Re: Hormones and MS

[Guest guest]

Wow, this is a great article!!! Good info PH!

Thank you!

Patty

>

>

> Hi Beth,

>

> Here's an article that mentions face numbness. I'm not saying you

have

> MS. I know for myself I have a lot of MS-like symptoms, including

> numbness, brain fog and visual disturbances...am hoping that balancing

> my hormones will resolve these annoying sytmpoms! - PH

>

> http://www.holisticprimarycare.net/app/3_111.jsp

> <http://www.holisticprimarycare.net/app/3_111.jsp>

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> Hormone Therapies Improve Symptoms and Delay Progression of MS

> By August West

> Contributing Writer

> PHOENIX, AZ—Just a few years ago, Simpson was bed-ridden,

in

> constant pain, and unable to manage even basic daily tasks. Multiple

> sclerosis had all but claimed the life of this once vibrant biotech

> executive.

> Today, at 54 years old, she's completely symptom free, highly active,

> and dedicating her considerable energies to helping others with MS,

> especially women.

> What enabled her to bounce back from a disease most physicians deemed

> untreatable? Comprehensive hormone balancing therapies aimed at

> re-calibrating the endocrine system, normalizing glucose/insulin

> metabolism, and reducing inflammation. Speaking at the annual meeting

of

> the American Association of Naturopathic Physicians, Ms. Simpson told

> her story and outlined the hormone-based strategies she discovered

> through her own diligent research.

> " This is not a cure. It's a set of treatments that can resolve

> symptoms, " explained Ms. Simpson. " If I stop treatment the symptoms

come

> roaring back. So this is not a definitive therapy. But it is very

> effective for reducing symptoms. " It is also a testament to what a

> motivated, science-minded patient can do for herself when conventional

> medicine has little to offer.

> If it strikes you as far-fetched that MS—the quintessential

> neurodegenerative disease—is related to hormone dysregulation,

> consider the epidemiology. MS has a 4-fold higher prevalence among

women

> versus men. The mean age of onset in women is around 32 years, just at

> the time that thyroid and sex hormones begin to decline. Further,

> symptoms tend to abate during pregnancy, when there's a big hormone

> surge, and then rebound post-partum.

> Symptoms also stabilize and progress very slowly from the mid 30s, to

> the early 50s, at which point there's an accelerated progression right

> around menopause. " The disease moves to the 'secondary progressive'

> phase in the same general time frame as hormone levels decline, " said

> Ms. Simpson. Roughly 50% of all cases become progressive within 10 to

15

> years of diagnosis, with an additional 40% progressing within 25 years

> of onset.

> Further, many MS symptoms are also symptoms of hormone deficiency:

> numbness and tingling; chronic fatigue; bladder/bowel problems;

balance

> loss; decreased coordination; vision abnormalities; cognitive

> impairment; sleep problems; reflux; emotional problems; mood swings;

> depression; sexual dysfunction; muscle stiffness; cramps; and

neuralgia.

> " All of this points to a hormonal connection, " she suggested. Various

> Doctors, Various Diagnoses

> Ms. Simpson's personal saga began in her early 30s, with debilitating

> hand numbness. Various physicians came up with various diagnoses:

carpal

> tunnel syndrome; degenerative arthritis; " the effects of aging. "

> After the birth of her second child she developed severe low back

pain,

> disruptions of balance, and difficulty walking. The neuromuscular

> problems were accompanied by stomach cramps and visual disturbances,

> which were seldom considered by the specialists, none of whom could

> provide effective therapies.

> The crisis came in her early 40s, when the right side of her face grew

> numb, and she nearly choked on a piece of steak. At this point, a

> neurologist told Ms. Simpson she had MS. The diagnosis was confirmed

by

> MRI, which showed multiple brain and spinal cord lesions.

> Ms. Simpson began thinking holistically. " My father had just died from

> progressive supranuclear palsy, another slow neurological disease. So

I

> started thinking about family history and environmental toxins. " Heavy

> metal testing showed very high mercury and cadmium, which Ms. Simpson

> attributes to having grown up in Manila, where heavy metal exposure is

> widespread. Chelation and replacement of amalgam fillings helped a

bit,

> but not significantly. Thinking Holistically

> Applying a scientific acumen she'd honed in the biotech world, she

> studied everything she could find about the epidemiology and

> pathogenesis of MS. That's when the hormone connection jump out at

her.

> " I decided to get my hormones tested. " Initially, her primary care

> doctor thought the idea was crazy, but given what little conventional

> medicine has to offer for MS, he was open-minded enough to take a

look.

> " It turned out I had very, very low estrogen, progesterone,

> testosterone, and thyroid hormones. " Many other aspects of her

endocrine

> profile were out of balance. In researching her family history, she

> found out that her mother had been taking thyroid hormone since she

was

> in her mid-40s; her grandmother and sister were all hypothyroid, too.

> A trial of estrogen and thyroid hormone replacement led to " a huge

> symptom improvement, " and this opened a pathway to recovery, one she's

> followed ever since. In the interest of helping others with MS, Ms.

> Simpson published her story, and her therapeutic protocols in, The MS

> Solution: How I Solved the Puzzle of My Multiple Sclerosis (Los Olivos

> Publishing, 2008). Inflammation & Demyelination

> How do hormones affect nerve function? Why does hormone replacement

> attenuate MS? The answers aren't entirely clear, but Ms. Simpson

> stressed that, " The neurological system does not exist independent of

> the rest of the body. "

> Histologically, MS is defined by gradual myelin degeneration, leading

to

> scar tissue and plaque formation. This ultimately impairs nerve

impulse

> propagation. Myelin deterioration is driven in part by genetic and

> environmental factors, but the process is fueled by inflammation. She

> hypothesized that the decline of thyroid and sex hormones with age

> predisposes people to chronic, systemic inflammation, which speeds

> demyelination. " Inflammation begets inflammation. "

> Widespread inflammation is fostered by high glycemic diets, excess

> insulin production, abdominal adiposity, high arachidonic acid levels,

> and elevated cortisol, all of which are common among women with MS.

> Ms. Simpson described four core goals of MS management: normalization

of

> insulin and glucose metabolism; normalization of cortisol levels,

> elimination of infections; and restoration of optimal hormone levels.

> There are many different therapeutic tools that can be brought into

play

> in a given case, but hormone modulation is key, she said. Estrogen &

> Testosterone

> With estrogen, " it's very important for women to have enough and for

men

> to not have too much, " she said. Several studies of estriol in women

> with MS showed marked resolution of symptoms as the hormone increases

> (Zych-Twardowska E, Wajgt A. Med Sci Monitor. 2001; 7(5): 1005–12.

> Soldan SS, et al. J Immunol. 2003; 171(11): 6267–6274. Sicotte NL,

> et al. Ann Neurol. 2002; 52(4): 421–428). Animal studies show

> exogenous estriol can even reverse CNS lesions analogous to those in

> humans with MS (Polanczyk M. American Journal of Pathology. 2003; 63:

> 1599–1605).

> Men with MS typically have very high estrogen levels, often greater

than

> 30 ng/ml, and very low testosterone, a very pro-inflammatory

situation.

> Chronic estrogen elevation in men increases sex hormone binding

> globulin, which binds testosterone, creating a vicious cycle of

hormonal

> imbalance.

> Elevated estrogen " tricks " the hypothalamus, which stops telling the

> pituitary to stimulate testosterone production. Estrogen also attaches

> to testosterone receptors, effectively blocking testosterone's action.

> Low testosterone is also common among MS women, and it correlates with

> more inflammation and increased CNS lesions (Tomassini V. J Neurol,

> Neurosurg & Psych. 2005; 76: 272–275). Overly high levels of

> testosterone can also be problematic. " You don't want too much or too

> little, " said Ms. Simpson.

> One of the challenges is that the " normal " range in standard lab

assays

> is very wide, typically from 230–1,200 ng/ml. " A level of 260 is

> read as 'normal' though it's not enough testosterone to keep a bird

> going, " Ms. Simpson said. " Don't just look at total testosterone, look

> at free T levels. That's how you get a sense of the androgenic effect.

> Dihydrotestosterone is the active metabolite. You need to look at

that. "

> Progesterone Is Protective

> In both women and men, progesterone is neuroprotective. There's a

wealth

> of recent data to suggest it preserves and restores myelin integrity,

> and may actually regenerate nerves even after lesions have developed,

by

> promoting myelin formation and increasing neuronal survival

(Schumacher

> M, et al. Endocrine Reviews. 2007; 28(4): 387–439. Ghoumari AM, et

> al. J Neurochem. 2003; 86: 848–859).

> Ms. Simpson said MS in women tends to break out when ovulation slows

> down, in part because loss of ovulation means loss of the

> progesterone-rich luteal phase. Men have lower baseline progesterone

> levels, but still need this hormone. " I encourage you to measure

> progesterone in both men and women with MS. " Thyro-centricity

> Many MS patients are hypothyroid, and the " soft " symptoms accompanying

> MS such as visual abnormalities and bladder dysfunction are also

common

> in non-MS hypothyroid patients. It is interesting that MRI studies

have

> shown more brain lesions in hypothyroid versus euthyroid MS patients.

> " I'm very thyrocentric, " said Ms. Simpson, pointing to a study showing

> that mean T3 levels were markedly lower in MS patients versus matched

> non-MS individuals. Interestingly, thyroid disorders are roughly three

> times more common in women versus men with MS (Zych-Twardowska E,

Wajgt

> A. Med Sci Monitor. 2001; 7(5): 1005–1012).

> Hypothyroidism slows liver function, which in turn slows clearance of

> estrogen and estrogen levels build up. That may not be a problem for

MS

> women, but it can be detrimental to MS men.

> Good thyroid function is essential for neural health. Many common

> complaints like " sciatica " and low back pain are strongly associated

> with low thyroid, and usually improve with thyroid therapy. If a

patient

> does not respond to T3, check reverse T3; if that is high, it can

block

> responsiveness to the exogenous T3.

> " If the problem is 'upstream' in the sense that it is between the

> pituitary and the thyroid, it won't show up as a T4 or TSH

abnormality, "

> Ms. Simpson explained. " You really need to look at levels of free T3,

> the active metabolite. Low T3 is very common among MS women. "

> Ridged nails and loss of eyebrows are common and very suggestive signs

> of functional hypothyroidism. " These people will show nice normal T4

and

> TSH levels, but if you look at free T3, it will be very, very low. "

> Thyroid dysfunction can be caused by many of the same things that

cause

> pituitary-hypothalamic dysfunction, including chronic stress, toxin

> exposures and physical trauma. " My symptoms started within a year of a

> severe whiplash injury, " Ms. Simpson said.

> Hypothyroidism often precedes adrenal fatigue and vice versa, because

> the endocrine glands are interrelated. " If you are trying thyroid

> treatment and you get either no response or a hyper-response, it is

> usually due to adrenal dysfunction. The exogenous thyroid hormone is

> trying to increase metabolism, which puts pressure on the adrenals.

But

> if the adrenals are burnt out, they cannot step up properly. " In this

> situation, it is very important to get the patient on an adrenal

support

> program with vitamins, minerals, adrenal glandular formulas and low

dose

> cortisol. " MS patients are almost always going to need low dose

> cortisol. "

> There are many aspects and nuances of hormonal therapy for MS, and

> almost by definition, treatment must be individualized. When done

right,

> it can make a world of difference in restoring MS patients to more or

> less normal life. " I have a lot of energy and I'm in much better shape

> than most of my girlfriends, " said Ms. Simpson, who now works a solid

> 12–14 hours per day.

> This approach requires considerable patient effort, and it is not

cheap.

> Hormone testing may be covered by insurance, but the bioidentical

> hormone treatments and other ancillary supplements can cost patients

> over $300 per month. Still, that's not bad given that conventional

> immunomodulatory drugs cost roughly $1,500 per month, have many side

> effects, and little disease-modifying benefit.

>

> Ms. Simpson, along with Dr. Barney Van Valin, established the Hormone

> Research Center, a clinic in Solvang, CA (tel. 805-693-8700)

> specializing in hormone-based treatment of MS and other

> neurodegenerative diseases. She is currently a co-investigator on a

> study of the impact of bioidentical estrogen (E2) and progesterone (P4

)

> in women with MS.

>