Should I support my hormones first or should I support my adrenals first?
Question that we hear a lot.
I'm Dr. Carrie Lam. This is Dr. Michael Lam, our authority on Adrenal Fatigue Syndrome.
People have a lot of overlapping symptoms.
Is it the hormone issue or is it the adrenal issue?
How do you tease that apart?
It is difficult and it's no question because it's convoluted.
First, most important is to take a detailed history.
Now, both the hormonal system as well as the adrenal system
are part of the neuroendometabolic stress response.
Most people – it's almost like you have legs of a stool.
You cannot say one is more important than the other one.
It really depends on which one is broken and how and to what degree the other ones are affected.
But generally speaking,
you don't want to overly support any hormone or any adrenals.
Both are not good, and the reason is because they affect each other.
You need to be able to do a picture to do balancing.
It's almost like a lock step,
you know, not necessarily one and then the other.
Sometimes you have to do both at the same time if both are symptomatic,
but if the person has, for example, a detoxification issue,
then hormones may have to take a backseat because hormones are oftentimes, you know,
metabolized by the liver and if you have a liver congestion,
then more hormones can actually make you worse.
So not only just adrenals and hormones, but also you have to think about your liver
and your gut and your inflammation, so it's a whole body approach.
Yeah. Many people, they kind of put on bioidentical hormones, estrogen, progesterone,
they throw in testosterone and throw in the thyroid,
and for the healthy people, there's no problem. It works quite well
but it doesn't work well for some people
and despite a lot of adjustments, they just simply don't do well.
The question is, why? Why don't they do well when it's the right thing to do?
The answer is quite simple. It's because the body simply say it's not the right time
or the right dosage or the right frequency,
so there's a lot of modulation that has to go in.
That's when we look in depth outside,
the benefits and say hey, "Is it really the right time?"
If not, so when is the right time?
It's not just to say what is the right thing or the wrong thing to do, you see.
How does someone deal with their adrenal issue even when they have their hormonal symptoms?
Well, oftentimes in Adrenal Fatigue, there's so many symptoms, you have to prioritize.
It's possible if you know what you're doing
in the sense that let's say now you have symptoms of hot flash,
you know, at the same time you are fatigued.
Now if you want to address the hot flash, it can actually make the fatigue worse.
These are things that you have to discuss
and see to what degree one is important versus the other one,
and sometimes you can do both.
Sometimes you have to kind of take your time and work it out.
There's no rule, so to say. Everybody's different
and we plan a course, so to say,
to have the blue print where we make sure that every issue,
in this case, both the hormonal circuit as well as the adrenal circuits
are taken care of simultaneously.
It is easy for the inexperienced doctors to just focus on or the other,
and sometimes it's helpful if they are young and the body can handle it.
But when you get to a weak point, the weaker the body, the more careful you have to be.
Always remember, steroidal hormones such as estrogen,
progesterone, testosterone, they're 85% metabolized by the liver
and the metabolites can build up very quickly.
If you have a liver congestion or extracellular matrix congestion,
the best hormone may not work,
and not only that, you will end up taking more and more and more, and eventually,
you can have adverse effect.
In terms of balancing estrogen, progesterone, testosterone, cortisol,
which one come first, this takes a lot of questioning, a lot of history,
a lot of understanding of what the body is because everybody is different
and so you have to be very careful.
My recommendation if you are one of those people
is to find someone who can take a detailed history because the history will tell the story.
That's how you can decide whether
to deal with your adrenals or your hormones or all of it at the same time.
We are here to help you on your health journey.