What MOST Doctors Get WRONG About Fixing Your Hormones

If you’ve tried thyroid medication, birth control, metformin, HRT or TRT, and still feel tired, foggy, or stuck with weight gain, you’re not alone—and you’re not broken. Thank you to our sponsors! Primally Pure: primallypure.com use code AXE15 for an exclusive discount Sunlighten Sauna: https://get.sunlighten.com/axepodcast Manukora Manuka Honey: https://manukora.com/axe Here’s some links to past episodes related on these topics discussed today : Testosterone → https://youtu.be/XTe7GURWyCA?si=AeHxUSoA4GqBcBA2 Sleep → https://youtu.be/1iRsdk_zxk0?si=78-mOB_qWsO0qHzO Circadian Rhythms → https://youtu.be/A2CU3a6PuH8?si=LEh751RHpz-5PHDO Watch The Dr. Josh Axe Show every Monday & Thursday on YouTube: https://www.youtube.com/@drjoshaxe?sub_confirmation=1 🎧 Early Access! Our podcast listeners get every episode early, and you can tune in and be a part of our exclusive listeners below → Spotify Apple Podcast Order my NEW BOOK, The Biblio Diet → https://bit.ly/4oPEP3t Watch my free training on how to naturally balance your blood sugar and reverse your symptoms → DrAxeDiabetesClass.com Discover practical steps you can take today to start healing your thyroid naturally → DrAxeThyroidClass.com If you’re ready to start feeling like yourself again and balance your hormones, take my free class → DrAxeHormoneClass.com Uncover what’s really going on in your body with advanced biomarker testing for hormones, thyroid, and metabolism— plus a 1-hour consultation with a Senior Health Advisor! → MyBloodWork.com CONNECT WITH DR. JOSH AXE Instagram Facebook TikTok X LinkedIn Website Sign up for my newsletter Ask me a question Links https://www.ama-assn.org/public-health/population-health/what-doctors-wish-patients-knew-about-polycystic-ovary-syndrome https://naturemed.org/do-you-have-hypothyroid-or-hashimotos/ https://www.thyroid.org/patient-thyroid-information/ct-for-patients/march-2024/vol-17-issue-3-p-3-4/ https://restorativemedicine.org/journal/peripheral-thyroid-hormone-conversion-and-its-impact-on-tsh-and-metabolic-activity/ https://pmc.ncbi.nlm.nih.gov/articles/PMC11168896/ https://journals.lww.com/acsm-essr/abstract/2024/07000/short_sleep_duration_disrupts_glucose_metabolism_.1.aspx https://link.springer.com/article/10.1007/s13679-018-0306-y https://www.unc.edu/posts/2018/11/28/only-12-percent-of-american-adults-are-metabolically-healthy-carolina-study-finds/ https://pubmed.ncbi.nlm.nih.gov/14747278/ https://linkinghub.elsevier.com/retrieve/pii/S001502821000542X https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome https://www.ajog.org/article/S0002-9378(08)01047-8/fulltext https://pmc.ncbi.nlm.nih.gov/articles/PMC12216464/ https://pmc.ncbi.nlm.nih.gov/articles/PMC2941530/ https://www.fertstert.org/article/S0015-0282(10)00542-X/fulltext https://www.urologytimes.com/view/testosterone-levels-show-steady-decrease-among-young-us-men https://jamanetwork.com/journals/jama/fullarticle/1029127 https://pubmed.ncbi.nlm.nih.gov/21058750/ https://oasis.library.unlv.edu/cgi/viewcontent.cgi?article=3210&context=thesesdissertations https://menopause.org/patient-education/menopause-topics/perimenopause https://www.jci.org/articles/view/180073 https://www.jci.org/articles/view/180073 DISCLAIMER This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Learn more about your ad choices. Visit megaphone.fm/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Josh Axe?

  If you've tried thyroid medications, birth control, antidepressants, Metformin, TRT, or HRT, and you're still dealing with fatigue, weight gain, or brain fog, you don't have one hormone problem. You actually have what I call a hormone cascade problem. Today, I'll show you how hormones work like dominoes. When the upstream signal breaks, everything downstream fails, and I'll cover the biggest cascades behind issues like hypothyroidism, stress and insulin resistance, PCOS, infertility, low testosterone, and menopause, and I'll walk you through exactly how to restore the signal at the source and heal

• 0:45Josh Axe?

  your hormones at the root cause. Welcome to the Dr. Josh Axe Show.

• 1:05Josh Axe?

  So I can't tell you how many patients I've seen over the years, and they've told me, "Dr. Axe, I've tried thyroid medications, I've tried hormone creams, birth control, even insulin, but nothing is working for me." But when I zoomed out, I was able to realize something crucial. They were treating the symptoms, not the root problem, which is a hormone cascade issue. And once we fixed the upstream signal, the downstream hormones corrected themselves automatically. Now, most doctors today treat hormones like isolated light switches. One hormone is on, or one is off, and they try to fix it in isolation, but hormones don't work independently.

• 1:48Josh Axe?

  They work in sequences. They work synergistically together. Think of hormones like a domino chain, or a waterfall. One signal triggers the next, and the next, and the next, and this happens over time. Now, I want to give you an example of how this happens, and I'm going to walk you through exactly how you can heal the root causes of, as I mentioned, PCOS, low testosterone, insulin resistance, hypothyroidism and menopause with this strategy. But an example of this would be with the endocrine cascade. You know, one of the things that happens so often when people eat food that can imbalance blood sugar, and it could be not just sugar, processed carbohydrates, it could be even

• 2:30Josh Axe?

  certain types of dairy. And what this will do is all of a sudden your blood sugar is off. Okay. So we see blood sugar is off. And then what happens is insulin's impacted, right? So we see insulin. Well, when insulin increases, that increases stress on the adrenal glands. So then the adrenal glands start impacting your pituitary gland. And this is where you're releasing cortisol and stress hormones. And then your thyroid is impacted. And then your sex hormones like estrogen and testosterone, then those are impacted. And we see that there are different initial dominos that will kick off hormone imbalance. And if the first domino falls the wrong way, or the water source is disrupted upstream,

• 3:13Josh Axe?

  everything downstream is then impacted. Even those glands themselves that are perfectly healthy, those are impacted. And that's why fixing one hormone number often doesn't fix how you feel, because the original signal never got restored. I can tell you from taking care of thousands and thousands of patients with hypothyroidism, even when they get on a T4 medication like levotiroxin, they still don't feel 100%. There's still metabolism issues. There's still thinning hair problems. There's still low body temperature. There's still, uh, you know, weight gain. There's low energy. All of those things are still there. Now, some of them change a little bit to where you get a little bit of relief,

• 3:53Josh Axe?

  but those problems are still underlying there because you never got to the root of that first domino, causing the hormone imbalance in the first place. Listen, I believe 80% of hormone issues actually start in the brain. So it's not a gland like your thyroid gland. It is in the brain. And treating a final hormone like T4 or estrogen or insulin often misses the root problem and doesn't. Doesn't put an end to the symptoms for good. And this is why you continue to have, you feel a level of chronic stress. There's a level of inflammation, right? And with that inflammation, you don't look as young or feel as young as you want to. And, and that's the key is if we can start to fix things at the root, you will feel younger.

• 4:36Josh Axe?

  You will look younger, your hormones will balance out, right? And these are examples of hormone cascade issues because it's not just one hormone. It's many hormones that are impacting each other. Now I want to walk you through some of the statistics today regarding hormone issues. The first is this hypothyroidism now affects one in eight women. And 60 to 80% of women who have hypothyroidism don't even know they have it. PCOS affects 20 to 25% of women. It's the most common reproductive disorder and fertility issue. Think about that, anywhere from one in five to one in four women have PCOS. That's incredibly high. And again, it's the biggest thing impacting fertility.

• 5:20Josh Axe?

  Testosterone in men has dropped 30 to 40% since the 1980s alone. If we go all the way back to the 1950s and 60s, it's dropped by 50%. So we see that testosterone in men is the lowest it's been in the past 100 years. Insulin resistance impacts, listen to this, 88% of American adults. Wow, 88% of people do not have their ideal blood sugar. And this isn't due to genetics alone, since genetics are not changing this quickly. It's due to hormone cascade failure due to our modern lifestyle. And the first hormone cascade I'm going to hit on here is the thyroid cascade.

• 6:03Josh Axe?

  And then we're going to get into the ones related to menopause, testosterone, insulin, and a couple others as well. So let's dive into the thyroid cascade. Now here's a common scenario. Someone is exhausted, gaining weight and just generally struggling, feeling overwhelmed. And they finally go to their doctor and get told your thyroid is low. Okay, so they're prescribed a thyroid medication. Their labs improve, but they still don't feel like themselves. One in four people. On thyroid medication, still report symptoms despite absolutely and completely normal lab values. And that's because what looks like a thyroid problem is actually a bigger issue. So here's what's typically causing this cascade in hypothyroidism. It never starts with the thyroid, okay?

• 6:47Josh Axe?

  In fact, hypothyroidism is almost always starts in the brain, or the gut, or the adrenals, or the liver. Okay, so everywhere, pretty much anywhere but the thyroid is where thyroid problems start, okay? And for a lot of people, it starts with this hormone cortisol. And you have something called your HPA axis, your hypothalamus pituitary adrenal axis. And so your pituitary is impacted, and this is really where TSH, right, is released. That then impacts the thyroid. Your thyroid then releases T4, but then in order for your body to function properly, okay? For your cells and your organs to be fueled like they should, they need a hormone called T3.

• 7:29Josh Axe?

  So your T4 that your thyroid produces needs to be converted to T3. And 80% of that conversion happens in the liver, and another 20% happens in your gut microbiome. And the pattern works something like this. The hypothalamus senses chronic stress, inflammation, or blood sugar swings, okay? And it sends a danger signal to the pituitary. And the pituitary lowers or dysregulates TSH, that's thyroid stimulating hormone. And then the thyroid produces less T4, okay? And then the liver and the gut struggle to convert T4 to T3. And so your cells slow their metabolic activity to conserve energy.

• 8:14Josh Axe?

  This is what hypothyroidism is. And by the time symptoms show up, the thyroid is just the messenger, not the original problem. And medications fall short again because of this. Thyroid meds can replace hormones, but they don't automatically restore proper brain to thyroid signaling, which is converting T4 to T3. Again, that conversion happens in the liver and in the gut. So here's a solution. We want to reduce chronic stress and cortisol overload. I really believe that's the number one thing. If you want to know what is the main upstream problem causing hypothyroidism today? It's not TSH, it's not T4, it's cortisol and it's really your brain. It's chronic stress causing cortisol overload.

• 8:58Josh Axe?

  And studies show stress and inflammation reduce that T4 to T3 conversion by up to 50%. Even when TSH is normal. And I've done episodes on how to reduce stress in the past. We'll link them in the show notes. And here are some things you need to do to stop the stress on the thyroid. Now, let me say this, the thyroid is of course involved and you do want to support thyroid health and you do want to support the body in some very specific ways that then impact the thyroid. And let me walk you through how this works. So one of the first things you want to do to kind of lower cortisol, but also balance out insulin and support liver and gut health is you want to consume a diet that's higher in protein and fiber and healthy fats, but you do want to get some carbs.

• 9:42Josh Axe?

  The carbs that tend to be the best for the thyroid, according to Chinese medicine specifically, are berries and pomegranate, so really dark fruit, black whole grain rice is good and sweet potato. Those carbohydrates tend to be the best for, you know, keeping stabilized blood sugar, but still having, you know, some carbohydrates in your diet because you do want some when you have hypothyroidism. There are also some really key nutrients, both the thyroid needs and the adrenals need, iodine being one. Now, if you have Hashimoto's thyroiditis, you need to be careful of or autoimmune disease, you need to be careful of how much iodine you take. You typically want to start with a lower dose and start taking some other things to lower the autoimmune reaction first, like selenium.

• 10:26Josh Axe?

  Selenium is one of the most critical nutrients for thyroid function and overall organ function when it comes to stabilizing and supporting thyroid hormones, typically around 200 micrograms a day is the ideal dosage. And you also need to make sure you have proper levels of zinc and iron and, and, and B vitamins. You want to be methylating properly as well. So iodine, selenium.

• 10:50Josh Axe?

  Zinc and iron are key nutrients if you have hypothyroidism and you do want to make sure you're eating enough calories. You also want to warm your body up. This really helps. It helps with relaxation. It helps with mitochondrial health, which is also deeply connected to hypothyroidism. And I would say getting in an infrared sauna, getting red light therapy, doing an infrared heating pad, warming up your feet and your midsection, and even doing some of that light right on your thyroid is good as well. But again, when we're looking at these hormone cascades, the single biggest hormone that is negatively impacting hypothyroidism or thyroid issues today is when cortisol gets too high. And when cortisol gets too high, insulin gets high, estrogen can get too high. And then

• 11:32Josh Axe?

  what happens is that down regulates the thyroid hormones. So listen, if you have a hypothyroidism issue and you're just trying to treat it with a medication or even outside thyroid supplements, it typically is not a total fix because we really need to impact cortisol in a positive manner. Now, let me say this. The number one herb prescribed today by functional medicine practitioners for hypothyroidism is ashwagandha. Now, ashwagandha doesn't magically impact thyroid hormone. You know what it does impact, though, is stress and cortisol. So ashwagandha is known as an adaptogenic herb, and it helps your body better adapt and deal with stressors. So what it does is it lowers cortisol and then it improves thyroid hormone because of how it's impacting cortisol. So that's

• 12:17Josh Axe?

  why ashwagandha is such a well-known herb for hypothyroidism and typically the number one herb I recommend for hypothyroidism. But again, if you want to cure and fix the thyroid cascade, you first and foremost need to fix cortisol.

• 12:36Josh Axe?

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• 13:20Josh Axe?

  Now, the next cascade I want to get into is the cortisol insulin cascade. Okay. And this is really tied to stress, weight gain and burnout. And let's say someone feels wired, but tired a lot. Okay. They're gaining weight around their midsection. They're craving sugar or caffeine and they can't seem to recover from stress. And, and they really don't feel motivated either. And here's what most of the doctors would tell them. They'll say, uh, you need to eat less, exercise more, and maybe even start on a blood sugar medication. But no matter what they try, their energy stays low and the weight won't budge. That's because what looks like a weight or an insulin problem is often a stress signaling problem.

• 14:04Josh Axe?

  Listen, your body, this is just sort of, this is innately how God made us. When our body gets stressed, okay, our body stores fat. Cause part of it is your body's thinking, okay, I am in danger. And, and, and think about during pre, you know, just historic times. You know, if we are, know, we're going to be dealing with some sort of a very cold winter. Okay. Or going into a battle. Our body starts to store fat saying, okay, we're going to need this for energy later on. Cause we have something coming up here in the future, something, something we're going to, a battle we have coming up. Right. And our body gets in a fight or flight state. When you're in that fight or flight state, your body stores body fat.

• 14:46Josh Axe?

  So you can be eating less, you can be exercising more. But if you're staying in the fight or flight state, you can't lose weight. Your hormones are working against you. And I can tell you, and if you've ever experienced this, if you've ever done what I've talked about, you've, you've eaten less, you've dieted, you've worked out more, you've done all that, and you still didn't lose the weight. It was like fighting an uphill battle, right? You just couldn't do it because your hormones are working against you versus here's what happens. If we start to balance out cortisol, all of the sudden, weight loss becomes so easy. It becomes really easy because your hormones start working for you, not against you. Chronic stress activates what we talked about earlier, the HPA axis, your hypothalamus. Okay.

• 15:29Josh Axe?

  And then what happens is your pituitary releases something called ACTH. And then the adrenal glands pump out cortisol. Cortisol then raises blood sugar to create emergency fuel. Your insulin spikes to manage that sugar. And over time, your cells stop responding to insulin because it's like, it's like, you know, yelling in their ear too loud and they become deaf. They can't hear, so they get burnout essentially. And then your fat storage increases and inflammation rises. Okay. In this scenario, here's the reality, the body isn't broken. It's doing what it's supposed to. It's responding exactly as designed to prolong stress. Think of cortisol as your emergency fuel switch. In a true emergency, it's life-saving.

• 16:12Josh Axe?

  But when that switch is stuck on all day, every day, the engine floods. You don't get more power. You get breakdown. And until we can fix your natural rhythms of cortisol and melatonin and those normalize, your insulin never gets a chance to work. Blood sugar meds might lower numbers temporarily, but they don't fix the chronic stress signaling driving cortisol. And the same would be said, listen, if you've got a weight gain issue and you're taking all these GLP-1s, high dose GLP-1, you're going to lose weight, a lot of muscle, which is not what you want to do. Okay, you're going to lose that. And, and now, but your body is keeping on to a good amount of the fat because it's having to do that because it thinks that you're going to go into hibernation mode and you're

• 16:55Josh Axe?

  going to need to burn that for, to keep you alive. So we really need to work with your hormones and do everything we can to support cortisol. If you can fix cortisol and you can fix insulin, you will lose weight and you will lose it very quickly. Here are some things that really help. I mentioned this earlier with hypothyroidism, but dietarily, you want to do high protein, high fiber. Okay, high protein, high fiber, low carb, not, not no carb, okay, but just lower carb. You really want to be careful doing carbs in the evening as well. So you really want to start out, get some carbs in the morning, moderate, like, like, and I wouldn't say high, but one serving of carbs then, one serving of carbs.

• 17:39Josh Axe?

  For lunch, none at dinner and then high protein, high fiber. That's kind of the ideal diet there. And you really want to reduce excessive caffeine because remember your body's right. It's in survival mode with high cortisol. Giving your body more and more caffeine. Now, here's the thing, you're going to feel tired, but that's good. Your body's feeling tired for a reason. It's telling you, hey, take a nap, go to bed earlier, sleep in a little bit more. Do whatever you can to restore those adrenal glands. And this also becomes very important is your rhythms throughout the day, not rushing. That's one of the biggest things that keeps cortisol high is you're rushing here and here and here. And from the moment you wake up at 6:00 AM to the moment you crash at 10:00, 11:00 PM at night, you have every moment scheduled. You don't have a breather.

• 18:23Josh Axe?

  You need to schedule some margin time for prayer, time to read spiritual growth books, time to go on walks, time to exercise, time to connect with others and get filled, get your cup filled. That's really important. So part of this is saying no more often. What can you say no to? To create more margin for these things that build peace? That's going to lower the cortisol, get you out of fight or flight mode. And all of a sudden now cortisol is working and naturally balanced. Insulin is balanced. And so now you start losing weight, you feel great, you look younger. All of those things happen. Now, another thing that can is great for cortisol, as I mentioned a little bit ago, is adaptogenic herbs.

• 19:05Josh Axe?

  It could be ashwagandha, rhodiola, tulsi, known as holy basil, reishi mushrooms, but doing whatever you can to get some adaptogens and then magnesium, like a good magnesium glycinate or 3-aneate or a food or a magnesium chelate supplement. But you want to be able to do some sort of magnesium to lower the tension and stress. And so if you can do that, it's going to make a tremendous difference at fixing insulin if we can fix cortisol and help you lose weight.

• 19:37Josh Axe?

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• 20:17Josh Axe?

  support the microbiome, and deliver deep nourishment without any endocrine disrupting chemicals. Their less is more approach has earned a massive following, especially their deodorant and tallow-based creams and balms, which actually work with your body, not against it. If you're ready for skincare that supports your health instead of adding to your toxic load, you need Primely Pure. Your skin and your whole system will feel the difference. Use code AX15 to get 15% off your purchase at primallypure.com because when your skin thrives, so does your health. The next cascade is the PCOS and infertility cascade.

• 20:59Josh Axe?

  Now, PCOS is the most common hormonal disorder in women, impacting around 10 to 25% of women, according to the American Medical Association, and it's also the leading cause of infertility in the United States and many developed nations. And so many women today are struggling with irregular cycles, acne, weight gain, and infertility. And oftentimes, women are told they have PCOS and that their ovaries aren't working properly, and that treatment usually focuses on birth control, fertility drugs, and other forms of suppressing symptoms. But PCOS rarely starts in the ovaries themselves. Here's the truth: in almost all cases, PCOS begins

• 21:46Josh Axe?

  With metabolic signaling dysfunction. So it's it's an insulin issue. So so know this, if you have PCOS, okay? It almost is always starting with insulin. Okay, not estrogen, it's starting with insulin. And insulin resistance develops even in lean women, up to 70% of women with PCOS are insulin resistant, even those with normal body weight. Insulin levels remain chronically elevated and high insulin stimulates the ovaries to produce something called androgens, okay? And that's, that's not something women want. Men tend to have more androgens, women when that gets high. This is also where women can have excess hair growth in areas they don't want it.

• 22:29Josh Axe?

  And then what happens is ovulation is then disrupted or suppressed. And then progesterone drops. And then you have what we call estrogen dominance and then the and then fertility issues. Follow when estrogen gets too high, progesterone gets too low, androgens are too high. And that is the cycle we see with PCOS, that is the cascade. But again, it's all starting with insulin. So PCOS is a broken metabolic signal. The ovaries are responding to insulin, the way smoke alarms respond to fire. They're not malfunctioning, they're just reacting to the wrong signals. And this is why medications often fall short. It's common for PCOS symptoms

• 23:12Josh Axe?

  to return when medications stop. Hormonal suppression can regulate cycles on paper, but it doesn't fix the real problems which are insulin resistance driving androgen production and loss of ovulation signals. And then again progesterone dropping. And then the other thing that happens is inflammation and metabolic stress are happening. And here's the reality, we don't need to suppress hormones. We need to restore proper metabolic signaling. We need to get the fire alarm turned off. We need to get insulin in line. Okay, if you can lower insulin through protein and fiber forward meals and reduce refined carbohydrates and sugar load, okay? Your insulin levels will

• 23:56Josh Axe?

  Improve shockingly almost overnight. Okay, they will start improving rapidly. In fact, improving insulin sensitivity alone has been shown to restore ovulation in 50 to 60% of women with PCOS, even without fertility drugs. So listen, by simply changing your diet, and listen, a lot of these people in these studies, their diets weren't even perfect. But if you can go and do lots of protein, lots of fiber, lower carbs, a lot of healthy foods, you know, avocados and doing extra virgin olive oil and lots of organic meat and lots of fiber from getting some, you know, berries and beans and those types of foods, boom, insulin restores. You know, another great thing to start to restore insulin is weight training. Okay?

• 24:41Josh Axe?

  For women, now, now, I also want to say this, you don't want to overtrain, but you do want to go and say, I'm going to do two or three days of weight training, you know, cardio a day or two and get out and walk a lot. Even a 15 minute walk can help lower insulin enough to make a difference. Okay? The other thing I want to say with PCOS, it's really wonderful if you can add in herbs that can balance out blood sugar. I would recommend a lot of cinnamon, like do pumpkin pie spice. Well, you know, I had a patient come in, she was struggling with PCOS and infertility. And I had her every morning start doing one full teaspoon of pumpkin pie spice in a smoothie, and it was a pumpkin smoothie. So it was like a, you know, like a three fourths a can of pumpkin, little bit of coconut milk. She did collagen protein, she did a plant protein,

• 25:26Josh Axe?

  vanilla flavor, she did a teaspoon there of pumpkin pie spice. And then for lunch, I had her do something like organic meat and a sweet potato and vegetables, and avocado, vegetables, sweet potato, extra virgin olive oil. For dinner, I had her do meat, avocado, and some vegetables and extra virgin olive oil. So really lower, no, almost no carb for dinner, mostly protein, healthy fat. And then I had her take some chromium and berberine, and within three months, she was pregnant. And I've seen this so many times, hundreds of times with women. So all that being said, We just have to balance out insulin, insulin, insulin, insulin. If you can fix that, you're, you're, you're going to see dramatic results. Sometimes in a few weeks, if not a few months with PCOS.

• 26:09Josh Axe?

  You know, I was recently reading the story about Kiki Palmer. She's an actress and she has PCOS and she has access to the best doctors and the best medicine. But she said that managing her diet and her stress and her health has helped her cope and keep her symptoms in check. And let me say this, the only time that I don't see that dietary change where we really do fix insulin with diet. The only time that that doesn't fix PCOS for the most part is if cortisol is too high. Okay. Cause cortisol then will keep insulin high. So it's that combination of diet and weight training that we talked about and walking, and then doing some things to reduce stress. If you can do that, your fertility, your, the PCOS, you're taking care of that first domino.

• 26:54Josh Axe?

  And it's creating a domino effect in the right direction, helping heal and balance out all of your other hormones. Now, the next hormone cascade I want to talk about here is the testosterone cascade. Average testosterone levels in men have dropped 30 to 40% since 1980s and over 50% since the 1950s. And it's not because of aging. Men today have less testosterone on average than men of the same age who lived decades earlier. And here's something I see all the time with men I'm counseling and working with who have low testosterone. Man comes in, they feel exhausted, they feel unmotivated, they are, they're losing muscle, they're gaining belly fat.

• 27:38Josh Axe?

  They just noticed a drop in, as I mentioned, motivation in libido and lab show low testosterone. And then this man is typically told by doctors before they come see me that testosterone naturally declines as you age. And you know what? You're just getting older. And so now we need to put you on testosterone replacement therapy or you're just going to have to live, live with this. Okay. That, that's what they're told. Testosterone production is highly sensitive to stress and metabolic health.

• 28:08Josh Axe?

  Stress and poor sleep especially suppress hypothalamic signaling. And then your pituitary reduces LH and FSH in men. And then the testes produce less testosterone. And then there's an issue in men, by the way, where insulin resistance increases something called aromatase activity. And here's then what happens, men. Your testosterone is converted into estrogen. And this is where you start to see your chest grow and droop. You start to have more of the excess body fat around your midsection and hips. You feel the lack of motivation, the lack of libido. You don't feel strong anymore. You're you're missing that ambition.

• 28:47Josh Axe?

  You know, when you're younger, you wanted to go and take on the world and you felt this sense of just excitement and purpose. And you wanted to pursue and and do big things with your life. And you just don't feel like doing it anymore. You just want to come home and you just want to crash. You just want to watch TV. You just want to drink a beer and then that's all you want to do. That's so many men today. Okay. And part of that is your hormones working against you. And specifically you feeling that lack of testosterone. It's muscle loss, it's fatigue, it's low motivation. All those things follow. You know, testosterone is like a performance bonus. When the system is stressed or you're not getting enough sleep or you're inflamed. The body cuts the bonus first.

• 29:28Josh Axe?

  It uses energy to focus on survival and other essential processes rather than making more testosterone. Okay. And so if you want to raise your testosterone, you really want to do everything you can to make your body well rested and giving it the fuel it needs to go out there and create enough testosterone. But if you're under a high states of stress and not sleeping enough, it's nearly impossible to get your testosterone where it should be. Now, what a lot of men turn to today is hormone replacement therapy. They look to TRT. Okay. And TRT can raise your levels of testosterone. But it doesn't restore your brain to testes signaling or insulin sensitivity or sleep driven hormone release.

• 30:13Josh Axe?

  An overall healthy lifestyle is needed for healthy testosterone levels. Okay. The solution is focusing on rebuilding your testosterone at the foundation. A big thing here, listen, optimize sleep in your circadian rhythms. Okay. Go to bed earlier. And get at least eight hours of sleep, at least, okay? You know, I wear an Oura ring oftentimes and so I'm tracking my sleep every day to say, you know, where is my HRV? Where is my sleep? Doing everything I can to get good sleep. You know, you want to optimize your sleep. In one study, men sleeping fewer than five hours per night experienced a 10 to 15% drop in testosterone in one week. Over time, that's going to be a 30, 40 to 50% loss. Okay, that's one week alone.

• 30:59Josh Axe?

  I did an episode on how to optimize sleep and circadian rhythms in the past and I'm going to link to that in the show notes because it is so crucial. If you could walk through that episode and optimize your sleep, it's going to do wonders for your testosterone levels. Now, some of the best things men can do, again, get good sleep. That's number one. Number two, lift heavy weights. Okay, go out there and lift weights several days a week. Work your larger muscle groups, your butt, your legs, your back, your chest, those areas. That's going to help raise testosterone. Men also want to make sure there's two nutrients in particular. Zinc and vitamin D are crucial for supporting testosterone levels. Around 30 grams of zinc a day, around 5,000 IU's of vitamin D a day. You want to get plenty.

• 31:44Josh Axe?

  You also want to reduce alcohol and any endocrine disrupting exposures like BPAs for men. If you're eating out of plastic bottles, that's taking your testosterone and turning it directly into estrogen. Okay, and so that's going to sabotage you if you're using, you know, cooking with Teflon pans or using a lot of plastic or exposing yourself to chemicals, eating a lot of non-organic food, all of that glyphosate, those chemicals are going to take your testosterone and turn it into estrogen. Cause some men, I mean, I know some macho men and they might think, well, gosh, eating organic, that's for sissies or, you know, or, or, or taking, you know, or, or I'm going to eat out of plastic bottles and, and eat whatever I want.

• 32:27Josh Axe?

  It's taking your testosterone and turning it into estrogen when you have all of those chemicals in your system. So for men, get really good sleep. Lift weights, have some margin in your week, have a guys night, take your wife on a date night, you know, make sure to not, not work every second of the day. Okay. You want to work, but you also want to play. Okay. And if you can do that, it's going to make a radical difference. Now, listen, there are some other supplements I like for supporting testosterone in men, Fenugreek is great, Tongue Catali, deer antler, Panax ginseng. So those are great as well. You can take some of those things as well, increasing protein intake. That's really, if you want to fix your testosterone levels, you got to fix your sleep and you got to fix stress and you got to lift weights. If you do that, it's

• 33:12Josh Axe?

  going to make a world of difference.

• 33:16Josh Axe?

  Are you interested in functional nutrition tips to burn fat, reduce inflammation, improve your brain and energy levels and heal naturally? Then I want to encourage you to listen to my friend, Dr. Dave Jockers podcast, the functional nutrition podcast. This podcast is designed to help you with easy, actual steps to improve your nutrition and lifestyle, understand your lab work and address the root cause factors that may be driving up inflammation in your body. Now, I've been friends with Dr. David Jockers for 20 years and he's truly a world expert in functional nutrition, cellular healing, and so much more. If you want to learn the best nutrition and natural healing tips, tune into the Dr. Jockers functional nutrition podcast on Apple iTunes, Spotify, YouTube, and wherever you can listen to podcasts worldwide.

• 34:03Josh Axe?

  The last cascade I'm going to hit on is the menopause cascade. 80% of women enter menopause and suddenly experience hot flashes, anxiety, sleep disruption, weight gain and brain fog. And they're told it's just estrogen loss and it's part of getting older. But menopause is not simply a hormone deficiency. Menopause is a transition in hormone sourcing and adaptability. So ovaries slow down estrogen and progesterone production. That's what starts to happen during perimenopause and menopause. The body shifts hormone production to the adrenal glands and fat tissue. Okay. And chronic stress overloads adrenal capacity. And so your cortisol

• 34:48Josh Axe?

  output rises and then blood sugar becomes unstable, right? Insulin. So it's same pattern. You'll notice this same pattern with a lot of these. Cortisol goes up. So blood sugar goes up, so thyroid hormones go down. And then when that happens, progesterone and estrogen both drop even more than they should. Now here's what happens after menopause, up to 50% of circulating estrogen must come from your adrenals and peripheral tissue conversion. Okay, so if the adrenals are stressed and dysregulated, estrogen will suffer and menopause symptoms will likely be more intense. Okay, that's the reality.

• 35:31Josh Axe?

  So we got to do everything we can to fix cortisol if we're going to improve progesterone and estrogen and also those circulating hormones. Part of that is due to the food you eat. In fact, in Chinese medicine, there were foods called yang building foods and yin building foods. The yang is more masculine, it's tied to testosterone and creating more anabolic compounds in your body. This yin is tied to more progesterone and estrogen. These are foods that bring more moisture, they're more calming to the body, they're, they help with balancing and improving estrogen progesterone levels. So there are actually foods you can eat that will make a dramatic difference in your hormones, specifically estrogen progesterone. Now I do want to mention something here because it's one of the most common questions I get.

• 36:16Josh Axe?

  Dr. Axe, what do you think about HRT, hormone replacement therapy in women? I know the black box boarding was removed, this is great for women. Listen, it can be great for women, but even if you can go and take hormone replacement therapy, it doesn't fix everything. Okay, if you truly want to have healthy hormones and live a long time, hormone replacement therapy alone is not the answer. Now listen, I think hormone replacement therapy can be beneficial for some women, not all women, for some women. But before you get on hormone replacement therapy, the first thing you should be doing is improving your diet and your lifestyle and taking the right herbals or even peptides. And then, once you do those things, then let's look at hormone replacement therapy as kind

• 37:01Josh Axe?

  of a cherry on top to kind of in a small dose to balance out the body. And by the way, if you go to Japan today, which has the health Women in menopause, they have the least amount of symptoms. Almost none of them are on hormone replacement therapy. They are doing just what I shared with you. They're living a very healthy lifestyle. They're building peace. They're eating certain foods like purple sweet potatoes and a lot of wild caught fish with with omega threes. They have a very specific diet that is incredibly beneficial to their progesterone and estrogen levels. And that's what you want to do if you truly want to heal and improve estrogen, progesterone and age well. Okay, so don't solely rely on hormone replacement therapy. It can be a great tool used in addition to, but it's not the foundation. If you just do that and keep everything the same,

• 37:46Josh Axe?

  you're going to be suffering in other areas of your health. So what you really want to do is focus on strengthening adrenal resilience by managing stress and getting enough good quality sleep. Having high cortisol is associated with a two to three times greater increased risk of developing insulin resistance and obesity and make menopausal symptoms much worse. You know, if you're gaining weight as you go through menopause, part of it is due to the insulin and cortisol issues. Okay, and so when cortisol goes up, remember insulin sensitivity is impacted by about 25% according to one study. And so we got to stabilize blood sugar with balanced meals. Again, you want to focus on protein, fiber, healthy fats. Say it with me.

• 38:29Josh Axe?

  Protein, fiber, healthy fats, low moderate carbs. And the carbs you get ideally are fruit, especially berries and pomegranates, and it's sweet potatoes. Those are the golden carbohydrates for women that are going through perimenopause and menopause. Say with me. Berries, pomegranates and sweet potatoes and yams. Okay, that that's really what you want to be doing for your carbohydrates. And it's lots of healthy fats. It's extra virgin olive oil. It's avocado. It's, by the way, in Chinese medicine, an avocado is known to look like a uterus and olives like ovaries. Those foods as fats are probably the most healing and beneficial for women looking at supporting their hormonal health.

• 39:14Josh Axe?

  And then addition to that, wild caught fish with EPA, DHA. You also want to support progesterone and estrogen with flax seeds and pumpkin seeds. Okay, flax and pumpkin seeds, great fats there as well for supporting hormonal health in women. You can also do some organic yogurt can be great for women there as well. Very moistening to the body and good. Organic eggs are pastured eggs are great as well. And as you go through menopause, you also want to stabilize blood sugar with weight training. As you're losing muscle, you want to keep muscle on. So a lot of walking outside and then doing weight training. If it's just two days a week will make a big, big difference. And listen, you will notice a major difference in menopause.

• 39:56Josh Axe?

  If you can do what I just shared with you, you know, follow the diet I talked about. Get some good movement, get good sleep, and then a couple herbs can make a miraculous difference. Black cohosh tends to be the most noticeable herb as you go through menopause for balancing out that cycle, balancing out and supporting and raising up the estrogen and the progesterone. Red clover is also great. Wild yam is great. Shadavari, which is used in Ayurvedic medicine. Those are some herbals, Don Quai is another that can really, really help. But again, remember the hormone cascade. It's cortisol and insulin that impact almost every other hormone in the body. Now we've talked a lot about the functional medicine view of these different cascades that happen in the body, right?

• 40:39Josh Axe?

  And again, as I talked about, it almost always starts first with cortisol and then with insulin. And if you can fix those two hormones, almost every hormone can fall into place. Okay, cortisol being the master hormone. But there's also a view of this when we look at ancient medicine and we look at biblical scripture. Health is viewed as being systemic, not isolated. And ancient cultures understood that everything is connected. So it's obvious that to fix one thing, you need to fix the entire system or fix the one thing that does fix the entire system. So, so this is why they had daily and yearly rhythms.

• 41:18Josh Axe?

  Fasting and feasting, right? Rest, uh, you know, sun, sunset and sunrise, right? We not, and we have some of these natural rhythms. Sabbath days and foods, these were non-negotiables and part of restorative hormonal medicine. You know, if a woman in ancient China struggled with irregular cycles and fertility, acne, or excessive hair growth, the practitioner didn't say, "Your ovaries are broken." There wasn't even a word for PCOS. Instead, in Chinese medicine, they said, "Your reproductive symptoms are viewed as a flow in signaling, not a defect of a single organ." The practitioner would look at everything from sleep patterns to diet to stress.

• 42:00Josh Axe?

  And they would say something like, "Okay, we notice in your body, uh, you have too much movement called stagnation, or too much movement called wind, or your body's too hot, or it's too cold, or it's too damp, or it's too dry. And we simply need to change the flow of energy, which you get via food you eat and via movement and things like that. We need to strengthen, if your body's cold internally, like hypothyroidism, well, we need to warm it up. Let's eat more warming foods. Let's drink more ginger tea. Let's do more sunbathing. Let's do more things to warm your system, right? So, so they, so they understood this one thing impacts another in changing and supporting one area of the body that impacts another. In fact, there's something called the five elements of Chinese medicine where it's

• 42:44Josh Axe?

  a whole chart and graph that shows, you know, basically that one thing impacts another. You know, this is really how I learned in part how to heal hypothyroidism at its root, is I started to notice, "Oh, well, they have the thyroid here, but they're saying that the adrenals impact it here, and the gut impacts it here when it's autoimmune disease." So, so really, hypothyroidism is really an adrenal issue and a gut microbiome issue. And then I started learning how to completely reverse and help women get off their thyroid medications and reverse their conditions because of understanding the patterns and how if you influence one thing, it might correct the whole pattern. But if you're starting in the wrong spot, you'll never fix your hormone issues.

• 43:27Josh Axe?

  Quickly to fix these issues, again, it's not one medication or one supplement. And that's what's happening so often today. It's no, we need a protocol, we need a lifestyle change. We need it, we need to say no more often, right? We need to get better sleep, we need to take a few supplements, but we need to change and improve our diet and eat the foods that are exactly right for you. Listen, the diet doesn't taste better or worse. One, it's what your body is craving and needs. But I'll give you an example, I've had so many women come in with hypothyroidism. And they said, well, I'm eating really healthy, I'm eating a lot of salads and smoothies. That's not, that's not healthy in most cases for hypothyroidism. Your body's cold, so you're eating, drinking cold ice water and you're doing cold salads and you're doing raw foods. And that's terrible for, but we gotta warm the body up.

• 44:12Josh Axe?

  We need also lower cortisol, so we need to lower insulin. What do we do? It's a lot of soups, it's a lot of herbal teas, it's a lot of warm home cooked meals. It's a lot of things like sweet potato and, and grass fed beef and wild caught salmon. That fixes it, that'll fix it, okay? So there's different types of eating healthy, you need to eat the type of healthy that's right for you and your body and your hormones. Okay, and, and, and here's my challenge, instead of asking which hormone is low? Ask which signal is broke first, okay? And what is the most likely reason that it broke? Okay, so if cortisol is high, ask what, why, what's causing me to live in a fight or flight state? Okay, is it stress at work? Is it I've said yes to everything?

• 44:57Josh Axe?

  Is it I have no free time in my day? And then figure out how to solve that problem. That's how you'll start to see real results, okay? In that way, and listen, sometimes it's coming from multiple angles. Sometimes if your diet's poor, that's an insulin issue and then you have high cortisol, that's another issue. So you have both those issues. So sometimes there's a couple pathways that are impacting you. You need to say, well, I need to fix this issue and this one. And then your hormones will come back into balance. But if you want to heal your hormones, you have to start with that first domino, okay? So it's lowering cortisol, it's improving insulin and it's getting to bed earlier. It's having some more time to yourself, it's more protein and fiber at every meal. It's, you know, taking one or two supplements that are the ones that are the

• 45:40Josh Axe?

  needle movers for you, walking in nature, spending more time, you know, reading and personal growth and spiritual growth, prayer, those things will start to get to the root of your hormonal issues and you can finally address your hormones at the root cause. I want to say thanks so much for tuning in here to the Dr. Josh Axe Show. Remember each and every week, we're diving deep into the science and principles of how you can heal physically, mentally, spiritually, and take your health and your life to the next level. Hey, I've done a lot of podcasts on a lot of these topics as well. So if you want to continue to learn more about a certain element, maybe it's getting better sleep. Maybe it's about hypothyroidism or low testosterone. Just search on YouTube, Dr. Josh Axe, testosterone or hypothyroidism, or look in the show notes and I'm going to have

• 46:25Josh Axe?

  more of those episodes in there that you can look back at and listen to to further your wisdom and knowledge on these areas to help you take your health to the next level. Also, remember the number one thing you can do to support the show is subscribe. Sometimes because we talk about controversial topics on the show such as cancer and certain natural remedies like ivermectin and hydroxychloroquine, and I have some, you know, controversial experts on the show, it gets shadow banned. And so if you're not subscribed, you may not see it. So thanks so much for your support on that. Thank you for sharing and I can't wait to see you on the next episode.