This fact sheet is Part 1 of the Hormones and Chronic Disease series. Follow along each month to learn more about hormones and how they impact chronic disease risk, prevention, and management.
Introduction
Hormones are part of the endocrine system which includes various glands (pituitary gland, pineal gland, hypothalamus, parathyroid, thyroid, thymus, and adrenal gland) and organs (pancreas, ovaries, and testes) throughout the body, each serving a different function. Hormones drive many processes in the body. These chemical messengers work together to control biological processes including mood, growth, development, organ functioning, metabolism, and reproduction as well as signal genes to make certain proteins. These chemical “messages” or “signals” work in very small quantities to help the body communicate between different systems, including the endocrine, cardiovascular, and immune systems.
What do hormones do?
Over 50 different hormones have been identified. These hormones work together across many different functions. See Table 1 below for more information on what hormones impact different common biological processes.
Table 1. Roles of Hormones in Common Biological Processes (Note: Hormones are listed in alphabetical order and are not necessarily in the order of importance to the stated process.)
| Biological Process | Hormones Involved | Role in the Process |
| Blood Pressure | Adrenaline | Increases blood pressure |
| Aldosterone | Controls salt and water reabsorption in the kidneys to regulate blood pressure levels | |
| Blood Sugar/Energy | Cortisol | Increases blood sugar as part of the stress response |
| Ghrelin | Prepares the body for food | |
| Glucagon | Breaks down glucose (sugar) stored in cells to be used for energy | |
| Insulin | Moves glucose from the blood to the cells where it can be used for energy | |
| Leptin | Balances energy spent and food consumed | |
| Growth and Development | Growth hormones | Muscle mass and bone development |
| Testosterone | Bone density and muscle strength | |
| Thyroid hormones | Growth and neurological development | |
| Hunger Cues | Ghrelin | Stimulates hunger |
| Glucagon-Like Peptide 1 (GLP-1) | Appetite regulation | |
| Peptide YY | Decreases appetite and helps you feel full | |
| Leptin | Stimulates feeling full | |
| Metabolism | Adrenal gland corticosteroids | Slow down digestion during the stress response |
| Leptin | Regulation of energy burned throughout the day | |
| Thyroid hormones | Influence how fast cells burn fuel from food to make energy | |
| Mood | Oxytocin | Bonding with others |
| Serotonin | Mood boosting and stabilization | |
| Reproduction and Reproductive Development | Estrogen | Female sex hormone, maintains pregnancy, and regulates menstruation |
| Follicle Stimulating Hormone | Women: egg production in the ovaries Men: sperm production in the testes | |
| Human Chorionic Gonadotropin (HCG) | Pregnancy hormone | |
| Oxytocin | Uterine contractions during childbirth and lactation (milk production) | |
| Progesterone | Female sex hormone that prepares uterus for embryo | |
| Prolactin | Stimulates lactation | |
| Testosterone | Male sex hormone and stimulates puberty in males | |
| Sleep/Wake Cycle | Cortisol | Affects circadian rhythm through natural daily fluctuations (high in morning, low in evening) |
| Melatonin | Regulates sleep/wake cycles | |
| Stress (“Fight or Flight”) Response | Adrenaline (epinephrine) | Increases blood pressure and heart rate |
| Cortisol | Increases blood sugar, blood pressure, heart rate, and muscle tension |
Hormonal Changes
The levels of each hormone fluctuate throughout the day, throughout the lifespan, and between men and women. For example, reproductive hormones increase during puberty and pregnancy and decrease during menopause. Melatonin and cortisol levels throughout the day control how sleepy one feels, and hunger hormones change throughout the day as one eats and burns energy. Changes in hormones are a natural process of their functioning. They operate in very small quantities, allowing for adjustments throughout the day to keep the body going. However, when hormones are out of balance, it can lead to many health problems and even influence risk for developing certain chronic diseases.
What Causes Hormone Imbalances?
There are several factors that can affect the body’s hormones and lead to an imbalance. These include exposure to endocrine disrupting chemicals, damage to endocrine glands or organs, autoimmune conditions, using certain medications, and stress. Depending on the cause and the hormone affected, these imbalances can be short-term or long-term, and some have treatments that can be recommended while others do not require treatment.
Endocrine Disrupting Chemicals (EDCs) are chemicals that alter hormone functioning by mimicking, interfering with, or blocking the normal process. There are both naturally occurring and man-made EDCs. These chemicals not only have effects on hormones’ operation, but they have been linked to various health conditions as well. Examples include
- reproductive issues (premature puberty, infertility, and pre-term birth),
- vaginal cancers,
- lower immune response related to vaccine use,
- ADHD symptoms, and
- increased risk of metabolic disorders (diabetes, obesity, and cardiovascular (heart) disease).
EDCs cannot be completely avoided as they are found in products like cosmetics, food packaging, and pesticides. However, mindful choices at the store can help reduce exposure.
Damage to endocrine glands or organs from things such as surgery, illness, radiation, blood loss, lack of blood flow to the area, traumatic brain injuries, and tumors can cause hormone imbalances. The type of imbalance caused and treatment recommended varies depending on which endocrine gland or organ was affected.
Autoimmune disorders have a wide range of effects on the endocrine system and how the body regulates hormones.
- Addison’s Disease: For individuals with Addison’s disease, their body does not produce enough cortisol or aldosterone, leading to weakness, low blood pressure, and low appetite.
- Graves’ Disease: Graves’ disease causes hyperthyroidism (too much thyroid hormone) which speeds up metabolism and increases risk for heart attack and stroke.
- Type 1 Diabetes: In type 1 diabetes, the body’s immune system destroys the cells in the pancreas that make insulin (beta cells), therefore disrupting the regulation of blood glucose. Individuals with type 1 diabetes will always need to take insulin to live.
Certain medications such as steroids can impact hormones by increasing the body’s stress response and increasing insulin resistance (how effective the body’s insulin is). This can lead to a higher risk of developing conditions such as diabetes. Switching to a different medication under the direction of a healthcare provider can help alleviate these effects.
Stress impacts cortisol and adrenaline, causing these hormones to rise as stress increases. Prolonged, unmanaged stress can lead to higher risk for diabetes and hypertension (high blood pressure) due to increased blood sugar and blood pressure during the stress response. Finding healthy ways to manage, cope with, or reduce stressors can have a big impact on mitigating the hormonal stress response.
Symptoms of Hormonal Imbalances
Since hormones affect almost every part of the body, the symptoms of an imbalance will vary depending on what is out of balance. However, for hormonal imbalances related to metabolism, which can lead to metabolic disorders like diabetes or obesity, symptoms include:
- Acanthosis nigricans (darkening of skin in underarms and groin)
- Anxiety
- Constipation
- Depression
- Diarrhea/more frequent bowl movements
- Dry skin and hair
- Extreme thirst
- Fatigue
- Frequent urination
- High cholesterol levels
- Irregular fat distribution
- Numbness or tingling in your hands and feet
- Skin tags
- Slow/fast heart rate
- Thin, moist, warm skin
- Unexplained weight loss or gain
If you believe you are experiencing a hormonal imbalance, talk with your healthcare provider as soon as possible. There are many tests including blood, saliva, and urine tests that your provider can do to determine your hormone levels, whether you have an imbalance, and what your treatment options are. Remember, the earlier you bring up your concerns with your provider, the sooner you can start your individualized treatment plan.
The Chronic Disease Connection
Since hormones regulate the body’s functions and processes, there is a link between the body’s hormones, hormonal imbalances, and chronic diseases such as high blood pressure, diabetes, and obesity.
Over time, as the levels of these hormones change, the risk for various chronic diseases increases. Studies have shown that risk of developing chronic conditions such as heart disease, stroke, diabetes, dementia, cancer, and bone fractures, change with hormonal changes across the lifespan (for example during puberty, pregnancy, and menopause), highlighting the importance of hormones on long-term health.
Hypertension (High Blood Pressure)
Endocrine-related hypertension can result from medical conditions affecting hormones involved in blood pressure regulation. There are several conditions that are related to this type of hypertension affecting various organs of the endocrine system.
- Adrenal Gland: The production of too much aldosterone, cortisol, or adrenaline like hormones leads to raised blood pressure. These conditions are known as primary aldosteronism, Cushing’s syndrome, and pheochromocytoma respectively.
- Thyroid and Parathyroid: When thyroid hormones are too high (hyperthyroidism) or too low (hypothyroidism) blood pressure can be affected. Hyperthyroidism affects the systolic (top number) more while hypothyroidism affects the diastolic (bottom number) more. Too much parathyroid hormone (primary hyperparathyroidism) can increase blood pressure as well.
- Pituitary Gland: If the pituitary gland sends too many signals to the adrenal glands or thyroid glands, it can elevate blood pressure as well by causing the hormones of those glands to increase.
Furthermore, several body processes involve hormones that impact blood pressure, for example the stress response and sleep/wake cycle. Prolonged periods of unmanaged stress or poor sleep can cause blood pressure to rise and stay high, increasing your risk for conditions such as heart attack or stroke. High blood pressure is linked to conditions like obesity and insulin resistance in addition to the more well-known link to cardiovascular disease.
Diabetes
Diabetes occurs when there is a problem with the hormone insulin. This may be when the body does not produce any or not enough insulin or does not use the insulin it has like it should and is a metabolic hormone imbalance.
For individuals with type 1 diabetes, they do not produce enough insulin to live. Research has shown that changing hormonal levels throughout life including during puberty and at menopause, women have higher risks for conditions including excess weight gain, PMOS, and cardiovascular disease in what is called the “hypothalamic-pituitary-ovarian axis.”
In type 2 diabetes, the defining characteristic is insulin resistance, where the body does not use the insulin it does produce effectively. Insulin resistance is impacted by hormones throughout life, high cortisol levels, PMOS, obesity, and hyperlipidemia (high cholesterol).
Obesity
There is growing research on obesity and its impacts on the body. When one has obesity, the body holds on to an increased amount of fat. The brain, gastrointestinal tract, and fat cells produce many hormones that affect how much you eat, how many calories you burn, and how much you weigh. For example, ghrelin and leptin are two primary hormones regulating the body’s hunger response. These hormones can be affected by stress and lack of sleep, leading to the impaired ability to control the amount of food consumed as well as the energy burned as leptin plays a key role in this process as well. Additionally, bacteria in the gastrointestinal tract disrupt hormones involved in metabolism, the process of turning what one eats into useable energy.
Certain conditions related to hormonal imbalances like hypothyroidism, Cushing’s syndrome (too much cortisol in the body), polyendocrine metabolic ovarian system (PMOS; formerly known as polycystic metabolic syndrome where in too many hormones are produced by the ovaries), and menopause increase one’s risk of having obesity. All of these conditions are also associated with high blood pressure and insulin resistance, both of which are related to obesity.
Conclusion
Hormones play a vital role in the biological processes that run the body. However, changes in these hormones can have a substantial impact on one’s health and raise the risk for developing various chronic diseases. Learning about this link can provide useful insight into how you can take charge of your health to reduce your risk for or manage various chronic diseases.
Follow along each month as we explore this link in more detail.
For more information, check out the following articles:
References:
- Cleveland Clinic. (2022). Addison’s disease: What it is, causes, symptoms & treatment. https://my.clevelandclinic.org/health/diseases/15095-addisons-disease.
- Cleveland Clinic. (2025). Cortisol: What it is, function, symptoms & levels. https://my.clevelandclinic.org/health/articles/22187-cortisol.
- Cleveland Clinic. (2026). Cushing syndrome: What it is, symptoms & treatment. https://my.clevelandclinic.org/health/diseases/5497-cushing-syndrome.
- Cleveland Clinic. (2025). Graves’ disease: What it is, symptoms & treatment. https://my.clevelandclinic.org/health/diseases/15244-graves-disease.
- Cleveland Clinic. (2022). Hormonal imbalance: Causes, symptoms & treatment. https://my.clevelandclinic.org/health/diseases/22673-hormonal-imbalance
- Cleveland Clinic. (2025). Leptin: What it is, function, levels & leptin resistance. https://my.clevelandclinic.org/health/body/22446-leptin.
- Cleveland Clinic. (2022). Oxytocin: What it is, function & effects. https://my.clevelandclinic.org/health/articles/22618-oxytocin.
- Cleveland Clinic. (2022) Polycystic ovary syndrome (PCOS). https://my.clevelandclinic.org/health/diseases/8316-polycystic-ovary-syndrome-pcos.
- Endocrine Society. (2022). Diabetes and endocrine function. https://www.endocrine.org/patient-engagement/endocrine-library/diabetes-and-endocrine-function.
- Endocrine Society. (2022). Endocrine-disrupting chemicals (EDCs). https://www.endocrine.org/patient-engagement/endocrine-library/edcs.
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- Endocrine Society. (2022). Obesity. https://www.endocrine.org/patient-engagement/endocrine-library/obesity.
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- Stárka, L., & Dušková, M. (2020). What is a hormone? Physiological research, 69(Suppl 2), S183–S185. https://doi.org/10.33549/physiolres.934509.
Author:
- Melissa Bales, Extension Associate, Rural Health and Nutrition
Reviewed by:
- Michelle Altman, Extension Associate, Rural Health and Nutrition
- Ellie Lane, Extension Associate, Rural Health and Nutrition
