Introduction

Hormonal balance refers to the regulation and function of hormones balanced in the human body, and it is important for maintaining overall health. Hormones are secreted in the glands of organs that make up the endocrine system, such as the thyroid, pancreas, and adrenal glands.¹ The hormones act as chemical messengers to regulate essential biological processes of the human body, including:

• Metabolism                               
• Blood sugar levels
• Growth and development 
• Mood and emotions 
• Sleep cycle 
• Reproduction 
• Immune function 

An hormonal imbalance means the disruption of all the biological functions and is either less or more of specific hormones. It could eit

her be caused by primary or secondary factors. The primary causes of hormonal imbalance involves the glands themselves, which can be influenced by genetic conditions. Secondary causes, on the other hand, involve external conditions that affect the glands, such as medications, ageing, and stress.²

There are many conditions caused by hormonal imbalance that affect women and men. For example, the pituitary gland is a part of the endocrine system and is responsible for stimulating hormones such as luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which are directly related to reproduction in females.³ In this case, there is a secondary cause of hormonal imbalance that occurs outside of the hormone-producing target gland, usually due to problems in the pituitary gland. The deficiency of the hormones reduces ovarian functions due to the lack of stimulation from the glands. It is important to understand whether the hormonal imbalance in the body is caused by primary or secondary factors to accurately diagnose and treat the condition.  

What are the primary causes of hormonal imbalance?

The primary causes of hormonal imbalance originate in the glands themselves, whether this is a genetic condition, an autoimmune condition, tumour, or trauma to the glands. An example would be primary hypothyroidism caused by decreased thyroid hormones; the thyroid glands are underactive and do not produce enough hormones, also known as hashimoto’s disease.⁴ Primary hypothyroidism is an autoimmune condition, which is when the immune system mistakenly attacks the thyroid gland. There are genetic factors associated with primary hypothyroidism, as there is a risk of you having thyroid problems if someone in your close family has it, and studies have shown that thyroid-stimulating hormone (TSH) levels have a genetic influence.⁵

Other primary causes of hormonal imbalances include conditions such as type 1 diabetes and addison's disease, which is adrenal gland failure. For example, the adrenal glands are responsible for the production of steroid hormones like cortisol and aldosterone which regulate metabolism. Conditions like diabetes affect the production of these hormones, which in result causes adrenal impairment.⁶

What are the secondary causes of hormonal imbalance?

The secondary causes of hormonal imbalance refers to external factors that affect the glands, and these can range from lifestyle to environmental factors, which indirectly disrupt the balance of hormones.

Pituitary tumours

• Tumours such as pituitary adenomas can block and interfere with the regulation of hormones like LH, FSH, and TSH, which can lead to secondary adrenal insufficiency or even conditions like infertility⁷

Genetic conditions

• Systemic conditions affect the brain region controlling the pituitary glands, such as kallmann syndrome, which is a secondary cause of hormonal imbalance. It generally affects more men than women and is characterised by the loss of smell and delayed puberty, low sex hormone level, and also LH and FSH are visible⁸ 

Head injuries or trauma 

• Injuries to the head can damage the pituitary or hypothalamus, which is generally caused by an external factor including surgeries, radiation, or trauma to the head. This results in decreased hormone secretion, causing an imbalance in the body

Chronic stress 

• Stress can affect and increase the secretion of various hormones, such as growth hormones, steroid hormones like cortisol and thyroid hormone. Thyroid function is decreased, specifically the hormones  T3 and T4 levels can drop significantly⁹

Changes in diet 

• Diet changes, such as eating disorders or experiencing sudden weight loss can disrupt hormone signals from the brain to reproductive glands, causing fertility problems such as polycystic ovary syndrome (PCOS). A specific dietary pattern including carbohydrates such as a high glycemic diet, can increase blood sugar level which is known to affect metabolism and thyroid levels¹⁰  

Key differences between the primary and secondary causes of hormonal imbalance

The key differences between primary and secondary causes of hormonal imbalance originates from the location of the dysfunction. Hormone level patterns change in both secondary and primary causes. An example of a primary cause is a condition called functional hypothalamic amenorrhea (FHA). In this condition, the reproductive cycle is suppressed due to a problem in the hypothalamus, specific hormones like the gonadotropin-releasing hormone (GnRH) is affected, which releases other hormones like LH and FSH.¹¹ A secondary cause related to this condition is the dietary habits of the affected individuals, chronic stress, and excessive exercise can result in this problem in the hypothalamus, which is very important in regulating the menstrual cycle.¹²

Nevertheless, the diagnostic tools for differentiating between primary and secondary causes of hormonal imbalance are similar but useful in understanding the root cause. Blood tests such as TSH, T4, and T3 are used to measure how well the thyroid is functioning. These tests are important in diagnosing thyroid problems but also suggests if the condition is due to primary or secondary causes, for example if there is a TSH change that is in the opposite direction of T4 and T3, there must be problem with the thyroid gland, however, if it is parallel to T4 and T3 this suggests an external problem affecting the pituitary gland.¹³ On the other hand, medical imaging is also a useful diagnostic tool specifically for secondary causes of hormonal imbalance, such as tumours. Magnetic resonance imaging (MRI) can be used to visualise where the tumour is located and how it may affect the glands.

There are key differences between treatment approaches for primary and secondary causes of hormonal imbalance. If there are primary causes, treatment is focused on the gland, whereas, if there is a secondary cause such as stress factors involved, this could be treated with medications that relieve stress and regulate the mood. Treatments for secondary causes are more promising as they can be easily addressed with therapy and different types of medication, which are suitable for the root condition.

FAQs

What is the most common illness caused by hormonal imbalance?

Thyroid disease and diabetes are the most common conditions. 

Which of these is a common cause of hormonal imbalances? 

Having a history of autoimmune conditions, genetic disorders, or even having chronic stress in your life. 

How do you naturally fix an hormone imbalance?

Reducing stress, having a balanced diet, and getting enough sleep can balance hormones. 

What is a hormonal belly?

Hormonal belly refers to the weight gain caused by conditions that cause hormonal imbalances like diabetes or PCOS. 

What is the main cause of hormonal imbalance in females?

Factors such as puberty, pregnancy, and menopause can cause imbalances.  

What is the best diet for hormone balance?

Protein-rich diet including chicken, eggs, and meat, is important as well as vegetables and fruits. 

Summary

There is a clear difference between the primary and secondary causes of hormonal imbalance. It is important to actually diagnose the root cause of the imbalance for effective treatment. In particular, the secondary causes of hormonal imbalance can be misdiagnosed with other conditions due to the various possibilities; therefore, it is good to check for symptoms. If you experience any hormone imbalance symptoms which can be problems, such as eating difficulties, mood disorders, or any recent injuries to the head, a check-up with a medical professional is critical. Misdiagnosis and delayed diagnosis can cause further health complications, specifically secondary causes such as tumours or injuries to the head.