“It happens, you’re probably just getting older.”

Sound familiar?

Our current healthcare system is quick to brush off age related hormonal changes.

Hot flashes, weight gain, lack of libido, hair loss, fatigue, and poor sleep seem to be a ‘sign of the times’ according to some medical providers.

However, we often find that patients have been to a litany of specialists who write their symptoms off as “normal” or merely “stress related” with minimalistic lab work or a quick, cursory examination.

While these sorts of complaints are common, we have to be careful in differentiating ‘common’ from ‘normal’.

Poor sleep is common but is not normal. The body will produce a desired outcome (deep, restful, restorative sleep) when provided with the correct inputs (environmental inputs, circadian cues, parasympathetic biochemistry, etc).

Occasionally patients can determine the driving factors behind their hormonal complications but given the complexity of the endocrine system, simply knowing the cause doesn’t always provide a solution.

Testing for Hormones

More often than not, patients will have some rudimentary lab work completed with a primary care provider or perhaps even an endocrinologist.

“Everything looks good.”

We’ve all heard those dreaded words before. They’re even more frustrating when you feel terrible and you’re struggling to get answers from the medical community.

Blood is considered the gold standard for hormonal concentrations and we utilize it with many patients, but we must remember that many hormones within the body are diurnal. In other words, they have a rhythmic pattern over the course of a 24-hour day - if you measure them at 4pm in a fed state, they’ll be different than fasted at 8am.

This is why we must consider additional mediums which allow us to see hormonal metabolites. In females this becomes especially important as total estrogen production is only part of the puzzle - how well can you remove estrogen through the liver and is it balanced with progesterone?

Or perhaps you’re transitioning through menopause with endless hot flashes and exceptionally poor quality sleep.

You’re struggling to keep your eyes open and the fatigue is relentless. Your motivation for anything seems to wane with every passing day and the scale continues to increase.

Maybe your hormones look more like this…

Without data, it’s impossible to know what your hormones are doing. Symptoms may provide an idea for where things might be out of balance but they’re often generalized and can be associated with multiple systems.

For example, let’s consider fatigue for a moment. The adrenals are often blamed, but most physicians only run a single waking cortisol measurement which is unreliable and lacks applicability.

We want to know what your adrenals are doing all day long. Is this your diurnal cortisol rhythm?

If so, then it makes sense why you can barely keep your eyes open at 3pm.

Or, maybe you’re the type of person who just. can’t. shut. your. brain. off.

Well yeah, with a cortisol curve like this it makes complete sense…

Would we know any of that without testing?

No. Data drives decisions, not the other way around.

What Causes Hormonal Imbalances?

Outside of frank medical pathology (e.g. tumors), hormones don’t just randomly shift out of balance. The body is responding to the environmental, nutritional, biochemical, and genetic inputs it receives over time.

For example, here are just a few areas which might play a role in someone’s hormonal imbalance:

  • Environmental Toxicants
  • Hormonal Birth Control
  • Xenobiotics
  • Excessive Stress
  • Nutritional Deficiencies
  • Child Birth
  • Poor Sleep Hygiene
  • Autoimmunity
  • Over Exercising
  • Lack of Exercise
  • Latent Infections

Generally speaking, there usually isn’t a singular cause for hormone dysfunction. It’s a slow, steady trickle of dysfunction over the years as the body has a hard time keeping up with the demands of everyday life.

Our job in the world of functional medicine is to start unpacking your story: “How did you get here? What do we need to add or remove to regain balance?”

Traditionally hormonal problems are hard to diagnose and ever harder to treat as the body has a litany of positive and negative feedback cascades for every system.

As such, patients tend to jump from one medication to the next in the hopes that they will find some sort of relief.

Often, we find that patient may even go through a “honeymoon phase” with conventional hormone modification in which they better for 2-4 months and then the body crashes even harder.

As we’ve said before, ‘it’s never as simple as a single pathway, mechanism, organism, or pathogen.’

The body doesn’t make mistakes - when the warning signs pop up (aka what someone perceive as symptoms), it’s time to start digging.

Patient Reviews

S. Carpenter
I highly recommend Functional Health Center of The Carolinas. I was struggling with a hormone imbalance and my individualized treatment plan was easily explained to me. With changes in nutrition and adding supplements, I started to see results quickly. I not only lost weight, but saw positive changes in my mood, anxiety, and energy level. I no longer take medication and I am extremely happy with how much better I feel overall.

M. Nesbitt
In the beginning I may have been a bit skeptical for what, if anything, functional medicine had to offer me with my complex medical issues. After working with Dr. Riser and Michael Wines, I learned more about the root causes (and mitigating solutions) to my health concerns than I ever would have learned on my own. Traditional medicine providers were only focused on the "right-now", and interested in deploying medications or medical interventions that would seemingly not solve the issue, but cover them up. The other option I was granted by traditional providers was to ignore my symptoms altogether until they became "more serious". Neither worked for me. I wanted to get answers and work to correct whatever was going wrong BEFORE things got worse. Dr. Riser and team understand that concept. They are patient, attentive, and kind. I highly recommend them to anyone challenged by or frustrated with traditional medical solutions.

O. Graceffa
My experience at Functional Health Center has been great! I’ve been able to clear my acne, balance my hormones, & get rid my anxiety! Dr. Riser has been there for me every step of the way. I would recommend him to anyone who is looking to heal themselves with natural medicine.

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