There are so many reasons why you might feel bloated on a given day—food sensitivities, traveling, exercising, and more. But if you’re scrolling TikTok and searching for “bloating relief,” you could get the impression that your hormones are at the root of your tummy and energy woes. And more specifically, that you could benefit from “balancing your hormones” to avoid this lethargic fate.
Experts in This Article
an intuitive eating coach, anti-diet dietitian
chief of endocrinology, diabetes and metabolism at Suburban Hospital and associate professor at Johns Hopkins Medicine
endocrinology specialist at Millennium Physician Group
Los Angeles-based OB/GYN who is also an integrative/Ayurvedic medicine specialist
“[The concept of hormone balancing has] become a big trend in wellness culture and social media for sure,” says registered dietitian, podcast host, and author Christy Harrison, MPH, RD, CEDS, who recently devoted a podcast episode to the topic after having received a high volume of listener questions about it. Fitness instructors, food bloggers, alternative medicine practitioners, and influencers of all stripes are using social media to tell followers that if they’re tired, bloated, acne-prone, carrying more weight than they’d like, or really feeling less-than-optimized in any way, they might work to “balance their hormones.” The proposed remedies are often diets, supplements, and workout regimens.
And for some, curiosity about hormones is mounting. According to Google Trends data, searches for the term “hormone health” have steadily and dramatically increased over the last five years, peaking this past spring. At face value, this interest may seem perfectly natural. Hormones play a role in digestion, metabolism, energy, and more, so why shouldn’t we pay attention to them when it comes to how we feel day in and day out? The only problem is the fact that the concept of “balancing your hormones” is mostly nonsense.
It is possible to have a genuine medical condition known as a hormone imbalance (meaning, one hormone or group of hormones is out of the normal range for your age). However, these conditions’ existence doesn’t mean there’s an inverse situation of an ideally “balanced” hormonal state. In the case of a hormone imbalance, the best path forward is to seek medical diagnosis and treatment with a doctor catered to your personal symptoms—not just heed the advice (and products) of an expert (or “expert”) you encounter on social media.
“If you truly believe that you have hormonal imbalance symptoms, then please seek help from a physician,” says Misha Zilbermint, MD, chief of endocrinology, diabetes, and metabolism at Suburban Hospital in Bethesda, Maryland, and an associate professor at Johns Hopkins Medicine. If you—like many folks—are curious about what constitutes optimum hormone function, what experts want you to know is that the concept of “balancing” them isn’t a medically sound or recommended path.
For starters, what are hormones?
Our glands, muscles, and other tissues secrete chemicals known as hormones that travel throughout the body in the blood, sending messages between our organs and prompting them to do their various jobs. There are more than 50 known hormones, and researchers are still discovering both more hormones and the functions of the known hormones.
Hormone levels vary from person to person1, and levels even change over time2. Doctors do not expect a teenager and a retiree to have the same levels of testosterone3, for instance, according to Raymond de la Rosa, MD, an endocrinology specialist at Millennium Physician Group in Florida. “Some people may have a little bit higher levels, some people may have a little bit lower levels, but it doesn’t mean it’s abnormal,” says Dr. Zilbermint. “Everyone is different because our body has so many hormones, [and] each of the hormones have a different prevalence.”
What medical experts think about the phrase ‘balancing your hormones’
“This phrase is meaningless and overly broad,” says Suzanne Gilberg-Lenz, MD, an OB/GYN who is also an integrative and Ayurvedic medicine specialist. Even as someone who says she has feet in both the worlds of research-backed and holistic-leaning medicine, she is flummoxed and concerned by the term. “I think the implication is supposed to be about homeostasis—or a so-called ‘point of balance’—but in fact our hormones are supposed to fluctuate. It is true [that for people who menstruate, hormones] should do this with some predictability and pattern during our menstruating lives. But the promise of perfection is based on misunderstanding at best and manipulation at worst.”
One misunderstanding implied by the term “balancing hormones” is that all doctors approach a hormonal concern like a ratio or formula, looking at various levels in relationship to each other. But most doctors assess hormones individually, not systemically. “We check for hormonal dysfunction, hormonal excess, or hormonal shortage,” says Dr. De la Rosa. “It’s not a balance protocol. We’re looking for the appropriate levels.”
“The promise of perfection is based on misunderstanding at best and manipulation at worst.” —Suzanne Gilberg-Lenz, MD
If you come to your doctor with concerns about your energy, mood, or another function that could be tied to hormones, they might order a blood test that looks at the levels of an individual hormone or a small group of related hormones. Your doctor will have to order the specific test you need based on your particular concerns, says Dr. De la Rosa—there is typically no general, all-encompassing “hormone levels” test. For example, a doctor might test a patient with dramatic weight gain or weight loss for thyroid hormones since the thyroid gland regulates metabolism.
If one hormone or group of hormones measures outside the realm of expected levels, it is addressed, but this is not an exercise in balancing the whole of all hormones.
So then why is today’s digital world especially ripe for social media users, in particular, to chase the misinformed goal of balancing their hormones? Dr. Gilberg-Lenz points out that an overburdened medical system and its legacy of dismissing women’s health concerns mean that patients won’t necessarily get what they’re looking for when they bring hormone questions to a physician. As we’ve seen play out in the misguided backlash to hormonal birth control, the promise of a “natural” wellness solution can be “appealing to people who feel like they’ve gone to doctors for symptoms and problems and not gotten help and relief,” says Harrison. (Meanwhile, since the science around aging and longevity—and hormones’ role in it—is still an active area of research, there are some outlier physicians who do take a more active approach in tinkering with hormone levels, sowing both interest and confusion.)
Hormone health can also be a screen for ways to talk about weight loss—focusing on bloating and metabolism can feel more body neutral than using the words “weight loss”, even if the end goal of getting smaller is the same. Harrison says that this dovetails with cultural expectations about what it means to be a healthy, productive member of society. “In some cases, people don’t necessarily have anything medically going on, but it’s more of the cultural pressure to never have a bloated belly, or to constantly be energetic,” Harrison says. Rather than acknowledging these are normal parts of life, hormones take the blame.
Can—or should—you be proactive about hormone health?
Generally, hormone health is not something you need to actively worry about. “[Hormones] are always in flux and the body typically does a great job of regulating them all on its own, except in the case of these true endocrine disorders,” Harrison says.
What’s more, exercise programs, supplements, and other products promising to “balance your hormones” that aren’t prescribed by your doctor are likely to be ineffective, and potentially harmful. It’s not wise to take a hormone without medical supervision, or do to a “hormone-balancing diet” that could result in disordered eating, and actually end up causing a hormonal problem.
“The bottom line is there is no universal hormone you can take to fix everything, and there’s no one vitamin or pill to fix it,” Dr. De la Rosa says.
While lifestyle choices can affect some hormone levels, the truth is that there are a host of conditions that can only be treated by a doctor. For example, if someone has high levels of cortisol4 (a hormone whose production is supercharged by stress), they might be able to take up meditating5 to bring it back to baseline. But, if a person’s adrenal gland is not functioning properly, they might be producing an insufficient amount of cortisol, and no lifestyle change or supplement or diet will adequately treat that.
“I think the question is,” says Harrison, “how can we find empathetic care providers who will give us evidence-based medicine and also admit the limits of what we don’t know in conventional medicine in a way that’s not going to drive people to unproven, potentially harmful treatments that they might find in alternative spaces?” If we can find the answer, we may finally be able to stop falling prey to false problems—and solutions—peddled on TikTok.
Ganie, Mohd Ashraf, Subhankar Chowdhury, Vanita Suri, Beena Joshi, Prasanta Kumar Bhattacharya, et al. ‘Normative Range of Various Serum Hormonal Parameters among Indian Women of Reproductive Age: ICMR-PCOS Task Force Study Outcome’. The Lancet Regional Health. Southeast Asia, vol. 15, no. 100226, Elsevier BV, Aug. 2023, p. 100226, https://doi.org10.1016/j.lansea.2023.100226.
↩︎Pataky, Mark W et al. “Hormonal and Metabolic Changes of Aging and the Influence of Lifestyle Modifications.” Mayo Clinic proceedings vol. 96,3 (2021): 788-814. doi:10.1016/j.mayocp.2020.07.033
↩︎Kelsey, Thomas W et al. “A validated age-related normative model for male total testosterone shows increasing variance but no decline after age 40 years.” PloS one vol. 9,10 e109346. 8 Oct. 2014, doi:10.1371/journal.pone.0109346
↩︎Fukuda, S, and K Morimoto. “Lifestyle, stress and cortisol response: Review II : Lifestyle.” Environmental health and preventive medicine vol. 6,1 (2001): 15-21. doi:10.1007/BF02897304
↩︎Jacobs, Tonya L et al. “Self-reported mindfulness and cortisol during a Shamatha meditation retreat.” Health psychology : official journal of the Division of Health Psychology, American Psychological Association vol. 32,10 (2013): 1104-9. doi:10.1037/a0031362
↩︎Grant, Paul, and David Lipscomb. “21st century endocrinology.” Clinical medicine (London, England) vol. 9,5 (2009): 459-62. doi:10.7861/clinmedicine.9-5-459
↩︎Mehta, Jaya et al. “Risks, Benefits, and Treatment Modalities of Menopausal Hormone Therapy: Current Concepts.” Frontiers in endocrinology vol. 12 564781. 26 Mar. 2021, doi:10.3389/fendo.2021.564781
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