Yesterday I talked about an issue that many women face, Polycystic Ovarian Syndrome (PCOS). In that article I discussed a little bit about the Ovarian-Adrenal-Thyroid (OAT) axis, and it’s involvement in the issue of PCOS. After some amazing feedback that I received from it, I felt the tug to expand on it just a bit more in an effort to help clarify things for women who feel like this might be the cause of many issues they are dealing with. I am a firm believer that you should NOT feel like you can’t get through the day without 10 naps, that you should NOT feel like you have no energy, that you’re exhausted, can’t think straight, and worse – feel like you are just living in a shell that was once you and you have a hard time even enjoying life as it seemingly passes you by. So, if you are a woman that deals with things like:
Brain fog/poor memory Hair loss
Dry skin Frequent headaches
Digestive issues Tender breasts
Joint & muscle aches Chronic fatigue
Loss of libido Mood swings
Allergies, frequent infections Low cold tolerance
Depression &/or anxiety Sleeplessness/un-restful sleep
Difficulty losing weight/weight gain Difficult PMS
Irregular/Scanty/Heavy menstruation Water retention
Low blood sugar (hypoglycemia) Sugar & caffeine cravings
A key part of the OAT axis and where the stool topples over (it makes sense if you read the last article) typically starts with the adrenal glands. I like to refer to these little glands as kidney hats. Seems a little silly, but helps you remember doesn’t it! They sit on top of either kidney and although they are small, they are mighty!! They are important for the production and regulation of MANY different hormones including the current ‘buzz’ hormone, cortisol. Cortisol is important for the “fight or flight” response (sympathetics) of your body. It’s like your body’s alarm system. When you are under sudden duress, your body signals the sudden release of cortisol. This allows you to increase speed, endurance, focus better, hear better, and even see better…..for a period of time. This is GREAT if we ever find ourselves suddenly being chased by a bear (or for those of us in my neck of the woods, and nice big Gator). The problem is in order for us to be able to be able to do all of this, we have to shuttle the energy from elsewhere. That means important things like memory and digestion are ignored for the time being, because the body doesn’t care if you need to digest the meal you just ate. The body cares about moving a whole bunch of energy to the large muscles in your legs to help get you the heck out of there!
So with all that being said, cortisol is a great hormone, when we really need it. The problem is that in our society today, we are CONSTANTLY being stressed and stimulated. Our flight or fight response is constantly going and we are more often than not, dumping out way more cortisol than we should be. So we not only find ourselves in a heightened state, but we also have trouble with things that our rest and relax (parasympathetics) should be dealing with, such as proper digestion and regulation of heart rate. There are also a ton of other associated hormones and neurotransmitters that do other things in your body, meaning that if you have decreased parasympathetic responses, then you affect all of those as well.
Now we focus back on the woman that is under continued stress. If she also deals with conditions such as PCOS, endometriosis, just had a difficult pregnancy, has 4 kids under 4…..you get my drift….. she’s stressed! So the adrenals are working overtime to try and continue cranking out the continued cortisol that it needs. However, the adrenals can’t keep up.
There is an amazing hormone called pregnenolone. This hormone is made in the adrenal glands. It is a precursor to many other important hormones like DHEA, estrogen, progesterone, testosterone, and more. So progesterone, coming from pregnenolone, is then used to make…..drum roll please…….cortisol! So now our tired, stressed, exhausted woman begins to steal more progesterone in an effort to keep cranking out cortisol.
Are you still with me?
Progesterone is a hormone complementary to estrogen. It helps maintain uterine lining during pregnancy, it’s needed for breast development and breastfeeding, and it also works with testosterone as another precursor hormone. It helps to regulate the menstrual cycle, keep you calm, regulate your mood and sex drive, and even helps with weight stabilization. Can you see how if you begin to pull progesterone for cortisol production, progesterone goes down? Meaning all the things that progesterone helps with, start to disappear and you begin to see mood swings, irregular menstruation, weight gain, low libido, etc. While we could just supplement with progesterone, it doesn’t actually fix the issue and it will only work for the short term.
So let’s recap:
Increased stress with poor nutrition, being overworked, etc = decreased cortisol production from the adrenal glands, because they can’t keep up with the demand. Because they can’t keep up, they start pulling from progesterone to make more. This means that there is less progesterone = more estrogen in the body. This is when we then start to see Estrogen Dominance rear it’s ugly head.
Estrogen is crucial for everyday functioning in women. It supports and promotes the development of female characteristics in the body. Basically, it works alongside progesterone to help make us pretty! But when we have too much estrogen, it can back fire big time. We begin seeing mood swings, frequent headaches, decreased libido, fibrocystic lumps in breasts, bloating, increased weight gain around hips and waist, menstrual problems, and more. The liver works to help clear out excess estrogen from the body. So we should detox and support the liver then and we’ll be fine, right?! Well….kind of. Remember how I said we’re cranking out cortisol because we’re in a state of fight or flight most of the time? And that when we are in this state, our body focuses less on things like digestion? That includes processes like liver detoxification. Now, our bodies are great at adapting. So these processes are still happening. Otherwise we wouldn’t live very long. But our bodies are also getting very confused as there are all of these different signals happening at once, and it’s working overtime to try and keep up.
So now we have Estrogen Dominance. Because there is this Ovarian-Adrenal-Thyroid axis, we’re now going to start seeing problems with the thyroid gland as well. Thyroid hormones are made in the gland mostly in the form called T4, an inactive form of the thyroid hormone. There is also a little of the active form (T3) that is made there as well. These hormones are then sent out and circulate through to body to be used where and when they are needed. The inactive T4 form is converted to the active T3 form whenever it is needed for energy in the cells. Ingenious really! I mean, are our bodies amazing or what?! The thyroid just says, here you go! Use it wherever and whenever! Of course, that’s when our bodies are working like they are suppose to be working too.
Estrogen can actually prevent the conversion of inactive T4 to active T3. Yep, an “uh-oh” is an appropriate response. If you have Estrogen Dominance, you now have more thyroid hormone caught in the tissues. This means they are just hanging around rather than being free (T3 form) and active to be used by the body’s cells. Now, our body has this great system called a negative feedback loop. This is when signals are sent back to the glands (and the brain in some cases) that says “hey guys, we’ve got plenty, we don’t need anymore). Then the glands say “ok!” And hormone production slows. Normally this is perfect. However, in this case it only makes matters worse as signals are being sent back to decrease the production on an already low supply. It’s like putting your hormones on back order.
Increased estrogen not only blocks the conversion of inactive T4 to active T3, but also disrupts the communication from the brain to the adrenal glands. So we’ve not only pulled the progesterone to make more cortisol, but we’re also now producing less cortisol in general, because estrogen is blocking communication signals (despite the continued need for it). Over time, because of long-term stress, our body senses the lowered adrenal function. So our body’s solution is to go, “let’s conserve!” Normally, this would great. Except that in this case, the last thing we want to do is start conserving an already lowered supply. But our bodies just continue on and begin to convert the already low levels of active T3 into something called Reverse T3. This is all done in an effort to conserve energy usage. It’s like suddenly throwing on the brakes. However, if too much is converted in a short period of time, a person can literally feel like their body is shutting down. Debilitating fatigue, memory loss/fog, and even difficulty breathing with any activity can occur.
The whole idea behind it is that when the stress decreases, things will begin to return to “normal”. T3 will stop being converted to Reverse T3, and the body will again resume typical operations. However, with lowered thyroid function and lowered progesterone combined with stressed adrenals, women begin to find themselves in a vicious cycle. This cycle is one that is difficult to break. It takes time (we’re talking YEARS in some cases), effort, and patience. And for anyone who thinks more and more exercise is the solution to the growing waist line typically associated with this, I'm here to challenge you on that. Intense exercise is going to tax the adrenal glands even more, meaning it's not the best option. After you begin treatment for the OAT axis imbalance, you can start to introduce gentle exercises and eventually work your way back up to more intense cardiovascular exercises, based upon your physician's recommendations. Treating OAT axis imbalance requires having a physician who doesn’t compartmentalize the body. It HAS to be approached from a holistic standpoint, fully understanding ALL the components that are involved. However, it can be done!!
If you are tired of being tired, let’s talk. There are options for you!
Dr. Stewart is a Chiropractic Physician, Integrative Nutritionist, and Paramedic. Having personally fought with Polycystic Ovarian Syndrome, Ovarian Torsion, Estrogen Dominance, and Adrenal Resistance, Dr. Stewart has a passion for helping women of all ages regain a strong grasp on their health to live the best life possible.