HORMONES - POSSIBLE SOLUTIONS
Hormones affect so much of how we feel with Lyme, from energy and sleep to mood, weight and our monthly cycles. This post gathers the things Lyme-literate doctors, research and our community use to support hormone balance. Please work with your doctor on any of these, especially anything that changes hormone levels.
Short on time or energy? A quick-view graphic with the key points is at the bottom of this post.
Want to learn how Lyme affects hormones first? Read the education post:
HORMONE EFFECTS IN LYME
Buy links are right under each product. Sign up here first for the Fullscript discount (25% off):
START WITH TESTING
- Lyme-literate doctors usually test before treating hormones, so they know what's actually low or high.
- Common tests include a 4-point saliva cortisol test through the day, DHEA-S, a full thyroid panel with antibodies, and sex hormones (estrogens, progesterone and testosterone).
- The education post above has more on testing.
TREAT THE ROOT CAUSES
- Dr. Horowitz sees hormone problems as one result of the inflammation that comes from infections, mold and other toxins, gut problems, poor sleep and nutrient deficiencies. Working on those can help hormones recover.
- Dr. Todd Maderis shares that the body's stress-hormone system (the HPA axis) can recover once the infection is treated.
INFLAMMATION / PAIN
MOLD AND LYME TREATMENT ORDER
MOLD SOLUTIONS
ADRENALS AND CORTISOL
Adaptogen formulas
Adaptogens are herbs like ashwagandha, rhodiola, ginseng and cordyceps that help the body handle stress. Many Lyme-literate doctors use them for adrenal support, often in a blend taken in the morning and midday, since later doses may disturb sleep. Holy basil (tulsi) and eleuthero are other adaptogens you'll see in some blends.
ADAPTOGENS
RHODIOLA
TULSI
Buy here (PERQUE Adreno Distress Guard: rhodiola, magnolia and phellodendron, which my doctor added for my stress):
Buy here (XYMOGEN Adrenal Essence: cordyceps, rhodiola, Asian ginseng and B5, a formula Dr. Horowitz has used):
Ashwagandha
In a 2026 review of 23 studies, ashwagandha lowered cortisol. A 2025 review found it lowered cortisol too, but it didn't clearly change how stressed people said they felt.
ASHWAGANDHA
Cortisol Manager (for high cortisol at night)
A bedtime blend of ashwagandha, L-theanine, phosphatidylserine and magnolia. I took it at bedtime.
CORTISOL MANAGER
Buy here (Integrative Therapeutics Cortisol Manager):
Buy here (Integrative Therapeutics Cortisol Manager Allergen Free):
Phosphatidylserine
In his 2018 review, Dr. Horowitz noted it can be used to lower high cortisol at night and help sleep. Older small studies (1992 and 2004) found it softened the body's cortisol rise during stress.
Buy here (Integrative Therapeutics Phosphatidylserine, soy-free):
Vitamin C and B5
Lyme-literate doctors say vitamin C and B5 (pantothenic acid) are important for the adrenals, and many adrenal formulas include them. In a small 2024 study of 69 women with stress-related high cortisol or DHEA-S, the women who took 1,000 mg of vitamin C a day for 2 months saw their high levels come down. Women who didn't take it saw little change.
VITAMIN C
B VITAMINS
Adrenal glandulars
Some Lyme-literate doctors use adrenal glandulars, made from animal adrenal tissue, when testing shows low adrenal function. They can contain hormones like cortisol and DHEA, so they're used only with your doctor and after testing. I used Adrenoplex in the past. It contains adrenal glandular and a small amount of licorice, so it's one to use with your doctor's guidance. Licorice can raise blood pressure, so check with your doctor if yours runs high.
Buy here (Priority One Adrenoplex):
Salt, water and electrolytes
Low adrenal function can bring dizziness when standing. Dr. Horowitz has used extra salt and plenty of water with some patients. Ask your doctor first if you have high blood pressure, heart or kidney problems.
ADRENAL COCKTAIL AND ELECTROLYTES RECIPES
ELECTROLYTES
ADRENAL FATIGUE
THYROID
THYROID ISSUES IN LYME
Selenium
In a 2024 review of 35 studies, selenium lowered thyroid antibodies in people with Hashimoto's, and lowered TSH in those who weren't on thyroid medicine. Lyme-literate doctors often include it for thyroid support. More isn't better, so stay with the amount your doctor suggests.
SELENIUM
Buy here (Pure Encapsulations Selenium):
Buy here (Protocol for Life Balance Selenium, a lower-priced option):
Zinc and iron
Lyme-literate doctors check zinc and iron (ferritin) and replace them when they're low. Dr. Horowitz has patients take iron at a different time than antibiotics so it doesn't block them.
ZINC
ANEMIA IN LYME AND CO-INFECTIONS
Iodine (test first)
Doctors test iodine before adding it, because both too little and too much can upset the thyroid, especially with Hashimoto's.
Thyroid medicine
Prescription thyroid medicine is your doctor's call, and doctors differ on which type they use.
WOMEN'S HORMONES
Cycle flares
Dr. Jaquel Patterson, in an ILADEF interview, shares that she calms inflammation before the period with turmeric or boswellia, and looks at estrogen balance and detox support. Dr. Horowitz has also seen flares during a period as a sign the infection is still active, so tell your doctor.
TURMERIC / CURCUMIN
BOSWELLIA
Periods and iron
Monthly periods can lower iron. Dr. Horowitz found very low ferritin tied to periods in one patient, so ask your doctor to check yours.
MAGNESIUM AND MENSTRUAL CRAMPS
MENSTRUAL CYCLES AND THE EFFECTS ON POTS
Perimenopause and menopause
Lyme-literate doctors decide on hormone therapy case by case. Some prefer bioidentical hormones through the skin, along with progesterone. Talk with your doctor about whether it's right for you.
LYME IN WOMEN
PREGNANCY AND LYME
MEN'S HORMONES
- Lyme-literate doctors test total and free (or bioavailable) testosterone.
- If it's low, doctors may use prescription testosterone or medicines that help the body make more of its own.
- Poor sleep and sleep apnea are linked to lower testosterone, so ask about a sleep check.
- Doctors check zinc and vitamin D and replace them if they're low.
- In a 2026 review, ashwagandha raised testosterone in men.
BLOOD SUGAR
- Low blood sugar can feel a lot like Lyme symptoms (tiredness, headaches, racing heart, mood swings, brain fog).
- Dr. Horowitz uses a low-carb, low-sugar diet with small, frequent meals to keep blood sugar steady, and in a 2024 case report it helped a patient's blood sugar swings and energy.
- High cortisol can also raise blood sugar.
HYPOGLYCEMIA IN LYME
DAILY HABITS THAT SUPPORT HORMONES
- Sleep: aim for about 8 hours, wind down in the evening, and limit late caffeine and screens.
- Gentle movement: walking, yoga or Pilates, built up slowly so you don't crash.
- Stress care: breathing, meditation, journaling, time in nature and counseling.
- Food: colorful vegetables and an anti-inflammatory diet. Some Lyme-literate doctors suggest limiting gluten, dairy, alcohol and too much caffeine.
- Sauna: Dr. Patterson suggests starting with 15 to 20 minutes of far-infrared sauna.
SLEEP - POSSIBLE SOLUTIONS
SLEEP ISSUES AND INSOMNIA
STRESS - POSSIBLE SOLUTIONS
EXERCISE WITH LYME
INFRARED SAUNA THERAPY
BEFORE YOU START
- Read the warning on each bottle.
- Never start, stop or change a hormone, thyroid or adrenal medicine without your doctor. Some Lyme medicines, like rifampin, can lower thyroid and adrenal medicine levels.
- If you're pregnant or nursing, ask your doctor before any of these. Avoid ashwagandha in pregnancy, and the Adrenoplex and Cortisol Manager labels say not to use them while pregnant.
- Ashwagandha has been linked to overactive thyroid in rare cases and may flare autoimmune conditions, so ask your doctor if you have a thyroid or autoimmune condition or take thyroid medicine.
- Men with prostate cancer should ask their doctor before ashwagandha, since it may raise testosterone.
- Glandulars and DHEA can change your hormone levels, so use them only with your doctor and after testing.
- Rhodiola may interact with warfarin. Eleuthero and ginseng may throw off digoxin blood tests.
- If you have diabetes, watch your blood sugar on Cortisol Manager.
- Always ask your doctor before adding anything new.
MY EXPERIENCE
- My Lyme-literate naturopathic doctor has me use adrenal support, rotating between formulas depending on my health. Adding it made a huge difference for me, and I noticed it from the very first day.
- In the past I used Adrenoplex, and another formula that has since been discontinued.
- My doctor recently added Adreno Distress Guard to help with my stress levels.
- My doctor also has me on CDG EstroDIM by Ortho Molecular, a DIM and I3C formula that supports how the body processes estrogen. This is something my doctor chose for me, not a general suggestion, so talk with your own doctor before trying anything like it.
- I took Cortisol Manager at bedtime when I needed help with sleep and stress.
- When I'm fatigued, I always look into thyroid and adrenal fatigue, along with EBV and anemia.
MORE RESEARCH WITH MIXED RESULTS
- Magnesium for sleep: a 2026 review of 12 studies found the results inconsistent. It may help some people a little.
- Inositol for PCOS: a 2024 review of 30 studies found some benefit for metabolic markers like insulin and possibly ovulation, but the evidence is limited.
- Vitamin D did not clearly raise testosterone in men in a 2026 review. It's still worth checking and replacing if low.
RELATED POSTS
STRESS - POSSIBLE SOLUTIONS
FATIGUE - POSSIBLE SOLUTIONS
HAIR LOSS AND LYME
WEIGHT GAIN AND WEIGHT LOSS IN LYME
SOURCES
Fornalik et al., Ashwagandha review of 23 studies, Planta Medica, 2026
Lopresti et al., Magnesium and sleep review, J Diet Suppl, 2026
Paez-Allendes et al., Vitamin D and testosterone review, Nutrients, 2026
Memorial Sloan Kettering, About Herbs: Ashwagandha, 2026
Memorial Sloan Kettering, About Herbs: Rhodiola, 2026
Memorial Sloan Kettering, About Herbs: Siberian Ginseng
Dr. Marty Ross, Heat Up, Speed Up: Thyroid & Adrenals in Lyme (2025, updated 2026)
Albalawi, Ashwagandha, cortisol and stress review, Nutrition and Health, 2025
ILADEF, Fred Diamond with Dr. Jaquel Patterson, The Overlooked Intersection of Lyme Disease and Women's Hormonal Health, 2025
Vargas-Uricoechea et al., Iodine and thyroid review, Diseases, 2025
Dr. Richard Horowitz and Phyllis Freeman, 3 Case Reports, Microorganisms, 2024
Huwiler et al., Selenium and Hashimoto's review of 35 studies, Thyroid, 2024
Beglaryan et al., Vitamin C and high cortisol, Stress and Health, 2024
Fitz et al., Inositol for PCOS review, J Clin Endocrinol Metab, 2024
Dr. Bill Rawls, Elevated Cortisol and What You Can Do, 2024
Global Lyme Alliance, Lyme Disease and Hormones, 2023
Dr. Richard Horowitz, Phyllis Freeman and others, 25-Patient Study, Microorganisms, 2023
Liu and Reddy, Sleep and testosterone review, Rev Endocr Metab Disord, 2022
Dr. Todd Maderis, Hormones in Lyme Disease, 2022
Dr. Todd Maderis, Causes of Fatigue in Lyme Disease, 2019 (older source, still worth reading)
Dr. Richard Horowitz and Phyllis Freeman, MSIDS 200-patient review, Healthcare, 2018 (older source, still worth reading)
Hellhammer et al., Phosphatidylserine and stress, 2004 (older source, still worth reading)
Monteleone et al., Phosphatidylserine and cortisol, 1992 (older source, still worth reading)
Disclaimer: Rise Above Lyme makes no claims about any possible benefit of using any product mentioned within this site. Always consult with your doctor before adding anything. The information shared is based on personal experience, years of accumulated researched resources from Lyme Literate doctors and polls conducted within Lyme groups from actual patient experience using these solution ideas.
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