Mood Swings, Brain Fog, Fatigue? Let’s Talk Hormonal Health
We know how powerful Hormones are: they shape how we think, feel, sleep, eat, move, and function—every single day. And yet, for many women, hormonal shifts often go overlooked or dismissed, especially when standard lab tests come back “normal.”
If you’ve ever found yourself saying, “I just don’t feel like myself,” it’s worth considering whether hormones might be part of the picture—particularly if you’re anywhere between your mid-30s and 50s. This is a critical window when hormonal changes become more common, even if they’re subtle at first.
When “Normal” Labs Don’t Tell the Full Story
Hormones influence the brain’s chemistry directly—impacting neurotransmitters like serotonin, dopamine, and GABA, which regulate mood, focus, and stress response. So, when your hormones are out of sync, it doesn’t just affect your cycle—it can impact your mind, energy, and emotions too.
Common symptoms of hormone-related changes may include:
Brain fog or slowed thinking
Low mood, anxiety, or emotional flatness
Fatigue that doesn’t improve with rest
Irritability or increased sensitivity
Poor sleep or early waking
Weight gain or difficulty losing weight
Low libido or vaginal dryness
Insomnia or restless sleep
Abdominal weight gain
Irregular or missing periods
If any of this sounds familiar, your hormones may be signaling for attention.
Understanding Hormonal Shifts by The Decade
20s–30s: Hormones are generally stable, but factors like high stress, inadequate nutrition, or postpartum recovery can cause imbalances.
Mid-30s–50s: Perimenopause can start as early as your mid-30s. During this time, estrogen and progesterone levels fluctuate, often causing mood swings, sleep disruptions, and cognitive changes.
After menopause: Hormones like DHEA and testosterone begin to decline, affecting energy, libido, bone density, and brain function. Thyroid concerns also become more common with age.
The reality? These changes are very real. You’re not imagining it—and you’re not alone.
What Else Impacts Hormone Balance?
Hormones don’t operate in isolation. Their balance can be disrupted by:
Chronic stress (raises cortisol and depletes sex hormones)
Poor sleep (alters hormone regulation)
Nutrient deficiencies (like low vitamin D, magnesium, or B12)
Overtraining or undereating
Underlying conditions (such as PCOS, thyroid disorders, or insulin resistance)
What Labs Are Typically Included in a Hormonal Evaluation—and Why They Matter
First off, laboratory testing is NOT always needed during hormonal evaluations as most of the time we develop a treatment plan based on symptoms however sometimes when you're not feeling like yourself, a standard lab panel often misses the nuances of hormonal shifts. That's why we go deeper.
Here are some of the key labs that can be performed during a hormone evaluation, and what they can reveal:
Sex Hormones
Estradiol (E2):
Helps regulate the menstrual cycle, skin health, mood, and cognition.
Low levels: Common in perimenopause/menopause, leading to hot flashes, mood changes, and vaginal dryness.
Progesterone:
Balances estrogen and supports sleep, mood, and menstrual regularity.
Low levels: Can cause anxiety, poor sleep, irregular cycles, or spotting.
Testosterone (Total and Free):
Important for libido, energy, muscle mass, and mood.
Low levels: Can cause fatigue, low drive, and poor muscle tone.
DHEA-S:
A precursor to sex hormones, produced by the adrenal glands.
Low levels: Often associated with fatigue, low resilience, or burnout.
Reproductive Signals
FSH (Follicle Stimulating Hormone) & LH (Luteinizing Hormone):
Help regulate the menstrual cycle and ovulation.
High FSH/LH: May indicate menopause or premature ovarian aging.
Low levels: May indicate hypothalamic suppression (often from stress, overtraining, or disordered eating).
SHBG (Sex Hormone-Binding Globulin):
A protein that binds sex hormones and controls their availability.
High SHBG: Can reduce available free hormones.
Thyroid Panel
TSH (Thyroid Stimulating Hormone):
Main screening tool for thyroid function.
Free T3 & Free T4:
Active thyroid hormones—vital for energy, mood, metabolism, and temperature regulation.
Thyroid Antibodies (TPO, TGAb):
Can detect autoimmune thyroid disorders like Hashimoto’s.
Adrenal & Stress Markers
Cortisol (AM test):
Measures stress hormone rhythm throughout the day.
High levels: May cause insomnia, anxiety, belly weight gain.
Low levels: May indicate adrenal fatigue or burnout.
Prolactin:
Elevated levels can interfere with ovulation and cause mood changes.
Insulin & Nutrient Markers
Fasting Insulin & Glucose:
Helps detect early insulin resistance before A1c is elevated.
High insulin: May be linked to PCOS, fatigue, sugar cravings, or weight gain.
Vitamin D:
Crucial for hormone receptor sensitivity, immune health, and mood.
Low levels (<40 ng/mL): Can exacerbate fatigue, PMS, and low mood.
Vitamin B12 and Folate:
Support energy, neurotransmitter function, and methylation.
Low levels: May worsen fatigue, depression, or brain fog.
Lifestyle Is Medicine—And It Starts with a Plan
The good news? There’s a lot you can do to support your hormones naturally —even before reaching for medications.
We believe the best outcomes happen when you don’t just receive lab results—but, you get a step-by-step roadmap to apply them.
Lifestyle changes can seem overwhelming when you don’t know where to begin, but having a structured plan reduces stress and boosts your confidence.
Sleep hygiene: Going to bed and waking up at the same time daily. Prioritize restful sleep (aim for 7–9 hours per night)
Meal planning: Balancing protein, healthy fats, and fiber to stabilize blood sugar
Movement: Incorporating strength training and low-impact cardio
Stress resilience: Learning what brings you calm—whether it’s mindfulness, nature walks, or creativity
Support systems: Building a team around you, from your doctor to your community
With the right labs, personalized insight, and a sustainable plan, you can reclaim your energy, focus, and sense of well-being.
Let’s Take the Guesswork Out of How You Feel
Far too often, women are told “everything looks fine” even when they clearly feel otherwise. We believe your symptoms matter. We listen, we test thoroughly when appropriate, and we treat with you—not just your labs—in mind. Whether you’re navigating perimenopause, menopause, post menopause changes, or feeling out of sync, you deserve to understand what’s really going on. Reach out today to schedule a comprehensive hormonal evaluation.
**We offer comprehensive hormonal evaluations to non-members. Contact us to learn more. If you're looking to establish care with a primary care physician, explore our Primary Care Membership Program. This program offers unlimited access to your doctor with no co-pays, unhurried appointments, and discounted lab tests for uninsured members. Start your healthcare journey today by enrolling and learning more HERE.