In ancient times, people used to start the new year by making promises to their gods to be a better person. These promises were offered in the hope that the gods would grant in return, good fortune and health during the new year.

Top new year’s resolutions made in 2018 continue to show our focus as a society on health and ability to make better financial decisions. But as the year unwinds, common habits, ailments re-emerge and familiar stressors come back to overwrite our new year’s resolutions. Sometimes these habits, ailments, stressors can creep up to create an insidious imbalance in our complex hormonal system, affecting many aspects of our mind and body.

Why worry about ‘hormonal balance’?

An imbalance in hormone levels in both men and women may not be life threatening. But it can deeply affect our regular quality of life with physical (health/skin) and mental health challenges (anxiety, depression).

Hormone levels fluctuate in our bodies through the various stages of our life, more active in some life phases like puberty, menopause, andropause than others. 

But Dr Elke Cooke, a functional medicine doctor with BodyLogic MD, CA, has observed an increase over the past few years in women, and some men, in their 20s and 30s reporting symptoms of hormonal imbalances. Symptoms like acne, facial hair growth, scalp hair loss, weight gain and more troubling cases of PCOS, infertility, breast growth in men are increasingly pointing to hormonal imbalance.

How do hormone levels get imbalanced?

Hormonal ‘imbalance’ presents uniquely in each body. “So it is very helpful to learn why some of these hormonal imbalances occur to better understand the signals sent by our bodies,” says Dr Cooke.

Both internal and external factors can disrupt the body’s ability to generate optimal hormone levels.

i) Lifestyle: how we live daily including examples such as chronic stress, over/under nutrition, hours of sleep each night, alcohol consumption, food we are eating (organic vs conventional), active vs sedentary lifestyle.

ii) Underlying health stages/conditions: like puberty, pregnancy, midlife, aging, family and personal health history can change the balance in our body’s hormones.

(iii) Environmental factorscan include exposures to: 

(a) EDCs (endocrine disrupting chemicals) – EDCs are synthetic substances found in fragrances (candles, perfumes, air fresheners, skin/hair care products), in pesticides on food. 

When EDC exposure is via the skin for example, the synthetic substance applied on the skin fits into the shape of the hormone receptor on our skin. Very much like a key that fits into a lock. When EDCs mimic the hormones already in the skin receptor, they can cause too much hormones, or ‘dominance’. When EDCs block actual hormones produced in the body from getting into the skin receptor, it causes too little hormones.

Fertility and pregnancy wellness are known to be the most vulnerable to hormone disruption from EDC exposures (footnote #1).

(b) Phytoestrogens – present in food like soy, dietary supplements (footnote #2).

(c) Natural ingredients – used in food, personal care products like tea tree oil, rose oil can be unpredictable in their effects on a body’s hormone levels. Reducing exposure from daily factors is the most in our control to manage health risks.

How to read clues for our body

The human body has a complex hormonal system, with multiple organs in our body generating different hormones to keep our system of ‘wellbeing’ running smoothly. An imbalance in this system can show up as (a) problems with skin/hair (Table 1 below), (b) physical health conditions (Table 2 below) and/or (c) mental health conditions (Table 3 below).

This makes investigating a hormonal imbalance a complex task. Medical practices like functional and integrated medicine have emerged from a growing recognition among medical practitioners that it is not enough to treat symptoms alone. The root cause needs to be identified by observing multiple areas of an individual’s life. These new medical practices are now being offered at some of the most well known healthcare institutions like The Mayo Clinic, Cleveland Clinic, Johns Hopkins. Such practices are becoming experienced at a holistic investigation of hormonal imbalances.

Note: Although the clues categorized in the tables below help point to something being awry in one’s body, the root cause can be difficult to self diagnose. To investigate any concerning, abnormal symptoms, always consult a professional.

Start the new year by including these tips into your daily routine.

1. Manage/reduce stress – Some well known stress management tips are exercise, meditation. But some simple ones are: to pick up a hobby, maintain good friendships, indulge often in a sense of humor and volunteer more.

2. Change exposures to decrease inflammation

(a) Diet – (i) An anti inflammatory diet is different for everybody. For example, Dr Cooke puts most people on an elimination diet to figure out which food groups are causing reactions; (ii) Include diet high in fish oil – Omega 3 fatty acids; (iii) Increase fiber to get rid of toxins, EDCs (endocrine disrupting chemicals) from the body.

(b) Products – Use food items, skin/hair cosmetic products that don’t use EDCs (endocrine disrupting chemicals) for ingredients.

3. Lose excess fat – regular exercise to tone muscles and reduce body fat can help get rid of toxins stored in body fat.

4. Detox 1-2 times a year (Footnote #3) – Detoxing is the process of channeling the right nutrients to the liver, helping toxins stored in the liver become water soluble and easily excreted out of the body. It should be practiced under trained, experienced supervision, especially by those with underlying health conditions. Although “juice cleanses” are now widely popular, offered by many website services, they can sometimes cause reactions in some people. Some ways to detox responsibly:

a) A liver cleanse: Any type of liver cleanse needs to be done carefully, under the guidance of physicians in a controlled environment and with the right nutritional aids.

b) Time in the sauna – sweating is great for detoxing and increasing blood circulation.

Dr Elke Cooke, M.D. received her medical degree from the University of Michigan in Ann Arbor. She os board certified in Emergency Medicine and trained in Functional Medicine and Anti-Aging Medicine through the Institute for Functional Medicine and A4M. She currently works at BodyLogicMD of Sacramento where she helps women experiencing menopause, and men experiencing andropause, or other hormonal imbalances achieve a longer, better life.

TABLE 1: Problems with skin / hair

Effects from ..

Effects on Skin & Hair

Estrogen levels

Skin thickness, wrinkle formation and skin moisture. Female pattern alopecia (low levels of Estrogen). Melasma (skin pigmentation) during pregnancy.

Testosterone levels

Increased oiliness or even adult acne. Male pattern alopecia, due to too much dihydrotestosterone (a powerful metabolite of testosterone).

Cortisol levels from chronic stress affect insulin levels.

Dry skin, aging, wrinkles.

Insulin resistance. Metabolic diseases like diabetes

Dry skin, aging, wrinkles, discolorations, loss of glow, acne, skin tags (can imply insulin resistance).

Thyroid problems

Dry, flaky, lackluster skin, more wrinkling, decrease cell turnover, thinning hair and eventual hair loss.

TABLE 2: Physical health conditions

Effects from ..

Physical health conditions

Cortisol, adrenaline levels from chronic stress

Anxiety, Depression, Digestive problems, Headaches, Heart disease, Sleep problems, Weight gain

Body’s ability to process/detox hormones (testosterone /estrogen)

Acne, weight gain, headaches, low libido.

High inflammation – abnormal hormone metabolism4

Low testosterone, high estrogen in men can lead to Joint pain. arthritis, body aches.

Insulin resistance – Metabolic diseases like diabetes

Weight gain, high LDL cholesterol, breast growth in men, sex hormone disturbances.

Pituitary gland disorder

Unexplained symptoms of eating disorders, unusual hair growth, diabetes, weight gain, infertility etc.

Table 3: mental health conditions

Effects from ..

Mental health conditions

Estrogen dominance (more than the body needs)

Anxiety, PMS, mood swings.

Lack of estrogen

Dementia, difficulty with focus, mood swings, depression


Depression, impaired memory

Adrenaline levels

Fatigue, stressed out feeling

Pituitary gland disorder

Unexplained symptoms of headaches, depression, mood swings,


1. EDCs and pregnancy – statement by Endocrine Society –;

2. Phytoestrogens –

3. Detoxing –

4. Hormone metabolism –