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Hormones, HPG axis- For Sharon

Posted: Thu Apr 17, 2008 8:49 pm
by cheerleader
Hi Sharon,

Wanted your wisdom and input....

We had my husband do a saliva hormone test, recommended by a holistic doc who is a good friend. Jeff has been taking DHEA supplements (50mg) daily, so his DHEA was slightly elevated, but what really surprised my friend were his levels of lutenizing hormone and follicle stimulating hormone...off the charts. His levels were 10x normal. Usually these high numbers signal infertility and testicular failure.

But Jeff's testosterone was normal, just a bit low, and his progesterone and estrone were OK as well. As my doc friend explained it, Jeff's body is working on overdrive to keep his hormone levels normal. She said he "must be exhausted!" And he is...

We're going to get him on a testosterone supplement, to see if his LH and FSH will come back into normal range. We're also going to test his adrenals.

Have you heard of this before, Sharon? If we had just tested his testosterone level, it would have been low normal, and we wouldn't have known anything was amiss. Those LH and FSH numbers show that the MS is affecting his hormones. I wonder if this also happens to women?

any input?
AC

Posted: Fri Apr 18, 2008 7:41 pm
by Shayk
Hi AC

No wisdom but rather some late night rather random comments--

Specific to your husband’s test results, the only research I recall specifically addressing the HPG Axis is this abstract and they only looked at men--

Dysregulation of the hypothalamic-pituitary-gonadal axis in experimental autoimmune encephalomyelitis and multiple sclerosis
The ability of sex hormones to regulate cytokine production is well established, but the ability of cytokines to regulate sex hormone production has only begun to be investigated.

An inverse relationship between cytokine and testosterone levels in male mice with EAE, coupled with an increase in serum luteinizing hormone (LH) levels, suggests that inflammatory cytokines suppress testosterone production by a direct effect on testicular Leydig cells.

Gender differences in the sensitivity of the hypothalamic-pituitary-gonadal (HPG) axis to inflammation may be an important factor regulating the duration and severity of central nervous system (CNS) autoimmunity.
Given the “related articles” that pop up with this abstract it really doesn’t seem the info has been pursued.

Now,
But Jeff's testosterone was normal, just a bit low,
As an FYI, it’s my understanding the men with RRMS in the pilot trial of testosterone also had low normal testosterone levels and even with the trial dose their testosterone levels remained within the normal range. So, I think it’s worth trying testosterone. The bell curve for normal hormone levels is a big one.

Re: the adrenals--I think it’s definitely smart to have your husband’s adrenals tested. For lots of reasons I’ve often wondered if MS may in part be a “disease” of the adrenals. This abstract (full article available) highlights one of the more intriguing reasons.

Congenital adrenal hyperplasia and multiple sclerosis: is there an increased risk of multiple sclerosis in individuals with congenital adrenal hyperplasia?
CONCLUSIONS: Some clues suggest that the association between CAH and MS could be nonincidental: a possible MS susceptibility locus is on chromosome 6p21,
Additionally, I think in one study a majority of people with MS were found to have enlarged adrenals at autopsy. And, some abnormal sex hormone levels found in people with MS are associated with hormones produced primarily in the adrenal gland, i.e. in women for example, a major source of testosterone is the adrenal gland and in one study high and low testosterone levels in women were associated with lesions on MRI.

Time to quit…I definitely agree with your approach AC and think it’s important for both men and women to have all of their hormone levels tested. We all have the same ones.

So glad you’re checking all of this out.

Sharon

Posted: Sat Apr 19, 2008 8:23 am
by cheerleader
Thanks, Sharon....

I knew you'd pull through :)
Once again, I know it's mice, but this really caught my eye-

"An inverse relationship between cytokine and testosterone levels in male mice with EAE, coupled with an increase in serum luteinizing hormone (LH) levels, suggests that inflammatory cytokines suppress testosterone production by a direct effect on testicular Leydig cells."

This would explain why the LH numbers are SO high...cytokines are holding back testosterone, and his body is struggling to keep levels normal.

I'm hoping with bio identical hormones and supplements, we can help Jeff reach some equilibrium.

For those interested, the hormone and adrenal tests are really easy. Just spit into a plastic cylinder! Finding a doc who understands the importance of these tests is the hard part, but there are more integrative practitioners every year.

best,
AC

Posted: Sat Apr 19, 2008 11:10 am
by jimmylegs
i decided to have a look at zinc since i know it's implicated in reproductive function. who knew i would end up reading about rat gonads, but there you go.

http://www.ncbi.nlm.nih.gov/pubmed/779495
Am J Physiol. 1976 Jun;230(6):1730-2.
Function of pituitary-gonadal axis in zinc-deficient rats.
Lei KY, Abbasi A, Prasad AS.
The role of zinc in gonadal function was investigated in rats. The increases in luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone were assayed after intravenous administration of synthetic luteinizing-hormone-releasing hormone (LHRH) to zinc-deficient and restricted-fed control rats. Body weight gain, zinc content of testes, and weight of testes were significantly lower in the zinc-deficient rats compared with the controls. The serum LH and FSH response to LHRH administration were higher in the zinc-deficient rats but serum testosterone response was lower in comparison with the restricted-fed controls. These studies indicate a specific effect of zinc on testes and suggest that gonadal function in zinc-deficient state is affected through some alteration of testicular steroidogenesis.
so i'm sort of taking away that if you fire up the LH, FSH and testosterone in rats, using LHRH, that zinc deficient rats end up with elevated LH and FSH, but lower testosterone than control rats.

on the other hand, there are findings saying that zinc deficiency means low LH:
http://jn.nutrition.org/cgi/content/abstract/126/4/842
so that doesn't match the scenario, but there doesn't really seem to be a lot out there to get a better sense of the amount of debate in the research. if i find anything else i'll come back to it :)

Posted: Sat Apr 19, 2008 11:16 am
by jimmylegs
oh that was fast. more about rats.
http://jn.nutrition.org/cgi/reprint/109/6/958.pdf
In sexually mature, zinc deficient rats serum concentrations of GH and testosterone were significantly lower and serum LH levels significantly higher than in ad libitum fed control rats.
but there's still plenty out there saying LH is down from control in zinc deficiency. they do say the testosterone is down more than the LH, however...