A photograph of the back of a woman with back acne.

Are your hormones unbalanced—and what does that even mean?

The beauty of hormones is that they exist to keep the body in balance. Here’s what experts say you can do instead if you’re feeling off-kilter.

Some social media influencers promise women that they can clear up their acne simply by making subtle adjustments to their diets to bring their hormones back into balance. But, experts say, it's not quite that simple.
Photograph By SeventyFour Images / Alamy Stock Photo

Social media is filled with people telling women that if they don’t feel well, the answer may be that their hormone levels are out of whack—and need to be balanced.

Some influencers promise that eating a raw carrot salad will balance excess estrogen; others say that waiting to drink coffee until after you've eaten can resolve everything from painful periods to hair loss. Unfortunately, neither of these remedies will yield the desired effect and neither are based on science.

The advantage of these supposed home remedies is that they don’t require a visit to the doctor—which may appeal to women who feel like their doctor isn’t really listening to them.

(Women’s health concerns are dismissed more, studied less.)

What these social media enthusiasts seem to be missing, experts say, is that hormones are part of a system that’s designed for balance—and that serious hormone disorders require medical intervention.

The role of hormones

Hormones refer to a whole category of proteins that send signals throughout the body, says Marilyn Tan, an endocrinologist and professor at Stanford Medicine. Over 50 different hormones have been identified in the human body, mostly released into the bloodstream by glands like the thyroid, pancreas, ovaries, testes, adrenal, and pituitary.

Hormones have many functions including growth, metabolism, reproduction, and mood, but their overarching role is to coordinate metabolism across organ systems, explains Anne Cappola, professor of endocrinology, diabetes, and metabolism at the University of Pennsylvania School of Medicine. They carry messages from the glands through the bloodstream to various organs and tissues to tell them how to function. This complex network of glands and organs is known as the endocrine system.

There are times when changes in your hormone concentrations result in physical symptoms. Sex hormones, in particular, fluctuate as a woman transitions through different phases of her life cycle—from puberty to menopause. During those hormonal changes, women may experience an onslaught of symptoms, such as mood swings, weight fluctuation, changes in libido, and hot flashes.

(Is it possible to cure hot flashes? We may be getting closer.)

And there are serious endocrine disorders caused by hormone imbalance like diabetes, thyroid disease (hypothyroidism and hyperthyroidism), and polycystic ovary syndrome (PCOS)—which can result from having too much androgen in your body. However, these conditions must be diagnosed by a doctor.

But Cappola says that subtle endocrine abnormalities that can be cured by slight dietary changes are not as common as social media may lead you to believe.

Your hormones are designed to be balanced

Acne, fatigue, and weight gain, are among the most frequent symptoms that TikTokers attribute to a hormone imbalance. Digestive and sleep issues, body aches, and anxiety are also thrown into the mix of symptoms—all of which is collectively referred to online as “adrenal fatigue.” (Not to be confused with adrenal insufficiency, a medical condition in which the adrenal glands can’t make enough cortisol.)

But experts are skeptical that hormone imbalances are causing these symptoms.

“It really takes a pretty big insult for your adrenal glands not to work,” Cappola says. “These glands have a lot of built-in redundancy. You have two adrenal glands. You need less than one to function.”

The same is true for the thyroid gland. Cappola says you only need about 20 percent of a normal thyroid gland to be fully functioning. “That's why this whole idea of adrenal fatigue, it just doesn't exist.”

(Debunking popular myths and misinformation about PCOS.)

Although it is possible for hormones to play a role in causing these symptoms, they can also be caused by a multitude of things—including sleep, stress, diet, and activity levels. You might also be mistakenly assuming there’s a problem with your perfectly normal energy level simply because you’re comparing yourself to others with seemingly boundless energy.

As for the idea of whether changing your diet can help keep your hormones in balance, Cappola hasn’t seen any evidence of that—and can't even think of a mechanism where a diet would help. The beauty of hormones, she says, is that they exist to make the balance.

“If something is off in one way, they compensate, they adapt, and they regulate,” she said. “They're only there trying to help normalize when things are off for another reason.”

For example, the pituitary gland releases more thyroid-stimulating hormone (TSH) into the blood if it senses that levels are too low—and if those levels increase, it releases less TSH.

(These 7 hormones influence how much—or how little—you eat.)

Another example is insulin, a hormone released by the pancreas to process sugar so that your body can use it for energy. When there’s too much glucose in your bloodstream from the food you’ve eaten, insulin will tell your body to store the excess in your liver and hold onto it for later until glucose levels decrease. Essentially, your hormones adapt to what’s going on around them, not the other way around.

If you don’t feel well, see a doctor

Cappola suggests making a list of your symptoms—without consulting the internet—and thinking about what else is going on in your life that could cause them. It’s possible that stress could be behind your brain fog, or that diet and activity levels are contributing to skin issues. Bring that list to a physician you trust.

She believes it’s worth it, though, for a doctor to take a thorough history, do an exam, and send off some tests based on your symptoms. Thyroid issues, for instance, are most common and easy enough to diagnose with a blood test. But if everything looks okay, you might need to accept that there may not be a medical cause.

“Of course, I wouldn't want anyone to miss an endocrine disease, but I also don't want people to be misdiagnosed with an endocrine disease," Cappola says. “I also don't want them to have to rearrange their lives because they think the timing of their coffee is going to be what puts their hormones in alignment.”

Not all of the advice that TikTokers lay out for hormone balancing, like better sleep hygiene and a balanced diet, is bad—it’s just good advice for overall health rather than a magic cure for hormone issues.

“I think it's excellent to do in conjunction with any recommended therapy from your doctor,” Tan says. “But if you do need prescription medication, lifestyle changes would not be a sufficient substitute.”

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