Treating Sex Hormone Imbalances

Sex hormones are that are involved in the regulation of sexual development and reproduction. The primary sex hormones are estrogen, progesterone, and testosterone. Men and women have all of these, just in different amounts and ratios...

When men and women have low energy caused by an imbalance in their sex hormones, it is usually from different hormones. For men, it is usually due to a testosterone deficiency. For women, it is usually due to estrogen and/or progesterone imbalances.

Sex Hormones & Low Energy

The symptoms of menopause are no joke. They are incredibly uncomfortable and can change the quality of your life significantly. When a woman comes to me with menopausal symptoms, she is usually pretty desperate for relief. I use both natural and pharmaceutical therapies to get her that relief.

Treating Thyroid Disease

I am a big believer in natural medicine. It can be very powerful and work very well. I prefer to use it as long as the natural treatment is safe and strong. Unfortunately, when treating low thyroid, we usually need both the natural and the prescription treatments. In college, I learned from playing the card game euchre not to “send a boy to do a man’s job.” In medicine, this means using the treatment that you know will work. If I think a natural treatment will work, but I know that a medication will work, I should use the medication as long as there are no significant side effects. This is because I want to make sure you get results right away so that you can get your life back

Treating Thyroid Disease

Thyroid disease is one of the most common health problems we face today. The majority of people with thyroid dysfunction have hypothyroidism. Hypothyroidism (“hypo” means low) is a condition where the amount of thyroid hormone in your body is less than what is needed for optimal function. According to the American Thyroid Association, more than 12 percent of the US population will develop a thyroid condition during their lifetimes, and more than half will be unaware that they have a problem. Women are five to eight times as likely as men to develop thyroid problems.

Advanced Adrenal Recommendations

Last week, I went over the recommended supplements to treat Adrenal Fatigue. This week I’ll go over adrenal recommendations as well as a plan to reduce stressors.


Treating the physical symptoms is only the first step. Once you start to feel better, it’s important to begin addressing the causes of the problem: the sources of stress that compromised your adrenals in the first place.

Testing & Supplement Options for Adrenal Fatigue

Last week we discussed the main symptoms as well as the causes of adrenal fatigue. This week, I will focus on testing and supplement options for treatment.


If you have most of the symptoms listed last week, you probably have adrenal fatigue. However, how do we test for adrenal dysfunction?

How Adrenal Fatigue Causes Chronic Fatigue

This week I will discuss how adrenal fatigue is a primary cause of chronic fatigue. 


It's estimated that up to 80% of adults experience adrenal fatigue during their lifetimes, yet it remains one of the most under-diagnosed illnesses in the United States. Conventional medicine does not yet recognize adrenal fatigue as a distinct syndrome

Food Allergies & Low Energy

Food allergies can cause almost any symptom the body can manifest, including low energy. The gastrointestinal tract maintains a delicate balance of good bacteria, specialized immune cells, and various neurological and hormonal activities. In fact, 80% of your immune system resides in your gut, so anything you put in your mouth can trigger a reaction. Once your digestive system detects what it considers a “foreign particle,” your immune system reacts, and the inflammation that follows creates pain and dysfunction.

Food and Your Energy

Food is a touchy subject, especially if you’re not feeling well. We have a lot of emotional attachments to it, and it can give us joy at times when nothing else can. However, food allergies play a significant role as a cause and contributor to fatigue and, as a doctor, I have seen amazing improvements in the health of my patients when they change their food choices.

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Advanced Adrenal Recommendations

November 19, 20235 min read

Last week, I went over the recommended supplements to treat Adrenal Fatigue. This week I’ll go over adrenal recommendations as well as a plan to reduce stressors.

My Advanced Adrenal Recommendations

If more energy is needed and cortisol remains low (less than 15 in blood on serum cortisol), I recommend a prescription medication: Hydrocortisone/cortisol (Cortef). Your healthcare provider must prescribe this. 

Cortef is a steroid, and you may have concerns about taking it. Cortef brings your cortisol levels into the normal physiologic range that the adrenal glands would be producing if they were functioning correctly. The recommendation is to replace what is deficient and not take any more than that. The goal is to restore your body to how it was before you became unwell.

Treat the causes and reduce the stressors

Treating the physical symptoms is only the first step. Once you start to feel better, it’s important to begin addressing the causes of the problem: the sources of stress that compromised your adrenals in the first place. 

Stress can have physical, mental, emotional, and energetic (spiritual) elements. 

The physical stress from heavy metal toxicity, infections, chemicals, molds, and food allergies must be addressed. 

Mental and emotional stressors are just as important. Here is a list of action items. Besides restoring your adrenals, choose one thing to do from this list: 

1. Make a plan to manage the stress that arises from juggling relationships, family, finances, and work. 

2. Go to bed at 10 p.m. This will help reset your circadian rhythm, and you’ll avoid missing your sleep window. Lights go off at 10, so start getting ready before then. 

3. Start a gratitude practice. You will experience a noticeable reduction in your level of stress. Every day say out loud or write down three things you are grateful for. 

4. Start a stress-reducing technique. Effective stress management tools include:

  • meditation, 

  • mindfulness training, 

  • yoga, tai chi 

  • Emotional Freedom Techniques (EFT or tapping

There are many others. Pick one and go for it! Start slow, once a week, and increase as your energy grows. 

5. Start having more “YOU” time! You deserve 30 to 60 minutes of “YOU” time each day to take care of yourself. Put the time on your calendar and make it happen. You will be amazed at how you can transform your life! 

Other Lifestyle Action Items: 

1. Avoid caffeine in chocolate and coffee. 

2. Drink more water and sea salt. When your adrenals aren’t working, you’re not making enough aldosterone to keep the salt in your body. Start with a pinch of sea salt per glass of water and increase slowly. Consume 3-4 liters of water per day in between meals. 

3. Eat protein and fat every 2 hours and stop eating grains and sugar. Grains and sugar will spike your blood sugar and your insulin reacts to push it into your cells. Cortisol is then released to manage the insulin. When your blood sugar is stable, your cortisol is preserved for other adrenal functions. Good sources of fats are nuts, olive oil, coconut oil, and avocado. Your ideal diet will be meat and vegetables. A 1/4 of your plate at every meal should be meat and the rest vegetables (1/4 can be starchy vegetables). A plate of varied, colorful vegetables is ideal.

4. Exercise and move as you are able. Exercise is a powerful tool for mitigating stress, but only if you have enough energy to tolerate it. Start low and go slow. Too much exercise will deplete the adrenals. I recommend 5 to 10 jumping jacks or burpees per day as a starting point. 


Consider if you may be “spiritually, or energetically stressed”. I encourage you to visit for tools and support in pursuing a richer life. My wife, Stacy, suffered from chronic fatigue for 3 years. An important part of resolving her fatigue involved exploring opportunities for mental, spiritual, and emotional growth. She took her personal experience and her experience with her clients and created to help you change your life for the better.

The Plan

If you have adrenal fatigue, this plan is for you.

1. Start Adrenal Stress End: 1 capsule in the morning and noon. Take with food. Watch for side effects of the licorice root in this product: feeling wired, insomnia, high blood pressure, heart palpitations or swelling. If this occurs, stop the product and start BioAdreno 1 capsule in the morning, noon, and at 3 p.m. Increase to 3 capsules 3x/day as able. If BioAdreno is too stimulating, take chromium picolinate 1000 mcg 1-6 caps/day. It’s a great treatment for sensitive folks, just not very strong. 

Note: 3 p.m. doses are not needed if you do not have an energy crash between your last dose and 10 p.m.


2. Start Adrenal Px: 1 capsule in the morning, at noon, and at 3 p.m. Increase in one week by 1 capsule per dose. Max 4 capsules 3x/day to get cortisol levels into the normal range. Decrease if you experience any agitation, insomnia, or feeling wired (rare). 

3. Start DHEA 25 mg per day (for men) and increase up to a max of 75 mg/day as needed to fix your blood levels. For women, start at 5 mg per day and increase up to a max of 25 mg per day. 

4. Start Cortisol Manager: 1 tablet 2x/day if you are feeling overwhelmed, anxious, or have insomnia. It can also be helpful if you are feeling “wired and tired,” if you startle easily and for high cortisol readings.

I recommend taking the above supplements until energy increases to a 7/10 and symptoms and laboratory values improve into the normal range. Once the causes of the adrenal fatigue are remedied, you can wean down as able.  


Take Action

  • Start Low. Go Slow

  • Continue to implement the lifestyle changes you have made.

  • Join the Conversation in our Facebook Group

  • Share this article with your friends and loved ones on social media and help me achieve my mission of helping 1 million people increase their energy!

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Evan H. Hirsch, MD

Evan H. Hirsch, MD, (also known as the EnergyMD) is a world-renowned Energy expert, best-selling author and professional speaker. He is the creator of the EnergyMD Method, the science-backed and clinically proven 4 step process to increase energy naturally. Through his best-selling book, podcast, and international online telehealth programs that can be accessed from everywhere, he has helped thousands of people around the world increase their energy and happiness. He has been featured on TV, podcasts, and summits, and when he’s not at the office, you can find him singing musicals, dancing hip-hop, and playing basketball with his family.

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