Your Hormones and Rheumatoid Arthritis

Hi RA warrior, how is it going on your side? Have you ever noticed that RA affects mostly women and actually most Autoimmune Diseases for that matter? What is the connection between your hormones and rheumatoid arthritis? I hope that this post will give you some helpful info.

Rheumatoid Arthritis is uncommon on men under age of 45. It, however, increases when men are old. Simply because they're protected by their hormones, unlike us ladies... That's quite unfair bearing we're doing the heavy duty keeping humanity from extinction lol!

It's commonly said that RA affects women who are menopause, but I guess you and I know that this isn't the case anymore. There're so many young ladies far below menopause who are already RA patients. Personally, I was 30 yrs when I was diagnosed, but my symptoms had manifested too early at the age of 16.

So even if most of the research that I came across is done on women who are either premenopause or postmenopause, the scientific evidence will apply to you at a given period of time. I believe the early you get hold of important information the better, to help yourself improve in subsiding the effects of RA.

Our mother nature gave us everything we need to survive here on Earth, your body has it's own pharmacy to help itself repair and heal. Your Adrenal glands(found on top of each kidney) produce varieties and some of the most vital hormones for your body.

What are hormones?

Hormones are chemical substance. They act as your body messengers. They are secreted in various organs in the body and then transported by the blood to different tissues or cells that can read their message. Some hormones are vital for your existence, while others will assist your body to function properly.

Cortisol

It's made in adrenal glands. Almost every cell in your body contains receptors for cortisol. This means that cortisol has a lot of different actions in your body depending on which cell it's acting upon.

Cortisol has anti-stress and powerful anti-inflammatory properties. It influences the formation of your memory, It regulates blood sugar, controls salt and blood pressure.

It also helps in the development of a foetus and gives it a wide range of enzymes which are essential for surviving after birth.

When you are subjected to high stress or panic, eg in an accident, it's the cortisol that maintains the body on the alert mode.

When you're chronically stressed, you'll produce more cortisol. It's therefore important to control this stress to bring cortisol to normal.

As it's an anti-inflammatory hormone, it thus helps lower inflammation in RA. When there's low cortisol production by adrenal glands(adrenal fatigue) the inflammation will be high.

RA and other chronic inflammatory diseases do stimulate high production of cortisol when the inflammation is not controlled, it may lead to a point where normal adrenal cortisol secretion does not occur. This will make cortisol level to drop leading to more severe inflammation with tissue damage.

Chronically elevated cortisol will lower DHEA another important hormone!
It's therefore important to maintain a normal level of cortisol in your body.

DHEA (Dehydroepiandrosterone hormone) and DHEAs.

DHEA is a hormone produced by adrenal glands, it's also made in teste and ovaries but in small amounts. In turn, DHEA helps in the production of other hormones like Estrogen and Testosterone. The peak of DHEA is at early adulthood and then it slowly decreases as you age.

Before menopause DHEA will provide most of your estrogen. But after menopause, your body will depend uniquely on DHEA for estrogen since the ovaries stop producing this hormone after menopause.

DHEA has several effects in the human body.

1. Protects from aging, promotes bone health, prevents metabolic diseases, cancer, immune system, and its disorders, cardiovascular diseases, diabetes, muscle functions, sexual dysfunctions, and others.

2. A low level of DHEA is associated with an increased risk of cardiovascular disease, low bone mineral density(BMD) in women and osteoporosis.

3. It has anti-inflammatory properties, which will help you in managing Rheumatoid Arthritis.

4. DHEA lower the levels of Interleukin-6(IL-6), a proinflammatory cytokine which plays a role in bone loss and joint destruction.

5. It can also(DHEA) lower the production of Tumor Necrosis Factor-alpha(TNF-alpha), a protein in your body that causes inflammation.

6. This chemical (DHEA) regulates the immune response and also enhances the secretion of Interferon-gamma(IFN-y), a cytokine that plays an important role in your immune response.

7. In addition, DHEA will increase your ability to control virus replication through various immune mechanisms.

8. It has been found that DHEA is low in chronic inflammatory diseases like rheumatoid arthritis.

9. Low production of DHEA affects the production of other hormones like Estrogen and Progesterone, which are very important too.

Progesterone

Also referred to the hormone of pregnancy. It's secreted mainly by your ovaries, but also in small amount by adrenal glands and by the placenta during pregnancy.

Progesterone has been indicated to impact the risk of developing an Autoimmune Disease in different ways depending on their concentration.
It's known as an anti-inflammatory hormone and it stimulates bone formation.

During pregnancy, progesterone suppresses disease activity in rheumatoid arthritis by inducing anti-inflammatory molecules. This period of pregnancy, together with that of menstruation period, the progesterone level goes up.

Progesterone imbalance causes irregular periods, mood swings, headaches, fatigue, and joints pain.

Irregular periods and PMS(Premenstrual syndrome) are two first signs in a young lady that she's experiencing a hormonal imbalance that can lead to bone loss in her future.
In a normal cycle, estrogen rises during the first weeks and once the ovulation occurs they begin to fall. Progesterone increases in the second half of the cycle.

If this balance is disturbed, then problems like fibroids, heavy bleeding, fibrocystic, ovarian cysts, and bone loss occur.

Androgens

Though normally known to be a male hormone, women produce androgen as well. These hormones are produced in ovaries, adrenal glands, and fat cells.

Androgens are mainly converted into Estrogen in women. Clinical evidence suggests that androgens protect men more than ladies patients from the development of immune-inflammatory diseases. They're anti-inflammatory and are believed to regulate the functions of other organs such as kidney, liver, muscles, and others.

They play a key role in the body physical changes during puberty.
Androgens also have direct beneficial effects on bones cells and skeletal growth. They stimulate bone formation and growth early in puberty.

The level of androgens in the body starts falling at the age of twenty. This decline of androgen in the woman's life as she ages might lead to bone loss.

In synovial tissue, TNF down-regulate the increased conversion of androgens (anti-inflammatory) to estrogens (immune response enhancers).

The inflammation in RA clearly downregulates androgen production, but the estrogens(at least some hydroxylated estrogen metabolites) encourage immune-inflammatory response.

Estrogens

Estrogen is one of the main sex hormones that you have. It's responsible for the reproduction and your physical features. Men also do produce estrogen but in a low amount.

It is produced in ovaries and some amount in adrenal glands and in adipose tissue

There're three hormones making estrogen; estrone, estriol, and estradiol. Estradiol also known as the "bone hormone" being predominant.

Estrogens can have different effects on different immune cells depending on the serum concentration. It has both stimulatory (promote) and inhibitory (protective) effects in your immune system. Estrogen affects all cells of the immune system as well as non-lymphoid tissues that are next to the targeted tissue.

It seems that estrogens are mostly pro-inflammatory as they suppress cellular immunity.
There are several physiological, pathological and therapeutical conditions that can change the level of estrogen; these are the menstrual cycle, pregnancy, the after birth period(postpartum), menopause, chronic stress, and chronic inflammation.

Serum levels of estrogen have been found to be normal, but synovial fluid levels of pro-inflammatory estrogen relative to androgen are significantly high in both women and men with RA. Thus showing the role of estrogen in RA.

The level of estrogen drops during menopause, which may worsen the RA symptoms.

Estrogens are able to increase the expression of CCR6 (a protein TH17) that is associated with auto-immune diseases. In RA and other autoimmune diseases, estrogen levels appear to be driven too high by actions of inflammatory mediators like TNF-a( Tumor Necrosis Factor-alpha).

Estradiol

It's an estrogen hormone. It's referred to the bone hormone, for it's essential for the development of adolescent bone mineral density.
A decrease of estradiol level triggers bone loss. This hormone partners with progesterone to maintain your bone balance.

To sum up

Overall, ladies tend to have a more responsive and robust immune system compared to men. It is therefore not surprising that us ladies respond more aggressively to self-antigens and are more susceptible to autoimmune disorders.

During pregnancy, the increase of corticosteroids, estrogens, and progesterone suppress proinflammatory cytokines, that's why some ladies go on remission during this period.

Some ladies have less pain during the monthly periods as the hormones are preparing the body for a potential pregnancy.

On a personal note, I have always disliked periods, and so many women do. Researching on this blog post made me embrace them. Periods (listen to the podcast) are that sign that assures you of your hormonal balance.

Regular periods with consistently normal ovulation during premenopause, will prevent you from Osteoprosis, heart disease and breast cancer.

Periods are also a sign that you're being protected by your hormones against many disorders that will rise with menopause, because gal, they are many!

It's not easy to be a lady, we picked the forbidden fruit, remember. [just kidding!]

Lot's of hugs, Githu.

https://www.lifeextension.com/Magazine/2001/8/report_dhea/Page-01
https://www.medscape.org/viewarticle/819962_6
https://academic.oup.com/rheumatology/article/56/8/1254/2631597
https://www.sciencenewsforstudents.org/article/explainer-what-hormone
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4701921/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1257423/
https://pdfs.semanticscholar.org/76a5/ab00d18a662cc95d1781caf8d1019f728de2.pdf
https://www.womenshealthnetwork.com/pms-and-menstruation/irregular-periods-and-bone-health.aspx
https://www.clinexprheumatol.org/article.asp?a=2220