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Celiac.com 05/16/2011 - Nearly 75% of the 24 million Americans suffering from autoimmune disease are women, according to the American Autoimmune Related Diseases Association (AARDA). Women appear to mount larger inflammatory responses than men when their immune systems are triggered, thereby increasing their risk of autoimmunity. The fact that sex hormones are involved is indicated by the fact that many autoimmune diseases fluctuate with hormonal changes such as those that occur during pregnancy, during the menstrual cycle, or when using oral contraceptives. A history of pregnancy also appears to increase the risk for autoimmune disease. The sex hormone that is commonly low in such women is Dehydroepiandrosterone (DHEA). This is a natural steroid and is produced by the adrenal glands, the reproductive organs and the brain. DHEA is used by the body to make the male and female hormones, testosterone and estrogen respectively, and is known to have anti-inflammatory effects. It has been proposed that a DHEA deficiency is a contributing factor in autoimmune diseases. Last year a study was done to look at precisely that effect. The study’s conclusions have been supported by other, similar research and I think you’ll find it quite interesting. The Journal of Clinical Endocrinology & Metabolism Vol. 94, No. 6 2044-2051(2009) published an article entitled “Low Serum Levels of Sex Steroids Are Associated with Disease Characteristics in Primary Sjogren’s Syndrome; Supplementation with Dehydroepiandrosterone Restores the Concentrations”. The authors investigated whether there was a relationship between steroid levels and the disease characteristics of Sjogren’s. They based their study on the known data that DHEA not only declines with aging but is reduced in Sjogren’s, an autoimmune disease. The study was populated by 23 post-menopausal women with primary Sjogren’s syndrome and subnormal levels of DHEA. The investigation was a controlled, double blind crossover study, conducted over a 9 month period, where DHEA was assessed by sophisticated laboratory measurements and typical symptoms of Sjogren’s such as dry mouth and eyes and salivary flow rates were similarly assessed. Results revealed a strong correlation between low DHEA and Sjogren’s symptoms. DHEA and its sex hormone metabolites (testosterone and estrogen) were found to increase with DHEA supplementation but not with the placebo. Symptoms such as dry eyes were seen to improve as estrogen levels The researchers concluded that the disease manifestations of primary Sjogren’s syndrome were associated with low sex hormone levels and the supplementation of DHEA allowed the body to transform into androgens, testosterone and estrogen, with testosterone production predominating. Please allow me to add some personal interpretation. For the most part I agree with the premise and applaud the results. The facts that autoimmune disease occurs more often in women, that women frequently have low DHEA, and that androgens have anti-inflammatory effects that can benefit autoimmune disease are all true. But should we simply give such women DHEA and call it a day? I don’t think so. I propose that we do three things: First, evaluate hormonal levels in women regularly; Second, address WHY their hormonal levels are imbalanced; And third, when supplementing with hormones such as DHEA, ensure that the delivery system is one that mimics what the body does naturally. Remember that autoimmune disease can begin many years before the first symptoms become manifest. Therefore evaluating hormonal levels in our younger women is a good idea. When I find DHEA levels that are low, my first order of business is to assess why. Frequently it is due to a phenomenon known as “pregnenelone steal” that occurs when the adrenal glands are under stress. It is a common occurrence and one of the fantastic abilities of the human body to shift from one pathway to another when under stress. The “steal” pathway diverts the body away from making sex hormones and instead it makes more “stress” hormones. So while adding some DHEA into the mix might very well help, does it make sense to find out WHY it’s being diverted away from making sex hormones? I hope so because it’s the very foundation of the medicine that we practice—functional medicine. Once you understand the root cause of the deficiency you can take steps to truly remedy it rather than simply covering it up by taking DHEA. Not to keep hitting you over the head with this concept, but supplementing with DHEA as your sole treatment misses the underlying cause since the body is designed to make adequate quantities of DHEA. A common reason for the diversion or “steal” pathway to become activated is adrenal stress from poor absorption of nutrients, unstable blood sugar and the presence of infections—all problems we see with the gluten intolerant patient! While I’m not implying that every autoimmune patient has a gluten intolerance, it certainly warrants screening all of them because of its high prevalence. As we travel down the road to optimal health through avoiding any food the body isn’t tolerating well, improving the integrity of the small intestine and normalizing adrenal function, there are certainly times when hormonal supplementation is beneficial. I don’t recommend the oral route because the first place the hormone travels is to the liver and this can be burdensome to that organ. When the body makes hormones naturally it delivers them straight to the bloodstream. In an effort to mimic that delivery system we use a buccal route (placed between cheek and gum in the mouth) that does a good job in bringing the hormone directly to the bloodstream and bypassing the liver and digestive tract. Autoimmune diseases comprise the third leading cause of death in our country and research strongly suggests that its rapid increase is due to environmental factors, especially those that weaken the small intestine. I am committed to earlier diagnosis while the disease is still remediable, as well as overall reduction of incidence through addressing digestive health. I hope you find this informative. Please share this information with those who have autoimmune disease themselves as well as in their family.

Celiac.com 03/11/2022 - As many of you already know, celiac disease can be associated with quite a few other autoimmune diseases such as lupus, fibromyalgia, Crohn’s, Sjogren’s, multiple sclerosis, diabetes, etc. In addition, celiac disease can also be connected with a few hormonal issues such as thyroid disease (specifically Hashimoto’s), adrenal fatigue, and high/low levels of estrogen. For those with celiac disease and hormonal issues, some of the symptoms you can experience include hot flashes, insomnia, headaches, weight gain or loss, fatigue, muscle spasms, heavy menstrual cycles, heart rate changes, and much more. There are many ways you can treat hormone imbalances, but many people prefer to first try more natural methods, in the hope of avoiding pharmaceutical medications. For those in this group, nutrition can be an excellent way to help stabilize your body’s estrogen levels and feel better fast. Foods to eat include pistachios, artichokes, cruciferous vegetables (broccoli, Brussels sprouts, kale, and cauliflower), chia and hemp seeds. Simply by incorporating these nuts, seeds, and vegetables into your daily lifestyle, you’ll begin to feel more energetic and have less pain. Even if you don’t happen to be living an allergen-friendly life, these foods can definitely be beneficial for hormonal regulation. For those with celiac disease, eating gluten-free foods can help reduce the intensity of your thyroid and adrenal fatigue symptoms. There are even certain herbs that can be beneficial for your hormone levels, and picking the right once, of course, will depend on your body’s individual needs. From maca, yarrow, red raspberry, ashwaganda, chase tree, black cohosh, mother wart, mugwort, shepherd’s purse, stinging nettle, to burdock. Choosing the right one may help decrease fatigue, lessen menstrual pain, reduce hot flashes, and ease headaches. Be sure to read up on the known side-effects of any of these herbs before taking them, as they may interfere with other conditions you may have, for example ashwaganda can increase your blood pressure. Lastly, there are certain types of exercises that can help to alleviate chronic pain and adrenal fatigue. Yoga can be a fantastic way to become flexible, strengthen muscles, and balance estrogen levels. Try working out three times per week doing yoga or light dancing. In summary, many people with hormone imbalances can often find relief with basic approaches, such as exercise, nutritional changes, and adding herbal supplements which can often make a big difference. References: Reuters.com Glutenfreesociety.org