The Paleo Mom again, with the explanation of why my rebound is so s-l-o-o-o-w

There's this...
When I came back from Colombia, I was really, really unwell and in a zombie phase, to put it plainly. Multiple naps, didn't know what was wrong, and starting to feel like I was somehow, someway, just simply doing "it" wrong. Where "it" was life...

Then I found out I had a parasitic infection. Ew. But, an explanation at least. I expected to feel better once that was solved; and I did feel better, but I didn't feel well.  I have an easier time being gentle, encouraging, and patient with others, but for myself? Not easy.  Not easy at all...

So I kept working with the doctor who diagnosed the tricky parasite. I do not like feeling tired, weak, unhealthy, or unproductive and I'm quite stern with myself. I hoped that I'd bounce more quickly, when I didn't, it was rough...because there are things I want to do! I have kids to take care of and a business to build and a husband with a very demanding work schedule that means I parent in what I call 'solo-flight mode' quite frequently. I don't enjoy the thought that there might be things I can't do...that is a bit of a nightmare phrase actually.  "Can't"?!! No thanks.  Getting "can't" to be a less obscene part of my vocabulary is possibly the greatest challenge I've faced, to date. It's rough to think that "can't" is part of life - but that's the challenge, and I'm taking it on! I'm trying hard to coach myself in a way that I might coach a friend... 

That's a long introduction to what the PaleoMom is talking about.  I've been working at accepting that the parasitic infection (that went undiagnosed for almost two years) dealt my system some heavy blows...and has caused extreme physical stress for this body of mine.  That level of stress is tricky, because I've been walloped from the inside and nothing really showed.  Well, except the knee injury - that was visible... and more to heal from. I think I healed more slowly because I wasn't in 'fighting shape' when I got hurt-but I'm digressing a touch, but only a touch.  Healing is hard work, and I've been working hard from the inside out.

So the long term effects of healing/living with infection and injury is that the body's messengers for stress response (i.e. hormones) prepare to survive, rather than thrive.  Survival is shorter term, thriving is longer term...and the transition is tough, which brings me to the PaleoMom's explanation http://www.thepaleomom.com/chronic-stress-leads-hormone-imbalance/ here.  I'm leaving the link, because credit where credit is due--and I'm including the text here as well. While the stress was physical, the kicker now is that while supporting my body with exercise, nutrition, and meditation, I have to accept the speed of healing physically-- I'm still working at the mind-aspect of healing up...because that is something I can influence.

She has lots in there about sex hormones- so I'll just add, it's not 'Barry White crooning in the background' sex hormone, it's more like gender definition sex hormones.  Females have hormone cycles that impact whole body health - so in short, it's not about libido - it's about how women are built to function, and the libido aspect of hormones is a bit arbitrary... Reading/Biology note- in the article she mentions positive and negative feedback loops; the positive meaning "more and more" of whatever is happening, and negative feedback means triggering a shutdown, or slowing of whatever hormone is being made...so with that - here's the PaleoMom!

The HPG Axis

The primary role of the HPG Axis is to control reproduction, however it is also important for development (puberty and aging) and the immune system.

 The hypothalamus releases Gonadotropin-Releasing Hormone (GnRH), which signals to the pituitary gland to secrete two hormones:  Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH).  LH and FSH signal to the gonads produce estrogen and progesterone in women, and testosterone in men.

Because women’s bodies are particularly susceptible to effects of stress on sex hormone levels due to interaction between the HPA and HPG Axes, I’m going to focus from this point forward on the female HPG Axis.

Estrogen and progesterone also signal back to the pituitary gland and the hypothalamus.  Generally, estrogen provides positive feedback, further stimulating the HPG Axis (although there are some mechanisms for negative feedback as well).  Progesterone provides negative feedback, inhibiting the HPG Axis.  In the menstrual cycle, the positive feedback from estrogen prepares the follicle in the ovary and the uterus for ovulation and implantation. When the egg is released,  progesterone production inhibits the hypothalamus and pituitary, blocking the positive feedback from estrogen.  If the egg is fertilized, the fetus takes over production of progesterone (why you don’t ovulate again while pregnant). If conception does not occur, progesterone productions starts to decline, which allows the HPG Axis to be stimulated, causing menses and the whole shebang to start over again.

This is an oversimplification.  There are other hormones at play here.  And all these hormones are controlling dozens of aspects of fertility and menstruation, as well as things like linking back to thyroid function, bone formation, and immune health.  And it’s very important that these hormones cycle in rhythm with each other.  And when one of the players is out of tune, the whole symphony sounds wrong.

The Links Between the HPA and HPG Axes

The HPA and HPG Axes are not isolated endocrine systems.  There’s crosstalk.  Plenty of it. For instance, progesterone activates the HPA axis.  This is probably part of the metabolic controls, shift in immune system, and shift in the body’s resource priorities during pregnancy.  Probably why we also tend to have such strong food cravings in the days leading up to our periods starting.

But the links are more insidious than food cravings.  Cortisol inhibits the HPG Axis at every point.  It reduces the production of GnRH by the hypothalamus.  It reduces the production of FSH and LH by the pituitary gland.  It suppresses ovary function, reducing estrogen and progesterone secretion.  This is because, if you are running away from a lion, reproduction is just not a priority.  The body takes those resources and uses them for immediate survival.

 

But, what if the lion never stops chasing you?  When you are chronically stressed and especially if your stress level is high (and you aren’t spending time outside, and you aren’t active during the day, and you are staying up late and not getting enough sleep and using caffeine and sugar to get you through the day), it’s basically the same physiologic effect of chronically running away from a lion.  Reproduction (and digestion, and bone formation, and growth, and parts of the immune system, and collagen formation etc. etc. etc.) never get prioritized.

So, if you’re chronically stressed, estrogen and progesterone can be decreased.  But, what’s more, the body converts progesterone into cortisol.  And into estrogen. And testosterone (a hormone that the female body still needs, albeit in much lower concentrations than in men).  Yes, progesterone is a substrate from which cortisol and estrogen and testosterone are synthesized.

The following diagram shows how these essential hormones and their precursers and  intermediaries are produced from cholesterol (yet again, the essential cholesterol!).

Yes, it’s complex.  Here’s the important part:  cholesterol (the backbone of all steroid hormones) is converted into pregnenolone.  Pregnenolone is the converted into either DHEA or Progesterone.  DHEA is converted into testosterone and estrogen.  Progesterone is converted into cortisol.  Still with me?

When the body is stressed, and it starts using up progesterone to make cortisol.   It needs more progesterone, so it starts using more pregnenolone to make it.  This is called pregnenolone steal.  The HPA Axis is literally stealing the precursor for testosterone and estrogen (because pregnenolone is being used to make progesterone instead of DHEA) from the HPG Axis.  What’s more?  It’s using up all that progesterone to make cortisol.

By the way, this is also how chronic stress leads to low testosterone in men (one of the symptoms of which can be balding!).

There’s some extra complications here.  When DHEA is low, the body tends converts testosterone and what little DHEA is being produced into estrogen.  Environmental estrogens (like the phytoestrogens in soy or flax seed or walnuts, or like the xenoestrogens in some plastics) further increase estrogen.  Nutrient deficiencies and lifestyle factors like type and frequency of activity can further influence exactly what hormones are getting produced and what hormones aren’t.

The Take-Home Message

The take-home message is this:  chronic stress messes up your sex hormones.

How might you know if chronic stress has negatively impacted your hormones?  Symptoms include:  depression, fatigue, anxiety, hair loss, facial and body hair growth, headaches, dizziness, brain frog, poor memory, low libido, vaginal dryness, breast swelling and tenderness, fibrocystic breasts, thyroid disorders, osteoporosis, PMS, dry or wrinkly skin, urinary tract infections, endometriosis, uterine fibroids, weight gain (or resistance to weight loss), water retention, bloating, sleep disturbances, mood changes, irregular periods, loss of periods (amenorrhea), heavy periods, and infertility.

The natural follow-up question is what can you do if you think you have hormone imbalance as a result of chronic stress?  Well, first and foremost:  reduce your stress!  Say “no”, ask for help, get enough sleep (at least 8 hours!), be active (but avoid strenuous activities), have fun, laugh, spend quality time with loved ones, orgasm, spend time outside, learn to meditate, make time for hobbies, and go for a walk.  It’s time to give up caffeine and alcohol (temporarily!).  Support liver health by eating a nutrient-dense diet that includes organ meats, seafood, and plenty of vegetables.  I recommend The Hormone Cure by Dr. Sarah Gottfried and Sexy By Nature by Stefani Ruper as two excellent resources for optimizing diet and lifestyle to restore sex hormone balance.

This is serious stuff, and depending on a variety of factors, diet and lifestyle are sometimes not enough to set things straight. If you are going to consider hormone balancing therapy, know that it will not work if your diet isn’t clean (nutrient-dense Paleo, meaning a Paleo diet with a focus on organ meat, seafood, and vegetables, should suffice) and your lifestyle isn’t optimized (stress is low, activity level is moderate, and sleep is ample).  Get tested and find a skilled medical professional to work with before you start messing around with supplements and taking hormones.

This is me again - please comment if you've found this useful, inspiring, or if it's sparked questions for you.  She goes right into the science of it...