By: Margaret Christensen, MD, FACOG, IFMCP, ABOIM
No matter your age and stage in life, (or your sex), our bodies interacting hormonal systems have a profound effect on heart health and function. And like Goldilocks conducting a complex symphony, not only does each individual hormone have to be “not too much, not too little– just right”, they also have to be in balance and harmony with one another.
All of the major hormones in the body including adrenaline, cortisol, insulin, thyroid, estrogen, progesterone and testosterone hugely impact mitochondrial function (energy producing organelles) and thus how well the heart and vascular system is working. Because the heart muscle cells never turn off, they have the most mitochondria of any cells- 5000 per cell!
Anything affecting mitochondria including hormones, biotoxins (mold, heavy metals, Lyme, viral infections), food and nutrients, inflammation and stress levels will impact overall heart and cardiovascular health. Remember, maintaining heart health and blood vessel health is an important goal for maintaining long term brain health too.
Are hormones good or bad for your heart? It all depends! Is the body making it or are you taking it? (Endogenous vs Exogenous?) Type, Dose, Route of administration, synthetic or bioidentical, oral vs topical vs injection?
Too much cortisol, adrenaline, insulin and thyroid can be toxic to the heart muscle, causing everything from palpitations, to high blood pressure, to weakening the ability of heart cells to contract.
Chronic stress and the Standard American Diet (SAD) promote irritating inflammation and excess insulin and cortisol. Not enough thyroid, estrogen, progesterone or testosterone can also compromise heart function, affect blood pressure, and impact the type of cholesterol production.
What if your mitochondria have already been compromised by toxins such as heavy metals, biotoxins from Lyme, viruses, co-infections or mycotoxins from mold? It’s why we see so many problems with heart palpitations and racing, feeling short of breath, feeling anxious and having hot flashes and night sweats (including men!) with biotoxin illness. Biotoxins are effecting the heart and cardiovascular system as well as disrupting hormonal function!
The difference between how natural hormones produced by the body (endogenous) work to support cardiovascular health, and how synthetic versions of hormones (exogenous), particularly synthetic estrogens and progestins found in conventional birth control pills, fertility drugs and hormone replacement therapy, is HUGE.
Controversy has raged over the past 20 years regarding the risks and benefits of estrogen, progesterone and testosterone on cardiovascular health. The problem is many of those studies were done on synthetic versions of these hormones, given in large pharmacologic doses and taken orally (has to go through the gut and liver thus impacting detoxification pathways.)
Many of those studies showed detrimental effects of HRT from increased risk of blood clots, high blood pressure and strokes (including fertility drugs and birth control pills, as well as male testosterone replacement.)
However, newer data is pointing to the very beneficial effects of these hormones, when given in their bioidentical forms and in smaller physiologic doses (like the body would make), and used trans-dermally (through the skin) to avoid the “first pass effect” through the liver.
Here are some examples:
Cortisol: A double edged sword- too much, too long increases insulin, weight gain and diabetes risk. Too little contributes to immune suppression and chronic fatigue.
Adrenaline: Too much causes heart racing, palpitations, anxiety and elevated blood pressure- good in an acute situation of running away from a tiger (or whatever immediate crisis) but detrimental in the long run.
Insulin: Important to help the heart muscle mitochondria utilize glucose for energy, but in high amounts (typical with the SAD diet), “carmelizes” the blood vessels making them sticky inside, raises blood pressure, increases heart rate, impacts cholesterol and plaque levels heart disease 
Thyroid hormone: very necessary to help fuel the mitochondria and provide energy. Not enough increases cholesterol, risk of heart failure, causes fatigue, slow heart rate and weight gain. Too much increases palpitations, anxiety and blood pressure, and risk for congestive heart failure. 
Estrogens: produced in the body increase vascular elasticity, supports mitochondrial energy production, promotes anti-oxidant production and helps repair hearts after ischemic injuries. But we are talking about pure estradiol, in physiologic not pharmacologic doses.
Synthetic estrogens (like horse estrogens): increase the risk for coronary events, so if you’re going to take ERT they should be bioidentical in small physiologic doses. 
Testosterone: can be beneficial, again also in small physiologic doses for men and women. With the right dosing, helps treat insulin resistance in diabetes, weight management, improves muscle mass, immune system function and sexual health and vitality. Too much causes irritability, acne, hair loss and can be “aromatized” into estrogens causing “man boobs” in men, excess bleeding in women. 
Progesterone: naturally lowers blood pressure, dilates blood vessels and has natural diuretic effects. Yet synthetic progestins increase risk for blood clots and strokes, as well as hormone related cancers and depression. 
What Can YOU Do?
- Eat a low sugar. Low grain, anti- inflammatory diet [Repairvtie class]
- Mitochondrial support with CoQ10 and a diet full of colorful antioxidants
- Avoiding endocrine disrupting toxins- found in plastics, Styrofoam, personal care products
- Eat organic- pesticides are major hormonal and mitochondrial toxicants
- Stress management to keep adrenaline/cortisol stable with daily meditation and movement and adequate sleep, rest and play!
- Gratitude- increases heart rate variability and coherence, lowers adrenaline
- Cardiac supporting nutrients include B vitamins, Magnesium, Omega 3 fish oils, co Q10
- Lower blood pressure with raw celery juice, beet juice and magnesium
- Get tested for thyroid, adrenal and sex hormones- ALL together!
Testing may be done with blood levels, urine metabolites and saliva depending on which hormones are being evaluated. Testing also involves looking at gut health, detoxification pathways and other factors.
All of the bodies’ hormones have to work together in harmony, much like an orchestra playing a complex piece of music. And like Goldilocks you want them “not too hot, not too cold, just right”! So, it’s important when evaluating hormonal health to look at ALL of the hormones together, because they interact with one another, markedly influencing how each functions.
Optimum hormonal balance is critical to both short and long term health!
Learn More By:
Watching Dr. Kina and Zarana’s online Advanced Cardiometabolic Prevention Class.
Want to know how to treat Biotoxin Illness? Monthly Biotoxin Orientation with Dr. Christensen
Tune in to 50 Ways to Women’s Wellness Online Health Summit on September 9th. 50 Ways to Women’s Wellness is a groundbreaking, online event created for women, by women to help YOU cope with the exhausting pressure of being a super woman expected to do everything perfectly, all the time.
 Biol Sex Differ. 2017; 8: 33. Published online 2017 Oct 24. doi: 10.1186/s13293-017-0152-8
The protective role of estrogen and estrogen receptors in cardiovascular disease and the controversial use of estrogen therapy
 Testosterone and Cardiovascular Health Elagizi, Andrew et al. Mayo Clinic Proceedings, Volume 93, Issue 1, 83 – 100
 Steroids Volume 78, Issue 6, June 2013, Pages 583-588
Protective actions of progesterone in the cardiovascular system: Potential role of membrane progesterone receptors (mPRs) in mediating rapid effects https://www.sciencedirect.com/science/article/pii/S0039128X13000202