“Hormone types” are a best guess as to what lifestyle elements one may want to start with. They stratify women into buckets based on life stage and hormonal symptoms. . There are not 7 hormone types, there are infinite types. Each woman is different. The types help narrow down each woman's most likely best starting place. From there the detective work starts to find the best lifestyle for you.
Can you really tell someone's hormones from a quiz? Is there any science behind it? Is it a scam?
All good questions. This blog explains the concept, how it is used and why it may be useful as a first step in lifestyle change for women at different stages of their lives.
First let's get the obvious out of the way. Women and men are not the same. There are real biological differences between men and women. Women have two major sex steroids. Men have 1. Female sex hormones fluctuate and cycle throughout the month. Male hormones stay fairly static. Women go through 4 to 5 hormonal stages in life (puberty, pregnancy, peri-menopause, menopause, post-menopause). Men go through two (puberty and andropause.)
One quick note here. Menopause, peri-menopause and post-menopause are not being used here in their diagnostic capacity, but rather because they each have slightly different hormonal state.
Let's get into the rest of the background so you can understand the rationale behind metabolic types and hormone types in particular. The following comes directly from my book Next Level Metabolism (Chapter 8 pages 266 to 273). GET THE BOOK HERE
Understanding Hormone and Metabolic “Types”
In reality, there are no such thing as “hormone types” or “metabolic types,” at least not as far as science is concerned. The best way to think of these “hormone types” or “metabolic types” is as hormonal stages or metabolic states or even diagnoses. After all, what is a diagnosis if not assigning someone a “type” based on clinical symptoms and measurable laboratory disturbances? (More on diagnosis later.)
Take blood sugar, for example. We have those with normal blood sugar levels and normal blood sugar responses. We then have those who sometimes see blood sugar drop and suffer predictable signs and symptoms of hypoglycemia (fatigue, difficulty thinking, agitation, increased hunger, etc.). We call these people hypoglycemics. That’s their type or “diagnosis.” We then have others who have mild blood sugar impairments along with high blood pressure, elevated insulin levels, high triglycerides, and fat gain centered around the middle. We call this the metabolic syndrome type or prediabetics. Then, of course, we have diabetics type 1 and type 2.
The same could be said for thyroid. There are people with high thyroid function who suffer from anxiety, sweating, and increased heart rate and are usually thin with pronounced eyes. We call these hyperthyroid. Others have normal thyroid. They are called euthyroid. Then we have low-thyroid types. They are called hypothyroid. Sometimes we divide these into different types as well, based on the etiology. For example, we have primary hypothyroid, secondary hypothyroid, and Hashimoto’s thyroiditis. These clinical entities are a form of typing. They are important for clinicians to understand so they can identify, stratify, and codify individual diseases. This allows the clinical entity to be studied and appropriate treatments to be determined.
As it pertains to women, think of it like this: clinically, we know that a normal menstruating woman has a particular hormonal reality characterized by fluctuating estrogen and progesterone. A pregnant woman is more progesterone dominant. A perimenopausal woman is more progesterone deficient with unpredictable estrogen (sometimes low and sometimes high). Clinically, these hormonal realities can help tailor lifestyle interventions. Estrogen and progesterone influence hunger, cravings, energy, and more. Accounting for them aids the ability to sustain low-calorie diets and healthy lifestyle changes.
Women have two dominant sex steroids; men have one. Men go through only two hormonal stages (puberty and andropause); women can go through five (puberty, pregnancy, perimenopause, menopause, postmenopause). Men have more static levels of testosterone throughout the month; women’s hormones ebb and flow. All of this matters.
We know young women go through an estrogen-dominant phase and a progesterone-dominant phase each menstrual cycle. Perimenopause is characterized by lowering progesterone and fluctuating estrogen, menopause by low estrogen and progesterone, and postmenopause by low estrogen, progesterone, and testosterone with relative testosterone dominance. Are these not useful hormonal realities?
Sex steroids impact other metabolic hormones (cortisol, insulin, thyroid, etc.) and influence hunger and cravings (due to effects on brain chemistry; estrogen impacts dopamine and serotonin while progesterone influences GABA). Taking these hormonal realities into account allows us to mitigate many of the compliance issues that plague most diet and exercise programs.
“Hormone types” are simply a best guess as to what lifestyle elements may be best to start with. They stratify women into buckets based on their life stage and hormonal symptoms. They are a form of temporary diagnosis. From there, the real work begins.
There are not seven different hormone types in women; there are infinite types. Each woman is unique in her physiology, psychology, personal preferences, and practical circumstances. By separating women according to their hormonal life stages, we provide some structure to begin. From there, we start the process of creating the lifestyle perfectly suited to their individual metabolic realities.
So there is no such thing as a hormone type, but you should probably still know yours.
Controversies in Medicine and with Metabolic Types
Let’s speak a bit more on the concept of diagnosis. A diagnosis occurs when your physician does a physical exam, considers your symptoms, and evaluates your vitals and blood labs. Based on all of this information, they then attempt to pick out patterns and give your situation a name or label. This is important because medicine has characterized many types of diseases. Matching your symptoms, blood work, and vitals to a particular disease name allows doctors to treat you more effectively. That’s because if your condition looks exactly like other people with the same condition, there is a body of research and case studies that might be helpful. Based on that body of research, there may be drugs that have been studied—depending on the diagnosis, there may even be a cure. Giving a diagnosis—or getting one—is one of the most important steps in treatment of a condition.
There is only one problem: most complaints don’t have a diagnosis. Most things people complain of fall outside of the criteria required to properly name and codify what is going on. This is why eight out of the ten times you go see a physician for something like unexplained weight gain, fatigue, mood issues, or other generalized complaints, they will tell you, “There is nothing wrong” or “Everything is normal.” At that point, your only option is to wait until things get so bad that a disease that can be named is discovered.
This points out one of the biggest flaws in conventional medicine. What can your doctor do for you if they can’t diagnose you? The answer? Not much. And yet, we all know that long before a disease can be detected, there is dysfunction occurring. An example would be type 2 diabetes. In order for your physician to diagnose type 2 diabetes, they would need to see a fasted blood sugar value of 126 on two or more occasions. However, long before you reach those blood sugar values, the blood sugar numbers would have been creeping higher and higher all along. Maybe you had some symptoms, or maybe you didn’t. Either way, at 126, you’re diabetic, but at 120, you’re not. Seems kind of silly, right?
That’s where functional medicine comes in. Functional medicine is the specialty of doctors like me. We specialize in keeping people well, not just in treating the sick. We pay close attention to the subtle dysfunctions that occur far in advance of actual disease. This is tricky since without a diagnosis, we can’t give a validated name to what people are experiencing. As a result, we use nondiagnostic descriptive terms like adrenal fatigue, sleep disturbances, menstrual irregularities, metabolic damage, estrogen dominance, and other terms you won’t find in any medical diagnostics manual.
A few months back, I had a run-in with a physician on the internet. This doctor took issue with the idea of hormone types and terms like “estrogen dominance.” He was an MD (medical doctor). Well, actually a DO (doctor of osteopathy). I am an ND (naturopathic doctor). In case you are wondering, these are all different types of doctors who work with patients. You can include chiropractors (DC) and physical therapists (DPT) and clinical psychologists (PsyD and PhD) in this as well.
Basically, he was behaving like a cop telling other first responders that they’re useless. The problem with that is, cops aren’t trained to put out fires and you don’t want them trying to save your life in the back of an ambulance. Imagine a police officer who has taken an oath to protect and serve the public and instead spends their time attacking firefighters and paramedics to show who the better first responders are. That’s how many health and fitness professionals behave on the internet.
MDs and DOs deal with drugs and surgery. Some ply in lifestyle medicine, but this is not their training. It’s like a cop who learns CPR and advanced first aid. That’s handy, but it’s no substitute for the training of a paramedic.
In my opinion, one of the best things that has happened in medicine, health, and fitness is the number of different specialty doctors that are now available. There are those who specialize in diagnosis, drugs, and surgery. Those who specialize in injury rehab and joint health. Those who specialize in lifestyle medicine, supplements, and optimizing function rather than treating disease. All of these professionals serve a role and, like the first responders, do better by their patients when they work together.
So why am I going through all of this? I wanted to set the stage correctly for the discussion of female metabolism. Clinically, I use “hormone types” as a first step in stratifying women. It’s the beginning step in helping them find their own unique type. If you are a woman, or a man who loves women, you should know it was not until 2001 that policymakers and regulating bodies in research and medicine realized women were drastically underrepresented in studies. At that point, these organizations put recommendations together to try to close that gap. Up until that time, research on health and fitness was almost entirely extrapolated from college-aged males. Recent research suggests not much has changed. In 2021, women are still often treated as small versions of men.
There is technically no such thing as a specific “hormone type.” Each woman is uniquely different and so represents her own individual type. And as you know by now, it takes time, attention, mastery, and practice to finally uncover the individual metabolic makeup. In the meantime, however, it is useful to have subsets of types that represent a better starting point than simply guessing (i.e., a functional diagnosis). This is especially true of women because they have fluctuating hormones monthly. The idea with the female hormone types is to provide a starting place that more closely resembles her current hormonal/metabolic reality. Obviously, a young menstruating woman requires different considerations than a perimenopausal mature female. Understanding these different hormonal states is imperative if you are going to be effective in controlling metabolic outcomes.
Most women notice the hormonal fluctuations that go along with menses and the changes that occur during a regular menstrual cycle, through pregnancy, and then through menopause, but not all are aware of the precise way that estrogen, progesterone, and other hormones ebb and flow, thereby influencing all of the other hormones in their bodies, particularly the fat-burning hormones. Most women, particularly those with stable and predictable menstrual cycles, can actually make these hormonal changes work to their advantage when it comes to fat burning. Even if a specific hormone type doesn’t apply to you, I encourage you to read this whole chapter as your hormonal balance and hormone type are bound to change over time. Understanding the different types will arm you with the critical information you need as these changes occur. Let’s take a closer look at what’s happening at each stage....."
The above has been an excerpt from Chapter 8 of Next Level Metabolism.
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