Many doctors won’t test hormones because levels change on a daily basis. 

While that’s true – it’s also true that your other lab values change daily.

The secret to figuring out daily changing labs?

Get to know patterns. 

Hormone levels at certain times of the period cycle are well documented. 

Using that as your guide, you can assess where average levels are supposed to be and figure out where you stand in comparison.

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In the case of longer or shorter cycles every few months and missed periods things get tricky. 

This is where I have women looking at their cycles when they were regular (or more regular) and noting the correlation between period starts and moon cycles. 

It’s common for women to start or ovulate with full or new moon. 

You can easily look up the moon cycles and get a comparison to see where you stand. 

Using moon you can see your cycle even if your period isn’t coming regularly. 

Hormones shift patterns frequently in the 30-40’s. 

With spikes and drops in estrogens causing…

  • migraines (low estradiol)
  • breast tenderness, cramps, low back pain (elevated estrogen)
  • heavy periods (elevated estrogen + inflammation)
  • fatigue, weakness, dizziness (low estradiol)
  • brain fog (low estradiol)

At the same time cortisol rises, progesterone levels may be declining causing…

  • insomnia (cortisol/progesterone)
  • irritability, anger, easily frustrated feelings (progesterone)
  • abdominal weight gain (cortisol)

Sometimes testosterone spikes and drops with the estrogen…

  • fatigue (low testosterone)
  • acne (elevated testosterone)

Then at some point mid-40’s for some and into the 50’s for others the shift from ovarian hormone to adrenal hormone production occurs.

This full transition is when many experience the most intense hormone drop off symptoms – especially if the adrenal glands are taxed from long term stress.

Symptoms of low hormones…

  • vaginal dryness
  • fatigue
  • migraines
  • depression
  • lack of motivation
  • brain fog
  • muscle loss and strength decrease
  • cholesterol increases
  • blood sugar increases
  • thyroid slows
  • feeling that something isn’t right

While there are many overlapping symptoms it’s clear when the drop off of hormones happens. 

If a women is already taking bio-HRT (Hormone Replacement Therapy) it’s common to think hormone replacement has stopped working. 

More often than not women will come to me saying, “things have changed nothing is working anymore”.

It’s not that things aren’t working, it’s that the body has switched off ovarian production of hormones.

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While it’s a subtle process for some, for others it’s a drastic shift. 

Having support during this timeframe of life is important. 

Whether it’s a group of friends you can talk with to share your experiences, a doctor who gets what you’re going through or a supportive community. 

There are quite a few folks specializing in supporting women through hormone shifts and one of my favorites is Nicki Williams. 

I just released my podcast with Nicki last week – Ep 499 of The Health Fix Podcast where Nicki shares her experience and the title of her book coming out Oct 2024 – “Life After Menopause”. (click HERE to listen in)

The bottom line here is – the health of your adrenal glands matters as you get older. 

Adrenal glands are small glands that sit on top of your kidneys and they are in charge of…

  • electrolyte levels (sodium, potassium, chloride)
  • cortisol production (sugar, protein & fat metabolism)
  • adrenaline release (fight or flight/stress situations)
  • DHEA production (Testosterone & estrogen precursor hormone)

If the adrenals are receiving messages from the body that there’s constant or significant stress levels…

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…the following hormones will be altered…

  • Electrolytes – it’s common to see low sodium and chloride, in long term stress potassium will be low (elevated levels are seen in very acute stress situations)
  • Imbalances in cortisol production aka circadian rhythm imbalance – elevated cortisol in the evening night versus in the AM as it’s designed to be
  • Belly fat, difficulty burning fat, weight gain, muscle loss and insulin resistance are due to cortisol imbalances
  • DHEA-sulfate production declines the more taxed the adrenals become making it harder to make estrogen and testosterone naturally

It’s not uncommon for me to asses electrolytes, AM cortisol, DHEA-sulfate and hormones via blood and see elevation of markers in the late 30’s to early 40’s then a drop off of the numbers by late 40’s into the 50’s. 

This shift from higher to lower of these markers is what often indicates a full transition from ovarian hormone production to adrenal production. 

While this shift will happen naturally – you can support yourself over the years to make the transition smoother. 

Testing regularly will help you keep an eye on your transition.

  • Test the levels of electrolytes every 6 months and supplement with them as needed
  • Assess AM cortisol in blood between 6-8a and consider saliva testing to get an all day evaluation of cortisol levels
  • Have your blood sugar, hemoglobin a1c and fasting insulin checked every 6 months
  • Evaluate hormone levels day 19-26 of your cycle or consider a Mira continuous monitor for hormones during the month or saliva testing if you no longer have a cycle
  • Get a dried urine hormone evaluation like the DUTCH test at least once to know how you metabolize hormones 

Supporting your adrenal glands in every phase of your life will help you adapt to life’s stressors. 

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How do you support your adrenal glands?

Find an adaptogenic herb or formula that suits you.

  • Elevated DHEA-sulfate and/or cortisol with anxiety &/or insomnia –  Ashwagandha and Holy Basil Gaia Herbs.
  • Low DHEA-sulfate – DHEA supplementation 5-25 mg a day, Rhodiola (fatigue) or Rehmannia root (exhaustion)
  • Low electrolytes – Redmond’s real salt, Saltt or Good on Ya Electrolytes.
  • Low calcium + electrolytes – Jigsaw brand Adrenal Cocktail. 
  • Belly fat, insulin resistance – GD Aid – BioStack Labs 
  • Exhaustion and lack of motivation – L-tyrosine + adrenal cortex by Thorne
  • Fatigue and not feeling like yourself – Shatavari 
  • Chinese Herbal Formulas  -Kan Herbs – Liu Wei Di Huang Wan – hot flashes and fatigue or Ba Zhen Tang – fatigue and feeling depleted
  • Something for everything peri/menopause – Selaura 

By no means is this an exhaustive list, these are my go-to’s. 

You’re not going crazy – hormones do shift through different patterns with age. 

What worked in your early 40’s may not work by the late 40’s into the 50’s and 60’s.

Hormone optimization isn’t a “fix it and forget it” thing it’s a progression. 

You will need to tweak things as time goes on. 

Embrace the transition and use the symptoms as clues from the body as to where you can improve your life experience. 

If you’re feeling a bit lost in all the transition let’s talk – I offer quick initial consults over Zoom for $49 and you’ll leave with next steps to support your hormone transition (click HERE to consult with me).

Here’s to your adrenal health,

Dr. J

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