Aaron Hartman, MDFunctional Medicine Specialist | Clinical Researcher

The Impact of Trauma on Hormone Therapy

4 Jun 2025 · 1 min

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Aaron Hartman, MD discusses how trauma and chronic stress (sympathetic overdrive) elevate cortisol and complicate hormone therapy; he reports that patients with untreated trauma often respond poorly to hormone interventions. He emphasizes addressing foundational factors before or alongside hormones — environmental toxins, neuroendocrine disruptors, gut health, stress management, sleep, and nutritional status (noting vitamin D, magnesium, potassium, calcium balance) — to improve outcomes.

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And when someone's in sympathetic overdrive, they have trauma. These are actually some of my most difficult patients with hormones. When they have trauma and stress, the cortisol is high. Like, this is high, but it's from trauma and stress and whatever. And when that's really elevated, those are the people who do really poorly. When I start messing with the hormones, if I have not addressed that stuff first, and then there's filling in the holes. There's a lot of nuances you alluded to. Environmental toxins and chemicals, neuroendocrine disruptors, nutritional status. I mean, for me, like, you know, obviously, working on gut, working on stress, working on sleep, working on the foundations of functional medicine. If your vitamin D level's low, if your magnesium's low, if your potassium's low, I mean, how are hormones gonna work without magnesium and calcium being balanced.