Dr. Akoury sees patients in her clinic in Johnson City, Tennessee. To schedule an appointment with Dr. Akoury or learn more about her practice, click here.
- How Daily Stress Affects your Hormones and Longevity - August 13, 2022
- 5 Surprising Hidden Stressors That Are Making You Age Faster - August 13, 2022
- 7 Anti-aging Strategies to Flawless Youthful Skin at Any Age - May 10, 2022
HRT issues | Stress & reproduction | Allostatic load | Cortisol steals | Tyrosine | Find the root cause | References
We all know hormones play a huge role in longevity. As we age, the levels of many hormones tend to decline[1], which can greatly affect every aspect of our lives. Even more, low levels of certain hormones can increase the risk for age-related diseases[2].
But, while hormone replacement therapy can be an important anti-aging tool, it does neglect one important question. Is there perhaps something else going on in our bodies that cause our hormones to decline? Even more, why is it that some people seem to experience very low levels of certain hormones as they age, while others may not?
In this series of articles, we collaborated with Dr. Dalal Akoury, MD, an anti-aging medicine doctor who specializes in combining conventional and alternative medicine to optimize longevity and wellness. Dr. Akoury shared some surprising facts about the way daily stress can affect our anti-aging and sex hormone production and emphasized the importance of a holistic personalized approach that considers the unique way your body responds to stress.
To listen to the complete interview with Dr. Akoury, or read the transcript, see: LongevIQ Podcast.
Why are my hormones so low?
As an anti-aging medicine doctor, I often see patients who are deeply concerned about their hormone levels dropping with age. They often experience low libido, fatigue, mood swings, poor cognitive function, loss of strength, dull looking skin, among other typical “signs of aging”.
Indeed, studies have shown that a decline in hormones such as testosterone, estrogen, progesterone, and DHEA has been linked to several conditions and age-related disease in both men and women[3]. You may recognize these hormones as sex hormones, although they play a key role not only in sexual health, but in many non-sexual functions as well.
Now, hormone replacement therapy (HRT) is a popular anti-aging medicine option for age-related hormonal decline. Traditional treatment involves having your hormone levels tested by your doctor, and based on the results, they will prescribe a medication containing one or more hormones to bring the levels up. If this sounds simple enough, we should mention that hormones often influence each other. So, rather than trying to “fix” each individual hormone that is low, it is important to take a look at the complete hormonal picture. This allows your provider to address the root cause and let your body’s intelligence do the rest. The cause, however, can vary from one person to another. HRT is never a one-size-fit-all.
And just to add another layer of complexity, hormones levels can be greatly affected by many lifestyle factors. One major example, that is not always considered in hormonal replacement therapy, is stress.
How daily stress affects your sex hormones
Imagine our ancestors running away from a scary animal. It’s better not to be distracted by a sexy mate while you’re being chased by a lion, right? It is definitely not the time! Your attention and energy need to be directed towards what’s crucial for survival during this moment. Even the slightest distraction can lead to some fatal consequences.
While we have all evolved to respond to these types of short-stress threats in our environment, modern times have introduced a completely new type of stress. Unlike life-threatening situations which trigger a short response, we are now dealing with longer-lasting stress. Chronic stress can be triggered by the news, deadlines at work, tension with your spouse, or money, modern stressors seem to be everywhere around us. And they never really stop. It’s like the lion is always there. It never leaves.
When you get to think about it, this survival mechanism makes a lot of sense. Under chronic stress, it would be dangerous to have a baby in an environment where survival is constantly threatened. The body then smartly opts out of reproduction, just for the time being, hoping for better circumstances later on, when it’s more likely that you’ll be able to survive and care for an infant. With modern life, our stress response is triggered way too often. Eventually, you may start to see a decline in your sex hormones.
Clearly, a lot has changed since the days of our ancestors. We live in a completely new environment that our body hasn’t fully adapted to yet. But how much stress is too much? And what can we do to help our bodies better cope with stress?
The straw that broke the camel’s back
Have you ever been in a situation where something super small happened, yet you totally flipped and ended up stressed out for the entire day? What’s going on?
Turns out, there are several raw materials, nutrients, and resources your body needs to properly respond to stress. And with chronic stress, they often become low, leaving you more vulnerable to getting stressed out.
You can think about your body’s tolerance to stress as a bucket that can hold a certain amount of water. As long as you do not exceed its capacity, you are fine. If you keep pouring more and more water, however, the bucket will eventually overflow. Your ability to effectively cope with stress then, will be impaired.
The same thing happens in our bodies. Stressful life situations, poor diets high in processed foods, lack of sleep, and other factors add more water to the bucket. Over time, the bucket simply gets too full, depleting all of your body’s reserves. Healthy habits on the other hand, such eating a balanced diet, getting enough sleep, and doing things that you love that make you feel happy and calm, reduce the amount of water in the bucket. They help restore your body’s reserves, so it can better handle stress.
The bucket analogy is a simple way to describe allostatic load. This is the term for the overall burden that stress and life events have on our body[4,5]. When a potentially stressful event happens, and you have enough reserves (or space in the bucket), then chances are your body may have enough resources to respond to the situation in a positive way and maintain equilibrium. If the same event happens, however, and you have little to no reserves, then even a minimally stressful event can create a bigger stress response.
Now, remember that seemingly random small event that caused you to totally freak out? Chances are it wasn’t the real cause. It was just the straw that broke the camel’s back.
Healthy lifestyle choices all play a major role in helping keep the stress bucket empty. A nutritious diet is particularly important for helping cope with stress. Not only does food provide nutrients that can help mitigate the physical effects of stress, but it also plays a role in maintaining balanced hormone levels.
Cortisol steals – and your sex hormones decline
Most people know cortisol as the body’s primary stress hormone. What is less known, however, is that cortisol is actually a steroid hormone that just like our sex hormones, is synthesized from cholesterol[6].
This means that your body needs enough cholesterol to maintain healthy levels of cortisol, but also, your sex hormones. The body’s available pool of cholesterol, however, is only so large. When you’re making a lot of cortisol during times of stress, then much of the cholesterol is getting used for cortisol production. If this happens too often, there may not be much left for making enough sex hormones.
Also known as cortisol steal, this is one way that chronic stress can lead to a decrease in levels of DHEA, testosterone, estrogen, progesterone, and other sex hormones. Simply put, under a state of chronic stress, your body prioritizes cortisol production over sex hormones in an attempt to survive.
The plot thickens…adding tyrosine to the mix
Much like cortisol stealing cholesterol away from your sex hormones, adrenaline and noradrenaline which are also released when we are stressed[7], can steal the amino acid tyrosine, leaving less tyrosine available to support other systems in the body.
Tyrosine is used as a precursor for a variety of other substances within the body. For example, thyroid hormones are made from tyrosine. The neurotransmitter dopamine, which is very important in regulating our mood and ability to feel pleasure, is also synthesized from tyrosine[8,9].
Should we then take tyrosine supplements if we are dealing with a lot of stress, just to ensure our body has enough? We should be cautious even with a natural supplement such as tyrosine, as too much tyrosine could lead to the opposite problems. For example, an excess of tyrosine could cause an overactive thyroid (hyperthyroidism).
Treat the person, not the lab values
Our hormonal health can’t be “fixed” by supplementing with one or two hormones. We are far more complex. Making a decision to start hormone replacement by simply looking at the values of a few hormones, no matter how powerful these hormones are, may not give you the results you are hoping for.
It is true that HRT can bring low hormone levels up, which may help with many of the symptoms, but the story rarely ends there. There may be a specific issue unique to you that is contributing to a hormonal imbalance. When you address the root cause, your body may be able to bring those levels up on its own. This means you may need to take fewer hormones if any at all. Masking the symptoms by adding hormones without considering other potential imbalances is never a good long-term strategy for health and wellness, not to mention, for longevity.
You are unique, and so is your stress response
I often like to explain stress as an intimate conversation between our genes and our environment. Indeed, the individual response to stress can be very different from one person to another. Your genetics, what you eat or drink, your lifestyle habits (like exercise or sleep), your interactions with people, even your own beliefs and outlook on life, all create a unique internal environment along with a unique stress response.
With so much variance, the best way to truly understand your individual stress response and how it affects your health is by testing. This includes the sex and anti-aging hormones you may be worried about, but also other individual factors that can influence not only these hormones but many other aspects of health and wellness.
In fact, some of these tests can provide life-changing insights that we can then use to tailor a plan that meets a person’s unique needs. For example, due to genetics, there may be differences in the body’s ability to convert cholesterol to cortisol and sex hormones. If your body is less efficient at performing this conversion, then you may end up with low levels of sex hormones, and your cortisol may not rise much in response to stress. Since your cholesterol is not getting converted to other substances, this leaves extra cholesterol floating around in the bloodstream.
As you can guess, this can look very alarming in standard testing, unless you know the cause, which in this case is genetics. This understanding allows us to take a much more accurate and targeted approach, rather than “fixing” each abnormal lab value with medication.
Stress is not your enemy, it’s your friend
The stress of modern life may seem devastating and overwhelming at times. This, however, doesn’t mean we throw in the towel. By now, we have plenty of knowledge, tests, and tools that can help us understand the individual way your body responds to stress, and how to optimize it.
Always remember that you don’t have to take this journey all by yourself. A qualified practitioner can help guide you through all the steps and ensure you are on the right track towards optimal health and wellness.
When you have a healthy strong resilience to stress, you stop seeing stress as your enemy. In fact, don’t be surprised if it will become your friend.
Read next: 5 Surprising Hidden Stressors That Are Making You Age Faster.
