During the month of “love” most of us will be examining the amount of love that is present within our own lives. Although the word love is often abused in today’s society, the expression of love is an inherent need to almost every creature on this planet. From infants and through our entire adult life, love is an important component in our health. Certainly one of the greatest expressions that I’ve heard is “to love and be loved in return”. This is one of the great truths of life. What I find most intriguing about the subject of love, is its relationship to our internal health and hormonal balance. I have many consults in my office involving couples sitting in front of me who are frustrated, fatigued, and becoming depressed due to the lack of love and spark within their relationship. Life has a way to entangle us, causing excessive stress to affect our hormonal balance and metabolism. I challenge most of these couples to simply reflect on their internal health and hormonal balance after which I often bring them back together for conversation and counseling on issues intimacy and sexuality. Intimacy is a complex entity which is often affected by past experience, present and anticipated circumstances, as well as hormonal balance. Hormonal balance is critical in achieving the feelings of vitality, vigor, and maintaining energy. There is nothing more frustrating than feeling exhausted and not being able to show the affection and nurturing intimacy that is necessary in maintaining a sound relationship.
I would like to give you an example of a patient that I took care of in the past who had issues of stress greatly affecting her energy levels, vitality, and even the physiologic process of ovulation and fertility. This patient came to me in her early 30s complaining of severe anxiety and mental withdrawal. She actually had to pull off the road while driving because she was unable to focus and could not perform driving tasks accurately. When I questioned her during the initial consultation, she stated that she had no menstrual periods for over 4 to 5 months. She also stated that her menstrual periods were irregular for many years. She was told by six previous physicians that she would most likely be unable to have a child. Her initial symptoms upon presentation included facial numbness, mental withdrawal, difficulty with speech, hot flashes, insomnia, and severe fatigue both in the evening and in the afternoon. She complained of difficulty with memory as well as persistent drowsiness.
On initial laboratory assessment, she had very low progesterone as well as suboptimal estradiol. She had extremely low cortisol during a four point saliva test with a flat line response throughout the day. This was indicative of severe adrenal stress and a breakdown of hypothalamic pituitary axis. The hypothalamus and pituitary gland communicate to the body and send signals to the adrenal glands to release cortisol under stressful situations. When these situations are persistent and stress is continual, the system can breakdown and cortisol can be detrimental. Please see a recent hormonal blog I wrote called “The Greatest Super Bowl of Your Life”. This patient’s thyroid was also affected by her adrenal stress as she could not convert the active form of thyroid (T3) from (T4), the most abundant form of thyroid from our thyroid gland. This made her entire metabolic breakdown much worse. Adrenal stress often involves issues of thyroid function, pancreatic function and glucose utilization, as well as imbalance in our immune system. This in turn will affect oxidative stress on the brain and neurotransmitter balance as well.
The breakdown in this example came from an overproduction of stress on the body which affected adrenal cortisol release. Overproduction of cortisol will cause clinical depression, elevated androgens (male hormone), and elevated blood glucose levels. This causes an excessive amount of insulin secretion which leads to insulin resistance. As insulin secretion rises, more androgen hormone production occurs which is then converted to estrone, one of the estrogen hormones. This results in a disruption of the hypothalamus and pituitary gland to regulate the ovulation cycle by having excess LH (luteinizing hormone) and insufficient FSH (follicle stimulating hormone) which will compromise the ability of the ovary to ovulate properly. Lack of ovulation causes infertility and a reduction in progesterone. The patient will become highly irritable through estrogen dominance.
After correcting this patient’s impact of stress on her body, properly balancing her hormones with bio identical hormone replacement therapy, and supporting her neurotransmitter imbalance with the use of amino acids; her response was quite impressive. This patient’s menstrual periods began to return on a regular basis, and she became more calm and focused. Her energy levels began to increase in the vitality returned to her life. She was planning to get married in the near future and having a child was certainly important to her and her fiancé. This patient was instructed to follow-up with me in approximately three months for her third consultation. The patient called me 60 days after her second consultation and stated that she was pregnant. She had tears of joy as she was led to believe that this would not be possible. I referred this patient to an obstetrician for continual care and close observation during her pregnancy. This patient recently contacted me and allowed me to see and hold her healthy baby boy.
This case is an excellent example of the impact of adrenal stress on multi-organ systems. In addressing underlying metabolic issues such as the thyroid impact of adrenal stress, estrogen/ progesterone imbalance, the patient’s outcome was clearly optimize. There is nothing greater through the expression of love than a healthy newborn child. Hormonal optimization is critical in allowing this process to occur. This is only one simple example of the impact on hormonal optimization. Hormones have a great affect on many physiologic processes of the body, mental health, and vitality. If the love in your life is being squashed by mental fatigue, exhaustion, and feelings of apathy, metabolic testing and hormonal optimization can certainly help, and give you hope. Please see the attached testimony which nicely expresses the importance of hormones in our lives.