By Dr. Wendy Askew

My office is often a place of hope for patients who’ve been told over and over again, by physician after physician, that there is ‘nothing wrong’ with them. These patients seek out help and often leave their physician’s office frustrated when no obvious cause for their symptoms can be identified. These symptoms include:

• Insomnia
• Fatigue
• Mood changes
• Inexplicable weight gain
• Joint pains
• Lack of mental clarity
• Low sex drive, and many more

If their labs are normal, and their imaging studies and test results are unremarkable, this ‘absence of evidence’ is misinterpreted as evidence of absence, meaning that there is not a physiologic (“real”) cause for their symptoms. 

Even young women in their thirties and forties are told that feeling unwell and tired all the time is ‘simply a part of getting older.’ Sometimes, they are diagnosed with depression and offered treatment with antidepressants. But is that really all there is to it? Are they all truly experiencing depression? Are their symptoms merely figments of their imagination? An even more depressing concept to me is the idea that aging is simply synonymous with feeling bad most of the time, both emotionally and physically. I don’t believe all of this to be true, and it has taken decades of clinical patient care and nearly an additional decade of continuing education and clinical experience in functional medicine to see how much impact can be made on so many lives by looking beyond the usual places. Which brings us, finally, to the question that has not yet been asked: “Could it be my hormones?”

I am frequently informed by my patients that other physicians have told them that whatever the problem they are experiencing, it “must be due to their hormones.” Occasionally, I interpret this to mean that some providers are eager to direct patients elsewhere to look for help in situations when they aren’t able to figure out a cause or offer help. It is also important to realize that the term “hormones” is a vague umbrella term that describes nearly a hundred molecules produced in our bodies that regulate nearly every process that our organ systems perform. With that in mind, it certainly seems plausible that hormones may be involved in many if not most health conditions and symptoms that we experience.

Looking a little bit closer at what they are and what they do, hormones are chemical signaling messengers produced by our cells that can have effects throughout our bodies to direct and regulate most of our bodily functions. Consider a hormone called insulin. The pancreas makes insulin, which in turn circulates throughout our bodies and instructs cells to take up glucose to use it as an energy source so the cells can perform their jobs. Muscle cells in different parts of the body must contract so that we can move, walk and breathe. Insulin has other functions as well. The sex-steroid hormones estrogen, progesterone, and testosterone are involved in many processes as well. These hormones are involved in the regulation of our mood, cognitive function, bone, and muscle building, and of course, sexual health, to name just a few of their functions. Thyroid hormones are involved in the regulation of metabolism, skin health, gastrointestinal function, reproductive health, hair health, and immune system function, and other processes. There are dozens of other hormones that can also impact various aspects of health. Without optimal hormonal functioning, it makes sense that people may suffer from a constellation of non-specific symptoms, like those already mentioned. 

For patients seeking help from possible hormone-related symptoms, it’s important to select providers who are knowledgeable about and experienced in these areas. Attending a weekend course in anything doesn’t make one an expert in that topic. Every provider will have his or her areas of expertise as well as areas that they are particularly knowledgeable about. Being honest enough to admit limitations in one’s medical knowledge is a sign of wisdom, not weakness in healthcare providers. With that said, I can honestly answer that for many patients who perhaps aren’t sick but certainly aren’t feeling well, hormones might be a factor. 

Offering honest and not false hope for patients seeking relief is important in medicine. Having hope for more effective treatments and for better health is important for patients. Not only because those treatments may give relief, but because hope, in and of itself, is often a powerful and overlooked therapeutic agent.