Hormones – Pituitary Insufficiency

The hypothalamus and pituitary are small organs in the brain that are largely responsible for the regulation of most neuroendocrine functions throughout the body. They interact with each other as well as end organs such as the thyroid gland, the adrenal glands, the ovaries, testes, etc…via precise feedback systems which regulate hormone secretion.

Hypothalamic-pituitary insufficiency is common in tick-borne disease manifesting as, hypothyroidism, adrenal exhaustion, endometriosis, polycystic ovarian disease and a host of other hormone mediated diseases. The phenomenon of infectious disease causing such widespread and variable neuroendocrine disorders has not been systematically studied but is often clinically observed and requires nutritional, herbal and sometimes pharmacologic intervention. Return of normal hormone function is important in patients with Lyme Disease if healing is to occur.

The causal mechanism for disruption of the hypothalamic-pituitary-end organ axis in Lyme Disease is not well understood, however, the hypothalamus is encased in collagen, which is known to be a place where spirochetes reside to avoid detection by the host’s immune .

In order to regain health, all of the hormonal systems need to be balanced and normalized.  Additionally, nerve cells (axons) are encased in a myelin sheath composed of fatty acids, a substance that spirochetes are known to utilize. Spirochete residence and inflammation in the hypothalamus or pituitary may cause disruption of normal hormone regulation. However, proinflammatory cytokines such as interleukin-1, interleukin-6, and interleukin-8 produced by the host’s immune system in response to an infectious agent may also cause hormonal dysregulation. Magement of these neuroendocrine pathways can be achieved only after identifying which organs (if any) are affected. Consult your doctor with concerns about optimal hormonal health, as hormones are also intricately involved in more subtle signs of health such as a sense of well-being and optimism.

The hypothalamus and pituitary are small organs in the brain that are largely responsible for the regulation of most neuroendocrine functions throughout the body which regulate hormones. They interact with each other as well as end organs such as the thyroid gland, the adrenal glands, the ovaries, testes, etc…via precise feedback systems which regulate hormone secretion.

Hypothalamic-pituitary insufficiency is common in tick-borne diseases manifesting as, hypothyroidism, adrenal exhaustion, endometriosis, polycystic ovarian disease, and a host of other hormone-mediated diseases. The phenomenon of infectious disease-causing such widespread and variable neuroendocrine disorders has not been systematically studied but is often clinically observed and requires nutritional, herbal, and sometimes pharmacologic intervention. Return of normal hormone function is important in patients with Lyme Disease if healing is to occur.

The causal mechanism for disruption of the hypothalamic-pituitary-end organ axis in Lyme Disease is not well understood, however, the hypothalamus is encased in collagen, which is known to be a place where spirochetes reside to avoid detection by the host’s immune.

In order to regain health, all of the hormonal systems need to be balanced and normalized.  Additionally, nerve cells (axons) are encased in a myelin sheath composed of fatty acids, a substance that spirochetes are known to utilize. Spirochete residence and inflammation in the hypothalamus or pituitary may cause disruption of normal hormone regulation. However, pro-inflammatory cytokines such as interleukin-1, interleukin-6, and interleukin-8 produced by the host’s immune system in response to an infectious agent may also cause hormonal dysregulation. Management of these neuroendocrine pathways can be achieved only after identifying which organs (if any) are affected. Consult your doctor with concerns about optimal hormonal health, as hormones are also intricately involved in more subtle signs of health such as a sense of well-being and optimism.

Andropause is the natural male equivalent of menopause, characterized by a declining state in DHEA and testosterone levels, beginning as early as age 30. When a man has chronic Lyme Disease, persistent inflammation and infection cause significant dysfunction in the hypothalamic-pituitary axis, which ultimately leads to the decreased production of the androgen steroid hormones.

Symptoms of low DHEA:

• Decreased energy
• Decreased libido
• Decreased muscle strength
• Depression
• Difficulty dealing with stress
• Fatigue
• Irritability
• Inability to concentrate
• Insomnia

Symptoms of low testosterone:

• Anxiety
• Depression
• Low libido
• Inability to maintain erection
• Poor memory
• Inability to multitask
• Irritable
• Poor stamina
• Weight Gain

DHEA has a protective effect against:

• Autoimmune Diseases
• Cancer
• Heart Disease
• High cholesterol
• Diabetes
• Obesity

Bioidentical hormone replacement of testosterone can be done very safely with the proper laboratory evaluation and follow-up. Generally, men feel much better and gain a much greater sense of well-being when testosterone levels are returned to normal. Consideration of other hormones such as cortisol, insulin growth factor, insulin, and growth hormone are often needed, as all of these hormones are intricately related to the maintenance of optimal health.

BHRT, or bioidentical hormone treatment, is a method of balancing hormones that are naturally based using yams, soy, or peanut oil.  It IS NOT the use of synthetic hormones.  For women and men, it is essential to maintain a healthy balance of hormones throughout life, as the estrogens (estrone, estradiol, and estriol), progesterone, DHEA, pregnenolone, and testosterone all play a significant role in maintaining health in differing doses and combinations at differing times in life. These hormones form an intricate web that interacts with many other hormones such as insulin, cortisol, and thyroid hormones, allowing for healthy bodily function.

Hormones regulate cellular functions and essentially direct the actions of either anabolism (to build) or catabolism (to use) which should remain in balance to remain healthy.   Alterations in one hormone generally affect the production and release of other hormones.

When a patient is stressed by the presence of chronic infection(s), changes in cortisol, thyroid, and sex hormones frequently occur.  Inflammation mediated by proinflammatory cytokines compromises cellular and tissue function which interferes with optimal organ function.  Additionally, because all of the hormones work in concert, changes in cortisol production and release do not only affect the sex hormones, but also the metabolic hormones such as insulin, somatostatin, and leptin.  In addition to thyroid hormone dysregulation and mitochondrial dysfunction, this may be one of the reasons Lyme Disease patients often gain weight.  They are in general, hormonally compromised.

By using bioidentical hormone treatment, is a method of balancing hormones that are naturally based using yams, soy, or peanut oil, thyroid replacement, adaptogens (herbs that help to regulate cortisol), lifestyle modifications, and diet, we can correct the hormonal imbalances with natural substances (i.e., botanical medicines and herbs) using a combination of creams and oral capsules to optimize hormone function.  Patients will experience a greater sense of well-being which will dramatically contribute to their ability to heal from infection(s).

Women who have had or have Lyme Disease often have a difficult time during Menopause.  They may experience a “flare” in their symptoms due to the declining levels of estradiol and progesterone primarily, but also thyroid hormone, cortisol, DHEA, pregnenolone, testosterone, and growth hormone.  Weight gain around the midsection is common for women in perimenopause and menopausal states and can become even more of a problem when Lyme Disease is present due to metabolic dysequilibrium.

The bacteria that causes Lyme Disease, Borrelia burgdorferi, as well as coinfections such as Babesia, Bartonella, Rocky Mountain Spotted Fever, Q Fever, Ehrlichia, etc… initiate the activation of proinflammatory cytokines such as IL-1, IL-6, and TNF alpha.  This creates an internal condition of “endotoxemia”, in which the neuroimmune excitotoxicity causes the hypothalamus and pituitary gland to “behave” irregularly, affecting hormonal signaling to tissues.  During a women’s time of hormonal transition, these factors can contribute to exacerbations in fatigue, brain fog, poor memory, insomnia, mood lability, inability to multitask, headaches, increased joint pain, digestive issues, increased allergies, and a host of other symptoms that were not previously present, or were present to a lesser extent.

Symptoms of Progesterone Deficiency (P4) which declines more quickly than estrogen levels and contributes to an even greater hormonal imbalance:

• Abdominal Bloating
• Depression
• Emotional
• Irritability
• Insomnia
• Mood Swings
• Water Retention
• Weight Gain

Symptoms of Estrogen Deficiency (usually Estradiol – E2):

• Anxiety
• Brain Fog
• Breasts lose their shape and elongate
• Dizziness
• Dry Skin
• Flushing
• Frequent urination and frequent urinary infections
• Heart Palpitations
• Night Sweats
• Restless sleep
• Vaginal Dryness

Risks associated with Estrogen deficiency:

• Depression
• Digestive difficulties
• Heart attack and cardiovascular disease
• Metabolic Disorders
• Osteoporosis
• Vaginal infections

Symptoms of metabolic imbalance in menopause:

• Allergies
• Arthritis
• Anxiety
• Bloating
• Food cravings (alcohol, caffeine, sugar)
• Headaches
• Poor memory
• Difficulty handling stress
• Difficulty with sleep

Dr. Marra is particularly aware of these difficulties that women experience during this time of declining hormones and will help them regain hormonal balance which results in a better sense of well-being and general overall health.  She uses only bioidentical hormones coupled with botanicals and vitamins if needed and generally has great success in returning patients to optimal health.  Additionally, Dr. Marra treats underlying metabolic issues that result from chronic infection, which also contribute to symptom flares during perimenopause and menopause.  Having experienced all this herself, she brings not only professional experience, but personal experience as well.

Menopause can be a joyous time, as a woman enters a new phase of life, but imbalanced hormones can disrupt that joy.