What I Tell My Patients To Eat To Balance Their Hormones

What I Tell My Patients To Eat To Balance Their Hormones Hero Image
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Dr. Sara Gottfried is a Harvard-trained MD, best-selling author, and leading expert on hormones. Now, she's teaming up with mindbodygreen to share her secrets. Check out her new course, How to Balance Your Hormones for Glowing Skin, Deeper Sleep & Better Digestion.

When in balance, your hormones are like text messages in your body from a wise mentor. Each hormone sends a “do this” or “do that” task to cells far away in an effort to create homeostasis, which you feel as a full head of hair, strong nails, clear skin, stable mood and weight, stress resilience, and robust digestion and libido.

Unfortunately, the hormonal system is quite vulnerable to your environment—particularly toxins, poor sleep, the wrong foods or drinks, wayward microbes in the gut, and even limiting thoughts.

When it comes to restoring balance, I have a “food first” philosophy rather than immediately jumping to a prescription or even a supplement that contains the isolated compounds of a beneficial food.

Here I'll explain the top five hormones that create homeostasis in your body and share my favorite foods to help bring each back into balance:

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1. Cortisol

Cortisol is the primary hormone of the stress response and is secreted by the adrenal glands. When elevated, it raises blood pressure and blood sugar so that you can fight or flee. But when cortisol is chronically elevated, it can lead to a heightened sense of “rev” or unease in the body, depression, accelerated aging, weight gain, blood sugar problems, and metabolic syndrome.

What you may notice:

  • Feeling like you’re constantly racing from one task to the next
  • Difficulty losing weight, especially at your waist
  • Moodiness or depression
  • Quickness to anger or rage
  • Trouble winding down before bedtime or difficulty staying asleep
  • Weak nails or skin conditions like eczema or thin skin (sometimes literally and figuratively)
  • High blood pressure or blood sugar (or both)
  • Memory lapses or attention deficit, especially under stress
  • Craving salty or sugary foods
  • Low libido

Lab tests: Serum cortisol, diurnal dried urine (this tracks your cortisol levels at four points throughout the day, and reflects the quality of your hypothalamic-pituitary-adrenal axis, i.e., brain-adrenal conversation), “Complete Hormones” urine test, available from Genova. Old-school testing includes saliva testing, but I find dried urine to be more informative.

Eat this food: Extra dark chocolate, shown to lower cortisol levels. Yum! Honorable mention: cold-water wild-caught fish. My latest favorite is cod from Alaska, baked in a miso paste in parchment paper on a bed of asparagus or other vegetable.

2. Insulin

Insulin regulates the amount of glucose in your blood. The main problem with insulin is chronic elevation, leading to insulin resistance (when cells become numb to insulin, and blood glucose rises to pre-diabetes or diabetes levels).

What you may notice:

  • Cravings for sweet foods
  • Difficulty not eating carbohydrate-rich foods, such as chocolate, ice cream, or french fries
  • Fasting blood sugar higher than normal (greater than 85 mg/dl)
  • Feeling shaky, anxious, or irritable between meals
  • For women, a waist measurement 35 inches or greater (at the belly button). For men, greater than 40 inches
  • Body mass index greater than 25
  • Polycystic ovary syndrome (PCOS), a condition that includes irregular periods, acne, increased hair growth, and sometimes infertility and cysts on the ovaries
  • Low HDL (good) cholesterol and/or high triglycerides
  • High blood pressure (systolic greater than 140 or diastolic greater than 90)
  • Fasting insulin level that is greater than 5 μiu/ml (micro international units per milliliter)

Lab tests: fasting blood sugar, fasting insulin, HgbA1c.

Eat this: Sauerkraut (or kimchee, or any fermented vegetable), shown in studies to lower fasting glucose.

3. Testosterone

Testosterone is a hormone produced in the ovaries of women and the testicles of men, and in the adrenal glands. It's important for a sense of well-being, confidence, maintaining muscle tone, bone growth, and sexual function.

When elevated excessively, a problem facing many American women, it can lead to acne, irregular periods, excess body hair, loss of head hair, and infertility.

What you may notice:

  • Acne
  • Excess hair on your face, chest, or arms
  • Greasy skin and/or hair
  • Thinning head hair (sometimes combined with excess hair growth elsewhere)
  • Discoloration of your armpits (darker and thicker than your normal skin)
  • Skin tags, especially on your neck and upper torso
  • Hyperglycemia or hypoglycemia and/or unstable blood sugar
  • Reactivity and/or irritability, or excessively aggressive or authoritarian episodes (also known as ’roid rage)
  • Depression or anxiety
  • Polycystic ovary syndrome, usually with ovarian cysts (called a “string of pearls” on ultrasound), infertility, or menstrual cycles occurring more than every 35 
days

Lab tests: serum free and total testosterone, sometimes bioavailable testosterone

Eat this food: Green beans, which are rich in zinc. Honorable mention: pumpkin and sesame seeds, also rich in zinc. Zinc plays an important role in sexual development, menstruation, and ovulation. Zinc deficiency is associated with higher androgens, the family of hormones to which testosterone belongs, and acne.

4. Estrogen

Estrogen refers to a family of sex hormones that are responsible for female characteristics in the body, including the development of breasts and hips. But sometimes you can get too much of a good thing: Hundreds of known toxins from the environment can mimic estrogen and lead to excess estrogen pollution in the body.

What you may notice:

  • Bloating, puffiness, or fluid retention
  • Abnormal Pap smears
  • Heavy bleeding or postmenopausal bleeding (see your doctor!)
  • Rapid weight gain, particularly in the hips and butt
  • Increased bra-cup size or breast tenderness
  • Fibroids, endometriosis, or painful periods (endometriosis is when pieces of the uterine lining grow outside of the uterine cavity, such as on the ovaries or bowel, and cause painful periods.)
  • Mood swings, PMS, irritability, weepiness, mini breakdowns, or anxiety
  • Migraines or other headaches
  • A red flush on your face (or a diagnosis of rosacea)
  • Gallbladder problems (or removal)

Lab tests: Dried urine testing (see cortisol) with all estrogen metabolites, or salivary female hormone panel. Body burden testing in the blood and urine.

Eat this food: Cruciferous vegetables—for example, broccoli and cauliflower, and even cabbage, because people don't always remember what a gem of a food it is. These vegetables help block estrogen, the fiber helps you excrete excess estrogens, and overall the crucifers help cells with programmed cell death, so that senescent cells don’t keep circulating and loitering like zombies, wreaking havoc and accelerating the aging process. Today, I’m eating a salad at lunch with red cabbage, broccoli sprouts, grated carrots, and basil—topped with avocado oil and Meyer lemon. Scrumptious!

5. Thyroid

Your thyroid is in charge of metabolism, or how fast or slow you run biochemical reactions in the body, including the rate of calories burned. Specifically, your thyroid gland’s job is to take iodine, which is found in many foods, and combine it with tyrosine to produce thyroid hormones: a storage hormone called thyroxine (T4) and active thyroid hormone called triiodothyronine (T3).

About 10 percent of women lack sufficient thyroid hormone from a slow thyroid gland, so energy is triaged to the most vital functions and away from hair, skin, and bowel function. They suffer from a slow metabolism: They’re depressed; constipated; gain weight easily; and experience hair, skin, and joint problems.

What you may notice:

  • Dry, strawlike hair that tangles easily and/or falls out (hair loss may include eyelashes or the outer third of your eyebrows)
  • Dry skin; decreased sweating; thin, brittle fingernails
  • An additional few pounds, or 20, that you just can’t lose; fluid retention
  • Bowel movements less often than once a day, or you feel you don’t completely evacuate
  • Muscle or joint aches (you became an old lady overnight)
  • Cold or tingling in hands and feet, or intolerance to cold or heat, maybe a sensitivity to cold (you shiver more easily than others and are always wearing layers)
  • Slow speech, perhaps with a hoarse or halting voice, slow brain, slow thoughts; difficulty concentrating; sluggish reflexes and diminished reaction time
  • Lethargy (you feel like you’re moving through molasses) or fatigue, particularly in the morning
  • Depression or moodiness (the world is not as rosy as it used 
to be), or a prescription for the latest antidepressant, but you’re still not feeling like yourself
  • Heavy periods or other menstrual problems (see your doctor!), infertility, miscarriage, or preterm birth
  • An enlarged thyroid or goiter, or difficulty swallowing


Lab tests: Mainstream medicine usually runs only a serum TSH and T4 to determine thyroid function. A functional medicine thyroid panel includes several other labs such as free and total T3 (active thyroid hormone), reverse T3, and thyroid antibodies to rule out autoimmune thyroid problems.

Eat this food: Brazil nuts. In addition to iodine, you need selenium, zinc, and copper for proper thyroid function. Brazil nuts are the richest source of selenium from food. Sometimes people with Hashimoto's are advised to avoid selenium. You need selenium for glutathione production to help decrease thyroid antibodies. I recommend eating one to three Brazil nuts per day.