Chronic stress/high cortisol & hypothyroidism - more on brain/HPA re-programming

[vajra]

Hi all. I've been posting about the link between chronic stress and high cortisol levels with eventual thyroid, adrenal fatigue, auto immune, blood pressure, gut, cardio-vascular and other chronic illnesses - and on some seemingly promising (but as yet early days) approaches to treating this i've been working with. That's lifestyle changes, using adaptogens like phosphorylated serine and rhodiola etc. (see earlier posts - 'cortisol' is a good search word)

This is to post links to some more interesting material (below), and to keep the topic on the radar. It seems likely that chronic stress underlies many of our modern illnesses - but that given how cranked up most of us are that we don't recognise this. (we basically don't know what it feels like to be properly relaxed)

The essential issue seems to be that far from 'toughening us up' as it suited generations of parents and/or teachers and all sorts of people in authority to think, the effect of chronic stress is to cause a dysfunctional programming of the link from the brain to the pituitary and adrenal glands (the HPA axis) that eventually results in excessive responses to relatively minor stress. i.e. we do develop an enhanced/exaggerated short term response to stress, but at the cost of major issues of longer term health and well being.

This it seems happens as a result of (among other stuff) the adaptive growth/loss of hormone receptors that respond to the chemical triggers involved, and the shutting off of others involved in compensating calming responses.

The good news seems to be that while it can take quite a lot of time (maybe years) and may be limited by our make-up (the genetically and especially the developmentally determined set up of our individual systems) that in quite a few cases it's possible to largely reverese this programming. That's to re-programme the HPA to respond more normally.

There are strictly physical/disease based reasons why we can suffer from chronically raised levels of cortisols too - growths of one sort or another on the pituitary or adrenals for example.

It seems likely that quite a few of us are in the former place though - where after many years of stress we've developed HPA dysfunction, and are by now lumbered with chronically high stress and consequent high cortisol levels. Or with adrenal exhaustion caused by this...

Pre-birth and early life environment play a large part in determining how the various systems involved develop too - many of us seem to have ended up with unfortunately less than optimal wiring of the relevant hardware. With a reduced ability to cope with stress that is...

The first step in treating any of these issues is to avoid the circumstances giving rise to the stress that bothers us - whether emotional, physical exertion, dietary, health or whatever.

I thought i'd point to some additional (but ad-hoc, informal and definitely non medical - so apply your own judgement) communities of people working with these or similar issues:

1. The elite athlete/endurance/heavy duty physical training brigade have found they can run into this same problem (that over training over stresses the body, and can lead to HPA axis dysfunction and chronic stress), and have developed a high level of interest in re-programming to sort these problems: e.g. bengreenfieldfitness.com/20...

Given that the rate of recovery between training sessions is a central issue in athletic performance it seems likely that sports medicine is taking more than a passing interest in the topic. (never mind that the basic message the scenario sends is that it's unwise to stress the body beynd a certain point)

2. No pages linked, because most of the material is ad hoc - but it seems also that similar problems arise as a result of the long term mis-use of benzodiazepines. That's valium and the like - these drugs have potentially very nasty side effects. They can create a similar dysfunction of the HPA axis that can take years to resolve - with levels of cortisol etc so high that the resulting anxiety and depression can be incapacitiating. There's quite sizeable benzo self help groups out there with a strong interest in methods for the re-programming of dysfunctions in the HPA axis. e.g. benzobuddies.com The recovery stories can be scary.....

3. Foetal programming (conditions in the womb) and shortly after birth play a large part in determining the 'set up' of our personal stress handling and endocrine systems. Many of us may well be experincing problems going back this far. This paper summarising research and findings on the topic is pretty sobering: tiny.cc/o77g4w

Here's hoping some of this may help with insight, and that it will inspire some to dig some more.

ian

[PR4NOW]

Thanks Ian, fascinating stuff. I take it you continue to head in a positive direction? PR

[vajra]

Ta PR. None of this amounts to advice, there isn't necessarily good information about on the effectiveness or safety of the supplements, and the approach won't be applicable to everybody - for example i'd already done work to boost my adrenals, had my diet and meditation regularised for years, and had my thyroid replacement well sorted before starting work on reducing cortisol - but the project is continuing to deliver positive results it seems.

An adrenal stress test confirmed that my cortisol levels were high all day, and probably into the night too. My blood pressure has been out of control for many years, and seems to be triggered primarily by the high cortisol.

This sort of approach is perhaps most likely to be worth consideration by those of us in early or second stage chronic stress/adrenal fatigue when cortisol levels are still high (especially if it can be sorted before it knocks on to mess with the gut and the thyroid), or those on the way back from adrenal exhaustion. End stage adrenal exhaustion is likely to result in too low levels of cortisol until normal function is restored - the situation would likely be worsened by this sort of approach)

One perspective that's brought home by skimming papers etc in this area is that there may be scope for the re-programming of the many receptors involved in regulation/control of our very complex hormonal system by life experience to manifest in many ways - although exaggerated stress responses/high cortisol does seem very common.

I've been taking Seriphos (a phosphorylated serine), siberian rhodiola rosea, siberian ginseng, schisandra and high dose vitamin C to get control of the cortisol and blood pressure - which tends to be high most of the time, but especially in the morning. Also a multi vitamin and mineral.

The first two are adpaptogens and taken at intervals through the day to bedtime (normally taken at about 1hr before cortisol levels are high, or before meals and bed as in my case - but not when cortisol levels are low) - supplements that are supposed to encourage the re-programming of the HPA mentioned above.

This followed increasing my T3 dose and reducing the T4 (for the same equivalent dose) which had already helped gut function and energy, and got rid of gout and most joint pains. There was still a definite energy and stamina deficiency though which was seriously compromising my ability to work.

Low dose melatomin at night (0.3 - 0.5 mg) has been a big help in getting good rest. I wasn't waking in the night, but was very easily disturbed by noises etc, was sleeping very shallowly, suffering what felt like sleep apnoea, waking exhausted and struggling to get going until late morning - probably down to a sleep cycle disturbed by high cortisol too. These days I'm sleeping well, and waking rested and more naturally.

The plan is to re-start the anti-histamine Paul suggested which helped a lot before - it seems to help calm the auto immune side of things.

L-methionine, GABA supplementation extrahappiness.com/happines... and omega 3 oils look (very provisionally) like they might help too (amino acids seem to be important to the functioning of the calming processes), but i've been cautious about piling too much in willy nilly.

I've also been avoiding stress and as usual taking care with my diet - avoiding the gluten, bread, milk, wheat/flour, sugar, processed food additives and the like that cause bother. All problem items tend to trigger tinnitus and rising blood pressure (and probably cortisol) pretty quickly. Lots of meditation as always too.

There's been clear further improvements since starting work on reducing the cortisol. Much better energy and stamina, putting on some muscle, able to work physically without immediate muscle aches, losing weight (in one hole on my belt in a couple of months), told i look much better, calm feeling, 'comfortable' gut with normal function, normal appetitite, last of the joint aches gone.

Now getting good blood pressure control on a half tablet less of the beta blocker - which is great, because they reduce energy.

On good days i could (can if i choose, but see below) go all day without blood pressure meds while maintaining normal (say 125/85) pressures - although eventually something tips off a BP increase (the tinnitus starts) and it's time to take a BP pill.

There's occasional bad days caused by stressful events and/or stuff like eating the wrong food when even with all BP meds the BP might get to say 140/90 with tinnitus - but this tends to be just for a couple of hours and is very moderate compared to what i was experiencing.

So far i seem to have gained a situation where if i take some BP meds to control the BP effects of the morning surge in cortisol that it stays nice and stable to early evening. Minimal/no tinnitus or anything, and normal BP - although it's easily disturbed by wrong food.

The BP tends to rise a bit in late evening if I don't take it easy/misbehaved at dinner as the BP meds wear off, but the Seriphos and melatonin before bed keep it under control.

Before starting on the cortisol control my BP was with the same meds (plus another 1/2 beta blocker - the max I could tolerate) poor - running 140/90 on a very good day, around 160/110 normally, and up to 180s when under pressure - with continuous tinnitus/hissing in my ears. A particularly stressful couple of weeks would have seen it break 200 and more - i've ended up in hospital several times in the past 10 years.

I've taken the view that if the re-programming is going to happen that it's a case of re-training receptors and the like controlling the stress response in the HPA axis, and that the key is to keep the cortisol levels down until that happens. Which from reading could possibly take a year or more. For this reason (even though it might be posible to reduce on good days) i'm continuing to take my usual 3x blood pressure meds with the above - the beta blocker and another in the morning, the third in the late afternoon.

The big question is whether the re-programming will prove possible. It could be for example that my high cortisol is caused by strictly physical factors like pituitary or adrenal disease or growths. The Serphos and the like would presumably act in those cases too to reduce the expression of cortisol - but probably wouldn't change the underlying situation. For it to work requires that the cause is to do with the programming of the HPA.

So it's not clear yet how effective any re-programming may be. It does seem like there is an effect in the form of the long 'calm' evening period that has developed that wasn't there before. If the morning surge would just reduce then we'd really be flying....

I was feeling so good that i got a bit excited and did three hard days in succession sawing firewood last week - which previously would have been impossible. My arms would simply have started to hurt and stopped working after about 20 min. It was tiring, and I'm unfit from not doing enough work of this sort - but it was a novelty to be able to work for hours with the sweat blinding me. Trouble is it took me about 5 days to properly recover. So it's definitely not transported me back to being 25 yrs old again. (i'm 58)

I've an endo appointment in the next few weeks, so I'm wondering how to pitch all this to him without spooking the horses....

Comment, input and related experience appreciated...

ian

[PR4NOW]

Ian, I'm glad to hear things are progressing in a positive direction. I hope you are keeping a journal of your experiences, you have learned a lot and are gathering what I think is valuable information that needs to be written about so others can learn from your experience.

I don't know how you avoid spooking the endo unless you get the rare doctor who realizes how much research you have done and gives you some respect for what you have accomplished. If he would do that and just work with you he could actually learn from your experience but that doesn't happen very often. I'm afraid all I can do is just wish you good luck on that matter.

You and I are both outliers but in different directions, although related in some ways. As Dr. Derry observed children age 12 and younger who have suffered abuse or a great terror or fright (bullying will also have the same effect) quite often have maladjusted biochemistry. His thought was that the maladjusted biochemistry somehow allowed them to survive the experience. I think it is equally possible that it is just the result of having survived the experience. Thyroid hormone resistance is very common in this situation as is not reacting normally to pharmaceuticals. Some chase thyroid, which is to say they get a dose which works and then after awhile they have to raise it, which works for awhile and then again they have to raise it. Dr. Holtorf figured out that this is usually an RT3 problem and T3 is usually the fix. Others do just fine on NDT although many at a higher range of dosing, well, higher by TSH standards but not by the normal dosing range before the TSH test.

When I was for years old I was present when my mother slashed her wrists in her first attempted suicide. I still have a very clear memory of part of that experience, but not all. As a young girl my mother was classified as one of California's gifted children, as a teenager she was diagnosed as "weepy" and put on 1/4 grain of Armour and left there for the next 50+ years. In all that time not one of her doctors, including shrinks, ever had the intelligence or common sense to realize she was grossly under dosed on thyroid. She paid a terrible price for the arrogance, the ignorance and the incompetence of allopathic medicine.

The other possibility is since both my parents had problems on the thyroid/adrenal axis, my father never was diagnosed, that my problems are basically genetic in origin, or a combination of all of the above. There is no way to really know exactly. Mitochondrial DNA all comes from your mother so that could be another part of the problem. I had a normal life until my early thirties when my thyroid started to go south and I lost 14 years of my life before I came out the other end of the tunnel because doctors treat the blood test and not the patient. I was also financially devastated by that point. I did just fine until my late fifties/early sixties when I needed to do some readjustment again. I'm 65 now and I'm still fine tuning and will try CT3M later this fall. I fall down in the willpower and self-discipline department quite often, very hard to overcome my sweet tooth.

In 25 years of reading Dr. Derry is the only person I've found who has written about this class of thyroid patient, like so much of the thyroid (endocrine) world it is very poorly understood.

A lot of the material you have found resonates with what I have learned and am learning. Stress, in all its various forms and degrees, can have a lasting impact on our bodies that most are completely unaware of until it becomes too hard to ignore.

Be thankful you have a functional mind that can read and analyze, many are not as fortunate. And please keep us informed as you progress, I am learning a lot from your explorations and all the informative articles you keep sharing. PR

[mazb]

I'm very interested in the connections between the psychological and the physical.

i.e. why do some of us get/are prone to, auto-immune diseases, and other members of the population aren't.

I don't believe in 'luck,' but cause and effect, and trained in psychiatric nursing (only for about 15 months though), and then worked in care and counselling and studied psychology, before and after.

When I was diagnosed with Hashis/hypothyroidism (finally) in '91 it caused me to dig deep into, *why* and investigate the possible reasons/causes, but lack of time to keep on with that and discuss it with others, put it on hold.

Something snaps - we're not superhuman - I'm almost sure I can recollect my moment when 'enough was enough,' physically and the dormant Hashimoto's errupted.

Plus, I'm very aware now, that times of prolonged stress (which has been the last 5 years for me), exacerbate the condition.

[vajra]

Ta guys. That was a tough upbringing PR. I'd nothing like that to cope with, mine was more that despite good intentions low level conflict, intense pressure to achieve and attempts to micro control were always present.

Also that I was born very prematurely - which is often a sign of maternal stress and of foetal programming towards exaggerated stress responses. (i linked some papers in earlier posts about cortisol/chronic stress/exaggerated stress responses on this)

I'm reasonably certain by now that the modern epidemic of thyroid and broader metabolic issues (especially secondary hypothyroidism) is a consequence of a worsening mix of lifestyle, dietary and environmental stresses and deficiencies interacting with individual pre-dispositions.

That it's as you say M episodes of sustained (and often unnoticed) stress that tip us over the edge into initially exaggerated and dysfunctional stress responses, and then hypothyroidism and other problems - then eventually (if not sorted) to the consequent gut/autoimmune/cardio vascular and subsequent chronic diseases that we tend to end up with.

I struggled with low level fatigue for years, but can remember too the day that real chronic fatigue/hypothyroidism hit.

The bit that's daft is that we regard it as illness and failure, when actually it's often (presuming no overt disease as such) just the body (in response to prolonged stress/raised cortisol levels) reducing thyroid and adrenal output to force rest and faciliatate recovery.

We're supposed at that stage to go away and rest up for a few months - but rather than doing so we push even harder to try to get our way over nature. We're not permitted by work to do so anyway - try getting a diagnosis from a doc at this stage to justify taking x months off and see what happens.

Genetics plus foetal and life programming seem to set up some of us with reduced coping capabilities to others - the paper linked in (3) at the end of the first post sets out pretty clearly some means by which that likely happens.

Mind state is a huge factor I believe too - there's a strong tendency for the thinking/more sensitive types to get stressed and run into trouble. That tendency was present on one side of my famility too.

I've had a fair amount of Buddhist training over the years, and have found the teaching on the nature of mind and existence to be practically very usable in life, and highly trustworthy. One of the most basic teachings is that 'grasping' and 'ignorance' - that's trying to force our will on nature to cling on to what we have/get what we want/avoid what we don't want, and not knowing how to live wisely cause most of the suffering experienced by ourselves and others.

'Grasping' tends to follow from the belief that chasing selfish ends for ourselves can deliver happiness - but if everybody tries to get ahead at the cost of everybody else then that's not very likely.

What I guess i'm saying is that these traditions and some of their modern manifestations (e.g. see 'Full Catastrophe Living' by John Kabat Zinn - he's an eminent doctor who adapted some of the old methods to teach mindfulness in modern hospital settings to the chronically ill with amazing effect) transmit well proven ways to train the mind to gain space and calm which in this scenario can be enormously helpful - stuff like meditation etc.

You could argue that the modern world has made grasping a part of our everyday culture, and set people of insatiable greed in authority to drive others to perform in this regard. To over achieve, and to over consume. It's hallmark is the refusal to accept natural limits - whether that's on what our body is capable of, our mind state or the lived or natural environments.

Is it any wonder that stress related illness (im including all metabolic illness in this including thyroid) is becoming endemic? Viewed through the wide angle lens that's just life teaching the hard of hearing (most of us) that they need to change their ways....

Don't worry about willpower PR. We need an appetite to keep on digging and searching, and enough discipline and rationality to stick with it and use what we find. Too much though (especially in the form we perceive) quickly tips over into mental rigidity, dogma and the inability to admit key information seen so often in our professions.

It's probably mostly just wafflings (and pardon the length), but the forum i guess is the journal....

ian

[Hidden]

Very interesting material and extrapolations, Ian.

I'm guessing most of us don't have a great deal of control over the stressors in our lives, though. Which is probably at least part of the reason why so many thyroids eventually go out of whack ...

[vajra]

I guess H it depends to quite a degree on what we consider negotiable, and what not - most end up conditioned into believing that we really need all the stuff. That's why companies spend billions on marketing which (insanely) we end up paying for too...

Which is why freedom (and even the possibility of the survivalof the human race) follows from breaking free of our attachment to said stuff.

The same traditions often talk of the way of the spiritual warrior - which tends to point to the reality that it takes a lot of courage, insight and pro-active action to buck what in effect become social pressures. To act to structure our lives in a way that may (but will not if we get it wrong - there's always risk involved) be a much better fit and has heart - that can make us a lot happier...

ian