These tiny molecules keep your body humming along, so here’s what to know about keeping them in balance.
Everything from your metabolism to your fertility is controlled by hormones. There are more than 50 hormones in the human body, and some are really good at one job, while others multitask.
Hormones are messengers. “They are little molecules that are produced in different organs,” says Mihail Zilbermint, M.D., an associate professor of clinical medicine at Johns Hopkins University School of Medicine and the chief of endocrinology, diabetes, and metabolism at Suburban Hospital in Bethesda, MD. “They circulate in our bodies and give signals and directions to produce other substances that are responsible for keeping our bodies up to speed and balanced.” For a hormone to do its job, it needs to make its way to cells designed to receive it, as a key fits a lock. For instance, the hormone insulin can do its job of removing glucose from the bloodstream only if receptors in muscle, fat, and liver cells receive it. But hormones don’t work alone—insulin, like many, works as part of a team. Another hormone, glucagon, ensures that too much sugar isn’t taken from the blood.
Sound complicated? It is. The endocrine system is the network of hormones (and the glands and organs that produce them) that keeps the body functioning. We can’t explain it all here (endocrinologists spend years learning it!), but here are highlights of important hormones, along with what you can do to keep certain ones at proper levels and how to know if something is awry.
“Every time we eat, beta cells in the pancreas release insulin to help the body use or store blood glucose, which is the sugar we get from food,” says Dr. Zilbermint. When levels of insulin get out of whack, the result can be type 1 or type 2 diabetes, which together affect more than 37 million Americans.
“With type 1 diabetes, the pancreas may no longer produce insulin—the beta cells have been destroyed, most likely by an autoimmune process,” says Dr. Zilbermint. Only about 5% to 10% of people with diabetes have type 1. “People who have type 2 diabetes make insulin, but their bodies don’t respond well to it, so some of them may need pills or special shots to intensify their own insulin production—sometimes they take insulin itself as a shot,” explains Dr. Zilbermint. With either type, a person’s blood can become overloaded with glucose, which can lead to an array of issues including heart disease, vision loss, and kidney damage.
Though you can’t do much to sidestep type 1 diabetes, type 2 diabetes can often be prevented. In fact, 96 million people in the U.S. currently have prediabetes, which means their blood sugar is high but they don’t have full-blown diabetes and may be able to avoid it with diet and exercise. Eating more non-starchy vegetables, lean protein, fruits, whole grains, and unsweetened beverages while limiting processed foods, trans fats, sugary drinks, and alcohol can help. Research has also found that walking for just a few minutes after every meal can lower blood sugar levels because insulin promotes the uptake of glucose by muscles to make the exercise possible. The Centers for Disease Control and Prevention recommends at least 150 minutes of moderate-intensity exercise per week and muscle-strengthening activities on two or more days a week to keep all body systems healthy.
Many people don’t know they have prediabetes, says Dr. Zilbermint, who notes that early and regular screening is extremely important to catch it ASAP. “I practice in a hospital, and unfortunately when I catch it in patients, they’ve already developed complications, either heart attack or stroke or a foot ulcer or kidney failure,” he adds. Earlier symptoms can include extreme thirst, frequent urination, blurry vision, numbness or tingling in hands and/or feet, sores that heal slowly, dry skin, weight loss, and increased hunger.
Your thyroid is a small but mighty gland in your neck. The thyroid itself is controlled by a hormone from the pituitary gland called thyroid-stimulating hormone (TSH), and the hormones produced by the thyroid are thyroxine (T4) and triiodothyronine (T3). “Most of the cells in the body have receptors for thyroid hormones,” says Cesar Abuchaibe, M.D., an endocrinologist at Mount Sinai in New York City. “Think of thyroid hormones as a battery for our cells that gets the machinery working.”
When a person doesn’t have enough thyroid hormones (a common condition called hypothyroidism), it can cause symptoms such as low energy, slow heart rate, weight gain, dry skin and hair, sensitivity to cold, depression, constipation, achy joints and muscles, and irregular menstrual cycles. The good news is that a tiny daily pill containing synthetic thyroid hormones can usually treat the problem. On the opposite end of the spectrum, an overabundance of thyroid hormones (hyperthyroidism) can lead to fatigue, fast heart rate, weight loss, sensitivity to heat, mood swings, diarrhea, and muscle weakness. Treatment may include medicines designed to lower thyroid hormone levels or radioactive iodine to destroy cells in the thyroid.
“There’s no real natural way to keep the thyroid hormones in check, because the most common reason the thyroid goes south is an autoimmune process,” says Dr. Abuchaibe. Sometimes that autoimmune process is triggered by stress—mental stress like breaking up with your significant other or physical stress like a severe illness or giving birth. “Women can also develop postpartum thyroiditis up to a year after delivering a baby,” says Elizabeth Buschur, M.D., an associate professor of internal medicine and an endocrinologist at The Ohio State University Wexner Medical Center. “The thyroid can temporarily misbehave by making too much or too little thyroid hormone and then return to normal, most often without treatment.”
While being over 60 can raise your likelihood of developing a thyroid problem, slight changes in thyroid levels as you age are not usually a concern. “We know that as people mature or age, some of their thyroid levels may change,” says Dr. Zilbermint. “But now in the scientific community we believe those thyroid changes, though they may look abnormal on a blood test, could be just a normal adaptation of the thyroid to the aging process.” When it’s a matter of aging, other tests of thyroid function (such as radioactive iodine uptake) will produce normal results even when hormone levels are off.
These are our most important stress hormones, and they’re released by our adrenal glands, which sit on top of our kidneys. If you were to come across a bear, this duo would give you the sudden boost of energy you needed to get away, says Dr. Buschur. They’re rarely unbalanced unless you have an adrenal tumor or an autoimmune condition that affects the adrenal gland or you take steroids for long periods.
However, if you’re chronically stressed, your cortisol levels can remain slightly elevated longer than is ideal, says Dr. Zilbermint. For instance, he points out, humans naturally produce less cortisol at night when they sleep (and historically, this was when we faced fewer dangers), but research has shown that people who regularly work overnight shifts have higher levels of cortisol at night compared with daytime employees and a higher risk of metabolic syndrome. “Chronic production of excess cortisol is linked to weight gain,” Dr. Zilbermint says. Many things can cause the body to be stressed for long periods, but poverty, chronic pain, dissatisfying work, and strained relationships are common culprits. Cortisol and adrenaline also fall into the group known as counterregulatory hormones, which means they step in to help not only when you’re stressed, but also when your blood sugar gets too low—bad news if you have diabetes. “As a counterregulatory hormone, cortisol is going to decrease your insulin levels, and if you decrease your insulin levels, your blood sugar will go up and your diabetes will be uncontrolled,” says Dr. Abuchaibe. “That’s why stress plays a big role in diabetes.”
That said, it’s important to remember that cortisol is an anti-inflammatory problem solver that gears up the body to handle threats. Consider illnesses like COVID-19: “People who are hospitalized with COVID-19 and require oxygen are frequently getting extra doses of cortisol called dexamethasone to suppress the inflammation caused by the SARS-CoV-2 virus,” says Dr. Zilbermint.
We often call testosterone and estrogen “sex hormones” because of how they control our reproductive health. When cis females enter puberty, estrogen (primarily produced in the ovaries) ramps up to spur reproductive development and affects things like the urinary tract, mucous membranes, pelvic muscles, skin, hair, and the cardiovascular system. In cis males going through puberty, testosterone (mainly made in the testes) increases and causes changes in the reproductive system along with the skin, bones, muscles, and fat. People who are transgender may choose to supplement their natural hormone supply to help their bodies develop to match how they feel inside.
While women do produce testosterone and men do produce estrogen, the amounts are very small, and as both groups age, their production of all sex hormones decreases. Yes, that decline can result in sexual changes such as lower libido, vaginal dryness in women, and erectile dysfunction in men, but there’s more to it than that. “Estrogen is a hormone that protects our bones, and in cis men, testosterone is converted into estrogen,” says Dr. Abuchaibe. “That is a reason women, once they undergo menopause, are more at risk of osteoporosis. For guys, testosterone decreases later on in life, in the 70s or older, but for women there is a big change in the early 50s.” To build a strong skeleton before it’s too late, consider consuming calcium, doing weight-bearing exercise, and avoiding smoking.
“Melatonin is a natural hormone your brain makes to help with sleep and keep the circadian rhythm intact,” says Dr. Buschur. Typically when the retinas in the eyes receive light, a message is sent to the brain’s pineal gland telling it to stop secreting melatonin, and as a result, we awaken. At night, when our retinas register a darker environment, a signal is sent to trigger the release of melatonin, and we begin to feel sleepy. If you work a night shift and stay in a dark room during daylight hours, your pineal gland will adapt to release melatonin during the day, notes Dr. Buschur. This is why turning off light-emitting screens an hour or two before bed is often recommended for the best sleep.
These are a few of the many hormones that contribute to fertility and pregnancy. For example, says Dr. Buschur, after a woman ovulates, progesterone signals the uterine lining to thicken and prepare for a potential conception. Meanwhile, oxytocin helps during labor and delivery, while prolactin stimulates breast milk production. “These hormones have important roles in reproduction, but studies show that some hormones such as oxytocin, whose main role is to help with contractions in preparation for childbirth, can also have roles in bonding, intimacy, and relationships,” says Dr. Buschur.
Formally named somatotropin, human growth hormone (hGH) is made by the pituitary gland in the brain, and its primary role is to promote growth in children. “Rarely, people will have a pituitary tumor or a deficit of many pituitary hormones that can lead to low levels of growth hormone, but treatment in adults is controversial unless there are related symptoms,” says Dr. Buschur. “Growth hormone is necessary for normal childhood growth and should be supplemented in children with growth hormone deficiency. For those treated as children, it is often continued in adulthood.” It’s also possible to have too much hGH, a condition called acromegaly. When that happens, Dr. Buschur says, patients might notice that their hands or feet get bigger or see changes in the spacing of their teeth if the jaw enlarges, but it can also lead to weight gain and conditions like diabetes, heart disease, and sleep apnea. In cases of acromegaly, doctors will address the root cause (such as a pituitary tumor).
Remember, hormones control every system in your body, so if something seems off, see your doctor. If you need treatment, it may help to meet with an endocrinologist, a physician familiar with the ins and outs of all the glands and organs that produce hormones—especially one who has experience with your particular issues. And don’t rely on an at-home hormone test, cautions Dr. Zilbermint: “Incorrect numbers, high or low, can cause a panic.” An endocrinologist can decipher the info.
Kaitlyn Phoenix is a senior editor in the Hearst Health Newsroom, where she reports, writes and edits research-backed health content for Good Housekeeping, Prevention and Woman’s Day. She has more than 10 years of experience talking to top medical professionals and poring over studies to figure out the science of how our bodies work. Beyond that, Kaitlyn turns what she learns into engaging and easy-to-read stories about medical conditions, nutrition, exercise, sleep and mental health. She also holds a B.S. in magazine journalism from Syracuse University.
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