Updated: Apr 26

The system of hormones throughout your body is like a symphony. The pituitary, adrenal, thyroid, ovaries, testes, and other glands all work together to create a beautiful song. We call the system of hormones in the body the endocrine system, but the endocrine system does not work alone. It works in concert with the immune system, the nervous system, and even the gastrointestinal system. If one part of this orchestra is not playing well, it makes all of the music sound bad.

Because of the complex interactions of all of the body systems, digestive disturbances and hormonal imbalances can have a domino effect on one another, leading to a cycle of dysfunction. In conditions like leaky gut syndrome and irritable bowel syndrome (IBS), the interaction goes both ways: hormonal imbalance aggravates IBS, and IBS aggravates hormonal imbalance.

Let’s take a closer look.

Hormonal Imbalance Aggravates IBS

Stress activates the hormones in the hypothalamic-pituitary-adrenal (HPA) axis. The adrenal glands release cortisol, which is a stress hormone that has effects throughout the body. As the body produces more cortisol, it produces less of another hormone, dehydroepiandrosterone (DHEA). An elevated ratio of cortisol to DHEA is the hallmark of chronic stress.

Most studies show that patients with IBS tend to have elevated cortisol levels. Female college students with IBS have a higher morning cortisol level than those without IBS, and their morning cortisol peaks under prolonged stress.[1] In the digestive tract, cortisol triggers the release of histamine, which promotes an inflammatory response and can worsen the abdominal pain of IBS.[2][3] Cortisol also triggers the excessive release of zonulin, which promotes leaky gut.

Consistent with the hormonal pattern of chronic stress, studies also show that patients with IBS tend to have low DHEA levels.[4] Low DHEA is associated with more frequent bowel movements, loose stool, and long bouts of abdominal pain.[5]

IBS Aggravates Hormonal Imbalance

There is a definite relationship between stress hormones and IBS, but other hormones may also be out of balance in patients with impaired digestion. It is possible for a patient to have hypothyroidism, premenstrual syndrome (PMS), erectile dysfunction, or other symptoms of hormonal imbalance along with IBS. Hormonal changes can certainly occur independently, but they can also occur because of biochemical changes related to IBS.

The mechanisms to explain how IBS leads to hormonal imbalance include nutrient depletion, liver toxicity, and systemic inflammation. IBS is associated with low levels of vitamin D and vitamin B6, for example.[6][7] Vitamin D is essential for regulating the action of insulin for blood sugar control, and vitamin B6 is essential for detoxification of estrogens and synthetic hormones from the body. IBS can also lead to a leaky gut, which allows for toxins to enter the bloodstream and puts a strain on the liver—the key organ for detoxifying hormones from the body. IBS and a leaky gut also increase the incidence of food allergies and autoimmune disease. If autoimmune disease affects the thyroid, we see the most common form of hypothyroid disease, Hashimoto’s.

Finding Balance

If you are struggling with symptoms of a leaky gut or IBS along with symptoms of hormonal imbalance, you are not alone. It may seem overwhelming to figure out how to create balance and a sense of health. We find that a good place to begin is by treating the health of the digestive tract.

From a functional medicine perspective, we have a methodical way of doing this. We follow the concept of the “4 R’s.” We remove the irritants, replace deficiencies, re-inoculate with probiotics, and repair any damage to the intestinal lining. This process ensures adequate nutrient absorption, takes the toxic burden off the liver, and calms the fire of inflammation.

We can think of the digestive tract as the lead violin in the orchestra. When it starts playing the right tune, the rest of the symphony can follow suit. Once digestive health is restored, fine-tuning can then restore balance to hormonal health as well.

Related Products:

If you struggle with stress or hormonal problems, you might want to try a dietary supplement to support adrenal health. With adrenal support, we are able to respond to and deal with stress in a way that is less damaging to our body. Here are some products to consider:

  • AdrenalCare includes a combination of nutrients and herbs to support a more balanced stress response.
  • We have had excellent results using Cortisol Balance to help patients achieve a better sense of calm when faced with stress.
  • Hormone Balance helps the body process hormones in a healthier way that may reduce the risk of developing hormone-related illnesses.

You may also be interested in:

Why Vitamin D Might Cause Erectile Dysfunction and How to Fix It
The Leaky Gut Protocol


[1] Sugaya N, Izawa S, Saito K, Shirotsuki K, Nomura S, Shimada H. Effect of prolonged stress on the adrenal hormones of individuals with irritable bowel syndrome. Biopsychosoc Med. 2015;9(1):4.[2] Elenkov, Chrousos. Stress Hormones, Th1/Th2 patterns, Pro/Anti-inflammatory Cytokines and Susceptibility to Disease. Trends Endocrinol Metab. 1999;10(9):359-368.[3] Barbara G, Wang B, Stanghellini V, et al. Mast cell-dependent excitation of visceral-nociceptive sensory neurons in irritable bowel syndrome. Gastroenterology. 2007;132(1):26-37.[4] Sugaya N, Izawa S, Kimura K, et al. Adrenal hormone response and psychophysiological correlates under psychosocial stress in individuals with irritable bowel syndrome. Int J Psychophysiol. 2012;84(1):39-44.[5] Sugaya N, Izawa S, Ogawa N, et al. Effect of day-to-day variations in adrenal cortex hormone levels on abdominal symptoms. Biopsychosoc Med. 2010;4(1):2.[6] Khayyat Y, Attar S. Vitamin D Deficiency in Patients with Irritable Bowel Syndrome: Does it Exist. Oman Med J. 2015;30(2):115-118.[7] Ligaarden SC, Farup PG. Low intake of vitamin B6 is associated with irritable bowel syndrome symptoms. Nutr Res. 2011;31(5):356-361.

About the Author: Dr. Gerard Guillory, MD is Board Certified in Internal Medicine and has published two books on Irritable Bowel Syndrome (IBS). In 1985, he opened The Care Group, PC. Today, his clinic is a Primary Care facility that is a hybrid of functional and traditional medicine treating patients with digestive disorders, autoimmune disease, and other conditions. You can learn more about Dr. Guillory here.