Trouble sleeping? Feeling lethargic, or irritable, or bloated? Gained weight recently, or don’t feel hungry when you wake up? The answer, according to a new wave of health and wellness experts on the internet, is simple: your hormones are out of whack.
Even if you’re not an expert in “hormone imbalances” yourself, chances are you already know a bit about hormones. Perhaps you’ve heard of estrogen, testosterone and cortisol before, but never quite knew exactly what they did. Perhaps you decided to quit the pill because it was making you feel a bit weird, but you weren’t quite sure why. Perhaps you’ve felt bone-tired for months now, but your doctor doesn’t seem to be taking it as seriously as you would like. If so, the copious videos tagged #hormonebalance, #hormonehealth and #hormonehealing might seem like they’re speaking directly to you.
These wellness coaches are quick to acknowledge that you probably won’t know how your hormones affect your body or your mood. They’ll claim that hormone imbalances are overlooked and under-diagnosed by the established medical community, and that’s why they’ve taken matters into their own hands. They’ve “hacked their hormones” and are now telling the world about it. There are adrenal cocktails. Thyroid juices. Raw carrot salads. All taken with the sole goal of achieving “hormone balance”. “Yes,” one self-styled hormone health coach on TikTok says, “this will change your life.”
The essential idea that your health will suffer if your body is in a state of “imbalance” – hormonal or otherwise – is nothing new. For as long as there has been a concept of “health”, the notion of “balance” has been one of its bedrocks. Just think of the ancient Greek theory of the “four humours”, which dictated that the human body contained four vital fluids – blood, phlegm, yellow bile and black bile – that needed to remain in a state of equilibrium for people to stay healthy. In this belief system, pain would occur if any of the humours were in either deficiency or excess. Treatment was therefore a balancing act, variously consisting of bleeding, purging, and forcibly increasing the body’s production of urine, among other liquid tricks. Despite these treatments often exemplifying the phrase “the cure is worse than the disease”, the four humours theory was a mainstay of medical belief for 2,000 years. And now, a mutated version seems to have been picked up by the wellness brigade, with expensive supplements and superfood diets touted as necessary stabilising tools.
To give credit where it’s due, it is true that hormones can wreak havoc on both your body and mood – as anyone who has had periods, or gone through puberty, the menopause, or hormone treatment can attest. Certainly, intimate health expert Dr Shirin Lakhani suggests “hormones work together in the body like an orchestra, and an imbalance in one can have an effect on others”. This can “cause a wide range of symptoms”, she says, and “many people may be suffering without realising their symptoms could be due to a hormonal issue”. Yet, the question remains, can the hormones currently being targeted by the “I changed my whole life with raw diet and intermittent fasting” cohort wreak the kind of havoc they are claiming? And can they be cured with the methods they espouse?
The most popular hormone imbalance being diagnosed online at the moment is a “cortisol imbalance”. Cortisol is produced in the adrenal glands, which are located on top of the kidneys. It’s commonly known as “the stress hormone”, as it helps regulate the body’s stress response. It also keeps inflammation down, regulates blood pressure, controls your sleep/wake cycle, and manages how the body uses carbohydrates, fats, and proteins. So the jump to blaming cortisol for sleep trouble, fatigue and weight gain seems to make a kind of sense, right? The problem is that scientific evidence doesn’t really back this up.
Often, when a “cortisol imbalance” is discussed on Instagram and TikTok these days, it is connected to a controversial condition known as “adrenal fatigue”. “Controversial” in the sense of it not being real… What is indisputably real, however, is adrenal insufficiency, or the inadequate production of one or more of the hormones produced by the adrenal glands. This can indeed cause aches, fatigue, unexplained weight loss, low blood pressure and lightheadedness. Yet, adrenal insufficiency is the result of an underlying disease or surgical procedure and, crucially, can be diagnosed by blood tests that show inadequate levels of adrenal hormones. The unproven theory of adrenal fatigue, on the other hand, claims that your adrenal glands are unable to keep pace with the demands of chronic stress, and therefore become “burnt out”. Proponents of this theory suggest that existing blood tests aren’t sensitive enough to detect these changes in adrenal function. But supposedly your body can not only detect them, but be thrown off the rails by them.
Most doctors disavow the existence of adrenal fatigue. The Mayo Clinic stresses that “adrenal fatigue isn’t an accepted medical diagnosis”, but is “a lay term applied to a collection of nonspecific symptoms, such as body aches, fatigue, nervousness, sleep disturbances and digestive problems”. Yet wellness experts everywhere are proclaiming that, far from an unproven theory, adrenal fatigue and associated cortisol “imbalances” are rife. Indeed, Goop’s favourite “functional medicine practitioner” Dr Alejandro Junger has likened adrenal fatigue to an “epidemic”. So, when it comes to hormones, how do we separate fact from fiction? Are these online “experts” onto something the established medical community has been slow to pick up? Or, is this all a hodge-podge of science, pseudoscience and good ol’ goopy influencer marketing? Are hormone imbalances just the next internet trend – the new ADHD?
“There are many symptoms of hormone imbalance such as weight gain, depression or mood swings, problems with sleep, fatigue, loss of libido and more,” Dr Lakhani says, “but a lot of information out there on the internet will blame hormone balances when other health issues could be responsible.” While hormones do impact the way your body works, it doesn’t mean every bodily issue is hormonal. If a hormone imbalance isn’t to blame for sleepless nights and appetite changes, Dr Lakhani says that following advice from social media could be “at best a waste of time and may actually be harmful”. She adds: “I do not recommend following at-home ‘hormone cures’. The best course of action is to see your doctor.”
Dr Gareth Nye is a senior lecturer at Chester Medical School, specialising in maternal and fetal health, and the theme lead for Endocrinology at the Physiological Society. Like Dr Lakhani, he stresses that “hormones do not work in isolation and are part of a huge network”, which can mean that “when one aspect isn’t quite right, we feel symptoms that aren’t necessarily associated at first glance”. He suggests the real reason our endocrine system – the part of our body concerned with hormones – is poorly understood and vulnerable to disinformation campaigns is “mainly because it is so difficult to monitor in people”. Cortisol, for example, “naturally rises and falls over a 24-hour period as the needs of the body change”, Dr Nye notes. “Each individual will have an individual pattern and that is what their body is used to.” The difficulties emerge from the ability to track this cycle sufficiently. Even in reportedly healthy individuals, the amount of cortisol that shows up in blood samples can vary greatly, and still be considered totally normal.
“Anyone looking to test hormone levels should be testing at least four times a day, over a number of weeks to gauge their cycle,” Dr Nye suggests. “Making a diagnosis after less than this is not medically valid.” He goes even further, adding that since there have been no long-term studies to track the daily, weekly, monthly and yearly patterns of this hormone, or how it can change through a person’s life, “we can’t say for certain whether cortisol imbalance is an actual phenomenon”.
It seems clear that the symptoms hormone-hacking influencers cite as evidence for a hormone imbalance could, in fact, stem from many other modern lifestyle factors. As Dr Nye indicates, they could be attributed to “work patterns, eating times and increased screen time”. In this case, anything that mitigates these effects will have a beneficial outcome – eating a homemade raw carrot salad for lunch and going for a walk every day might indeed make you feel better than wolfing down a Pret at your desk while frantically replying to emails. But, this doesn’t mean the hormone-hackers’ advice is harmless. Like Dr Lakhani, Dr Nye emphasises that the symptoms they point to “can also be a sign of underlying medical conditions concerning mental health conditions, anaemias, problems with your thyroid gland and being overweight”. Self-diagnosing these issues as hormone imbalances, instead of seeking medical attention, could make certain conditions much worse.
“It is concerning that when someone is experiencing a change in their body they are turning to social media for help and advice rather than healthcare professionals,” Dr Nye says. Ultimately, it is this that makes the hormone-hacking content currently being spread online so pernicious. Central to contemporary wellness dogmas is a mass disillusionment with modern medicine, rejecting it in favour of so-called self-care and individual agency. Across every social media platform, wellness proponents preach how cutting “toxins” from their diets, or adding superfoods to their diets, cured their chronic conditions – the ones they claim the medical profession overlooked or failed to remedy. Of course, all placebos can go a long way. But the problem is, as with ancient bloodletting, sometimes you only realise the “cure” is disconnected from the disease when it’s already too late.