Approximately 80% of autoimmune patients are women (1). That is a staggering number. Why is it that women carry the burden of autoimmune disease? The other interesting fact is that many women are diagnosed with these chronic conditions during times of intense stress. And I’m not talking about general life stress. This is stress from hormone fluctuation – pregnancy, puberty, and menopause. Do hormones play a role in the development of autoimmune disease? And is this the reason why more women have them?
Diet, lifestyle and environment are typical triggers of autoimmune disease. Many of my clients make pretty significant changes in all of these and still suffer from symptoms of their autoimmune disease. Many times, hormones are not addressed in typical medical care and they could be the underlying reason why someone may be experiencing flares. When this is the case, I consider balancing out the hormones to help my clients feel better.
Hormones – An Overview
Many of the hormones studied and linked to autoimmune diseases are the sex hormones. Here’s a breakdown of what these hormones are and what they do:
Estrogen is one of the major female sex hormones. It is responsible for stimulating egg production, regulating mucus secretions from the vagina, and creating breast tissue. Estrogen also plays a role in bone development and cognitive and cardiovascular function.
This is the other major sex hormone in females. Progesterone is secreted during the second half of the menstrual cycle and helps to prepare the body for potential pregnancy. If the egg is not fertilized, progesterone levels fall.
Although testosterone is primarily a male sex hormone, it does play a role in female health. Testosterone helps regulate the menstrual cycle and also promotes bone and muscle strength.
The Endocrine Transition and Autoimmune Disease
Women undergo several hormonal shifts throughout their lifetime, starting with puberty. And researchers have connected these changes in hormone production to the onset or exacerbation of autoimmune disease. Why is this? Sex hormones also influence the immune system and can play either a protective or stimulatory role in autoimmune diseases. To make things more complicated, not every autoimmune disease is affected in the same manner. Below is a breakdown of how these sex hormones affect specific autoimmune diseases.
Rheumatoid arthritis (RA) is an autoimmune disease that affects the joint tissues. Most patients are diagnosed with RA at the onset of menopause. Estrogen levels are significantly related to disease progression or suppression. Women with lower estrogen levels tend to have worsening symptoms of RA, which explains why the menopause and peri-menopause may be triggers for disease development and/or increased joint pain. Pregnancy is seen to be protective for women with RA, and most expectant mothers experience remission or reduced symptoms during this time. Testosterone is also lower in women with active RA (2).
Multiple sclerosis (MS) is an autoimmune disease that affects the nervous system. It is similar to RA in the sense that both conditions are negatively affected by a drop in estrogen. In fact, disease progression is often seen in women over 50, implying that menopause and the corresponding drop in estrogen may be contributing to this phenomenon. Testosterone is also typically lower in both men and women with MS (2,3).
All of the body’s tissues are being attacked with systemic lupus erythematosus (SLE), including joints, organs and blood vessels. SLE is different from the above autoimmune diseases. Lower levels of estrogen is actually protective against disease progression. Both RA and MS see a decline in symptoms during pregnancy, where SLE may actually become more active. With SLE, there is a lower prevalence of disease development after menopause (2).
It is common for women with Hashimoto’s to have estrogen dominance. Estrogen dominance is when the estrogen levels are higher than the other sex hormones. It can cause a variety of unpleasant symptoms which I will flush out more in an upcoming blog post. The interesting thing about estrogen is it can actually trigger hypothyroidism.
How Do You Know if Your Hormones are Out of Balance?
If you suspect that your hormones may be exacerbating your autoimmune disease, ask your health professional to get your hormones tested. There are several blood tests you can do on specific days of your menstrual cycle to determine the levels of your major sex hormones.
Can Diet Help Balance Out Your Hormones?
Eating a balanced diet can help keep your hormones in check. Both carbohydrates and fat are needed for hormone production. Make sure you include complex carbohydrates like whole grains and starchy vegetables and limit refined grains. Fats should be high quality, such as plant based oils (olive and avocado are my favorites), nuts and avocado.
The other important consideration is to include foods to support your adrenal function. Your adrenals play a major role in keeping those hormones in check, so you want to do everything in your power to protect them. The best way to do that is to avoid sugar and stimulants such as caffeine and alcohol.
There are so many factors that affect hormone balance. If you are curious about your own hormones and how you can improve your diet to support them, please reach out to me and schedule a free call.