An overview of adreno-cortical fatigue and resulting hyperestrogenism

Caroline D. Levin RN
All rights reserved

When adrenal glands become exhausted by chronic irritation, they no longer produce cortisol. Precursors such as progesterone accumulate and “spilled over” into the adjacent hormone pathway. This results in elevated levels of adrenal estrogen. In other words, when one path is blocked, hormone activity is rerouted down another pathway. A good analogy would be boating down a river. If a dam were built across the river, the water would back up and you would have to steer your boat down a different branch of the river to continue on your trip.

Signs/symptoms of elevated adrenal estrogen closely resemble those of excess cortisol including, fatigue, confusion, depression, incontinence, irritability, seizures, and darkening of the skin. Elevated estrogen raises liver/pancreas enzymes (serum amylase/alkaline phosphatase), cholesterol, and triglycerides. Elevated estrogen also results in kidney degeneration, bone marrow and immunoglobulin suppression (anemia, cancer, infections, GI upset), increased histamine activity (allergies/itching), and thyroid binding.

Elevated levels of hormone precursors, such as progesterones and androgens cause impaired glucose tolerance (high blood glucose levels), obesity, increased body core temperature (heat intolerance/panting), increased appetite, aggression, thick coats, acne (small flesh-colored bumps), and bald patches.

Depleted cortisol levels cause anorexia, vomiting, abdominal pain, diarrhea, weakness, organ failure, and death. Low-dose glucocorticoid replacement therapy has been reported to reduce excess sex-hormone production in both humans and dogs. The hypothalamus recognizes the presence of the oral cortisol replacement hormone, which decreases chronic ACTH stimulation. This in turn reduces the excessive production of adrenal sex-hormones.

REFERENCES

Bagshaw S. The combined oral contraceptive. Risks and adverse effects in perspective (abstract). Drug Safety 1995; 12: 91-96.

Bianco AC, Nunes MT, Hell NS, Maciel RM. The role of glucocorticoids in the stress-induced reduction of extrathyroidal 3,5,3’-triiodothyronine generation in rats(abstract). Endocrinology 1987; 120: 1033-1038.

Blum M, Zacharovich D, Pery J, Kitai E. Lowering effect of estrogen replacement treatment on immunoglobulins in menopausal women (abstract). Revue française degynecologie et d’obstetrique 1990; 4: 207-209.

Carlberg KA, Fregly MJ, Fahey M. Effects of chronic estrogen treatment on water exchange in rats (abstract). American Journal of Physiology–Endocrinology and Metabolism 1984; 247: E101-E110.

Deaton M, Glorioso JE, , Mclean, DB. Congenital Adrenal Hyperplasia—Not really a zebra. American Family Physician 1999; 59: 1190-1196.

Derman RJ. Effects of sex steroids on women’s health: implications for practitioners (abstract). American Journal of Medicine 1995; 1A: 137S-143S.

Felman EC, Nelson RW. Canine and Feline Endocrinology and Reproduction, Third edition. Saunders, St. Louis, 2004.

Foldvary-Schaefer N, Harden C, Herzog A, Falcone T. Hormones and seizures (abstract). Cleveland Clinical Journal of Medicine 2004; 71: 11S-18S.

Goldenberg N, Wang P, Glueck CJ. An observational study of severe hypertriglyceridemia, hypertriglyceridemic acute pancreatitis, and failure of triglyceride-lowering therapy when estrogens are given to women with and without familial hypertriglyceridemia (abstract). Clinica Chimica Act: International Journal of Clinical Chemistry 2003; 332; 11-19.

Guthrie GP, Wilson EA, Quillen DL, Jawad MJ. Adrenal androgen excess and defective 11-beta-hydroxylation in women with idiopathic hirsutism (abstract). Archives of Internal Medicine 1982; 142: 729-735.

Hart JE. Endocrine pathology of estrogens: species differences (abstract). Pharmacology Therapeutics 1990; 47: 203-218.

Jeffries MK. Safe Uses of Cortisol third edition. Charles C. Thomas Publisher, Ltd, Spring eld, 2004.

Johannsen TH, Ripa CP, Reinisch JM, Schwartz M, Mortensen EL, Main KM. Impaired cognitive function in women with congenital adrenal hyperplasia (abstract). Journal of Clinical Endocrinology and Metabolism 2006; 91: 1376-1381.

Landau RL, Poulos JT. The metabolic in uence of progestins (abstract). Advances in Metabolic Disorders 1971; 5: 119-147.

Levin C. Sudden Acquired Retinal Degeneration, associated pattern of adrenal activity, and hormone replacement in three dogs – a retrospective study. Proceedings of the
38th Annual Meeting of the College of Veterinary Ophthalmologists 2007; 38: 32.

Parker WA. Estrogen-induced pancreatitis (abstract). Clinical Pharmacy 1983; 2: 75-79.

Plechner AJ. Cortisol abnormality as a cause of elevated estrogen and immune destabilization: Insights for human medicine from a veterinary perspective. Medical Hypothesis 2004; 62: 575-581.

Rogers SM, Baker MA. Thermoregulation during exercise in women who are taking oral contraceptives (abstract). European Journal of Applied Physiology and Occupational Physiology 2004; 75: 34-38.

Rosen eld RL, Lucky AW. Acne, hirsutism, and alopecia in adolescent girls. Clinical expressions of androgen excess (abstract). Endocrinology and Metabolic Clinics of North America 1993; 22; 507-532.

Rossi GV. Side-effects and possible complications of oral contraceptive drugs (abstract). American Journal of Pharmacology 1966, 138: 127-136.

Ruman J, Brenner S, Sauer MV. Severe hypertriglyceridemia and pancreatitis following hormone replacement prior to cryothaw transfer (abstract). Journal of Assisted Reproduction and Genetics 2002; 19: 94-97.

Shansky RM, Rubinov K, Brennan A, Arnsten AF. The effects of sex and hormonal status on restraint-stress-induced working memory impairment (abstract). Behavioral and Brain Function 2006; 2: 8.

Terral C, Godard P, Michel FB, Macabies J. In uences of estrogens on histamines liberation by whole blood induced by allergens in vitro (abstract). Comptes Rendus des Seances de la Societe de Biologie et de ses Filiales 1981; 175: 247-252.

Vasiadi M, Kempuraj D, Boucher W, Kalogeroitros D, Theoharides TC. Progesterone inhibits mast cell secretion (abstract). International Journal of Immunopathology and Pharmacology 2006; 19: 787-794.

Warne GL, Grover S, Zajac JD. Hormonal therapies for individuals with intersex conditions: protocol for use (abstract). Treatments in Endocrinology 2005; 4: 19-29.

Zayed I, van Esch E, McConnell RF. Systemic and histopathologic changes in beagle dogs after chronic daily oral administration of synthetic (ethinyl estradiol) or natural (estradiol) estrogens, with special reference to the kidney and thyroid (abstract). Toxicologic Pathology 1998; 26: 730-741.