Next I want to talk about hormones in the context of sleep and a few other things that I think you really need to know about. So it comes down to a balancing act. We all know that hormones change over time with age, nutrition, stress, medications awry, a variety of factors all go into how our body regulates hormones. And it's really it's a balancing act to achieve optimal health or our body does a pretty good job. But as we age, things tend to decline and deteriorate. And oftentimes what is described or as considered normal, is really pathologic, and it doesn't have to be that way.
So the players just a few hormones to know about cortisol, the stress hormone, it's catabolic breaks down tissues, muscle, thyroid, that's sort of the metabolism, the energy producing system, if you will, it's in the neck. estrogen and testosterone. You all know about those. progesterone is another hormone. It's a balancing act between some of the others above and DHCP and not going to dive into all these pieces. They sleep course and not a medicine lecture.
But really the possibilities, you know relate to cortisol when people are under stress various amounts of stress for various lengths of time. What happens with cortisol is obviously, it's designed to rise during stress, but over time that can become burned out or the adrenal glands just can't even produce enough cortisol to keep up with the emotional and the physiologic stress that we're under. We see this in overtrained athletes, people with chronic stress, chronic fatigue and a variety of other things. And that's often the starting point is to try to fix the cortisol system and manage stress and productive way through a variety of things including supplements, prescription medications, mindfulness meditation, it's a more it's a separate course in itself. But next is the thyroid. The thyroid can be overactive or underactive, so if it's if it's overactive, people are jittery, they're thin.
Their hair's falling out. They're hyper they have trouble sleeping and have trouble with the temperature regulation. And the same goes for an underactive thyroid Right those people are the authorities. They tend to be bloated, puffy, constipated, fatigued. And interestingly enough fatigue can go along with both over an underactive thyroid. So I know it's sort of common knowledge that if you're tired, your thyroids underactive, but it can happen with the hyperactive thyroid.
And the big player, at least in terms of sleep is the menopausal issue, pre post pre menopausal all create different fluctuations in normal hormonal levels and there's obviously quite a bit of variation through a normal monthly cycle anyways, but I'll get into more specifically about how that impacts sleep. And if you're a female in the Perrier postmenopausal state and are really struggling to sleep, you want to listen to this. And then Andrew pause. Well recognize that testosterone really starts to drop off at 40, sometimes earlier, depending on toxins and other physiologic things. But men certainly go through hormonal fluctuations as well that can affect mood, energy, sleep, In a variety of other things. So testing is key.
I mean, you can guess you can look at somebody and kind of have an idea. A doctor can look at somebody and sort of come up with a, an idea of what's going on before ordering tests, but really getting some accurate numbers to base decision making on is key. And this can be done in a number of ways. urine tests, blood spot, which is just a pinprick finger on a card that dries the standard blood test like you'd get at any hospital lab. We're testing serum, saliva, it's great way to test for cortisol and genetic testing. These are all possibilities.
You really need an expert here. I would suggest somebody who's trained in functional medicine, or integrative medicine, these specialties really go to the core of the issue more so than just you know, getting the lab test and offering a prescription, really diving into the root causes of problems and issues and really trying to solve them for more of a long term solution as opposed to a permanent prescription. Drug which, as we've talked about in other parts of this course, can have a whole host of detrimental side effects. I've never slept this good. This is just an example of a patient, a real patient who was in the pretty much menopausal state, and had just been sleeping poorly for years and really just kind of accepted it. As you know, it's just change of life.
We're going to have to deal with this and there's nothing to do. But in reality, after doing some testing, her estrogen and progesterone were really completely out of balance. And just by adding in a little bit of world progesterone, they get her great quality sleep, and I've never slept this good. We hear this all the time, after patients how their hormones balance. The balancing point is to achieve an optimal state, it's not normal. We're not looking for a normal number of parameter based on what it may or may not be right for an individual.
This is really a different type of medicine. It's a it's an individualized approach where Working with your practitioner, you can really go one on one, and really determine the interplay between mind and body, hormones stress, and all the factors that go into achieving an optimal state of health. I want to leave you with this. So what is considered normal as often pathologic, don't confuse normal the average. And the goal is really optimal function. Optimal function for you not optimal function on a piece of paper, or on a population study that shows that a, a TSH, a thyroid of three is normal.
It's really been shown, at least in the functional medicine literature, that bringing that number down closer to one really makes people feel better, improves their energy and provides potential for much more health. And so that's just a functional medicine perspective on it. It's not something that you'll get probably from a traditional Western trained a family practice, Doctor, but just take that with you as you leave this module.