Ben Schuff
April 24, 2023

How Can Hormonal Imbalances Influence Gut Health?

The gut-microbiome is the root of our physiologic tree. When our root is damaged, the rest of the branches can be disrupted.

There is a two-way relationship between gut-microbiome and hormones. Our gut is predominantly made up of what’s called the microbiome, the biodiversity of various bacteria, fungi and viruses that coexist with us. We know that the microbiome plays important roles in processing certain hormones like estrogen, for example. In turn, the hormones of our body act both generally and locally in our gut to influence function and overall balance. Our gut-microbiome is an intelligent system that senses then influences nearly every hormonal feedback loop in our body.  


Estrogen is a critical hormone for both women and men, being known for female sexual development, pregnancy and menopause. Estrogen also is involved in initiating metabolism, cardiovascular, bone and brain health.

Certain species in our gut-microbiome create a complex called the estrobolome that has demonstrated the ability to metabolize estrogen for clearance or activate it to forms our body can use via an enzyme called beta-glucuronidase.  

If our gut-microbiome is out of balance (called dysbiosis), this important turnkey of estrogen processing can manifest as estrogen-related conditions


Insulin is arguably the biggest player in our metabolic health. Meaning that insulin is all about managing blood sugar, regulating inflammation, restoring and reserving resources in the body. Insulin dynamics get deranged in a condition like diabetes because the body is having a hard time with consistently high blood sugar levels, it pumps out more insulin to compensate but eventually the cells become resistant to its effect, creating disease manifestations.  

The connection to the gut-microbiome again has to do with the complexes that it creates in order to metabolize hormones to adjust their activity. Research shows estrogen helps sensitize the cells to the effects of insulin, therefore, if our gut-microbiome is out of balance, it could lead to disruptions in the estrogen-insulin dynamic leading to problems. We see this play out in women that are post-menopausal and develop diabetes because the activity of estrogen in their body drops precipitously, naturally.


The thyroid hormones ramp up or down the rate of metabolism in the body. There are thyroid receptors on nearly every tissue and cell in the body. Dysbiosis in the gut-microbiome is associated with hypothyroidism where the body is having trouble producing enough thyroid hormone, creating many types issues.  

Melatonin & Serotonin

Melatonin is a powerful regulator of our bio-rhythms in its fluctuations with exposure to light and darkness, hence its popular use before bedtime.  

Darkness and specific avoidance of certain wavelengths of light are important inducers of melatonin production. The catch is that you need plenty of the neurotransmitter serotonin reaching the brain for that conversion to be efficient.  

Serotonin is thought to be a brain-based chemical (think of SSRI anti-depressant medications) but interestingly more than 90% of our serotonin is produced from our gut-microbiome. If our gut is out of balance and digestion is skewed, it could be that serotonin production and release could be impaired as well. This can affect sleep, mood, concentration, and the production of our sleepy hormone melatonin.  


Cortisol is well known for our adaptation to stress. As a hormone it mobilizes resources and processes to respond efficiently to emergent events. Stress is a common complaint in our society, so what are the bidirectional effects on the gut-microbiome?

When we are stressed by something, cortisol plays a role with our “fight or flight” sympathetic nervous system response which preferentially shunts blood to our brain, muscles and limbs instead of our digestive organs which, if repeated consistently, can make digestion and our gut-microbiome health out of balance. In other words, when we are in a stressed state, the body doesn’t prioritize digestion in a perceived time of crisis, and when chronic, it can eventually alter the gut-microbiome negatively. Cortisol is a key player here and is why stress management or looking to understanding how stress is manifesting in your life is so important.  

How can hormone-driven disruptions in the gut influence skin health?

Our gut-microbiome and our organs of detoxification, namely the liver, are tasked with metabolizing and making safe nearly everything that interacts with our system. In modern times, we are embedded in an environment of chemicals, herbicides, pesticides and microplastics that have endocrine-disrupting and gut-microbiome damaging effects. Some of these chemicals like BPA in plastic, for example, mimic the chemical structure of estrogen and can disrupt how natural estrogen should be functioning or cause an additive estrogen effect that manifests different problems.  

Other common products like scented candles, fragrances, deodorizing sprays, and beauty products can have various chemicals, for example “phthalates”, that disrupt hormones and the gut-microbiome.  

We have four routes of elimination in the body—stool, urine, breath, and sweat/skin.  When someone is not having regular bowel movements, digestion is off, their liver is overwhelmed, or other combinations, the skin may be utilized in a greater capacity to get rid of metabolic and hormonal by-products.  The skin, being the largest organ in the body, can emphasize its eliminative power out of balance to the point that the tendency to form acne, blemishes or other skin conditions are favored.  

What are some lifestyle changes, products, and other solutions that can counteract these effects?

The complexity of circumstance and the uniqueness of everyone’s gut-microbiome and hormonal tendencies requires an individualized approach with a qualified professional. That said, basic practices that support the gut-microbiome and balance hormones are the following:

  • Eat real food: our gut-microbiome responds to every single thing we consume so we are literally making a decision about its health, balance and integrity with every bite we take. Eating real intact foods also are less likely to disrupt blood sugar balance and create metabolic disorder which affects hormones. The gut-microbiome and liver prefer real food to processed refined foods, every time. The gut-microbiome also finds balance easier when plenty of colorful vegetables and fruits are consumed daily. The soluble and insoluble fiber in vegetables especially feed the gut-microbiome to build a robust and diverse microbial community within.
  • Eat fermented foods: Probiotics are very popular supplements and they have a time and place. However, there are foods that give us both fiber (the gut-microbiomes preferred fuel, called prebiotics) and probiotics, they are called fermented foods. This includes daily servings of some kimchi, sauerkraut, yogurt, kombucha, tempeh, miso, etc.
  • Work with your stress: Seek out professional help if you think your stress or mindset is negatively affecting health. This also includes seeking out community, human connection and pursuits that give deep meaning to our lives.  
  • Audit your environment: Could you be exposing yourself to problematic chemicals disturbing hormonal and gut-microbiome balance daily without knowing it? Women are especially sensitive to endocrine-disrupting chemicals in common products because of their menstrual cycles and utilization of the hormone estrogen. Unfortunately, most of these products are directly marketed towards women. You can take stock of what you regularly are exposed to and use resources like the Environment Working Group ( that grades common products on the markets and suggested alternatives if necessary.  
  • Move: Daily movement has a myriad of positive effects, not least being to help your bowels and digestion moving along and get rid of hormones and other metabolic by-products.
  • Sleep: Sleep is crucial and if you aren’t sleeping well, seek support to create that for yourself. Sleep deprivation disrupts metabolism, digestion, hormones and contributes to stress.
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