DH 51 | Hidden Hormone Imbalances


Hormonal imbalance is not uncommon these days. However, the symptoms are usually hidden and cannot be determined in its early stage. Founder of Hormone Health Educator at Your Hormone Balance, Candace Burch, has been through the difficulties of having hormonal imbalance. In this episode, Candace talks about the leading causes of hormonal imbalance and goes further with how our adrenals, cortisol, cholesterol and more affect it. She dives deeper as she explains how you can detect if you have hormonal imbalance and what you can do to balance your health again.

Listen to the podcast here:

Hidden Hormone Imbalances With Candace Burch

This podcast is entitled Hidden Hormone Imbalances. It’s the idea that all the different symptoms you might be walking around with like insomnia, fatigue, sweating, hot flashes and increased stress and anxiety, how do you know whether that’s due to the actual underlying hidden hormone imbalance? I’m so glad to have on our show, Candace Burch, who is a hormone health educator. Candace, how are you?

I’m doing fine. I’m here in England, Dr. Trish. We’re all ready to talk hormones.

Thanks for coming on this show. I’m going to give a bit of a bio for Candace Burch and I’m going to get into some questions. First of all, Candace Burch is a hormone health educator and Founder of Your Hormone Balance, a hormone testing and consulting practice that helps people of all ages detect incorrect hormone imbalances that negatively impact health and longevity. Candace received her Master’s in Health Education in 1979 and subsequently worked in medical publishing in the UK and as Director of Education at ZRT Hormone Testing Labs for over a decade. Candace is now the Cofounder of Women In Balance, an educational nonprofit. Her mission as a wellness advocate is to educate, inspire and guide women towards safe natural approaches to hormone balance and breast cancer prevention. I’d love to ask every single one of my visitors on this podcast, how did we all come and get to where we are and the mission and the service we’re giving out to the world?

We all have a story, don’t we? Mine basically is that as a kid, I grew up in Chicago. I had a lot of adrenal issues that I didn’t know about. I had horrible hay fever and asthma. I had to sleep in the bathtub in the summers because the pollinator machine worked in there. Later as a skiing bum in Aspen, Colorado, my knees started swelling up. I was back to the injections, the shots and meds that I didn’t want to take, which I developed an aversion to as a kid. I got interested in natural health. I remember reading a book called How to Get Well by Paavo Airola and the concept of biological medicine was discussed in that book. I came alive. I thought, “This is so interesting.”

I subsequently went on a seventeen-day juice fast to deal with my inflammatory knees that were making my skiing hard. I found that I felt much better. I could get off the meds. I didn’t have to do cortisone injections anymore. My hay fever, I didn’t have any more after this. It was like a miracle. I started a little group called AHHA, Aspen Holistic Health Association. We had groups and people come and talk and then later, I decided I’m going to get a Master’s in Health Education. I went back to school to get my graduate degree because I wanted to help people learn how to stay well naturally that all these medications weren’t necessarily helping. In fact, sometimes they were making things worse. Fast forward to when I went into menopause, I zoomed in on the menopausal issues that affect women my age.

I started out with hot flashes and night sweats every twenty minutes. I was having a hot flash and a mood swing in between and scaring my children. I decided it was time to focus my work and help ed, which had been in publishing and media more towards, “Let’s work with women and find out why this is happening and what’s happening to us.” The rest is history. I had a lot of experience working at a big hormone testing lab where I learned from the experts. I started in 2000 working at this hormone testing lab in Portland, Oregon and worked with biochemists, breast cancer researchers, compounding pharmacists and the whole explosion of functional medicine was happening then. I’ve learned from the experts and seen probably thousands of test results, which tell us a lot. From there, I’ve gone onto this hormonal imbalance, I privately consult with people, send them a test kit and we review test results together to see what’s going on. That’s it in a nutshell. There are worlds within that.

What are some of the top 5 or 6 symptoms that you would say to someone that would fit into the possibility of having a hidden hormone imbalance?

I would split that up into younger women and older women. Although, interestingly, because of the many years that a lot of young women have been on birth control which shuts down ovulation, I see symptoms in younger women that are reminiscent of symptoms in older women. You’ll see symptoms in Millennials that are the same as women in menopause, like hot flashes and night sweats, vaginal dryness, anxiety, weight gain in belly or in the hips, size, bottom. They have insomnia and they can’t sleep, can’t fall asleep or wake up in the middle of the night and can’t get back to sleep. I’d say those are the big ones. There are several others that are linked to particular imbalances, but those loom large.

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What does hormone imbalance mean?

All of the hormones occur in a cascade and the top of the cascade is cholesterol. Cholesterol is the backbone of all hormone formation. When you see a chart of it, I’m sure you’ve seen that. It starts with cholesterol. That’s one reason why people who are fat-phobic and on low-fat diets often have low hormones. All of these hormones that we’re talking about are the master female hormones, estrogen and progesterone, the androgens, testosterone, DHA and the cortisol hormone. The adrenal function that is determined by cortisol, the diurnal curve, they are all working in tandem with each other. The famous analogy is the orchestra where all the instruments have to play in tune. If one is playing out of tune, there goes all that lovely symphony.

I sometimes use the analogy of the synchronized swimmers. The older women, remember Esther Williams and the synchronized swimmers, all those women with their toes pointed in perfect federal formation. What if one of them swam off in a different direction or started splashing around, what would happen to the beautiful synchrony? Hormones are like that. They’re like a seesaw, one goes up, the other goes down. They’re interdependent. There’s no way to separate them out. Progesterone balances the growth activity of estrogen. The adrenals are supported by progesterone. It’s the precursor for cortisol production. The androgens have to do with bone strength, bone density and lean muscle.

They all have roles to play but they all interact and a deficiency of one creates an excess of another. That’s what we can see in the test results. What ends up being defined as an imbalance is where one hormone is low, the other one is high. There may be several of those within a cortisol curve when we’re looking at the adrenal pattern, which we like to see high cortisol in the morning as per the cortisol awakening response. You get up and go and they like to see that go from high, gradually to a lower level by bedtime. Sometimes you see an erratic pattern there where cortisol is low in the morning instead of being high and high at night instead of being low. That’s where you got people tossing and turning. That’s an imbalance. We can see that. We can pinpoint those imbalances in the test results. We can link those and match them up with the symptoms people say they’re dealing with unwantedly.

First of all, to make out a couple of points of what you went over with people and make sure they see the highlight of a couple of points. First is this idea of the hormone pathways all starts with cholesterol. We’ve been taught for many years now, no fat. Don’t give me fat. We want to drive our cholesterol in the toilet because God forbid, we don’t have a heart attack. Heart attacks aren’t caused by cholesterol. They’re caused by inflammation and toxic fat. The bottom line is you do not want to eat trans-fat or hydrogenated fats. Absolutely not, that’s poison. Anything that stays on a shelf forever in a box is not going to have good fats in it.

Healthy fats, avocado or coconut, why is coconut all over the place? If you tolerate dairy and yogurts, fantastic. If you don’t tolerate dairy, they now make almond yogurts. There are all sorts of options. You need to eat good fat because if you’re having a hormone imbalance, you want to be able to have the pathways and the balance you’re talking about happening properly. Another thing you’ve brought up is the balance of all the hormones and you mentioned progesterone and estrogen, testosterone, the androgens. You brought up cortisol and absolutely in the morning, we need our cortisol to rise. It’s our stress hormone and it gets us up in the morning.

It wakes us up and gets us able to get up, get dressed, get ready for work and all the things we want to do and feel alive. However, if the cortisol is always too high and out of balance, it doesn’t start to go down in the evening and we’re all faced with chronic stress, you can have a concept called cortisol steal. Would you talk about that, Candace, how cortisol steals? If you’re always stressed and you’re always producing cortisol, you can’t get to the other side of the pathway and produce your estrogen, your DHEA for your liveliness and your estrogen and your testosterone for your obvious sex hormones.

DH 51 | Hidden Hormone Imbalances

Hidden Hormone Imbalances: Cholesterol is the backbone of all hormone formation.


As you’re saying, cortisol is life-giving. We can’t live without it. People come back from the Vietnam War or the Iraqi where you’re talking about PTSD. Men come back from war with their adrenals completely shot. We hear that term, “My adrenals are shot. I’m completely stressed.” The adrenals can be so depleted by intense stress, whether good or bad, that they have to keep us going. Remember JFK was famous where he had to have cortisone shots all of his life because of his big rescue. He was treading water for 24 hours or something. He rescued somebody. He came back from war with completely shot adrenals.

The point being, “No, we can’t live with that awakening response that provides the regulation for blood sugar and insulin. Cortisol will steal from the bones, from the muscles, from anywhere it can get more of itself, to make more of itself to keep us going because it is the arbiter of how we respond to stressors. Stressors are not just money woes. They can be a great success in business. I talked to gals who’ve gone to twelve weddings or got married, got pregnant, had a baby or they have had a death in their family. The body doesn’t know between divorce or donuts. A high inflammatory sugar diet is stressful for the adrenals. That’s where wasting diseases happen. We start to waste away because the adrenals are pulling cortisol from wherever they can get it.

The other part of that is that progesterone, the hormone that is made upon ovulation, is also intrinsic to cortisol production. I was talking about that cascade. Progesterone is way up high there. It’s cholesterol. It’s pregnenolone. It’s progesterone and progesterone breakdown to all these other hormones. There’s a direct breakdown from progesterone to cortisol. If there isn’t enough progesterone, the adrenals go wanting. They’ll take progesterone as much as they can get. There’s also something called the progesterone steal. They will use up all the progesterone hopefully that we’re making upon ovulation and that leaves women in a state of estrogen dominance.

There’s not adequate progesterone being made to balance the effects of estrogen, which can be a pretty potent growth hormone and cause a whole lot of problems down the road. Cortisol steal, lack of stamina and strength, there are all kinds of things when the adrenals aren’t working properly. We can’t sleep. We start to gain weight in the belly because the body is trying to store a little extra fuel for us. We may have anxiety. We may have headaches. We get sick easily because we know the adrenals are the regulators of our immune defenses against illness. There are a lot of reasons why the adrenals get depleted even over-exercise. I talked to a gal who works in a spin cycle, a gym and is working out high intensity, twice a day, seven days a week. Her estrogen is low. Her progesterone is in the loo. Her cortisol curve is flatlined. She’s 25 years old.

This is an issue for people. Society says we have to be exercising hours a day. That’s not true. There is a balance between exercise being healthy for us and exercise possibly not being healthy for us as you’ve brought up. Stress can come from multiple avenues. It could come from physical stress. It also could come from negative stress, negative emotions and challenging things at work or challenge in your marriage or in our family. People with significant chronic illnesses and being a caretaker, that’s a big one.

Things that are unresolved stressors, that are relentless and carry on, that we can’t get a grip on, that we feel overwhelmed by, those are the worst.

Also, people need to realize and remember that when they rate the top stressors in one’s life, getting married is a joyful thing. It’s wonderful. It’s special and everything else is a great celebration. It’s one of the number one stressors in life and also having a baby, getting married, buying a new home. These are wonderful things, but they also are some of the top stressors. In the functional medicine world, we’re trained and educated to look upstream and look at the testosterone, the estrogen because women come in and say, “I’m fatigued. Maybe I need some estrogen.” Coming into the functional medicine world, we’re trained to look upstream. In the traditional medical model, looking at the adrenals, for example, I was a board-certified internal medicine primary care doctor one time in my life, but I was never trained to look at the adrenal glands until I learned about functional medicine. Give a little more and summarize a bit of adrenal fatigue. What does that mean and how do we then start determining if someone may have that?

People I talked to who have a very high-octane life, who have a low cortisol curve and what I would call adrenal fatigue, they don’t have that cortisol awakening response. They tell me they wake up in the morning, they may have slept for ten hours and often they don’t get very much sleep at all. There are people that say they had a lot of sleep and they woke up feeling exhausted. It’s that low cortisol awakening response that doesn’t stay flatlined or sometimes the levels are high and they crumble. Instead of gradually dropping to the lowest point at night for calming and preparation for sleep, they crash at some point in the afternoon and they bump along the bottom the rest of the day. That picture often makes sense to people.

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They say, “That’s the story of my life. I wake up in the morning, it’s either I’m pumped for the day, but then I can’t go past noon. I could crawl under my desk. I can’t stay awake,” or they can’t get out of bed. They’re exhausted even though they’d been sleeping or they didn’t sleep at all or tossed and turned all night and woke up with feeling wired. They’re tired but have a wired feeling. All of those things are examples of adrenal fatigue. The determinant is when you see it in that adrenal curve, the gold standard for testing is saliva because you have to collect in the morning, noon, evening, bedtime. You’ve got to collect those four times over the course of one day to get the diurnal curve. People say, “Doesn’t that fluctuate from day to day?” Yeah, it does, but if your adrenals are working for you, that pattern should pretty much stay in there no matter what happened.

You’re taking stress in stride because your adrenals are working for you. If they’re not working for you, getting stuck in traffic becomes a meltdown. You can’t eat in the morning because you’re so rushed. You’re eating sweets and drinking copious cups of coffee. You can’t concentrate, think or focus at work. At night, you’re wired and you’re ready to run a marathon, even though you’re exhausted. We see this picture and people will sometimes say, “That’s a picture of what my life is like.” Often people will say, “I thought my stress hormone levels, my cortisol levels would be off the charts. I’m a lawyer. I’m working ten hours a day. I work seven days a week. I never get a break.” I’m not exaggerating.

People, especially between the ages of 30 and 50, we’re living in a world of abundance, stress and everybody is crazy busy. That’s the phrase. Is crazy busy a good thing? They’ll be astonished that the cortisol curve is so low. They’ll say, “I thought it would be high because I’m so stressed.” No, it’s low because your adrenals are getting fatigued under pressure. Maybe they started out high, that’s what it should be. They started out with all the best intentions. Those little adrenals pump in for you, but they can’t keep it up under constant, relentless go. I’ll sleep when I die kinds of attitudes, working out constantly, not eating or skipping meals, all of this takes its toll. I often talk to people that have a flat lined or very low curve and say, “What’s been going on the last couple of years in your life?”

Often, you have to track back over an accumulated amount of stress and you wouldn’t believe this stuff. You hear this from people, their mother died. They crossed the country and are living in a foreign country. They broke up with their boyfriend. They’ve had an eating disorder. People over a two-year period can deplete their adrenals without knowing. That’s why we talk about hidden imbalances because this stuff is silent. It’s the stuff of your life. It’s what you’re doing. You carry on and you don’t know how it’s affecting you inside.

This is what sets functional medicine apart from other types of medicine. The Institute for Functional Medicine teaches us to do a timeline with someone. When I say a timeline, it’s from the time your mom was carrying you, are there any problems? What is your birth like? What’s your first decade? Was there physical trauma? Was there emotional trauma? Was there medical metabolic trauma? Where their infections and so on in the second decade, the third decade? How old are you and what’s brought you to where you are? What have been the antecedents? What have been the mediators? What have been the triggers? As a writer, you take the 30,000-foot view based on that history and are able to see the connection, the antecedents. We’re able to see the imbalances along with lab results and be able to talk with someone about a possible treatment option.

One of the things I wanted to mention though when you were saying looking upstream, so many people will say to me, “I’ve been gaining weight. I can’t lose. I don’t know what’s going on. I’ve never had a problem losing weight. My hair is thinning. I’m constipated. I have no libido. It’s my thyroid. I went to the doctor and I had my thyroid tested. He/she says it’s fine.” Part of that is not everybody has all of the thyroids tested. They may have TSH, Thyroid-Stimulating Hormone tested, which doesn’t tell you if your T3, which is the active thyroid hormone or your T4 is imbalanced. The other point is if you’re talking upstream, there’s something called functional hypothyroidism, which means you go to the doctor, your thyroid doesn’t test bad because it’s not in trouble. It’s a healthy functioning gland.

It’s the other things as we go up, it’s estrogen and progesterone imbalances. It’s adrenal imbalances that are undermining the thyroid and causing symptoms of the thyroid that has not to do with the thyroid itself. There’s even a blocking effect when estrogen is an excess. It can block the conversion of T4, the most abundant thyroid hormone into T3, the most active. That’s where you have to look upstream and say, “What are the other imbalances that are happening that we need to tackle before we start worrying about putting ourselves on thyroid for the rest of our lives?” Not getting to the root of the problem, which thank God, you, the functional medicine doctors are all about. That’s the future of medicine.

DH 51 | Hidden Hormone Imbalances

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The idea of what we were talking about cortisol before too, and the idea that if your cortisol is up or even your pre cortisol, meaning from the pituitary gland comes certain hormones that re the precursors to then go tell the adrenal, let’s say to put out more cortisol. If that’s elevated, it will block TSH. The adrenal pathway is gibbeting and causing this function in the thyroid pathway. Still, as if it’s pumping out enough thyroid hormone and it may still be functioning okay, but you’re having symptoms because of your adrenals in your increase in your cortisol pathway. It’s reading again these underlying hidden hormone imbalances that we find. You mentioned saliva. What tests do you do to identify these hormone imbalances? If the results show imbalance, what can we do about it?

When I first started going into menopause myself, the perimenopause when hormones start to bounce you off the walls in your 40s, I heard about a saliva test. I didn’t even know there was such a thing as a hormone imbalance even though I was a health educator for years. I thought I got to get a handle on this because I was scaring my children. My daughter Ryan looked at me one day with tears in her eyes and I thought, “She’s scared of me.” I had to get a handle on this. I heard about a naturopath in the town I was living in who did saliva testing. Long story short, I eventually wrote to Dr. John Lee, who’s the author of the bible of bioidentical natural hormone approaches called What Your Doctor May Not Tell You About Menopause. He also wrote one about What Your Doctor May Not Tell You About Pre-Menopause.

I read that book and I called this lab in Portland, Oregon. I called Dr. John Lee and said, “How do I learn more about this and how do I get a saliva test?” I ended up working with Dr. David Zava, who was one of the first to make saliva testing available to the mass market. Saliva testing was used among scientists to test DNA levels and active hormone levels. Saliva is the gold standard for measuring cortisol. As I mentioned, you’ve got to measure four times in one day. Who’s going to stick themselves with needles, which caused stress anyway and skew the results?

You have to have a noninvasive method of testing to get the right results. Also, the other argument about saliva testing is that hormones are carried in the bloodstream on a red blood cell and they are bound to that red blood cell by a carrier protein. They are inactive. When you measured a blood test, you’re not measuring that bioavailable fraction of hormone. That’s always that 2% to 4% that’s always leaving the bloodstream because she’s over here working out, lifting weights, we need a little testosterone. The brain signals and says, “We need some more testosterone.” Some of the testosterone escapes the bloodstream, moves into the target tissues.” When it does, we can capture that active hormone in a salivary gland. It’s moving into the tissue. We can capture those levels as it makes its way to the target tissues where hormones do their thing.

You always hear that analogy of hormone is the key and it opens the lock to the cell. The cell has receptor sites. Think of it, readers, as a helicopter pad or like the lock to your own front door, you use your key. It has to fit perfectly. That’s what we’re talking about when we’re talking about measuring those real active hormones that correlate so much more closely. This is what we found over the years at the lab as doctors moved into integrative functional medicine, they wanted to get to the root cause. They wanted to see active bioavailable levels at work in the tissue, as close as they could get.

How much is in the breast tissue? We want to know so that we can take action and that’s where we can determine imbalances more closely that correlate with symptoms that we’re experiencing. Often people become their symptoms. That’s one of the things about the hidden imbalance. It’s like, “I’m tired all the time,” or “I’m itchy, bitchy, sweaty, crappy, psycho, the seven doors of menopause, that’s me,” or “My mother was always like that or my aunt has endometriosis so I’m going to have it.” People think that they become these symptoms without realizing there’s a way to determine, to lift back the lid and open the window into that internal mysterious milieu. Thank God there is because we can help people feel a lot better by identifying that and correcting them.

I allude to it as looking under the hood. With cortisol, we’ve talked about the estrogen and the progesterone you’ve alluded to. The testosterone, is that also tested through saliva?

Yes. The test kit that we provide through your hormone balance is a typical big-picture look. It measures estradiol levels. Estradiol is the most potent of the three estrogens that women have. Estrogen is a growth hormone. It grew all of our female traits, our ovaries, our uterus, our breasts, our curves. Estrogen is all about growth. It grows the egg and the ovary every cycle and it grows the blood-rich lining that we shed as a period. Estrogen is a very potent growth hormone and estradiol is the most potent of the three. There are estrone and estriol, which is a weaker one.

We measure estriol because it’s the most potent. We measure progesterone, which is the hormone that’s made upon ovulation, hopefully not in women who are already menopausal or had a hysterectomy and not in women on birth control. Women who are having natural cycles should be ovulating. Upon ovulation, we make progesterone. Progesterone says to estrogen, “Enough growth. Let’s get things settled down. Let’s get ready for a possible pregnancy.” Progesterone is a key hormone in taking a successful pregnancy to term. We measure the androgens. Andro stands for male in Greek. Androgens refer to the hormones that build bone, build muscle, lean muscle, have to do with facial hair, deeper voice. The androgens are about strength, stamina, endurance, drive, sex drive, competitive drive. That’s testosterone and DHEA.

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We measure those as well. All of these are being measured in active levels and the four cortisols. A kit comes to you in the mail and you fill four tubes with your saliva throughout the course of the day. We can test all of those hormones in that one collection. We’re testing at a particular time of the month with women who have cycles. We have to test during what we call the luteal phase after ovulation when hormones should be surging. In women who are in menopause, we can test anytime and in women who are on birth control, if they’re not getting a cycle.

Women on birth control and women post-menopause can do the test at any time when they are not cycling. Women who are cycling need to do it in the luteal phase.

It is like days 19 through 21. If the first day of your period was January 1st, you would test January 19th, 20th or 21. Some people say to me, “My periods are so irregular, I don’t know when they are.” We’ll say to them test any day you’re not bleeding. It’s a bit complicated but for the most part, it’s pretty straight forward to test during that luteal phase, the second half of the cycle.

I assume any woman you’re working with that is cycling, you would work with her to make sure she tries to optimize the best time to do the testing.

Yeah, people get a bit confused about that. We send a lot of instructions before. When people order a test kit, we send all the instructions and we say to them, “Work out the days that you need to test, count day one is your first day of bleeding and count up. Nineteen, 20 or 21 is your window. Those are the days you can test your hormones. Most people, I’d say 99% of them get it right.

Let’s talk about hormone replacement therapy. The term is out there. There’s this concept of synthetic hormones versus bioidentical hormones. If you find an imbalance and you want to help someone with hormone replacement therapy, can you help people understand this? What’s the difference between synthetic and bioidentical hormones?

When I started at the ZRT laboratory, two years in, the results of the Women’s Health Initiative study hit the headlines. It was the first long-term clinical trial of women users of HRT, women who had been using hormone replacement therapy over five years. I’m talking about synthetic hormone replacement. When we’re talking about hormones, particularly estrogen derived from pregnant mare’s urine, we are not horses, but we have been put on pregnant mare’s urine. It was Premarin for ages along with the combo that they used in the Women’s Health Initiative study which was Prempro, which was Premarin synthetic estrogens derived from horse urine and a synthetic form of progesterone called progestin, which is a far cry from the natural hormone progesterone that our bodies make. Many talking heads in the press get that wrong.

They’ll call it progesterone when it’s a synthetic form progestin that is in birth control and HRT. When that study hit the headlines, they showed huge increases. They had to stop the study. They halted it three years early because there were greater risks than benefits. There was an increased rate of heart attacks, doubling of blood clots and increased risk for stroke, 41% increased risk, 29% increased risk of breast cancer. What was even more shocking is there had been a big dropout rate in that study. When they confined the data to those who had remained in this study, the risk rates went up way higher. We had increased risks, like a 51% increased risk of breast cancer. This study had been criticized later because it was older women and there had been other studies since.

There aren’t enough studies, but there have been plenty of European studies and now the Women’s Health Initiative, the KEEP Study, the SWAN Study, there are more and more studies building all the time that continued to show that there has always been this huge risk. In fact, the breast cancer rates have gone up in tandem over many years with the use of HRT, which was touted by Dr. Robert Wilson who wrote the book Feminine Forever, who was paid by Wyeth heiress, the makers of this synthetic Premarin. He was paid to go around the country and talk to women and say, “If you’re a woman that looked like a dried-up old crone who’s impossible to live with, then you better take this estrogen.” It was pretty much that language. You’ll be dried up. You’ll be crabby. There’s a certain truth to needing some hormone replenishment, but not synthetic because it’s lethal.

A doubling of blood clots, that’s insane. When that study came out, for a while there was a 50% drop in the use of HRT. That’s when the whole bioidentical movement started to flourish because European women had been using bio-identical as plant-based hormones that are made in a lab. They’re synthesized in a lab, but they’re made from plants. They’re made to be identical in structure and function to the hormones our own body makes. They fit like that key in the lock that we talked about. You use them in sync with the time of your cycle that you would have been making that hormone. You deliver them in doses that are analogous to what our bodies make. That’s the bioidentical hormone model which you, as a functional medicine doctor, know this has become the way.

DH 51 | Hidden Hormone Imbalances

Hidden Hormone Imbalances: It’s so important to cultivate a little stillness in the great outdoors. It changes the way you feel and it’s a great support for the adrenals.


Thank God we have those versions available. I still talk to women that are still on Premarin and Prempro and they’re afraid to get off or they’re working with a doctor. In fairness to a lot of doctors, if they don’t go and get the training as a functional medicine doctor as you did, they didn’t learn this in medical school. They didn’t learn how to interpret a hormone test result and individualize the hormone replenishment. There is a case for it because women stop ovulating. We didn’t live past 50, 100 years ago. We’re living another third of our lives until we’re 85, 90. We need those hormones. They’re lifesaving. They’d protect our bones, our heart, our blood vessels, our muscles, our moods, everything. They rule. We do need tiny amounts of them but in natural forms. That’s the way of the world now. Bioidentical is the way to go. I say to women, “If you have a doctor that suggests that you’d be put on a synthetic HRT, find another doctor.” IFM.org is where we can find doctors like you who know better.

As soon as you get trained, you get educated about bioidentical hormones. Myself, having an internal medicine background and also a pain specialist, I work very much with people as we were talking about before with upstream, with thyroid and adrenal. When it comes to dealing with bioidentical hormones, honestly, I refer to someone who’s like yourself or someone who does gynecological functional medicine because of the fact that you want to work with someone like yourself who is doing this all the time and is familiar with interpreting the hormone testing. As you say, be able to compound for someone to order the appropriate compounding of the bioidentical hormones.

Let me clarify though. I, as a health educator, have an interesting background because I worked with all these specialists. I cannot prescribe because I’m not an MD. There are nine out of ten women, especially when hormone imbalance has started to hit in perimenopause, in those 8 to 10 years of fluctuating hormones, the ovaries are packing their bags. It takes a good long while and it’s complicated by stress. A lot of those women can do very well by balancing and supporting their adrenals, making sure that they start to eat more properly, keep their blood sugar balanced, use adaptogenic herbs to support the adrenals, B complex and progesterone, which is so benign. There are some very good progesterone creams that are bioidentical on the market that do not require a prescription. When I was in my late 40s and started and many women are like this, I used progesterone cream. It changed my life for a good 10, 15 years before I even needed any estrogen.

Is that a progesterone vaginal cream?

There are progesterone vaginal creams. There are progesterone creams that you can get in a pump dispenser, which dispenses the Goldilocks dose, the 25 milligrams one-quarter teaspoon. That is what our bodies make naturally, and that makes life easy. There’s a company in Portland, Oregon where I live that started many years ago making progesterone that was used in many of the studies that have been done with natural progesterone, comparing it to synthetic brands. It’s called Emerita and their progesterone is called Pro-Gest. You can find it in any Whole Foods or natural foods grocery store. It’s very benign. You use a little bit, that Goldilocks amount, certain days of the cycle, days 12 to 24 usually because we’re trying to capture that luteal phase, the second half of the cycle. That can do a world of good because progesterone supports the adrenals and it wakes up estrogen receptors. If people are low in estrogen, it can balance everything for quite a while. That doesn’t mean just using hormones. It has to do with also lifestyle changes.

For progesterone, do people need a prescription or is that something they can get over the counter?

That’s what I mean, that progesterone, I’m talking about Pro-Gest. I use Smoky Mountain Nutrition and I provide an order link there. Because progesterone is not a potent excitatory hormone, but rather a calming benign hormone, it is available over the counter. There are people like those women who have hysterectomies with total removal of the ovaries who are now in instant menopause. If you have total removal of your ovaries, complete hysterectomy, those women need progesterone, estrogen and sometimes some testosterone. That’s where we get into working with compounding pharmacists who work with doctors. Compounding pharmacists are a huge resource for women. You can go to a local compounding pharmacist and say, “Who are the doctors in this locale that know and understand how to prescribe bioidentical hormones?” They can be a great source for a woman who’s had a hysterectomy or who needs something compounded. In that case, you get progesterone compounded with other hormones in a cocktail.

I totally point out and agree with you that back to this concept of you want to work upstream and the idea I work with people all the time. My curriculum is called the DENT Curriculum and I’ve written a book called Make A DENT in Chronic Disease. DENT is an acronym for start with detox through diet even first always and exercise, good levels of exercise and not over-exercise. Nutrition, eating the rainbow of red, yellow, orange, green, blue, purple and I don’t mean M and M’s or Skittles. There’s the management of your stress and the idea of let’s take some breathing techniques for five minutes a day. That might make a huge difference in your life. You can be taking some supplements and some adaptogens that do not require a prescription. The majority of my patients, I do not need to send to a physician because they get better with true functional medicine, lifestyle changing. Take control of your health. You’re going to transform your life. Candace, what does it look like for people to reach out to you and work with you?

A high inflammatory sugar diet is stressful for the adrenals. That's where wasting diseases happen. Click To Tweet

People find me through these podcasts and online, but basically, my website is YourHormoneBalance.com. We’re also on Instagram, @YourHormoneBalance. We put a lot of information out there trying to do our best to educate everybody. We just had some good information about estrogen dominance and the link to breast cancer. People can go to my website. You can order a test kit. We often have specials. In fact, I’d love to offer your readers $100 off the kit if they put in the code Dr. Trish and they will be able to get a kit. That’s a great offer, but I like to see people able to test their hormones, especially people who have been dealing with unwanted weight gain, who can’t sleep, who are anxious and nervous and who have no libido even though they love their husband or their partner and aren’t in the mood ever.

There are many things like bone loss or weakness. There are many things that are plaguing people’s lives. I hope that people will find me. When they do, we send you a kit in the mail. It’s a self-contained kit. It’s got four tubes in it. I also can test thyroids and Vitamin D for deficiency. Many people are with a simple blood spot. We call it a dried blood spot where we prick the finger and drop blood spot on a card, which dry and they can be processed for measurement of thyroid hormones. I like to start with the main hormones we’ve been talking about the sex hormones, estrogen and progesterone, the androgens and the adrenals because that’s the basis, the underlying before we get into the thyroid.

Those kits come to you in the mail. There’s a requisition form, you fill out all your symptoms. You tell me if you’re having periods, if you’re on birth control, there are a ton of symptoms we want you to fill out. You send your saliva collection in the kit. It’s prepaid postage. It’s good to collect saliva, keep it in the fridge until you put it back in the kit and send it. Saliva stays stable at room temperature. We have the test results analyzed at the IU Metrics lab in Portland, Oregon. I get the test results. We get on the phone and we talk about them. We send people a message and say, “Your test results are in. Here’s the schedule. Let’s book a time to talk with Candace about what your results mean and what you can do about it.”

We talk. I’ve talked to three women from England. Thank God the phone worked about their results. We went through them together. They’re going to get an action plan. That action plan is full of all the consensus of what we know in functional medicine, what studies tell us, all the good things, the herbs, the vitamins, the cruciferous vegetables, all the good stuff that we know helps to rebalance hormones. I provide all kinds of information about lifestyle, stress management, avoiding toxins in the environment, not being on your cell phone and your computer late at night. There are all kinds of lifestyle stuff that also plays in here because this is a holistic approach. You can take all the progesterone you want, but if you’re staying up all night on your laptop eating sweets and drinking caffeine, it’s not going to help much.

If you are wondering, “Do I have a hidden hormone imbalance?”

“Why do I feel this way?”

“I have insomnia. I’m exhausted all the time or I’m anxious or I’m in even pain. I have migraines or I’m lashing out at my spouse, my grandkids or my kids.” It’s like, “Why am I doing that?” What’s that website again?

It’s www.YourHormoneBalance.com.

If they want to do the testing, what’s it you’re offering for everybody?

We’re going to say if you want to do the testing, and we have three different test kits. Jumpstart is the basic one. The weight management kit adds in a Vitamin D with the blood spot and you talk to a nutritional coach as well as me. You get two 50-minute consults. We do the other testing, but you’ll see these tests. Just choose the one you want. I would suggest starting with the jumpstart and put in the code, Dr. Trish, and we’ll have that in there. We’ll know to give you a $100 off your kit. You’ll get a notice saying, “We’re glad you decided to test. Your test kit is on its way.” We send lots of supporting information so that people can figure it out. It’s pretty simple, but still, it’s a new language, this hormone testing, but we don’t leave you hanging. That’s the main thing because the big question is, ‘What do I do?” That why we have the action plan.

That’s why you counsel them. Don’t miss out on this opportunity. Candace, this has been great. The question I like to always end with any one of my people that come on for an interview is, what’s the number one secret you recommend for living a healthy life?

I think getting out in nature. We have an outdoor deficit here, deprivation. If you live near the ocean or in the mountains, good for you. If it’s a local pond, the park or a distant view, you can stretch your eyeballs. It’s so important to cultivate a little stillness in the great outdoors, sun and air. It changes the way you feel. It’s great support for the adrenals. We have to, especially in this world we’re living in, this world of abundant stress where people forget how to relax. Relax in the great outdoors. Do the things you love to do. I often ask people, “What are the ten things you love to do best in all the world?” Make a list. That’s an easy list to make. You go back through that list and jot down when was the last time I did that? When’s the last time I went down to the ocean or went camping or went to a play? It’s like a wakeup call.

I live in the white mountains of New Hampshire. I couldn’t echo what you said anymore. Thank you, Candace, so much for coming on with us at Discover Health.

You’re welcome. I’ve enjoyed it.

Take care.

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About Candace Burch

DH 51 | Hidden Hormone ImbalancesMy chosen career as a health educator, journalist, and women’s health advocate has been a journey spanning two continents over 30 years.

It all started with a skiing injury that led to the overuse of anti-inflammatories that didn’t help and only made things worse. Herbal remedies and a cleansing diet eventually took away the pain and made me a believer in natural medicine, and I spent the next decade advancing the stay healthy, prevent disease mantra in media and medical publishing. It wasn’t until much later when I started having hot flashes every 20 minutes and meltdowns for no apparent reason that hormones entered the picture. In my search for relief, I found a simple saliva test that identified the hidden hormone imbalances behind my roller coaster symptoms. That information not only restored my health and sanity but probably saved my marriage!

At the same time it propelled me into a Masters degree and my true calling as a hormone health educator. The rest is history. I pursued and landed the position of director of education at ZRT Laboratory and learned from the experts how to use hormone testing to detect and correct hormone imbalances. As a founding member of Women in Balance, one of the first nonprofits in the country to advocate for women’s hormone health, I helped to raise public awareness at a national level and lobbied senators on Capitol Hill for safe access to bioidentical alternatives to HRT.

Always on the soapbox, my work continues as a public speaker, hormone health educator, and private consultant, having counseled countless women and men on all things hormonal. The goal is to help people re-balance their hormones to relieve symptoms and restore balance in their lives. In my own life I practice what I preach as often as possible and maintain balance by doing what comes naturally, deliberately.

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