Question: How do I know if I have a hormone imbalance?

Answer from Nebraska Medicine medical education contributor and endocrinologist L.R. Mack, MD:

Hormones are chemical messengers that help control many of the body’s functions, including metabolism, growth, reproduction, and blood sugar. They are produced by endocrine glands such as the pituitary, thyroid, pancreas, adrenal glands, ovaries, and testes. A hormone imbalance happens when one of these glands makes too much or too little of a hormone.

Some of the most common hormone imbalances involve thyroid hormone, estrogen, and insulin. Hypothyroidism, or an underactive thyroid, occurs when the thyroid doesn’t produce enough thyroid hormone. Estrogen levels naturally decline during menopause, while problems with insulin can contribute to diabetes. 

Hormone levels also naturally change throughout life. A change in your hormone levels doesn’t always mean something is wrong. Hormones shift during puberty, pregnancy, perimenopause, menopause, and as we get older.

Symptoms of a hormone imbalance vary widely depending on which hormone is affected and whether your body has too much or too little.

For example, too much thyroid hormone can cause anxiety, a racing or pounding heartbeat, tremors, and weight loss. Too little thyroid hormone can cause fatigue, weight gain, and constipation. 

Low estrogen levels can cause hot flashes, fatigue, brain fog, and possible weight gain. Low levels of sex hormones can also affect energy, mood, sleep, and sex drive in both women and men. 

Other symptoms may be less obvious. Fatigue, changes in weight, sleep problems, or changes in how you feel may have other possible causes, including stress, lack of sleep, or sleep apnea. Sometimes routine blood tests ordered by a health care provider uncover a hormone excess or deficiency that a patient didn’t know they had. 

Some hormonal changes can be caused by medical conditions. Hashimoto’s thyroiditis, for example, is an autoimmune disease that can damage the thyroid and lead to hypothyroidism.

Polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS), is another example of a condition involving hormones and metabolism. In those with PMOS, insulin resistance can contribute to increased androgen production by the ovaries. These changes may interfere with ovulation, affect fertility, and contribute to weight gain.

In some cases, untreated hormone disorders can become serious. Severe excess thyroid hormone, for example, can lead to a life-threatening condition called thyroid storm. Severe, prolonged hypothyroidism can lead to a medical emergency.

If fatigue, unexplained weight changes, or other concerns last longer than three to four months, talk to your health care provider. They can review your symptoms, medical history, and family history and determine whether hormone testing is appropriate.