The Holy Trinity – Or Charlie's Angels – of Vitality: Estrogen, Cortisol + Thyroid (and why they've got your back + your rack, baby)

Step into my time machine. We’re nine years old. It’s 1976. We’re fledgling feminists (already!) and we’re mad-passionately-crazy in awe of a trio of crime-fighting, bad-guy-busting women with brains, brawn and physical agility. And they are just like the hormonal system, when it’s working FOR YOU not against you.

They’re amazing. They’re Angels. (They even have winged… hair.) They’re Charlie’s Angels: Sabrina, Jill and Kelly.

The Angels, played by Kate Jackson, Jaclyn Smith, and Farrah Fawcett, fought crime as ably as men – and they were the first to do that on 70s prime-time TV, where detectives usually packed guns, not ovaries. Sure, it was a bit weird that the Angels did the dirty work of a disembodied boss named Charlie, but whatevah – seeing the three of them working in sync was poetry. It was empowerment. It was teamwork.

And it worked.

And so it is with your hormonal system.

Sabrina is Cortisol. Jill is Thyroid. Kelly is Estrogen.


Sabrina (Kate Jackson) has brassy charm and a quirky wit. Her voice is clear and well-honed. She stands up to Charlie more than the other angels and she’s less inclined to manipulate men with her feminine wiles. Her considerable intellect was more effective.

And so Sabrina is the “Smart Angel”. She’s no-nonsense, smart and strategic-thinking – not unlike Cortisol, the main hormone of your stress-response system. Cortisol amps you up to deal with danger.

Sabrina and Cortisol are a pair of Generals. They get the damn work done. No time for niceties…they’re too busy coming to the rescue. Just as Sabrina rescues the “Angel in Danger,” Cortisol rescues you from tight spots, such as a car accident or racing after a toddler heading toward danger. Cortisol is your stress-protector, intelligently and skillfully mediating the scary effects of your everyday adventures.


Kelly (Jaclyn Smith) is Sensitive Angel: softer, voluptuous, like Estrogen. Queenly, but also street-wise and tough. Like Estrogen, Kelly could be powerful and in control one minute, and a seductress the next. Estrogen serves all these purposes. Estrogen keeps you flush with serotonin, the feel-good neurotransmitter that makes your mood, sleep and appetite right-for-you.

Stable mood? Check. Toe-curling orgasms? Checkety check. Lubricated joints and vagina? Checkety check check. All estrogen. All good. All systems go. Perky boobs rather than pancakes. Pretty skin sans wrinkles. Estrogen keeps the other angels, cortisol and thyroid, in balance.


Jill (Farrah Fawcett-Majors) is Sporty Angel – lithe and athletic. On the show, she plays tennis, basketball, swims, bowls, skateboards and rollerskates. Her metabolism is working for her, like Thyroid. She drives a speedy car with blue racing stripes, and even retires from the show to become a race car driver. Thyroid drives your race car. Without enough thyroid juice, you feel fatigued, gain weight, and your mood sinks. Libido? Fah getta bout it….

To Bust the Bad Guys – Depression, Lack of Energy, Slow Metabolism – Get Your Hormonal Angels Working Together

How do these three hormonal angels work together to protect your vitality?

All three, together, are absolutely pivotal to you feeling that all is right with the world. Cortisol, Estrogen and Thyroid are three legs to a three-legged stool. Get each in right proportion and you sit straight. No tipping or careening off to one side or another.

What I commonly see in my practice is that a woman has one wonky angel.

Let’s say it’s her thyroid. She has been taking the same damn dose of levo-thyroxine for 20 years, yet her thyroid is still not doing its job. She’s tired, particularly in the morning. She’s gaining weight and finds it hard to keep the pounds from piling on. Her joints are achey and her cholesterol is climbing with her weight – and it’s all attributable to thyroid. Angel Jill needs to get racy – and she needs her angel partners.

Because if your thyroid symptoms and numbers are missing the mark, you can bet that’s affecting the balance of the other hormonal angels: Estrogen and Cortisol.

Sometimes I’ll see a client with two wonky angels, thyroid and estrogen.

Let’s imagine this client is 45 years old. An enterprising gynecologist has started her on an estradiol patch (a form of bioidentical estrogen) for night sweats and low libido. Because this gynecologist knows that night sweats and low libido relate to thyroid function as well as estrogen function, she measured her client’s TSH and free T3 – and, sure enough, both numbers indicate a sluggish thyroid.

Our client gets started on thyroid medication and has a delicious honeymoon…of two weeks.  For fourteen days, she has more energy and vitality. More sex drive. She’s chasing her husband around the bedroom.


Where’s Sabrina? Her two angels need their third. Wonky thyroid and estrogen are working better, together, but cortisol steps in and demands to be noticed.

Most conventional doctors will take a look at your thyroid and estrogen but will not consider your cortisol levels. Yet, like the third leg in that three-legged stool, or  the Sabrina to your Jill and Kelly, cortisol is vital to your most robust, sustained vitality.  Cortisol is crucial to hormonal balance.

And what’s also crucial is to have all three angel hormones functioning in sync.

Each Hormonal Charlie’s Angel – Sabrina, Jill, Kelly or Cortisol, Estrogen and Thyroid – is important, essential and useful on her own, but it’s when all three of them are at the height of their individual powers and working together that the magic happens.

Health. Happiness. Vitality. Libidic lusciousness. And all the bad guys – depression, weight gain, sluggishness – busted and behind bars.

Ah, those angels. They were my girls when I was a girl and they’re my girls now that I’m a grown-up doctor-lady.

They can be yours, too.

Let’s get the Charlie’s Angels of your hormonal system – Cortisol, Estrogen and Thyroid – fighting for you.


  1. Constance Waterstraat on August 9, 2011 at 4:52 pm

    What if any would these three hormones play a part of my hair thinning. Thanks in advance for your answer.

    • Sara Gottfried MD on August 9, 2011 at 7:00 pm

      Yes, all three – fluctuating estrogen, cortisol and especially thyroid – may cause hair thinning. There are other issues too such as genetics (does hair thinning run in your family), iron levels (particularly your ferritin level), autoimmune conditions, etc. All the best, Dr. Sara

  2. Eva on September 30, 2011 at 10:47 pm

    Hi Sara,

    I’m 40, in great shape, gluten-free, have a good sex drive and lube, BUT I am usually in an aggro, irritable, stress-driven mood! Should I expect my weight and sex drive to plummet if the angry mood keeps up?

    Thinking about my future,

    • Sara Gottfried MD on November 24, 2011 at 11:39 pm

      I would say, Eva, that your mess is your message. Get curious about the aggro and irritation. Something crucial is getting mirrored, and your hormones are likely amplifying it.

      Keep us post,
      Dr. Sara

  3. Sara on November 24, 2011 at 1:53 pm

    Sara…I have a mission to connect with all beings named Sara on this transit, and here you are. Among the many things you seem to do awesomely (if I can tell from your lovely website), your writing style truly rocks. Wrocks. Thank you for bringing vital language to vital questions.

    With heart,

    • Sara Gottfried MD on November 24, 2011 at 11:38 pm

      Wrockin’ the love right back at you, Sara! Thanks for you comment!

  4. Amy Hudgens on February 6, 2012 at 7:27 pm

    Hi sara, I was wondering if an estradiol of 20 on day 3 of cycle is considered low for a 35 year old woman? I have ben having symptoms of fatigue, sleep loss and irritability. Pretty sure I have some adrenal fatigue going on but wanted to hear what you thought of the estradiol levels. I know you can’t give advice and don’t know medical history. FHS levels 9.9 day 21. having normal periods. ANy insight would be great..Thanks Amy

  5. Martha on May 25, 2012 at 10:34 pm

    I was told by a practioner that I am estrogen-dominant, and switched from a beta-17 gel to a yam suppliement 2 years ago. All was fine until I suffered a TBI, which sent my endocrine hormones spiraling. Six months later: thyroid numbers back within range, energy slowly returning, but have a “disabled” sex drive. Should I re-think beta-17, or patiently wait a bit longer for normalization (per my neurologist, may take up to 2 years for all systems to normalize)?