hour glucose tolerance test in our office diagnoses and helps me manage insulin, glucose and carbohydrate metabolism to rebalance neurotransmitters and hormones. Home glucose testing is not shown to make a difference in preventing diabetic complications in most cases. If a patient wishes home testing, we can teach them how to do it properly.
Some of the biggest mistakes we see patients make are not doing insulin and glucose testing properly or not scheduling appointments to understand all this and give me time to formulate and adjust a treatment protocol. Sadly, we often see these patients struggle with unregulated hormones and/or progress silently into preventable treatable insulin and master hormones complications. Management of insulin and glucose is a life long skill best learned in appointments. We have a pre-diabetic, hypoglycemia and diabetic education program that covers lifestyle changes and treatments in a series of appointments.
Some of the biggest mistakes we see patients make is not scheduling follow up for neurotransmitter problems, trying to manage neurotransmitters themselves, not testing neurotransmitters when necessary or using the wrong labs. Neurotransmitter receptors on cells are like light switches, they are either turned off or turned on. You may not recognize the symptoms when the switch is turned off because neurotransmitter levels are not high enough. We have tried various labs and supplements but have only found one accurate lab. If you want to balance hormones, get your insulin and carbohydrate metabolism testing done and follow up. See me to get neurotransmitter levels balanced. If necessary, we can test leptin, adiponectin, adrenal hormones, sex hormones, etc. Blood tests are best, saliva tests are not accurate (yet) and urine tests are problematic.
David Overton, PA-C works at Natural Medicines & Family Practice in Lacey, providing integrated conventional and alternative care, under the supervision of Dr. Faiola, MD, ABFM. 360-357-8054.