Hormones on Our Minds and on Our Nerves

Hormones on Our Minds and on Our Nerves

George Orwell’s novel 1984 predicted a society with language controls and “double speak.” It astonishes me how accurate these predictions have been in the field of medicine, as evidenced by the fact that various medical establishments meet regularly to decide how their members ought to think about issues such as hormones.

Some say that, without sufficient evidence to the contrary, all estrogens are alike and all progesterone/progestins are alike. Even basic science courses, going back decades, demonstrated that there were differences between molecules created by the body and those created or engineered by scientists— significant differences, including the molecule’s shape, size and functions. Recently, the KEEPS study opened the door to the idea that perhaps all estrogens are NOT alike, so adjustments to their thinking are being made. (See www.keepstudy.org for more info.)

One of the most enduring (and preposterous) pronouncements has been that women without a uterus do not need progesterone. The idea is that the hormone progesterone has a single function, which is to slough off accumulated tissue in the uterus, and that it has no other effects on the body. In a perverse way, this pronouncement has saved numerous women from the effects of progestins (altered progesterone molecules) such as medroxyprogesterone, which was implicated in the Women’s Health Initiative Study with an increase in breast cancer risk.

This type of limited thinking perseveres, potentially leading to serious deficits in medical care. Dr. Katarina Dalton wrote over 40 years ago that women without a uterus most likely had surgery because of a long-standing deficit of progesterone, and actually needed much more progesterone than women reaching a natural menopause.

One area of research that is currently opening minds to the potential of hormones focuses on “neurosteroids,” which are hormones produced by nerve cells in the brain, spinal cord and peripheral nervous system, independently of hormone production elsewhere in the body. In essence, this research indicates that the “sex” hormones we commonly identify as being produced by the ovaries, testes and adrenal glands (such as the estrogens, progesterone and its derivatives, DHEA, testosterone, pregnenolone and others) are so important to neural function that they are also independently produced by neural tissue.

The neural tissue responds to the hormones circulating in the blood stream AND to the neurosteroids (i.e., the hormones produced locally by the nerves themselves). The local neurosteroid production allows for higher concentrations of hormones when and where they are needed, and these concentrations can be 20 to 50 times the level circulating in the blood stream. Different areas of the brain, or different nerve cells, may produce or concentrate different hormones. Some hormones may also trigger opposing activities, depending on their concentrations.

The interplay of neurosteroids is extremely complicated, and the science is just getting started. What is equally exciting is that our minds are being opened to the possibilities that the so-called “sex” hormones might now also prove useful for treating neurodegenerative diseases!

Steroidal hormones are believed to help heal damaged neural tissue. For example, in the disease ALS (amyotrophic lateral sclerosis), it has been hypothesized that motor neurons may be affected by a deficiency of receptors for testosterone. Estrogens can make it worse by causing neuronal excitement. Progesterone may help repair the neurons by repairing the myelin sheath that protects them. Notably, ALS patients typically have low progesterone levels.

With Alzheimer’s disease, changes occur in brain cells that can be linked to hormone levels, according to Dr. Ray Peat. Of prime importance is the ability of the mitochondria (i.e., the part of a cell responsible for energy production) to use oxygen. The enzyme needed for oxygen uptake is dependent upon sufficient thyroid hormones, and antagonized by the presence of estrogen, iron and toxins. A low progesterone level, relative to estrogen, results in increased levels of LH and FSH (pituitary hormones associated with menopause, when elevated). Both LH and FSH are themselves very inflammatory, and may be balanced by DHEA and testosterone, and even more so by progesterone.

Dr. Katarina Dalton found that progesterone helped women eliminate premenstrual epileptic seizures. Neurosteroid scientists have demonstrated the effectiveness of both progesterone and its metabolite allopregnanolone in preventing convulsions.

As this research continues, we may discover that vision and hearing could be improved by ensuring the healthy functioning of the nerves involved. Cognition, memory and mood may be improved with a healthy nervous system. Mental diseases such as schizophrenia may be curtailed with neurosteroid hormones. And, we may find that one of the brightest neurosteroid stars—progesterone—is not just for the uterus.


References
· Once a Month: Understanding and Treating PMS by Katrina Dalton, MD; Hunter House Inc.; Alameda, CA; 1999.
· “Demystifying Dementia, Protective Progesterone” in Ray Peat’s Newsletter, January 2013.
· Neurosteroids and the Nervous System by Steven R. King; SpringerBriefs in Neuroscience; Springer Science+Business Media; New York, NY; 2013.
· “Progesterone as a neuroactive neurosteroid with special reference to the effect of progesterone on myelination” by Baulieu et al; Steroids; 65 (2000) 605-612.
· “Novel Perspectives for Progesterone in Hormone Replacement Therapy with Special Reference to the Nervous System” by Schumacher et al; Endocrine Reviews; 28 (4) 387-439; 2007.