Chronic Stress and Hormone Disruption

What disrupts hormone balance? The network of hormones can be disrupted by many factors, including:

  • Nutrition1,2,3
  • Exposure to air pollution4
  • Chronic stress5

Joel Evans, MD, longtime IFM educator, describes the impact of chronic stress on hormonal balance in the following video.

Chronic stress alters hormone production, transport, and processing. At the Hormone Advanced Practice Module, the complex interplay between sex hormones, the thyroid, the adrenals, the pituitary, and lifestyle is explored in much greater depth.

As Dr. Evans describes, the adrenals have a powerful effect on all other hormones. Stress can both predispose patients to and precipitate hormonal imbalances.5,6 Stress also increases symptoms for patients with hormone imbalances.7,8,9 When treating hormone imbalances, a Functional Medicine tenet says to, “Start with the adrenals.”

In Functional Medicine, evaluation of stress and stress management strategies offers a low-harm, high-benefit intervention that can assist with downstream thyroid and sex hormone production, transport, and processing. The steroidogenic pathways are modulated by many factors, and stress is just one example.



  1. Köhrle J. Selenium and the thyroid. Curr Opin Endocrinol Diabetes Obes. 2015;22(5):392-401. doi:1097/MED.0000000000000190.
  2. Jain RB. Thyroid function and serum copper, selenium, and zinc in general U.S. population. Biol Trace Elem Res. 2014;159(1-3):87-98. doi:1007/s12011-014-9992-9.
  3. McCabe D, Lisy K, Lockwood C, Colbeck M. The impact of essential fatty acid, B vitamins, vitamin C, magnesium and zinc supplementation on stress levels in women: a systematic review. JBI Database System Rev Implement Rep. 2017;15(2):402-453. doi:11124/JBISRIR-2016-002965.
  4. Li H, Cai J, Chen R, et al. Particulate matter exposure and stress hormone levels: a randomized, double-blind, crossover trial of air purification. Circulation. 2017;136(7):618-627. doi:10.1161/CIRCULATIONAHA.116.026796.
  5. Ranabir S, Reetu K. Stress and hormones. Indian J Endocrinol Metab. 2011;15(1):18-22. doi:4103/2230-8210.77573.
  6. Vita R, Lapa D, Trimarchi F, Benvenga S. Stress triggers the onset and the recurrences of hyperthyroidism in patients with Graves’ disease. Endocrine. 2015;48(1):254-263. doi:1007/s12020-014-0289-8.
  7. Pimenta F, Leal I, Maroco J, Ramos C. Menopausal symptoms: do life events predict severity of symptoms in peri- and post-menopause? Maturitas. 2012;72(4):324-331. doi:10.1016/j.maturitas.2012.04.006.
  8. Matsuzaki K, Uemura H, Yasui T. Associations of menopausal symptoms with job-related stress factors in nurses in Japan. Maturitas. 2014;79(1):77-85. doi:10.1016/j.maturitas.2014.06.007.
  9. Hirokawa K, Taniguchi T, Fujii Y, Takaki J, Tsutsumi A. Job demands as a potential modifier of the association between testosterone deficiency and andropause symptoms in Japanese middle-aged workers: a cross-sectional study. Maturitas. 2012;73(3):225-229. doi:10.1016/j.maturitas.2012.07.006.

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