Thursday, November 5, 2009

Female Hormones and Lyme

Lyme and co-infections affect ALL hormones by interfering with the parts of the brain that control hormone production, the hypothalamus and pituitary gland. All hormones (thyroid, adrenal, growth hormone, melatonin, ADH (anti diuretic hormone), and sex hormones are often deficient.

In addition to low hormones, hormone receptors can be affected- so blood tests may be "okay," but you feel like your hormones are low (see my women's health website, phulicohanmd.com for lists of low hormone symptoms). In addition to low hormones our liver can have problems activating and breaking down (metabolizing) hormones. So what does this mean?

Well, we infected ladies can become raging lunatics- particularly those of us still cycling (thank God I am 53 and done!). You can expect worsening Lyme symptoms during PMS weeks, (highest hormone levels) and during (or right after) your period (lowest hormone levels). To complicate this further, Lyme has its very own 4 week cycles......

So what's chronically infected woman to do? Two things: (1) support your liver and (2) support your sex hormones.

Liver Support

The liver is where hormones are processed, activated and broken down. There is a saying in Chinese medicine,"happy liver, happy woman."

In Lyme our liver is already overwhelmed clearing away dead bacteria, and processing antibiotics/medications and hormones. It's no surprise that liver nutrients become depleted, leading to a "congested" liver. This can cause us to feel sluggish, irritable and depressed. We may also have headaches, nausea, breast swelling, menstrual cramps, abdominal bloating, constipation or diarrhea, and nipple itching. Add to this hormone fluctuations and Lyme, Bart,and Babesia toxins and its a mess.

Things that help the liver:

1. Avoid alcohol, caffeine, dairy, sugar as much as possible (I know we are doing this most of the time so let’s not get too hard on ourselves- my opinion, this diseases is hard enough). If you have to cheat do it before ovulation!

2. Supplements like milk thistle and Lipotropic Complex (I like the one made by Integrative Health). Talk to your doc about these. At first use them daily (start slow to avoid nausea if your liver is particularly sluggish) and after you are doing better you can use them in the 2 weeks before your cycle.

3. Liver nutrients are important and can be taken anytime of the month, but run them by your doctor! The most important supplement for the liver is probably vitamin C, 1000 mg 2-4 times/day (too much and your bowels can loosen), lipoic acid, 100 mg twice daily, B vitamins- particularly Folic acid (many of us need methyl folate (Deplin prescription, or Folapro, by Metagenics), methyl B12, NAC, 500-1500 mg/day, Calcium -D glucarate, 1500-3000 mg/day (I talk about this in my book), reservatrol (expensive and I don't use it much but popular in Lyme books), pycnogenol (another expensive one use a little here and there). CoQ10 is great and can be measured- but it interferes with Mepron action so has to be used at the right time.

4. Acupuncture is great for Lyme and if possible schedule appointments in the 2 weeks before your cycle.

5. Food: wheat grass, green vegie drinks (see my juicing blog below), ground flax seeds (must be ground to work), sprouts (all of them and so cheap to do yourself),legumes (beans and lentils), dark greens (kale is best!!), cruciferous vegies (bok choy, broccoli, cabbage...)

6. Exercise. I know must of us can barely get out of bed many days but what ever you can do helps. Gentle movements can help the liver. Whatever stretching you can do helps. Yoga is great and helps the immune system.

7. Detox such as body brushing followed by infrared sauna or detox baths and colonics all help

Supporting Your Hormones

Natural hormone support is safe and can help you deal with Lyme. At any age, the stress of chronic infections lowers progesterone, (a precursor to cortisol). I like to think of progesterone as a "luxury" hormone because she is only made during "good" times ie times suitable to make babies (no infections, stress and lots of food). Lyme and chronic stress are not such times (maybe nature's way of protecting us against getting pregnant while infected). Also our infinitely wise body will always make cortisol over progesterone. Evolution does not care if we are a little crabby or bloated, while fighting wild beasts and infections.

Low progesterone can cause: heavy bleeding, short cycles (every 26 days of less), skipped cycles, headaches, insomnia, PMS/moodiness/sadness, bloating, or bowel upset, all before the period.

If you suspect your hormones are off, these blood tests (on days 19 to 21 if you are cycling) can help:

-Progesterone (it should be over 11).
-Thyroid (TSH, free T3 and free T4). TSH should be over 2.0

If needed, use natural progesterone (orally or skin cream) on days 15- 25 of your cycle. (Details of how to do this are in my book, The Natural Hormone Makeover)

If your ovaries are forty years old (or older), know that you no longer make progesterone reliably and your estrogen may be starting to drop also.

Estrogen normally starts to fall a few years later than progesterone, but Lyme can speed this up. It is not uncommon for infected women to show signs of low progesterone and low estrogen in their late thirties.

Signs of low estrogen are headache, fatigue, hot flashes, sweats, lack of sex drive, vaginal dryness, urinary frequency, hair loss, dry eyes, dry skin, dry throat, dry everything- all worse during and after the period. These symptoms are a lot like a bad Lyme day, so if in doubt, measure an estradiol level. It changes day to day but, if its under 60, consider using natural Estradiol, (skin lotion, gel, or patch).

Vaginal discomfort (dryness, pain, and itching) can be hard to tell from yeast overgrowth. Estriol vaginal suppositories (made by Bezwecken and available online) are great. I alternate these with yeast suppositories as needed. Let your doc know if you start these (Estriol). Estriol vaginal suppositories are safe (they can be used by women with breast cancer). Start with one/per day for a week, then one every 3-4 days as needed.

Transdermal (topical) testosterone is sometimes needed and can even be used vaginally. I only give it after I have supported a woman's DHEA (DHEA-S above 120), as most women make testosterone from DHEA. You have to be careful with Testosterone as it can cause hair loss (use Saw Palmetto to avoid this). Be sure to have your doc check a free testosterone level.

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