Gaby said:
Hormones.
- Many people with chronic persistent infections have hormonal imbalances. Their adrenal function is low, they don't produce enough cortisol, they may also have hypothyroidism with or without thyroid antibodies. Women have menstrual irregularities, men may have early "andropause".
- Patients with hormonal imbalances often have fatigue and lack of stamina. They may be diagnosed with fibromyalgia, CFS, Gulf War syndrome (from Garth Nicolson's research), environmental illness, Lyme disease. But they all have one thing in common: FATIGUE. Related symptoms include: autoimmune disorders and rheumatological diseases, cancer, co-infections with bacteria and parasites, deconditioning, depression, food allergies, environmental toxins, GI disturbances, heart disease, metabolic syndrome, mitochondrial dysfunction, sleep disorders, viruses, vitamin and mineral deficiencies, yeast and mold.
- Hormonal imbalances also cause problems with maintaining or losing weight. It could be either hypo or hyperthyroidism, insulin or leptin resistance. An overactive adrenal gland (high cortisol) will increase weight, whereas low adrenal may result in weight loss. Low testosterone may result in weight gain as there is less muscle mass and it can shift fat to the abdomen area, just like with insulin resistance.
- Pain and inflammation are also part of the symptom complex of endocrine conditions. RA, lupus, CFS, fibromyalgia, etc. can result in immune disorders and neuroendocrine abnormalities. In RA and lupus, estrogen levels can accelerate and androgens such as DHEA can inhibit the development of the disease.
- Prolactin may also contribute to autoimmune conditions. Elevated prolactin levels have been associated with lupus and other diseases: autoimmune thyroid disease, addison's disease, eye inflammation (iridocyclitis).
- Growth hormone and prolactin also regulate inflammatory reactions .Both increase resistance to bacterial infections.
- Defects in the HPA (hypothalamic-pituitary-adrenal) axis also results in hormonal imbalances. The hypothalamus also regulates temperature, hunger, thirst, the immune system, etc. Cytokines affect the HPA axis and thereby affect ALL hormones, specially the production of stress hormones such as cortisol. Cortisol is the main brake in the production of inflammatory cytokines. Although cortisol production is enhanced by cytokines, shutting down the production of cytokines will only take place if there is no cortisol resistance, and
cortisol resistance can be seen in painful musculoskeletal syndromes such as fibromyalgia and Lyme disease.
Defects in HPA are due to trauma, stress, infections.
- Autoimmune patients often have defects in the HPA axis (i.e. RA). These manifests as lower adrenal, thyroid, and sex hormone production by decreasing the pituitary hormones ACTH, TSH, and HCG (hypothalamic releasing hormones for the adrenals, thyroid, and sexual hormones respectively. There are more, this are only 3 examples). This causes abnormal growth hormone and prolactin secretion, with decreased prolactin activity, higher insulin levels and less endorphins which controls pain. There is more fatigue and joint pain.
- The underlying "cytokine storm" must be addressed (i.e. chronic persistent infections) and hormones must be rebalanced.
- New thyroid reference ranges by the American Association of Clinical Endocrinologists (AACE) in 2002: TSH is 0.3 to 3.0 and in some patients, TSH levels need to be on the lower end of the spectrum, i.e., a TSH close to 0.3 to see a significant clinical improvement.
- TSH and T4 (thyroid hormones) are both suppressed by cytokines. High cortisol levels may prevent T4 from converting to more active forms of thyroid hormones, T3 and free T3.
- 25% of chronically ill patients are deficient in iodine and other trace minerals. Iodine is necessary for thyroid hormones. Iodine deficiency is now considered to be an underlying cause of fibrocystic breasts. Patients treated with one drop of Lugol's solution (a concentrated solution with a high dose of iodine) have seen their cystic disease improve.
A word on adrenal dysfunction:
* During extended times of stress, the adrenal glands go into a "flight or fight" mode and secrete high levels of hormones like DHEA, aldosterone and cortisol. Cortisol's main functions include a proactive mode, in which it helps coordinate circadian rhythms, such as sleeping and eating, and processes involved in attention, learning, and sleeping and memory. But it also has a reactive mode, which enables us to adapt to and cope with stress. People with chronic persistent infections have stress which is caused by multiple infections. People often have to deal with the stress caused by the illness and its effects on their jobs, families, and friends. They have elevated cortisol levels during the day or at night, which keeps them awake when they are desperately trying to sleep.
Phosphatidylserine at night (and up to three times per day) with adaptogens during the day such as
rhodiola, ashwagandha, ginseng, B vitamins, vitamin C and pantothenic acid will help lower the stress response.
* Cortisol receptors are found throughout the central nervous system and are especially abundant in the limbic system and hippocampus, the parts of the brain involved with mood, learning, and memory. Chronically elevated cortisol levels may lead to adrenal fatigue and burnout. When cortisol levels are too high or too low, the memory and attention center in the hippocampus is affected. Atrophy of the hippocampus due to stress is associated with depression, PTSD, cognitive impairment and the breakdown of the blood brain barrier. Patients will experience fatigue, food cravings, mood changes, memory problems, and
many of the symptoms seen in those with non-Lyme-MSIDS (especially with Mycoplasma spp and other intracellular infections) and Lyme-MSIDS.
* Chronically low levels of cortisone also interfere with immune function, and the MSIDS patient may have
chronic infections symptoms that are resistant to antibiotics when they suffer from low cortisol levels.
* Phase I adrenal fatigue: fight or flight, high cortisol level in the morning. Supplements: phosphorylated serine mixed with melatonin. B5, B6, and vitamin C are also useful. So is EE :) (meditation and breathing).
Phase II adrenal fatigue: Normal or low cortisol level in the morning. Supplements: adaptogenic herbs added to the B and C vitamins, such as rhodiola, ashwagandha, ginseng, cordyceps (medicinal mushroom), adrenal glandular supplement.
Phase III adrenal fatigue: low cortisol levels, often related with decrease function of the HPA axis. There is fatigue and
increased susceptibility to infections. Supplements: Low dose hydrocortisone. DHEA may also be added at this stage, or at any time when levels are low.
* DHEA elevates mood, calms emotions, increases alertness and helps improve memory. Pregnelolone is a DHEA precursor.
-
Those with eye problems (blurry vision or double vision) should get an eye exam before starting Plaquenil (hydroxychlorquine) due to its potential side effects on the eye.
If there is a history of significant digestive problems and Herx reactions, metronidazol could also be reserved for last.
- As mentioned earlier,
those with severe symptoms who don't improve on antibiotics, may have a severe underlying adrenal imbalance which needs to be addressed.
- He covers the importance of addressing hormonal imbalances such as low testosterone in men. He recommends vitamin D, mung bean extract, zinc and high protein diets in order to increase testosterone. To decrease its conversion to estrogen, zinc and DIM (from broccoli) can be used.
- In women, symptoms often get worse right before or during menses. Women with MSIDS often have estrogen dominance or estrogen deficiency with or without early menopause. Iodine deficiency and xenoestrogens contribute to estrogen dominance. Detox can be achieved through FIR, cruciferous vegetables (DIM, sulforaphane). Progesterone (i.e. cream) stimulates GABA receptors in the brain and helps to achieve sleep.
- Hormonal deficiencies and hormonal imbalances are some of the most commonly overlooked causes for the failure of antibiotics in MSIDS.
