Hormonal Imbalance


As a Naturopathic Doctor, when I treat a patient, I am always looking for the underlying cause of the illness, the abnormal mechanism that may be going on than just the symptoms.

Many times the following symptoms for example are because of an issue with the hormonal balance.

  1. Adrenal fatigue
  2. Thyroid issues
  3. PMS
  4. PCOS
  5. Endometriosis
  6. Infertility
  7. Hot flashes
  8. Mood swings and irritability
  9. Low libido
  10. Andropause issues (men’s version of menopause).
  11. Mood changes
  12. Weight gain.

Most often these days, women are on HRT (hormone replacement therapy). The goal is to relieve the symptoms associated with the hormonal changes. However, the root cause of the symptom is never addressed.

In Naturopathic Medicine, when diagnosing Hormonal imbalance, we look broadly at as many systems as possible and as far back as possibly can through a detailed comprehensive history. The more information we can get and the more specific it is, the easier it will be to get an idea of what is actually happening and how to treat the most basic causes.

Predisposing Factors that can underlie Hormonal Imbalances

With hormonal disturbances, I  look for pre-disposing factors and possible triggers that could have affected the optimal hormonal function. These may not be the presenting signs and symptoms, but elements in the medical history that have led the patient to the situation they present with.

Most common causes of Hormonal dysregulation are:

  1. Chronic stress:  Chronic stress can lead to “Pregnenolone Steal” or “Cortisol Escape.” When the body is in a  “chronic stress response,” pregnenolone, the precursor to the rest of the steroidal hormones, is diverted to cortisol. This is at the detriment of all the other steroidal hormones; i.e. progesterone, aldosterone, DHEA and its metabolites: the sex hormones, estrogens and testosterone. As pregnenolone is diverted to cortisol- DHEA depletion begins. The result is a depressed cortisol-to-DHEA ratio and an imbalanced hormonal system. This is measurable with a Functional Adrenal Stress Profile.
  1. Toxicity/xenoestrogens: Many of the toxins we are exposed to on a daily basis have hormone-like activity and are known as xenoestrogens. They have the ability to either mimic estrogen or act as endocrine disruptors sitting on estrogen receptors, kicking off the real hormone and creating a myriad of problems in the body.
  1. Nutritional deficiencies: Certain nutrients act to detoxify hormones and act as essential cofactors in not only the synthesis of hormones but the biotransformation of hormones in peripheral tissues.
  1. History of synthetic hormone use : This would include oral contraceptives and infertility treatment.


Once we have a sense of the possible triggers and predisposing factors, I would then look at their impact on hormonal function to see,

– if there is a problem with synthesis

-or a disruption at the cellular levels that the message is not received at the target tissue

-Or if there is a problem with detoxification or excretion of hormones etc..

Once the underlying causes have been identified and looked at from this broad perspective, treatment can be advised with greater confidence.  Naturopathic Medicine treatments that include; stress reduction, botanical/herbal medicine, nutritional supplements, diet and lifestyle changes, and other  treatments such as castor-oil packs and hydrotherapy  are used.  If there be a need for a hormonal treatment, we have a good referral network of doctors outside the clinic that we refer.


The Big 6’s in Health


Here’s my 6 important steps for health (in order of importance) that I recommend to almost all my patients.

  1. Water:

To determine the amount of water intake per day, here’s a little calculation to keep in mind

  • 1/3 of your body weight (IBS) = Ounces of water


  • Body weight (kgs) -18 (approx)=Ounces of water.   (1 ounce= 30ml)
  • + 8 Ounces for every vice (alcohol, coffee etc.)
  • +8 ounces for every 20mins of exercise

(The recommended amount of water can include herbal teas )

  1. Protein and Vegetables:
  • 10-15gms of protein for breakfast- (One simple rule to determine amount of proteins=size of your palm)

Proteins are necessary for a healthy cortisol response in the morning where it is at its peak from 6-10am. Examples for Proteins include- beans, nut butters, muesli, seeds, eggs, animal protein etc.

  • Everybody should have at least 3 cups of veggies/day. Dark green vegetables and ideally organic.
  1. Sleep:
  • A good night sleep is necessary to restore your adrenals.
  • Ideally, one should fall asleep in 20mins and have uninterrupted sleep for 6-8 hrs. We need two 3-4 Rem cycles to restore the adrenals.
  • For those, who wake up in the middle of the night, a small amount of protein at bedtime and a calcium-magnesium supplement is helpful.
  1. Exercise:
  • Ideally, 15-20 mins twice daily or 1 hr/day if possible. It is best if it includes all the 3 components of exercise- flexibility, aerobics and strength. But, any form of movement is just good enough.
  1. Good supplement regime:
  • It is best to get this evaluated through your Naturopathic doctor for appropriate dosages based on current lifestyle, specific conditions etc. Here’s a overly general supplement regime that most people would need these days in my opinion.
  • A good quality multivitamin that may include iron or no iron depending on the requirement. I am not a big fan of advising multivitamins for everybody as most of it goes un absorbed especially in case of tablets. But, considering today’s scenario and the amount of ongoing mineral deficiencies I see in practice , everyone would benefit from an additional bonus of minerals if given in the correct format.
  • Omega 3 oils. Quality here is extremely important and needs to be a reputable brand that is tested for heavy metals.
  • A Calcium – Magnesium combination (1:1)
  • Probiotics or fermented foods.
  1. Connect with Nature/soul/Gratitude:
  • A daily routine to spend few mins of the day in activity that connects to your true self.
  • Expressions that connect to your self can be prayer, reflection/meditation, art, music or nature walks, breath awareness, expression of gratitude to nature etc.

If you have a health condition and would like to explore how Naturopathic medicine could assist in your healing and recovery, Give us a call.




Fever – A friend or a foe?


It’s likely that you’ll get a cold or flu this year at some point.  How you choose to deal with it may actually be more important for your long term health than you realize.  As a naturopathic Doctor, I think about these acute illnesses a little differently than you’re used to and I find it’s helpful for my patients to understand my thought process.  Hopefully this will help you take a new perspective on this year’s cold or flu.

The body is smart.  This is the principle from which I operate.  When we get acutely ill, often this is the body’s attempt to get rid of something harmful.  The mucous produced in a respiratory infection helps to clear out infectious organisms (if we let it).  When we have food poisoning, diarrhea helps to clear out the organism.  When we sweat during a fever, we decrease our inflammation.

Getting an occasional acute illness and then clearing it in a short period of time tells us that the immune system is capable of responding and is doing its job.  When I have patients who do not get acutely ill at all for several years, I begin to be concerned that they may not be releasing things from their body and may be building up inflammatory toxins, which can lead to more chronic illness.  I also wonder if the immune system is working effectively in these patients, which you need it to do in order to prevent long term issues like cancer.

Don’t get me wrong, I don’t want my patients to be excessively ill or to be sick frequently or for long periods of time.  I just want to know that the body is getting rid of things every so often, responding appropriately, and recovering efficiently.  Ideally, my patients would have no more than 1 cold or flu/year and no less than 1 fever every 3 years.

Finally, it forces you to slow down.  Let’s face it; many of you will only pause when you’re sick. Often getting sick is your body’s way of telling you that something needs to shift.  Maybe it’s just that you need a break for a few days or it may be that there is a larger pattern in life that needs to be changed.

Why Fevers Are Useful:

A Fever is the body’s way of stimulating the immune system.  Many parts of the immune system are temperature activated.  Immune activity tends to be greater at higher temperatures.  Conversely, many bacteria and viruses do not replicate as quickly at higher temperatures.  By creating a fever, the body is able to stimulate its own defenses and slow down the infectious organism in order to fight the infection more effectively.  By allowing the fever to run its course, you actually allow your body to fight the infection faster!  Many of the aches and pains we feel during a fever are actually caused by our own immune activity, not the infectious organism itself.  When we suppress the fever with Paracetamol, Advil, Motrin, or Aspirin, we’re actually interfering with our immune system’s ability to fight.  Fevers are uncomfortable it’s true, but they do have a purpose.

How we manage a fever can have profound implications for how quickly we recover from an acute illness as well as how our bodies deal with more chronic complaints.  I think of fever as a period of clearing and detoxification.  Physiologically, the body actually shuts down digestion during a fever and instead begins to break down muscle to use as fuel.  The liver becomes activated to process all of the breakdown and the immune molecules flowing through the body.

Because digestion is shut down, eating during a fever can lead to increased toxicity and can push your body to process more than it should.  It can cause toxic undigested food to build up in the digestive tract, which can further stress the liver.  It can also pull essential resources away from fighting the infection and toward trying to deal with the food.  While hydration is vital during a fever, I do not recommend eating.

Rather than eating, consider drinking water, nettle tea, other herbal teas, vegetable broth, or very dilute juice.  If energy is very low, you might drink something like coconut water, which will provide some glucose and great electrolytes without giving the body much to break down and process.  Typically, you’d want to fast and give complete rest until the fever has been gone for at least 24 hours.  When reintroducing foods, start with broths or blended vegetable soup for the first day and then return to solid foods following your appetite afterwards.

There are a few dangers to fever.  A temperature that is too high can cause organ damage, but this typically won’t occur below 41.6 degrees C (107 degrees Fahrenheit).  What is far more likely is dehydration since fluids evaporate so much faster from a hotter person.  Dehydration can then cause the person to run hotter than they otherwise would, because it’s harder for the body to cool itself naturally.  Febrile seizures can occur in children and the risk is higher in a dehydrated child. While febrile seizures typically have no lasting side effects, they can be dangerous if they go on for a long time, if the child falls and hits his or her head.  They are also scary for parents to watch!

Knowing what is normal and where the line of safety is when you haven’t navigated a fever this way can sometimes feel a little scary.

It’s a good idea to call your doctor and let them know what is going on so they can help you manage.  Your naturopath can help you assess if hydration is adequate or if the fever is getting too high.  We typically recommend that you call us before the fever hits a dangerous stage so we can reduce your anxiety and help you know how to keep the fever in a safe and useful range. 

 In an infant under 3 months, if the temp reaches 38.3C/ 101 F call right away.  For children 3 months to 13 years, call if the fever has been over 38.8C/102 F for more than 48 hours. 

 Adults don’t tend to spike fevers quite as high, so you may want to call with a temp over 38.6C/ 101.5 for more than 48 hours.

Remember that fevers will often go up by a degree in the evening, so a relatively high fever in the morning can become an intense fever later in the day.

Here are some guidelines to keep in mind when it comes to Children:

  1.  Pay more attention to how the child is looking/feeling than what the thermometer says. A really sick looking kid is really sick, no matter what the temperature (high or low!). Sometime kids will get listless, stop crying and cannot be stimulated. Other times they are uncontrollably cry and are irritable. Follow your parent instincts! 
  2.  Another myth: Breaking the fever will stop the infection- The chemicals that cause the fever will signal the immune system to do its job. We don’t want to interfere with that process.
  3.  Wait on the Paracetamol!… Again, its how your child looks is most important determinant of whether the child has a serious infection.
  4.  All that said.. It is NEVER normal for a newborn to have a fever. Any infant under the age of 3 months with a fever (greater than 100.4 F/38.0 C) needs to be checked out.

We’re always here to help you manage the fever safely, so even if you’re not sure about a lower fever, we’d prefer that you call than worry.  Naturopathic care has many supportive measures that can help the fever feel less uncomfortable without suppressing it.  These include herbs, homeopathy, or use of hydrotherapy.

Due to MOH regulations, I do not prescribe prescription drugs in Singapore, if a situation arise that would warrant conventional antibiotics or need further evaluation, we have a great network of GP’s and pediatricians that we refer to outside the clinic if needed.