Hormones

Testosterone

Testosterone is a hormone that plays crucial roles in both men and women - not just in sex drive, but in muscle mass, mood, energy, bone density, and even hair growth.

In men, testosterone is produced mostly in the testes, with a smaller amount from the adrenal glands.

In women, it’s produced in smaller amounts by the ovaries and adrenal glands.

Lifestyle changes like better sleep, resistance training, reducing alcohol, and managing weight can also support healthy hormone levels naturally.

Pregnenolone

Precursor to DHEA, progesterone, estrogen, testosterone, cortisol.

Supports memory, brain health, and cognition. May improve energy and mood. Could support hormone balance when deficiencies exist. Sometimes used in perimenopause and in adrenal fatigue.

LH

Luteinizing Hormone triggers ovulation and corpus luteum formation.

HIGH LEVELS:
PCOS, can disrupt ovulation, irregular periods, infertility, acne, excess hair

LOW LEVELS:
Suggest pituitary dysfunction or stress

Thyroid Hormones

TSH, Free T3, Free T4, and Anti-TPO antibodies

HIGH TSH LEVELS & LOW FREE T3/T4:
Hypothyroidism: fatigue, weight gain, cold intolerance, hair thinning, depression

LOW TSH LEVELS & HIGH FREE T3/T4:
Hyperthyroidism: anxiety, weight loss, heat intolerance, tremors

DHEA

Naturally produced by the adrenal glands and in smaller amounts by the ovaries and testes.

It acts as a precursor to sex hormones like estrogen and testosterone, helping the body make them. Thus, DHEA supports libido, mood, energy, and may mildly support bone health

DHEA naturally declines with age.

DHEA improves ovarian reserve and egg quality in women with low AMH or advanced age. Commonly used before IVF.

Too much DHEA can convert to androgens (tesosterone) and cause acne, oily skin, hair growth, mood changes (worsen irritabily, anxiety), disrupt natural hormone production,

Prolactin

Made by the pituitary gland located at the base of the brain. Stimulates breast milk production, normally high only during pregnancy/ lactation.

HIGH LEVELS:
Irregular periods, infertility, galactorrhea (milky discharge from nipples)

LOW LEVELS:
Rarely clinically significant

Cortisol

A stress hormone that is produced in the adrenal glands (they sit on top of each kidney). It regulates blood sugar, supports blood pressure, reduces inflammation, helps respond to physical and emotional stress, controls sleep-wake cycle.

Healthy cortisol levels rise in the morning and slwoly fall through the day.

Estrogen

Regulates the menstrual cycle. Maintains bones, skin, mood, and reproductive organs.

LOW LEVELS:
Symptoms: Hot flashes, night sweats, vaginal dryness, mood swings, low libido, amenorrhea
Causes: Menopause, perimenopause, anorexia, over-exercising, ovarian failure
Treatment: Hormone replacement therapy (HRT), lifestyle changes, addressing the underlying cause

HIGH LEVELS:
Symptoms: Weight gain, PMS, heavy periods, fibroids, breast tenderness
Causes: PCOS, obesity, estrogen dominance
Treatment: Balance with progesterone, lower xenoestrogen exposure, weight loss, DIM supplements

Androgens

Produced mostly in the adrenal glands and ovaries.

Both DHEA and Pregnenolone can raise androgens which raises testosterones levels.

HIGH LEVELS:
Acne, oily skin, hair thinning, hirsutism, irregular periods, deepending voice, irritability or aggression

LOW LEVELS:
Low libido, fatigue, brain fog, depressed mood/flat affect, muscle loss, low motivation or drive.

FSH

Follicle Stimulating Hormone stimulates ovarian follicles (eggs) and estrogen production.

HIGH LEVELS:
Menopausal symptoms (if not in menopause), irregular or absent periods, may indicate ovarian failure or menopause.

LOW LEVELS:
Irregular periods, infertility, may suggest pituitary dysfunction.

Progesterone

Prepares the uterus for pregnancy, balances estrogen, and regulates mood.

LOW LEVELS:
Symptoms: PMS, anxiety, irregular periods, infertility, spotting
Causes: Stress, perimenopause, anovulation
Treatment: Bioidenticla progesterone, stress reduction, Vitex (chasteberry)

HIGH LEVELS:
Symptoms: Fatigue, dizziness, bloating
Causes: Usually occurs during pregnancy, with hormone therapy, and after ovulation during the menstrual cycle

AMH

Anti-Mullerian Hormone reflects ovarian reserves, used in fertility evaluation.

HIGH LEVELS:
PCOS

LOW LEVELS:
May suggest diminished ovarian reserve.

Common Questions

  • Prolactin levels in men should be low. It is a hormone made by the pituitary gland. A pituitary tumor (usually benign) can cause elevated levels of prolactin in men. However, low thyroid function can also increase prolactin levels, as can certain medications.

    Symptoms that men may notice with high prolactin levels include a milky nipple discharge (galactorrhea), low libido, erectile dysfunction, infertility or low sperm count, fatigue, headaches, and vision changes.

  • Only when symptoms or clinical suspicion are strong, such as adrenal insufficiency or Cushing’s syndrome symptoms, chronic steroid use, unexplained severe fatigue, fainting, low blood pressure, rapid unexplained weight gain or loss.

    It should NOT be used as a random wellness test since cortisol fluctuates all day, and results can be misleading if symptoms don’t match.

  • LOW LEVELS:
    Adrenal Insufficiency: severe fatigue, salt cravings, low blood pressure, dizziness, fainting, hyperpigmentation, nausea, vomiting, abdominal pain, weight loss, muscle weakness, low blood sugar, brain fog

    Causes: autoimmune destruction of adrenal glands, chronic steroid use, pituitary gland disorders

  • HIGH LEVELS:
    Cushing’s Syndrome: rapid weight gain, purple stretch marks, thing/fragile skin, easy bruising, acne, irregualr periods, muscle weakness, high blood pressure, anxiety/depression, high blood sugar, poor wound healing, insomnia

    Causes: long-term steroid medications, cortisol-producing adrenal tumor, pituitary tumor making too much ACTH, rare ectopic ACTH production

    1. Morning serum cortisol blood test done around 8 AM when cortisol is naturally highest. Used to screen for adrenal insufficiency.

    2. Late-Night Salivary Cortisol is collected at night when cortisol is the lowest. Used to screen for Curhsing’s syndrome.

    3. 24-Hour Urine Free Cortisol measures how much cortisol you excrete in a day and helps to diagnose Crushing’s syndrome.

    4. ACTH Stimulation Test is Gold Standard for diagnosing adrenal insufficiency. Tests to see how adrenal glands respong to synthetic ACTH.

  • FSH (best checked on cycle day 2-4) , LH, Estradiol E2 (best checked on cycle day 2-4) , AMH, Progesterone (checked on day 21, 7 days after ovulation), Progesterone, Prolactin, TSH, Free T4, Testosterone, DHEA-S, Sex Hormone Binding Globulin

    1. Not ovulating (no egg released) due to PCOS, thyroid problems, very low body weight, very high stress, intense exercise, high prolactin, hormone imbalance

    2. Egg quality issues due to genetics, endometriosis, autoimmune issues, smoking/vaping, environmental toxins, chronic inflammation, high BMI

    3. Blocked fallopian tubes due to untreated STIs, endometriosis, past pelvic infections, scar tissue. If tube is blocked, the sperm and egg never meet.

    4. Hormonal imbalances. Hormones are the instruction manual for fertility.

    5. Endometriosis can damage eggs, block tubes, inflame the pelvis, and interfere with implantation.

    6. Male infertility (responsible for 40-50% of infertility cases) can be caused by low sperm count, sperm that don’t swim well, abnormal sperm shape, hormone issues, varicocele, smoking/vaping, heat (saunas, laptops on lap), medications.

    7. Lifestyle causes since fertility is extremely sensitive to lifestyle. Things that impact fertility: smoking, vaping, alcohol, weed, poor nutrition, obesity, extreme dieting, chronic stress, poor sleep.

    1. Women are born with ALL their eggs. They don’t make new ones. Some women naturally have: fewer eggs, lower AMH, weaker egg response to medication. This makes egg freezing harder.

    2. Not every egg is genetically normal. During freezing some eggs don’t mature, don’t survive freezing, don’t survive thawing, don’t fertilize, or some embryos don’t grow.

    3. Hormonal stimulation doesn’t always work well. Egg freezing requires medications to grow many eggs at once and sometimes ovaries don’t respond, follicles grow slowly, follicles grow unevenly, estrogen spikes too high, or cycles must be canceled. And your body decides how it will respond to these medications, not the doctor.

    4. Poor egg quality where the eggs look healthy but genetically abnormal. This is common in endometriosis, PCOS, autoimmune issues, and certain genetic conditions.

    5. Technical difficulties in retrieval because ovaries are far from the vaginal wall, follicles are too small, there is cyst formation, anatomy making the access difficult. These obstacles can reduce the number of eggs retrieved.

  • Pregnancy is actually very biologically inefficient. Pregnancy requires perfect timing, perfect hormonal coordination, and perfect cellular function - every single month.

    Even with perfect health:

    • You release 1 egg per month

    • That egg only lives 12–24 hours

    • Sperm needs to reach it at exactly the right time

    • The embryo needs to be genetically healthy

    • The uterus must allow implantation

    Even for perfectly healthy couples:

    • Each cycle has only 15–25% chance of pregnancy

    • Most couples get pregnant within 12 months

    • 1 in 5 pregnancies ends before a positive test (chemical pregnancy)