Friday, June 27, 2014

CFS and the HPA Axis

Every system in my body went wonky when I contracted CFS.  Thing is everything is so interwoven and interconnected I'm never sure which string to pull on first to mitigate some of the symptoms.  

Here is an interesting tidbit on why sex hormone regulation goes on the fritz.  

the enzyme that converts cholesterol to pregnenolone is limited, and it requires a lot of ATP, which is cellular energy.  It’s an energy-intensive process.  That means that the amount of pregnenolone we can make in the body is limited
Turns out that pregnenolone is the master hormone which regulates everything else in the body.  Guess what we have a shortage of with CFS?  Yup, ATP.  We have very limited cellular energy.  I must interject here that my general health did improve when I added more cholesterol and fats to my diet.  However, before I can say definitively that it made a huge difference I have to say that I made the switch to Paleo at that point so other things may have been a factor in the improved health.  Anyhoo, I digress.  Back to the topic at hand....

Oh and if we are under stress (read that as "sick") then the little amount of pregnenolone we do manage to make is converted into cortisol.  So for us CFSers it is pretty much a lose-lose situation.  So what happens downstream if we don't have enough pregnenolone as women (men are different)?

  • low progesterone-high estrogen
  • possible PCOS
  • hair loss
  • facial hair growth
  • loss of sex drive
  • irregular periods
  • mood imbalance
BTW, that entire list describes me except for the PCOS.  One of the first things that went wonky on me was my period.  I also started growing a nice mustache and I'm a girl.  Not that I had great sex drive before I got sick but I have NONE at all now.  My mood has stabilized since going Paleo but I can still have bad days as evidenced by this blog.   Also, my hair doesn't fall out by the handful anymore which I'm very happy about.

The gut issues we almost universally have as CFSers also gets into the act:
Impaired gut function can mess with hormones in several different ways, so if you have a parasite or a fungal overgrowth or dysbiosis or leaky gut, that causes inflammation.  Inflammation suppresses the function of the hypothalamus and the pituitary in the brain, which produce the stimulating hormones, and then it also suppresses the function of the adrenals and the ovaries and the gonads in men that produce the actual hormones.  Inflammatory cytokines can also cause hormone resistance, 
Interesting that he mentions inflammatory cytokines which are a known problem in CFSers.  Another strike against us.

As for myself, I've tested negative for everything except leaky gut.  I have done what I can with my diet and my gut is definitely doing better than five years ago.  However, I'm not perfect as I've mentioned before and cheat WAY too much.  I'm not sure I can ever climb back on the perfect Paleo bandwagon.

While there is lots of good basic info in the podcast, the author never really gets around to saying how to treat this properly.  People even complained about this in the comment section but there was nothing forthcoming from the author.  I did find it interesting how so much of the CFS issues overlap with HPA problems in the general population.

Here is the link to the podcast:

Here another somewhat unhelpful article on how to fix the HPA when you have CFS:
Mind that the article is written by a dietitian and not a physician.  Basically she covers the use of low dose hydrocortisone (which I did with mixed results: not much improvement but I did win an extra 20 pounds of body weight), getting adequate sleep (but she has NO idea about the severity of sleep dysfunction in CFSers and offers only the usual sleep advice) and reducing stress levels via meditation.   Like I said not helpful.  I need to do some reading on other sites regarding fixing the HPA axis preferably without drugs.

Even though these two pieces didn't help with fixing the problem I do like it when I learn what the problem actually is.  That knowledge gives me things I can search for on Dr. Google.

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