The Connection Between Female Hormones and Autoimmune Disease
Why Do Women Suffer From Autoimmune Disease More than Men?
Nearly 75% of the 24 million Americans suffering from autoimmune disease are women, according to the American Autoimmune Related Diseases Association (AARDA).
Women appear to mount larger inflammatory responses than men when their immune systems are triggered, thereby increasing their risk of autoimmunity. Sex hormones seem to be involved since many autoimmune diseases fluctuate with hormonal changes such as those occurring during pregnancy, the menstrual cycle, or when using oral contraceptives.
A history of pregnancy also appears to increase the risk for autoimmune disease.
Low Hormones Are a Link
The sex hormone that is commonly low in such women is DHEA.
DHEA is produced by the adrenal glands, the reproductive organs and the brain. It is a natural steroid and is used by the body to make the male and female hormones, testosterone and estrogen respectively.
DHEA is known to have anti-inflammatory effects and it has been proposed that a DHEA deficiency is a contributing factor in autoimmune diseases. A study was done to look at that precise effect and the study’s conclusions have been supported by other similar research that I think you’ll find it quite interesting.
The Journal of Clinical Endocrinology & Metabolism Vol. 94, No. 6 2044-2051(2009) presented an article entitled “Low Serum Levels of Sex Steroids Are Associated with Disease Characteristics in Primary Sjogren’s Syndrome; Supplementation with Dehydroepiandrosterone Restores the Concentrations”.
The authors aimed to investigate if there was a relationship between steroid levels and the disease characteristics of Sjogren’s, an autoimmune disease. They based their premise on the known data that the hormone DHEA not only declines with aging but is reduced in Sjogren’s, an autoimmune disease.
The study was populated by 23 post-menopausal women with primary Sjogren’s syndrome and subnormal levels of DHEA. The study was a 9 month controlled, double blind crossover study (a high quality study) where the DHEA level was assessed by sophisticated laboratory measurements and typical symptoms of Sjogren’s such as dry mouth and eyes and salivary flow rates were similarly assessed.
Those Given Hormones Showed Improvement… But Wait
Results revealed a strong correlation between low DHEA and Sjogren’s symptoms.
DHEA and its sex hormone metabolites (testosterone and estrogen) were found to increase with DHEA supplementation but not with the placebo. Symptoms such as dry eyes were seen to improve as estrogen levels rose. The researchers concluded that the disease manifestations of primary Sjogren’s syndrome were associated with low sex hormone levels and the supplementation of DHEA allowed the body to transform it into androgens (testosterone) and estrogen, with testosterone production predominating.
Please allow me to add some personal interpretation. For the most part I agree with the premise and applaud the results. The facts that autoimmune disease occurs more often in women, that women frequently have low DHEA and that androgens (testosterone) have anti-inflammatory effects that can benefit autoimmune disease are all true.
Let’s Look at the REAL Root Cause
But do we simply want to give such women DHEA and call it a day? I don’t think so. I propose that we do three things:
First, evaluate hormonal levels in women regularly.
Second, address WHY their hormonal levels are imbalanced.
And third, when supplementing with hormones such as DHEA ensure that the delivery system is one that mimics what the body does naturally.
Remember that autoimmune disease can begin many, many years before the first symptoms become manifest. Therefore, evaluating hormonal levels in our younger women is a good idea.
When I find DHEA levels that are low my first order of business as a Clinical Nutritionist is to assess why. Frequently it is due to a phenomena known as “pregnenelone steal” that occurs when the adrenal glands (the stress glands) are overtaxed. It is a common occurrence and one of the fantastic abilities of the human body that allows it to divert from one pathway to another when stress is present.
The “steal” pathway diverts the body away from making sex hormones and instead it makes more “anti-stress” hormones. So while adding some DHEA into the mix might very well help, does it make sense that finding out WHY it’s production is being diverted away from making sex hormones would be critical?
I hope so, because it’s the very foundation of the medicine that we practice – functional medicine. Once you understand the root cause of any deficiency or imbalance in the body you can take steps to truly remedy it rather than simply covering it up with taking DHEA or some other substance. Not to keep hitting you over the head with this concept, but supplementing with DHEA as your sole treatment misses the underlying reason “why” since the body is designed to make adequate DHEA.
A common reason for the diversion or “steal” pathway to become initiated is due to adrenal stress from poor absorption of nutrients, unstable blood sugar and the presence of infections – all problems we see with the gluten intolerant patient! While I’m not implying that every autoimmune patient has a gluten intolerance, it’s certainly prevalent enough to warrant screening them.
As we travel down the road to optimal health through removing any food the body isn’t tolerating well, improving the integrity of the small intestine and normalizing adrenal function, there are certainly times when hormonal supplementation is beneficial. I don’t recommend the oral route because the first place the hormone travels after oral ingestion is to the liver, and this can be burdensome to that organ.
When the body makes hormones internally, it delivers them straight to the bloodstream. In an effort to mimic that delivery system we use a buccal route (placed between cheek and gum in the mouth) that does a good job of bringing the hormone directly to the bloodstream and bypassing the liver and digestive tract.
Autoimmune diseases comprise the third leading cause of death in our country and research strongly suggests that its rapid increase is due to environmental factors, especially those that weaken the small intestine. I am committed to early diagnosis while the disease is still hopefully remediable, as well as overall reduction of incidence through addressing digestive and immune system health.
Here at HealthNOW in our Medical Center and Clinical Nutrition Department, we have good success treating autoimmune disease. We follow root cause analysis and put our attention on the intestinal tract and immune system to begin. Through functional medicine techniques, we determine why the body has created the disease and treat at that level – it works well. I hope you find this informative. Please share this information with those who have autoimmune disease themselves as well as in their family.
Do You Have Any of the Above Symptoms?
If you are suffering from any of the problems listed above—contact us for a FREE CONSULTATION. Call (408) 733-0400 to schedule. We are located in Sunnyvale, CA. If you are not local to us, our DESTINATION CLINIC treats patients from across the country and internationally. We will help you find the underlying root cause!
To your health,
Dr. Vikki Petersen
IFM Certified Practitioner
Founder of HealthNOW Medical Center
Author of “The Gluten Effect”
Author of eBook: “Gluten Intolerance – What You Don’t Know May Be Killing You!”