A ‘hormonal imbalance’ often appears in lifestyle magazines as the cause of many vague health complaints. Home test providers claim that you can measure exactly how your hormones are doing. Is that right? And is such a test useful?
‘When your hormones are not in balance, all kinds of vague, diverse complaints arise.’ ‘If one hormone is out of balance, the rest can follow.’ ‘A small hormonal imbalance can affect your feelings, behavior and appearance, among other things.’
This is a small selection of the texts that hormone coaches, self-help media and providers of hormone tests use to attract customers. In the self-help industry, our hormones have become a cash cow.
Yet all those claims about hormones are not complete nonsense, says Professor Max Nieuwdorp, internist-endocrinologist at Amsterdam UMC and author of the book We are our hormones. ‘Hormones are, as it were, the conductors of our body.’
About the author
Heleen van Lier writes for de Volkskrant about practical issues from daily life and (sustainable) travel.
Hormones are essential for the functioning of our physical and mental condition, Nieuwdorp emphasizes. ‘They transmit signals to the organs via the blood. In this way they keep all kinds of processes in the body in balance. A disruption of one hormone can also affect other hormones, then you have a hormonal imbalance.’
It is good that attention is being paid to the importance of good hormone balance, says Nieuwdorp. What he does have difficulty with is problematizing normal, and even necessary, hormonal fluctuations.
‘During our development we have many periods in which hormones rage through our bodies, with all kinds of physical and mental consequences. Consider toddler puberty, ‘normal’ puberty and, for women, the monthly cycle and menopause. These are not diseases. These hormone storms are part of the body. They play an important role in, among other things, our growth and fertility.’
Diabetes and thyroid abnormalities
Sometimes hormonal imbalance is a disease and the cause of all kinds of serious complaints, says Nieuwdorp. A well-known hormonal disease is diabetes, in which the production of the hormone insulin is disrupted. Thyroid abnormalities that result in fatigue or a hunted feeling are also among the diseases resulting from a hormonal imbalance.
With obesity, the production of the hormone leptin is often disrupted, resulting in an increased feeling of hunger. Excessive production of the hormone cortisol as a result of chronic stress can manifest itself in all kinds of health problems, such as weight change, depression and heart problems.
It is good to be alert to symptoms of a hormone imbalance, but it is a bad idea to use the self-tests that hormone test providers sell, says internist endocrinologist at Erasmus MC Liesbeth van Rossum: ‘Such a A snapshot says virtually nothing, because many hormones fluctuate constantly.’
Short-lived peak in the morning
For example, there are major differences in cortisol values if you measure in the morning or in the evening, says Van Rossum. Even between two measurements in the morning, for example one at a quarter past eight and one at half past nine, there can be a world of difference. ‘Cortisol peaks briefly in the morning because it plays a role in waking up.’
In addition, very large differences in values can be measured in women during their cycle and during certain phases of life.
Van Rossum: ‘Measuring and influencing our hormone balance is very complicated. It is not without reason that training to become an endocrinologist takes at least six years after medical school.’
An endocrinologist tests specifically based on the pattern of complaints, over a longer period of time and at the right times. The results must also be interpreted carefully: what are the normal values of this patient and what indicates disrupted hormone production?
Self-testing is a waste of money
According to Van Rossum, a self-test is a waste of money. A small selection from the offer: a testosterone test for men costs 120 euros at One Day Clinic; a saliva test for cortisol costs 29 euros at Yours Health Test; a menopause test 144 euros; At provider Medivere you pay 62.95 euros for a saliva test for progesterone and estradiol.
People should know what they do with their money, but it becomes problematic when they start working with self-test results, Nieuwdorp warns. ‘These test results are often accompanied by advice, or people themselves look for information on the internet. There you will, for example, come across hormone coaches who say that they “bring your hormones back into balance.”
‘Advice such as ”exercise enough, eat healthy and varied, and reduce stress” cannot of course do any harm. As endocrinologists, we also recommend the same.’
Soy, fennel and lavender
According to Nieuwdorp, advice to avoid hormone disruptors is also not wrong: ‘Scientifically proven hormone disruptors are, for example, certain parabens in cosmetics and plasticizers in plastic. But soy, fennel and lavender can also disrupt the hormone balance in large quantities, because they contain substances that resemble our own hormones.’
The effect of these disturbances can be, for example, reduced sperm quality, metabolic problems or diabetes.
According to Nieuwdorp, it is wise to be extra alert to this during important hormonal phases in life, such as early childhood, puberty and pregnancy. ‘There is normally nothing wrong with lavender, for example, but it is not a good idea to apply a thick layer of lavender body lotion to a baby every day.’
Check the source of the advice
Nieuwdorp recommends paying close attention to whether advice endorses the scientific consensus or comes from pseudoscientific sources. He regularly sees dubious advice on websites. ‘For example, about supplements with St. John’s wort, which actually has a hormone disrupting effect in combination with some medicines.’
‘Do not medicate yourself, but go to the GP if you have persistent complaints,’ advises endocrinologist Liesbeth van Rossum. ‘The GP can assess whether your complaints fit the picture of a hormone abnormality and, if necessary, refer you to an endocrinologist.’
A self-test result is not relevant. Van Rossum: ‘That only creates confusion. We see many healthy people who are worried by a meaningless test. It then takes a lot of time to remove all unjustified concerns. In our overloaded healthcare system, this is at the expense of paying attention to patients who really suffer from a hormone disease.’
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