Hi Guys. This long bloggish piece (what’s new ? ) is to float the topic of foetal programming, share some information and encourage some feedback. Bear in my mind that I’m not medical – this is an ad-hoc summary of what I seem to have picked up.
It may or may not be news to some of you, but it certainly created a big a-ha moment for me – given the fit between my birth circumstances and the list of conditions known to originate from disturbances to adult adrenal function as a result of foetal programming.
It’s in one way disappointing, in that it perhaps suggests that the root causes of the health issues reported by some of us are not easily soluble. It’s also positive, in that it may provide some into means for prevention for others, and treatments in our own cases.
Foetal programming may or may not be a big cause of metabolic and thyroid disease in the general sense – see below for some indicators of likelihood.
I’ve been searching for a solution to long running high blood pressure and (despite pretty optimal it seems T4 + T3 thyroid replacement) limited stamina – I’ve long been unable to work normally.
Longstanding chronic fatigue, undiagnosed hypothyroidism and a whole raft of associated immune and other related conditions led in my own case to a thyroidectomy for a thyroid cancer. Which likely developed from thyroid auto-immune disease – this in 2005. Which in turn may well have had it roots in adrenal issues originating with my foetal programming.
Work with the usual suspects that many of us are familiar with has since enabled a progression from chronic illness to reasonable basic health and well being - that’s stuff like T3, vitamin D, B12, nutritional supplements, omega oils, adrenal supplementation, removal of mercury from tooth fillings etc. It’s not unfortunately resolved the stamina or the blood pressure issues.
The question has always been what the missing cause/X factor was.
My sleep has for many years been marginal (lots of sleeping, but minimal refreshment/trouble waking up), so I recently started looking at melatonin as a possible means of improving the situation. This quickly led to information on how it partners with DHEA via the HPA (hypothalmus [brain]/pituitary [gland in the brain that controls most endocrine functions including adrenals and thyroid T4] axis) to control waking and sleeping cycles.
Foetal programming popped up as a possible underlying cause of problems in this regard, but the a-ha followed from the realisation that the consequent disturbances in the HPA are also linked to the very familiar series of the complex of health issues that many of us report.
Foetal programming has been an extremely active research topic for the past ten years and more - I’ll try to link papers below to capture some of the basic points.
One issue seems to be that while it’s getting a lot of attention there doesn’t seem to be much about by way of treatment strategies.
First off what is foetal programming? In simple terms it turns out that birth is triggered in part by the spurt of rapid growth and maturation of bodily systems necessary for survival once born. This is in turn triggered by activation of the foetal HPA - the unborn baby releases (and obtains from the mother) a cocktail of endocrine hormones over a month and more to make this happen.
The hormones are mostly ACTH and cortisol – adrenal hormones.
The issue that can develop is that if the mother becomes severely stressed, or due to health/lifestyle issues the baby becomes stressed it can prematurely trigger the HPA/this release of hormones.
It seems to be a survival mechanism, in that the result is an incomplete/less than optimised fast-forwarding of the development of bodily systems required for survival after birth, and the triggering of premature birth.
Stress is in this case a very general term. It can mean externally stressful circumstances, overuse of alcohol, dietary deficiencies, diseases, health issues and the like in the case of the mother - or anything leading to low blood oxygen levels (hypoxia) or exposure to excessive levels of adrenal hormones from the Mother for the foetus.
One result is that the ‘adrenal thermostat’ (the HPA) gets set too high in the baby - meaning that the child and eventual adult is ‘programmed’ to produce too much adrenal hormone in response to a given stress level. Another is that he/she is left for life with a number of less than optimum/less than completely developed bodily systems.
The bad news is that these tendencies seem to create a predisposition to a wide range of long- term health issues in the eventual adult – most of which many of us will recognise.
There are some differences in male and female tendencies – seemingly as a result of the influence of the sex hormones.
Thyroid problems often arise as a result of a complex of immune, gut and thyroid suppression issues resulting from raised levels of adrenal hormones and other pre-disposing factors.
The classic indicators that an individual may be in this category are a highly premature birth, and a low birth weight. (seemingly 1kg or below) Anything more than 10% below average birth weight is seemingly suggestive of the possibility of some issues however.
These problems normally don’t appear until adulthood – often it seems with the first experience of prolonged stress in e.g. work.
I was in the above category - over two months premature and around 1 kg at birth. It’s open to speculation as to how big a factor this is in general. My health collapsed about ten years after I started working – in response to a sustained period of moderately heavy stress and a serious motor accident.
What’s unclear is how common foetally programmed illness may be, or how the effect reduces as gestation periods and birth weights increase towards normal. They seem to be very common though - in that the realisation of just how wide ranging the implications for child and adult health are have led to the topic (and related matters like measures to minimise stress during pregnancy and protect the fetus) being placed high on many national research priority lists.
I’m unclear at this stage what may or may not be possible by way of interventions to help those of us who may be in this situation as adults.
There’s a diagram and descriptions of symptoms and causes of Cushing-ism/Cushing’s disease well down this very useful site: pathguy.com/lectures/adr-th... That’s the effects of too much adrenal hormone. The physical symptoms seem very familiar to me.
I’ve been worked up a couple of times and told that I didn’t have Cushings, but on other occasions tested for high levels of adrenal hormone which were not sustained. It seems possible that the issue could be that I respond excessively to stress as a result of foetal programming – but that its transitory nature means it’s not resulted in a diagnosis of high adrenal hormone.
I’m about to engage with my (pretty progressive and relatively new) endo on the topic, so wish me luck…
It’s worth noting that there are other situations during pregnancy that can programme endocrine and/or thyroid trouble in later life – for example low availability of thyroid or adrenal hormone from the Mother, or inherited tendencies and problems with the various bodily systems. That’s before the more commonly discussed life issues and their effects on endocrine health are considered.
Here are some papers (a Googled selection of mostly abstracts) on aspects of foetal programming, and some of the medical conditions it seems may originate from it:
How foetal stress, and consequent early HPA axis activation and exposure to adrenal/stress hormones lead to premature birth and low birth weights and the risk of poor adult health.
The correlation of low birth weight with excessive adrenal response in adults, and also with metabolic and cardiovascular disease, glucose intolerance, insulin resistance, hypertension etc.
Disturbance of the HPA axis thermostat by pre-natal stress and/or alcohol exposure – resulting in excessive exposure to adrenal hormone, reduced stress tolerance, reduced immune system competence, and increased immuno-suppression while stressed.
Functioning of the HPA axis, and the existence of foetal programming.
Pre-natal stress and foetal programming result in a disposition towards anxiety, depression, cognitive dysfunction (autism etc), psychiatric illness and vulnerability to drugs. Linking pre-birth exposure to excessive levels of stress hormones and psychiatric disorders.
Pre-disposition to gut trouble and irritable bowel as a result of dysfunctional brain/gut communication. Discussion of immune, neurological, HPA, reduced gut barrier function (leaky gut), alterations to microflora (bugs), exaggerated stress response and gut hypersensitivity in this regard.
Foetal programming of hypertension and reduced nephron count, reduced kidney capability and kidney disease.
Foetal programming of obesity and weight loss problems.
Foetal programming and low melatonin, sleep/circadian rhythm disorders and depression.
Foetal programming & wider effects of drugs.
Health effects of foetal programming are passed from generation to generation – by creating Mothers with a tendency to get stressed whose high stress hormone levels in turn create the condition in the unborn child.
Importance of avoiding stress during pregnancy.
Managing stress hormone levels in life to optimise health. (one informal view)
Canadian research group active in the field of foetal programming.