A functional approach: Hormone imbalance after metabolic and bariatric surgery

Photo by Martin Sanchez

Metabolic and bariatric surgery impacts hormone health in a variety of ways. Adipose or fat tissue plays a large part in endocrine system function and hormone communication. Changes in weight after surgery can disrupt hormone balance overall. In addition, gut hormones such as leptin and ghrelin, which impact hunger and fullness cues are impacted due to absorption and anatomical changes. Metabolic and bariatric surgery often improves hormonal functioning such as blood glucose control and sex hormones, however, if an imbalance was present before surgery we may still need to dive deeper. 

As a reminder, here are the following signs & symptoms of hormonal imbalance: 

• Weight loss or weight gain 

• Fatigue 

• Muscle aches and weakness 

• Mood swings 

• Increased or decreased sensitivity to cold and heat 

• Infertility

Other possible causes of hormone imbalances include medications, autoimmune disorders, diabetes, disordered eating, and stress. Hormone imbalances can be further caused by pregnancy, lactation, menopause, and diagnoses such as PCOS or endometriosis. 

What can be done to improve hormone health from a functional approach? 

Nutrition for hormonal balance

• Ground flaxseed

• Phytoestrogens

• Omega-3s

• Anti-inflammatory and Omega-3 foods:

• Variety of whole grains, fruits, vegetables, legumes, nuts and seeds

• Omega-3s: salmon, sardines, chia seeds, walnuts

• Blood sugar control

• Complex carbohydrates

• Pair with protein

• Cruciferous vegetables and sulfur donors

• Broccoli, cauliflower, Brussels sprouts, kale, arugula, eggs

• Healthy gut microbiome

• The last point of hormonal breakdown is in the gut! 

Sleep for hormonal balance

• Hormones such as growth hormone, melatonin, cortisol, leptin, and ghrelin are closely associated with sleep and circadian rhythm

• Emphasize consistent sleep and wake cycle 

• Avoid blue light 1 hour before bed and at least 30 minutes after waking 

• Reach out to us for more tips and tricks on sleep regulation 

Stress management for hormonal balance

• Increased stress hormone, cortisol, impacts blood sugar balance, and sleep, changes immune system responses, and suppresses the digestive system

• Managing stress is key during the recovery phase of surgery and to support long-term weight loss 

Hormone health functional testing

Functional hormone testing offers an evaluation of sex hormones, adrenal hormones, cortisol, and melatonin levels using dried urine samples. It can help identify hormone imbalances post-surgery so functional medicine changes can be made to optimize hormone health and address hormone-related symptoms such as fatigue, weight gain, hair loss, and mood swings. Not only are we able to look at hormone levels using functional testing, but we are also able to assess the breakdown of these hormones. This is why we believe this is such a powerful tool for all especially those who have been told all of their labs look normal but are still experiencing symptoms of hormone imbalance. 

Supplements for hormonal balance

Vitamin D3 

• Part vitamin, part hormone with its hormone-like functions

• Regulates blood calcium levels with the parathyroid hormone

• Shown to affect estrogen levels. 

Fish Oil or EPA/DHA

• Building blocks for making steroid hormones involved in reproduction, blood clotting, and inflammation

• Aid in the transportation of hormones throughout the body.

B Complex vitamins

• These vitamins should be adequate within a bariatric formulated multivitamin, but if you are not taking a multivitamin, or one that is not bariatric formulated, B vitamins may be low. We are happy to look at your vitamin regimen if you are confused or have questions!

• B Vitamins 

• Thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), B6, biotin (B7), folate (B9), and B12 are all linked with various hormones throughout the body, namely brain neurotransmitters and steroid hormones

• Help to support and promote hormone and cholesterol production

Depending upon the functional hormone results, specific supplementation is used to address hormonal imbalances directly. Some examples include DIM, Vitex, or Adrenal Support.

Interested in learning more about how we support hormone health and weight loss surgery?

We’d love to work with you! Click this link to schedule a complimentary Meet + Greet session. We look forward to finding individualized solutions to fit your needs and being a partner in your bariatric journey.

Published: June 4th, 2024.

This blog post was written by Amanda Sikkema MS, RD, LD, CSCS, a dietitian at Katie Chapmon Nutrition. She works with clients virtually and is accepting new clients.