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The OAT Axis and How to Balance it for Optimal Female Health

You may be familiar with the HPA (Hypothalamus Pituitary Adrenal) axis, a neuroendocrine axis that regulates numerous physiological processes from digestion and immunity to mood and the stress response. More recently, a new axis – the Ovarian Adrenal Thyroid (OAT)– axis has emerged as one that when out of balance, is implicated in numerous health conditions. In women, it is involved in the menstrual cycle, the stress response, libido and mood, and metabolism. The ovaries, adrenal glands, and thyroid gland are intricately co-dependent on one another for optimum health. Just like a three-legged stool needs all three of its legs in balance for it to be safely sat upon, all three organs of the OAT axis must be in a state of balance for a woman to feel well.


What happens when the OAT axis is out of balance? Subtle imbalances can occur when you have the occasional poor night’s sleep or are experiencing temporary mild stress. This usually doesn’t show up as anything more than a temporary feeling of fatigue or worry, for example. However, when the adrenals, ovaries, and thyroid are exposed to chronic or severe stressors, medical conditions can develop leaving one feeling incapacitated. These conditions may include hypothyroidism, PMS, fertility issues, headaches, anxiety, low mood, weight gain, and extreme fatigue.


One of the biggest misconceptions I see in practice is the assumption that the primary endocrine gland involved in someone’s hormonal imbalance should be treated aggressively, while the other two can be ignored. And for menopausal women– whose ovaries are no longer functioning as they once did– ignoring this part of the picture can be an obstacle to overcoming hormonal concerns. No matter what your age is, when supporting the OAT Axis, incorporate lifestyle, nutritional, and supplemental measures that provide a holistic approach to all three glands.



Ovarian and Estrogen Balance Support

Estrogens circulate in women at varying levels during different parts of the menstrual cycle and throughout a woman’s lifetime. When the body is unable to properly metabolize these estrogens, estrogen dominance can develop. Estrogen dominance contributes to PMS, heavy or painful periods​, hormonal acne, hair loss, brain fog, breast tenderness, headaches, uterine fibroids, and low libido.


Support the body’s ability to metabolize estrogens:

  1. Start your day with a cup of warm water with lemon

  2. Avoid harmful chemicals, pesticides and plastics by washing your produce, going organic, and using natural personal care and home cleaning products

  3. Consume detoxifying superfoods like broccoli, kale, cabbage, turmeric, beets, artichokes, and garlic

  4. Supplement with nutrients like calcium D-glucarate, indole-3-carbinol, green tea extract, turmeric extract, rosemary extract, lycopene, sulforaphane, and milk thistle seed extract. These promote healthy estrogen metabolism, balance hormones, reduce the symptoms of estrogen dominance, and support liver detoxification.


Adrenal and Stress Support

The adrenal glands produce many hormones, with cortisol– the stress hormone– being the major one. When under stress, levels of cortisol can fluctuate from being very high at times to very low at others. In both scenarios, fatigue, mood changes, and sleep concerns can be greatly exacerbated. The adrenals also pick up the slack in the production of sex hormones once a woman enters menopause. Because of this, adrenal optimization is crucial to help support the transition through this period of hormonal change.


Nourish the adrenal glands:

  1. Eat regular meals including protein-rich and fibre-rich foods while decreasing caffeine, alcohol, and refined carbs

  2. Engage in physical movement and relaxation exercises such as breathing and meditation

  3. Get a good night’s sleep

  4. Optimize nutrient intake, such as omega-3 fatty acids, magnesium, and vitamins D, C and the Bs

  5. Supplement with herbal adaptogens such as rhodiola, suma, Siberian ginseng, schisandra, and ashwagandha. By supporting healthy cortisol levels and adrenal function, these adaptogens help to reduce stress, promote relaxation, combat fatigue, and increase energy and well-being.


Optimize Thyroid Function

The thyroid gland is most known for its effect on metabolism. Most imbalances in thyroid health are related to poor thyroid function leading to hypothyroidism with symptoms including low energy, weight gain, mood changes, and hair loss.


Balance thyroid function:

  1. Follow a whole foods diet that includes foods rich in iodine such as kelp, nori, and seaweeds

  2. Minimize the consumption of raw goitrogens (broccoli, kale, cabbage, cauliflower, and turnips)

  3. Reduce levels of dairy and gluten in your diet and avoid GMO soy products

  4. Avoid toxins like fluoride and bromine

  5. Supplement with nutrients such as L-tyrosine, ashwagandha, guggul, pantothenic acid, copper, manganese, and iodine to help support thyroid health and enhance thyroid function. These nutrients support the conversion of T4 to the more active T3, and by doing so, can help enhance weight loss, improve energy, and safely support overall hormone balance.


Disclaimer: The information in this article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your healthcare provider before starting supplements or making lifestyle changes.

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