Autoimmune disease in relation to testosterone.

[cocarr]

I know quite a few members on this site have different forms of autoimmune diseases and I am curious about its relation to low T based on what you have found. I have ulcerative collitis diagnosed a few years ago and it seemed to correlate with my lower energy levels and an overall downgrade in how I felt. When it is active it really wears me down thats for sure.

Some of the research that I have done personally shows that forms of autoimmune disease can lead to low T. If true it does make sense but the list of things that can lead to low T is a long one so it makes me wonder how much of a factor it is.

My UC is also in remission most of the time so it makes me wonder how much it really factors in to my low T. It seems like if it had an affect on it that my T would fluctuate up and down as my UC flared up or down if that makes sense.

Thanks for your responses, Cody.

 

[Nelson Vergel]

Cocarr

I hope you have a good treatment for ulcerative colitis. My dad passed away last year after suffering from poorly treated ulcerative colitis. He never wanted to listen to my advise to take probiotics, glutamine, soluble fiber, and treatment. And he also refused to take testosterone and nandrolone to combat his wasting after his liver got screwed up with hepatic hypertension induced by long term ulcerative colitis. I got tested for the gene and I have it also. My gut is very sensitive but I keep on top of it!

I found a paper that linked low testosterone with autoimmune disease:

High frequency of association of rheumatic/autoimmune
diseases and untreated male hypogonadism with severe
testicular dysfunction

 

[cocarr]

Thanks Nelson I will check that out. Ya mine happened while I was on a huge 40 acre fire with 6 structures involved. I kept having to go hide in a burned up shed with severe diarrhea and by the 5th time it was solid blood. 3 more times of that and I was as white as a ghost and went to the ER and had a colonoscopy the next day.

In a way I am lucky it happened that way because it forced me into a situation that I had no choice but to follow through with. The increased risk of colon cancer associated with UC or Crohn's disease is massive. It increases odds something like 60%. I had a very good friend who was a fellow fireman and he "felt a pop" one day. He went and had it checked out and had stage 4 colon cancer and was dead within 3 months.

It is nothing to mess around with thats for sure.

 

[cocarr]

That study shows the opposite of what I had thought. Low T can actually lead to autoimmune diseases not the other way around. I assumed that my UC may have lead to low T but in fact my low T could have lead to the UC. Interesting.......

 

[Rorinsmith]

Cocarr

I hope you have a good treatment for ulcerative colitis. My dad passed away last year after suffering from poorly treated ulcerative colitis. He never wanted to listen to my advise to take probiotics, glutamine, soluble fiber, and treatment. And he also refused to take testosterone and nandrolone to combat his wasting after his liver got screwed up with hepatic hypertension induced by long term ulcerative colitis. I got tested for the gene and I have it also. My gut is very sensitive but I keep on top of it!

I found a paper that linked low testosterone with autoimmune disease:

High frequency of association of rheumatic/autoimmune
diseases and untreated male hypogonadism with severe
testicular dysfunction

Cody,
I as well hope you have a good treatment for this situation. The one thing I suggest you start taking if you aren't doing so already is L-Glutamine. It's done absolute wonders for me. AIDS left me with a mess of a digestive system. Constant diarrhea and very loose stool at best. Going shopping was a nightmare because I always had to make sure I was near a bathroom. Going out on the town with friends for the evening was out of the question. I new little about L-Glutamine until I read Nelson's BUILT TO SURVIVE. I learned about it's benefit to the gut and how it's critical in regeneration of the intestines mucous membranes. Once I started using this (three rounded teaspoons per day) the problems cleared up within four days. It's been about a year now and I haven't had a single case of diarrhea. L-Glutamine is also and foremost a bodybuilding supplement and is my favorite because it really works. The anabolic and anticatabolic ability of this stuff is amazing! Try it! You'll like it!

Ron

 

[SuperDutyDave]

I have autoimmune crohns. I firmly believe there was a predisposition in me for it but the collapse of my systems do to stress allowed it to become full blown and the treatment TRT etc has helped to minimize symptoms and keep it in remission

The below info from Dr. Romeo Mariano is a very accurate description of where I was at and how things progressed etc.


Chronic or traumatic stress may lead to hypothalamic-pituitary-adrenal axis dysregulation (the term which I believe is more accurate to use than the term "adrenal fatigue"), HPA dysregulation for short.

HPA dysregulation leads to lower production of adrenal cortex signals/hormones. This includes lower cortisol and/or DHEA, progesterone, pregnenolone, testosterone, estradiol, or aldosterone.

The primary signal for stress is norepinephrine. Norepinephrine is in a positive feedback loop with corticotropin releasing hormone. This positive feedback loop is interrupted by cortisol signaling. To increase norepinephrine, the brain has to also reduce production of some or all of the control signals that suppress norepinephrine signaling. These include reductions in serotonin, dopamine, GABA, etc.

Stress (particularly if it is a perceived threat), may lead to an increase in pro-inflammatory cytokine signaling from the brain and from the immune system (which is directly innervated by neurons of the sympathetic nervous system - the primary norepinephrine-releasing neurons of the nervous system). Stress may also lead to an increase in histamine signaling from brain mast cells. These changes lead to an activation of the immune system. These changes in large excesses may lead to an increase in inflammatory processes. The loss of anti-inflammatory signaling - which includes cortisol, DHEA, progesterone and testosterone - exacerbates these pro-inflammatory changes.

Excessive pro-inflammatory cytokine signaling may trigger automatic defensive programs in the brain. Defensive programs may induce behavioral changes including depressed mood, loss of interest or motivation in activities, loss of enjoyment from activities, social isolation, changes in sleep including the desire to sleep excessively.

There may be a loss of energy from excessive pro-inflammatory cytokine signaling. The actual mechanisms of the loss of energy are not clear. I currently speculate that perhaps there may be impaired brain astrocyte conversion of thyroxine (T4) to triiodothyronine (T3) - which leads to a hypothyroid central nervous system with a euthyroid body (as in Alzheimer's disease). Perhaps the increase in pro-inflammatory cytokines is one of the signaling problems leading to HPA dysregulation, aside from excessive norepinephrine signaling. However, other regulatory systems may also be involved - such as the opiate signaling systems (which also involve dopamine signaling).

HPA dysregulation, from whatever cause, leads to a loss of energy. The loss of energy production, however, under some circumstances. These circumstances include bipolar disorder and attention deficit/hyperactivity disorder with hyperactivity. In these cases, norepinephrine production is an effective signal for energy.

Nutrition plays a large role in the development of HPA dysregulation. Omega 3 vs. Omega 6 balance helps determine the balance between inflammation and anti-inflammation. Various nutrients (such as the B-vitamins, fat soluble vitamins, magnesium, etc) are cofactors for many of the processes involving signal production. Vitamin A and D are generally anti-inflammatory signals. Vitamin D reduces insulin resistance (which helps the body tolerate low blood sugar from impaired cortisol signaling), increases serotonin and dopamine production. Vitamin A helps regulate the sensitivity to various hormones/signals such as thyroid hormone.

The other endocrine signaling systems such as the reproductive system are in play. Testosterone helps reduce norepinephrine, increases dopamine production. It also suppresses adrenocorticotropin releasing hormone and directly inhibits adrenal cortex activity - this may be significant depending on the sum of signaling interactions and problems a person has. Estrogen acts similarly to a monoamine oxidase inhibitor - thus increasing serotonin, norepinephrine and dopamine (but serotonin primarily). Estrogen in relative excess may be pro-inflammatory, reduces free thyroid hormone. Thyroid hormone signaling loss is compensated by an increase in norepinephrine production with simultaneous activation of adrenal cortex signals. Over time, however, this compensation may fail as HPA dysregulation occurs. Insulin, glucagon, the incretins, etc. also have a role. Insulin, itself, is pro-inflammatory. Growth hormone has a calming effect and is anti-inflammatory. Etc. etc. etc. etc.

The entry point of all these processes is stress. This is represented primarily by norepinephrine signaling. However histamine (from brain mast cells) and pro-inflammatory cytokines (from brain microglia) are also involved in the process. Stress induces responses that are ostensibly designed to improve survival. The problem is that in the modern world, these responses may be dysfunctional instead.

===

Given the complexity of the interactions involved, a single intervention may or may not work. Which direction an intervention goes depends on the sum of the changes that occur as a result of that intervention. In psychiatry, the usual answer to a question is "It depends."

Stress is the entry point. Environmental and behavioral interventions would clearly help with few downsides.

Low dose testosterone may help, particularly in women, by helping to reduce norepinephrine and increasing dopamine signaling, and helping to reduce pro-inflammatory signaling. Low dose testosterone would not help in men since it may do nothing or it would suppress endogenous production of testosterone, leading to lower overall testosterone levels. Men would need replacement doses of testosterone. Testosterone, however, may also worsen adrenal cortex function depending on a person's susceptibility to this. In men, exogenous testosterone treatment also suppresses testicular thyroid releasing hormone production, leading to a loss of thyroid hormone production, which then leads to an increase in norepinephrine production. This is why in certain men, even if hypogonadal, testosterone treatment is intolerable. The rest of the system has to be optimized before testosterone treatment can be done.

Tamoxifen (I would prefer this to Clomiphene due to the visual changes that can occur with Clomiphene) is a weak estrogen. This blocks the stronger estrogens from being sensed by the brain. This then causes the brain to release more Luteinizing Hormone to stimulate testosterone production, leading to estrogen production. The increase in testosterone would have the effects listed previously. The problem is that Tamoxifen also blocks estrogen. This leads to lower estrogen signaling activity. Estrogen helps control norepinephrine by increasing serotonin and dopamine production. Estrogen is also needed to improve sensitivity to testosterone by increasing testosterone receptor production. Estrogen is also important in generating energy, motivation, drive, competitiveness, sex drive (libido). Estrogen (particularly in women) is important for neuron growth and memory. The loss of estrogen signaling, depending on the balance with testosterone, may lead to negative effects. If testosterone production is driven high enough, then perhaps this would improve things overall. This is particularly true in men. However, in women, this may not occur and destabilization of the system and dysfunction may occur instead. This is why many women do not like treatment with Tamoxifen or Arimidex for breast cancer.

Cortisol treatment alone may or may not work. Cortisol treatment in sub-replacement doses helps because it helps break the norepinephrine-CRH positive feedback loop. Cortisol also acts in the brain to improve concentration/focus by allowing the brain to ignore emotionally distracting memories or information. Cortisol also is the most important anti-inflammatory signal that reduces immune system activity. Cortisol triggers gluconeogenesis - helping improve blood sugar production. etc. etc. Thus it can be a useful component of treatment. However, Cortisol treatment alone also suppresses adrenal cortex activity. Thus, there is also a loss of pregnenolone, progesterone, DHEA, testosterone, estradiol, aldosterone, etc. If this loss is large enough, then the person may be worse off than without treatment. Since the majority of these other signals are calming, help control norepinephrine, are anti-inflammatory signals, a significant loss may cause the opposite intended effect of cortisol treatment. This is where some people become more tired, get "brain fog", become more anxious, etc. on cortisol monotherapy.

A systematic treatment has to be considered to address the multiple issues that invariably occur, contributing to HPA dysregulation. Single modality treatments may help - particularly in those people who don't have large problems in the rest of their system. But often, in more severe cases, they don't. A systemic approach would then be needed. I would count the person who responds to monotherapy as very fortunate.

__________________
Romeo B. Mariano, MD, physician, psychiatrist

 

[Eli1947]

I know quite a few members on this site have different forms of autoimmune diseases and I am curious about its relation to low T based on what you have found. I have ulcerative collitis diagnosed a few years ago and it seemed to correlate with my lower energy levels and an overall downgrade in how I felt. When it is active it really wears me down thats for sure.

Some of the research that I have done personally shows that forms of autoimmune disease can lead to low T. If true it does make sense but the list of things that can lead to low T is a long one so it makes me wonder how much of a factor it is.

My UC is also in remission most of the time so it makes me wonder how much it really factors in to my low T. It seems like if it had an affect on it that my T would fluctuate up and down as my UC flared up or down if that makes sense.

Thanks for your responses, Cody.

This is a Q of the Chicken and the egg. People with autoimmune diseases, as a fact are found on average to be with lower testosterone and other parameters. Low T is the cause or the result of is not a solved issue. other fact is that the gut is also protected /controlled by hormones: testosterone and estradiol. From my experience, low testosterone and gut problems and then rheumatological issues appeared in sequence after initiation and along use of drugs for cancer. Short time after initiation of TRT with Testosterone the gut problems just subside though the cancer treatment drugs continued at the same protocol.

 

[Shane]

I did 2 cycles(12 - 14 weeks each) of Sustanon 250 for the very first time in 2010. Immediately coming off, even with pct, I developed alopecia areata and had about a dozen bald spots on my head that lasted about 2 years. I thought it might have been related but I didnt know. I ignorantly never did any blood work. Im thinking now my T levels never rebounded and may have caused that particular autoimmune issue.

 

[davidrn]

cocarr, I am in that autoimmune group you speak of. I have had diagnosed Rheumatoid Arthritis for 15 years, it was only a few years ago that I read that 60% of RA men had low Testosterone levels. It took some fighting to get tested, and then start treatment. My Rheumatologist never knew the info about the relationship(I fired him).
I have a family history of Chron's, my mother had it for many years. One suggestion I would make is to read about using low dose naltrexone (LDN), I have been taking it myself on and off for some time.
http://ibdnewstoday.com/2014/08/25/low-dose-naltrexone-may-alleviate-crohns-disease-symptoms/
http://ldn.proboards.com/
These might help you get started, there is almost zero downside to trying LDN, only side effect commented on is sleep issues the first week to 2, I didn't have these myself.

 

[drewsonofdean]

I have done a lot of research on this, as my doctor's believe that there is no connection between crohn's and low T. I believe it is due to an over responsive immune system in the form of Cortisol, to combat an inflammed gut lining. Which disrupts the HPTA axis. Subsequently our Testosterone is lowered. Annoying as hell that the doctors don't know about this, nor do they even try to come to this conclusion based on their knowledge and the evidence. My T dropped literally at the same time as I started to suffer from Crohn's disease...

The good news is that, now that I am on TRT, my inflammation seems to have gone down. Testosterone is a natural anti-inflammatory after all.

 

[SuperDutyDave]

I have done a lot of research on this, as my doctor's believe that there is no connection between crohn's and low T. I believe it is due to an over responsive immune system in the form of Cortisol, to combat an inflammed gut lining. Which disrupts the HPTA axis. Subsequently our Testosterone is lowered. Annoying as hell that the doctors don't know about this, nor do they even try to come to this conclusion based on their knowledge and the evidence. My T dropped literally at the same time as I started to suffer from Crohn's disease...

The good news is that, now that I am on TRT, my inflammation seems to have gone down. Testosterone is a natural anti-inflammatory after all.

Very Much agree with this.....see my post above....that described me to a T (no pun intended) High Stress with High Cortisol Levels, High norepinephrine all led to deregulation of immune system with crohns being result.

Reduction in stress, lowering of cortisol, lower/control of norepinephrine and Increase in T levels etc. all have allowed crohns to go into remission and symptoms are virtually nil and I take no GI or Crohn's specific medication any longer nor have I for over 5 years. I also feel much better younger stronger etc.

Normal doc's have no clue of what to do on these things other than just load you up with immune suppressors which leave you with side effects, weaken immune system and overall feeling weak and impotent (figuratively and literally)

 

[Vince]

Doesn't gluten cause autoimmune disease, I've haven't eaten grains for almost 6 years now.

 

[SuperDutyDave]

Glutens don't bother me whatsoever. Those with ciliac disease have gluten issues for sure. For many it's just the new treaty thing.....kinda like Atkins was a few years back. However if you feel better without them. Good for you

 

[davidrn]

I would disagree on Gluten, many people with an Autoimmune disease have a sensitivity to either (GMO) wheat , yeast or Gluten, in the end bread or bread products. Maybe 5 years or so ago, I had a several month episode of the worst to date RA Flare. I tried acupuncture, and then I read about Gluten and RA. I had a history then of having a 3 to 4 day RA Flares that would keep me out of work every 1 to 3 months. After I went Gluten Free, I stopped the flares, and worked until I retired. I understand some people are using this as a diet, and cutting back on fast acting carbs will help lose weight. I do think there is a fair amount of the population that would benefit from trialing a 2 week Gluten Free diet, if they feel OK when they resume wheat, no problem, if they get sick, maybe they need to consider a 6 month GF period. My wife had to do that related to Gut issues, and then resumed all the foods she took a break from, and felt good again.

 

[Jinzang]

When I had irritable bowel syndrome, the naturopathic doctor I saw put me on glutamine powder, an omega 3 supplement, and probiotics. The combination cleared up the problem in about six months.

 

[SuperDutyDave]

I'm not saying that many people with crohns ibs don't have sensitivities too many things. Just have seen a huge increase in people claiming gluten issues Me thinks the trendy types.

That said as mentioned in above post deregulation of hormonal systems etc have a huge impact on immune system function. Re-regulation and even improvement can help significantly

Kinda reason we are here.......

 

[Jinzang]

Crohns and IBS lead to "leaky gut syndrome," where large molecules from your food make it into your blood stream. Your body reacts by producing antibodies, leading to food sensitivities. I used to have a problem with gluten, but no more, thankfully. I still have a problem with corn and soy. Anyone with Crohns / IBS should take food sensitivities into account and eliminate the foods that aggravate from their diet.

I agree that the gluten sensitivity thing has been overdone, but that doesn't mean it's not a real problem for some.