11 Signs You Might Have a Hormone Imbalance, According to Expert Doctors

Hormone imbalances can lead to a wide range of symptoms and signs, depending on which endocrine (hormone-producing) organ is affected and how, explains Feyza Erenler, MD, an endocrinologist at Tufts Medical Center. “Hormones are chemical messengers that enable communication between different organs and tissues in the body,” she says. This coordinated communication tells our body what to do and when, all in an effort to keep our body running smoothly. 

There’s no one statistic that tells us how many people experience a hormonal imbalance, largely because there are so many different ways our hormones can fall out of whack. 

For example:

• According to health experts, around 12% of the U.S. population has diabetes, a chronic disease that occurs when the pancreas doesn’t produce enough of the hormone insulin (or the body can’t use insulin properly).
• The American Thyroid Association estimates that 12% of Americans will develop imbalances with their thyroid hormones during their lifetime. 
• PCOS (polycystic ovary syndrome) affects one in five women, explains Ali Chappell, PhD, MS, RD, a board-certified reproductive endocrinologist and hormone expert at Lilli Health. PCOS generally involves imbalances in sex hormones and insulin, she explains. 

Still, these are just a few examples of how hormone imbalances can affect the body—there are more than 50 hormones that regulate key bodily functions, per 2024 research published in Frontiers in Reproductive Health. 

Why your hormone levels matter

“Hormones play a crucial role in maintaining the body’s internal balance (homeostasis) and creating harmony among systems, ensuring that the body can respond efficiently to internal and external changes for optimal health,” Dr. Erenler says. “They are synthesized and secreted by specialized glands, such as the hypothalamus, pituitary gland, thyroid, adrenal glands, pancreas, and reproductive organs, into the bloodstream, allowing them to travel to distant target organs.”

Dr. Erenler explains that hormones are responsible for a wide range of bodily functions, such as thyroid function, growth and development, mood and emotional well-being, blood pressure control, metabolism, and reproductive health. Your sleep cycle, appetite, and energy levels are also influenced by hormone function. 

Because hormones affect nearly every system in the body, she says that many factors can throw them out of balance, including:

• Diseases affecting endocrine glands, particularly certain inflammatory or autoimmune conditions
• Damage or injury to an endocrine gland, such as from trauma or surgery
• Certain medications, such as birth control, steroids, or antidepressants
• Infections can sometimes disrupt normal hormone production.
• Poor diet, especially due to nutrient deficiencies from extreme weight loss or restrictive diets without proper support
• Masses in the endocrine organs that can lead to the overproduction of hormones

Chronic stress and aging can also interfere with normal hormonal function, according to the Cleveland Clinic. 

Our exposure to endocrine-disrupting chemicals is another growing concern, per the National Institute of Environmental Health Sciences. These are either natural or man-made chemicals that may mimic, block, or interfere with our body’s natural hormones, and can include:

• Pesticides and herbicides
• Emissions from manufacturing, industrial processes, waste burning, or wildfires
• PFAS, or “forever chemicals,” found in a range of products from cleaning supplies to nonstick cookware, clothing, and personal care products
• Chemicals like BPA that are used to make plastic for food packaging, water bottles, toys, and more
• Foods containing phytoestrogens, such as soy products

Signs of a hormonal imbalance

“Hormone imbalances can be very difficult to diagnose early because the symptoms are often nonspecific and develop gradually over time,” says Brynna Connor, MD, a family medicine physician in Austin, Texas, and the healthcare ambassador for NorthWestPharmacy.com. “Additionally, fatigue, weight changes, mood shifts, and/or sleep disturbances can be symptoms of other conditions or can be caused by stressors in everyday life, which makes it much harder to determine whether or not they’re caused by a hormone imbalance.” 

Different types of hormone imbalances can present with different symptoms as well. However, some signs are more common across the board due to hormones’ broad effects on our major bodily systems. 

1. Constant fatigue

Fatigue is a common symptom of many different types of hormonal imbalances—particularly when there’s an insufficiency, or your body isn’t producing enough of a hormone. 

Because hormones are involved in nearly every bodily process, low levels of even just one hormone can have a knock-on effect. For instance, when you don’t have enough thyroid hormone in your body, many of the body’s processes slow down, says Salila Kurra, MD, co-director of the Columbia Adrenal Center at Columbia University. As bodily systems slow, so do your energy levels—leaving you feeling sluggish and drained. 

“When the adrenal glands are underactive, people usually feel exhausted,” adds Betul Hatipoglu, MD, a professor of medicine at Case Western Reserve University. Another example? “Low testosterone in men can show up as fatigue and brain fog,” Dr. Chappell says. 

If your body isn’t producing enough insulin—or your body doesn’t respond effectively to insulin, a condition known as insulin resistance—fatigue is a common symptom as well, according to the Cleveland Clinic. 

2. Unexplained weight gain

Because so many hormones are involved in regulating your metabolism, imbalances can often result in weight changes.

For instance, weight gain is associated with an underactive thyroid, also called hypothyroidism, Dr. Connor says. Thyroid hormones play a role in a healthy metabolism and our body’s fluid balance. So low levels can slow metabolism and cause the body to retain excess water, which can cause a slight weight gain and bloating. 

Excessively functional adrenal glands can also cause weight gain, particularly in the abdominal area, Dr. Hatipoglu says. This is often due to an overproduction of cortisol, a hormone that prioritizes fat storage, according to 2023 research published in the Archives of Pharmacy and Pharmaceutical Sciences. 

Even if blood sugar levels are normal, elevated insulin can lead to weight gain around the belly, Dr. Chappell says. “I see it constantly in women with PCOS, and it’s also a huge factor in midlife hormonal shifts,” she explains. In men, as insulin levels start to rise with age, this can cause weight around the midsection, too. “That belly fat can actually convert testosterone into estrogen, which drives testosterone levels even lower.” 

3. Unexplained weight loss

Certain hormonal imbalances can trigger unexplained weight loss, too. 

Dr. Hatipoglu says that underactive adrenal glands can lead to weight loss. Research from Endocrinology and Metabolism published in 2024 explains that low production of adrenal hormones like cortisol influences factors like low appetite, nausea, and fat storage, which can lead to unwanted weight loss. 

“Hyperthyroidism, or an overactive thyroid, will frequently present as weight loss despite the individual having a normal or increased appetite,” Dr. Connor adds. 

Unexplained weight loss can also result from insulin imbalances—in spite of increased hunger, according to the Cleveland Clinic. 

4. Swelling

Overactive adrenal glands come with a characteristic symptom called “moon face,” where the face looks swollen and round with redness in the cheeks, says Dr. Hatipoglu. This is most often related to elevated cortisol levels, which affect water retention and fat distribution, per a 2023 review in JAMA. 

Overproduction of certain pituitary hormones can have similar facial rounding effects, according to Dr. Connor. Estrogen imbalances can also cause swelling, particularly in the legs and arms, but can also occur throughout the body, according to 2021 research published in Cancers. 

5. Skin changes

As the body’s largest organ, skin changes are a common symptom of many hormone imbalances. Our experts tell us this is because hormones are involved with key skin health functions, such as oil production, hydration, elasticity, cell growth/healing, and inflammation control. 

For instance, low levels of certain hormones can cause specific skin symptoms:

• An underactive thyroid can cause dry skin, says Dr. Connor.
• Underactive adrenal glands can lead to yellowish or even tanned-looking skin, Dr. Hatipoglu says.
• Too little insulin, particularly associated with prediabetes or diabetes, can present as slow-healing wounds or frequent infections.

Excessive hormone levels can lead to other skin changes:

• Overactive adrenal glands can cause purplish-looking stretch marks in the abdomen, says Dr. Hatipoglu. It may cause skin thinning with easy bruising, too.
• An overactive thyroid can cause increased sweating, says Dr. Connor.
• High testosterone—common in women with PCOS—can lead to acne, says Dr. Chappell.

6. Hair thinning

Thinning hair is a possible sign of thyroid hormone imbalances, the experts say.

According to 2023 research published in Cureus, hair loss affects 50% of people with an overactive thyroid (hyperthyroidism) and 33% of people with an underactive thyroid (hypothyroidism). The research says this is likely because:

• High levels of thyroid hormones interfere with scalp skin cell growth, slowing or reducing hair growth. 
• Low levels of thyroid hormones seem to trigger cell damage, though the way hyperthyroidism causes hair loss is less clear. 

Dr. Hatipoglu adds that overactive adrenal glands can cause hair thinning as well. High testosterone can also trigger hair thinning as well as facial hair growth, especially in women with PCOS, Dr. Chappell says. 

7. Stomach problems

Thyroid hormones are important for maintaining normal function of the GI (gastrointestinal) tract, as explained by 2021 research published in Scientific Reports. 

When thyroid hormones are underactive, the whole digestive process can slow down, resulting in gut issues like constipation, bloating, and nausea. 

If your thyroid is overactive, everything can speed up instead. This means your body might not absorb water and nutrients as well, so you may experience diarrhea or frequent bowel movements, according to Dr. Connor. Underactive adrenal glands can cause a similar effect, adds Dr. Hatipoglu. 

8. Mood changes

“An overactive thyroid can lead to anxiety, insomnia, and a fast heart rate,” explains Dr. Kurra. “Too much thyroid hormone can cause many parts of your body to be overstimulated, leading to these symptoms of overactivity.” 

On the other hand, if your thyroid is underactive, it’s not producing enough “feel good” hormones like serotonin and dopamine—which is why hypothyroidism is associated with depression. 

There’s also a strong association between sex hormone imbalances and mood changes, per 2020 research published in Psychopharmacology. 

In particular:

• Low estrogen levels in women can lead to increased inflammation and a heightened stress response, both of which are linked with depression.
• High fluctuations in estrogen levels in women—such as big rises and drops during the menstrual cycle or major hormonal shifts that occur during phases like perimenopause—are associated with a greater risk of depression.
• In men, low testosterone levels are linked to depressive symptoms.

9. Menstrual and reproductive issues 

Sex hormone imbalances can have a strong effect on a woman’s menstrual cycle, Dr. Chappell explains. For instance, high testosterone levels can cause irregular periods. “But elevated insulin levels are still often the common thread,” she says. “In younger women, you may see skipped periods, infertility, recurrent miscarriage, or androgen-related symptoms.” 

Meanwhile, low testosterone levels in men can show up as low libido, she adds.

Dr. Connor explains that many other endocrine organs and glands affect the reproductive system, too:

• Both low and elevated thyroid hormone levels may cause menstrual cycle irregularities, including heavier periods.
• Pituitary hormone imbalances can cause amenorrhea (loss of your period) and/or infertility.
• Tumors or other pituitary problems may also reduce sex hormone levels. 

10. Sensitivity to heat or cold

Heat or cold sensitivity is most often related to thyroid problems, according to Dr. Connor. An overactive thyroid speeds up your body’s processes, and that can cause an intolerance to heat. Conversely, an underactive thyroid can lead to cold sensitivity. 

Still, imbalances in sex hormones—particularly estrogen and progesterone—can cause sensitivity to heat or cold due to how these hormones help regulate body temperature, according to research published in Temperature: Multidisciplinary Biomedical Journal. 

11. Racing heart

Because elevated thyroid hormones speed up processes in your body, an overactive thyroid can cause a rapid heartbeat, heart palpitations, and jitteriness, Dr. Erenler says. On the other hand, a decreased heartbeat can signal an underactive thyroid. 

A high heart rate or heart palpitations can also result from:

• High cortisol hormone levels, like with Cushing’s syndrome (an adrenal disease) or chronic stress
• Imbalances in sex hormones
• Elevated insulin levels

Causes of a hormonal imbalance

According to the Cleveland Clinic, diabetes is the most common hormone-related condition in the U.S. With diabetes, your pancreas either doesn’t make enough insulin or your body doesn’t use it properly, which leads to a range of symptoms if not treated. 

Thyroid issues are also common. “Hypothyroidism is more common than hyperthyroidism, with about 5% of the U.S. adult population having an underactive thyroid and only about 1% of the population having an overactive thyroid,” Dr. Kurra says. Research published in the International Journal of Molecular Sciences in 2023 adds that women are three to five times more likely than men to be treated for thyroid problems—with disorders affecting nearly 14% of adult women. 

Other potential causes of hormone imbalances can include:

• Addison’s disease, or an underactive adrenal gland: “[This] is most commonly caused by autoimmune destruction of the adrenal glands or infections from different reasons causing the adrenal glands to be destroyed,” says Dr. Hatipoglu. 
• Cushing’s syndrome, or an overactive adrenal gland: This is typically caused by a benign (harmless) tumor, Dr. Hatipoglu explains. 
• Pituitary adenomas: These are benign tumors that grow in the pituitary gland near the base of the brain, which can cause either excessive or insufficient hormone production, Dr. Hatipoglu says. 
• Hashimoto’s disease: The most common cause of an underactive thyroid is this autoimmune disease, Dr. Kurra says. “Your own body makes antibodies that can attack your thyroid, and make the thyroid cells not work as well and produce less thyroid hormone.” 
• Graves’ disease: In the U.S., an overactive thyroid is most often caused by another autoimmune disease. “Patients who have Graves’ disease make antibodies that bind to the thyroid and make it produce too much thyroid hormone,” Dr. Kurra says. “Having a thyroid nodule that produces thyroid hormone is also a cause of hyperthyroidism.” 
• PCOS: Polycystic ovary syndrome (PCOS) results from your ovaries creating excess hormones. According to the Cleveland Clinic, women with PCOS have higher levels of male hormones called androgens, but “one of the biggest, most overlooked drivers is chronically elevated insulin,” Dr. Chappell says. “It’s not just a blood sugar issue—high insulin levels affect the ovaries, suppress ovulation, increase testosterone, and reduce progesterone.” 
• Perimenopause: “In perimenopause, symptoms shift, women often gain weight around the belly, feel more fatigue, and start experiencing cycle irregularity and sleep disruption,” Dr. Chappell says. “It’s not just ‘aging,’ it’s often an underlying hormonal shift made worse by rising insulin levels that go undiagnosed.”
• Medications: “It’s also possible for certain medications, such as lithium or amiodarone, to impair thyroid function,” Dr. Connor says. 

Chronic stress is also a considerable factor in some hormone imbalances. Dr. Hatipoglu explains that the concept of “adrenal fatigue” is currently being debated in medical and scientific literature, but states, “We do not see evidence that supports the diagnosis of adrenal fatigue.”

“However, stress causing constant elevation of cortisol secretion can affect the individual’s well-being,” she says. This is not necessarily caused by an adrenal gland imbalance. “Instead, it is a response to chronic stress that makes the adrenal gland work appropriately—however, this overall homeostasis is unsuitable for the body long term.” 

Can you correct a hormonal imbalance naturally?

“Medical intervention is often necessary to treat and/or manage endocrine disorders; however, there are lifestyle changes that can help support overall hormone health,” Dr. Connor says. These can include:

• Eating a balanced diet with sufficient iodine, selenium, and healthy fats—all nutrients that play roles in healthy hormone function
• Regular physical activity to maintain metabolic and insulin balance
• Getting adequate sleep, as sleep deprivation can disrupt other hormone systems
• Managing stress—consistently high cortisol levels can also disrupt a range of hormone systems
• Reducing your exposure to endocrine-disrupting chemicals in some plastics, pesticides, and personal care products

For her patients with sex hormone imbalances, Dr. Chappell also focuses on dietary and lifestyle interventions. “I teach patients what I call a Low Insulin Lifestyle, which focuses on foods that don’t cause excessive spikes in insulin, such as lean proteins, healthy fats, non-starchy vegetables, and whole fruits,” she explains. “PCOS patients have seen up to a 53% reduction in insulin levels and improved sex hormone balance in only eight weeks following this approach.” 

When to see a doctor

Dr. Erenler says you should see a medical professional if you notice persistent, unexplained symptoms that suggest a hormonal imbalance, especially if they develop without a clear trigger. 

“Symptoms such as ongoing fatigue, significant weight changes, unexplained mood swings, or changes in heart rate should not be ignored,” she says. “If symptoms are severe—for example, if they involve difficulty breathing, chest pain, rapid heartbeat, or confusion—it’s important to seek immediate care in an emergency room.” 

But for non-emergent concerns, starting with your primary care provider is usually the best first step. “They can perform an initial evaluation, order basic tests, and, if necessary, refer you to an endocrinologist for specialized assessment and treatment.” 

To diagnose a hormonal imbalance, a doctor typically begins by taking a thorough medical history, and paying close attention to the timeline of symptoms and any potential triggering events, Dr. Erenler explains. “A detailed physical exam follows, focused on clues related to the suspected hormonal issue,” she says. “Based on the findings, the physician may order specific blood tests to evaluate hormone levels and assess the function of the relevant endocrine glands.”

But hormonal imbalances can be tricky, and it may take some patience to get to the root issue. 

“Diagnosing hormonal imbalances can sometimes require multiple visits, repeated blood work, and even imaging studies like ultrasound, MRI, or CT scans to fully piece together the cause,” Dr. Erelner says. “Treatment depends on the underlying condition and may involve lifestyle changes, medications, hormone replacement therapies, or referrals to specialists such as endocrinologists for more advanced care.” 

For daily wellness updates, subscribe to The Healthy by Reader’s Digest newsletter and follow The Healthy on Facebook and Instagram. Keep reading:

• “Here’s How I Knew I Had a Hormone Imbalance”: A Patient’s Firsthand Experience
• Drinking This Much Alcohol Can Mess with Your Hormones
• Should You Get Your Thyroid Hormone Levels Checked?
• 9 Medical Causes of a Slow Metabolism