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torquillWell, crap. The plus side of finding something which explains a lot is that clears up a lot of the mystery. The minus side is the subsequent "well, what do I do now?" Or, in this case, "how can I get someone to believe me long enough to (dis)prove it?"
I looked over my last round of blood tests a few days ago. They've been percolating in the back of my mind since then. The thought started to creep into my mind that the signals are confused. Last time around, I hadn't had a proper period in something like three months, which suggested that I should either be in a post-ovulatory state or the signals to ovulate should be really high. But my estrogen was high and progesterone was quite low (that's a pre-ovulatory condition) and my Follicle-Stimulating Hormone was also low (a post-ovulatory condition). FSH usually increases until ovulation happens; if it hadn't happened in 80-90 days, FSH should be through the ceiling. But nothing indicated I had a corpus luteum from ovulation, and FSH was in the basement.
That suggests that FSH isn't ramping up as it should, which would lead to irregular ovulation. It would be reflected in erratic temperature charts, which I have -- I used to have a textbook low-high pattern every cycle, and now it looks like the Alps. If the FSH->LH handoff isn't happening for some reason, erratic and patternless cycles result.
GnRH regulates both FSH and LH; secreted by the hypothalamus, it instructs the pituitary to send out FSH until GnRH gets downregulated by rising estrogen, and then to switch over to LH to sustain the corpus luteum. So either the GnRH isn't following its proper pattern, or the pituitary isn't responding as it should. There are a couple of tests that can be used to differentiate the two scenarios, which of course I haven't had.
Just for giggles, I looked up the functions of the hypothalamus. In reasonable detail, endocrineweb gave me a bullet list, and my stomach started to sink a little as I read it. Besides the GnRH stuff I've described, it produces:
ADH and oxytocin are stored by the pituitary. GH, FSH, LH, ACTH, and TSH are produced by the pituitary. Hell, it may just be a pituitary problem; I already know that there's something defective in my brainstem (oxygen regulation has been wrong since I was tiny), and brainstem swelling was something I experienced several times in early- to mid-2015 as a result of mycotoxin exposure. The pituitary is right in that neighborhood.
It's hardly a slam-dunk, but between the sex-hormone madness and this "oh, and by the way" list, I'd like to investigate further. I don't know whether there are any treatments for poor hypothalamus or pituitary performance, but if nothing else it might uncover something like irregular thyroid which *could* be treated. (Hell, this might be linked to my suspected defective amino acid synthesis, which is the reason I need animal protein, either as a cause or an effect.) It would also give me an idea of what else I might anticipate. It would validate my claims as well, of course, but I'm trying to keep that out of the picture. Mostly, I want knowledge I don't have. If I can get that through the internet, fine, but complex systems are hard to debug by reading research papers. If only I had access to an endocrinologist...
I looked over my last round of blood tests a few days ago. They've been percolating in the back of my mind since then. The thought started to creep into my mind that the signals are confused. Last time around, I hadn't had a proper period in something like three months, which suggested that I should either be in a post-ovulatory state or the signals to ovulate should be really high. But my estrogen was high and progesterone was quite low (that's a pre-ovulatory condition) and my Follicle-Stimulating Hormone was also low (a post-ovulatory condition). FSH usually increases until ovulation happens; if it hadn't happened in 80-90 days, FSH should be through the ceiling. But nothing indicated I had a corpus luteum from ovulation, and FSH was in the basement.
That suggests that FSH isn't ramping up as it should, which would lead to irregular ovulation. It would be reflected in erratic temperature charts, which I have -- I used to have a textbook low-high pattern every cycle, and now it looks like the Alps. If the FSH->LH handoff isn't happening for some reason, erratic and patternless cycles result.
GnRH regulates both FSH and LH; secreted by the hypothalamus, it instructs the pituitary to send out FSH until GnRH gets downregulated by rising estrogen, and then to switch over to LH to sustain the corpus luteum. So either the GnRH isn't following its proper pattern, or the pituitary isn't responding as it should. There are a couple of tests that can be used to differentiate the two scenarios, which of course I haven't had.
Just for giggles, I looked up the functions of the hypothalamus. In reasonable detail, endocrineweb gave me a bullet list, and my stomach started to sink a little as I read it. Besides the GnRH stuff I've described, it produces:
- Anti-diuretic hormone (ADH). I've noticed before that my kidneys are a little wonky about salt retention -- when I eat an especially salty meal, they start dumping salt until I actually have to eat sodium chloride to correct the balance. They dump salt at other times, particularly under stress; I'm the only person I know who regularly gets a low-grade sodium deficiency. High ADH can cause that.
- Corticotropin-releasing hormone (CRH). It links in with ACTH to talk to the adrenal glands. I haven't had adrenal exhaustion in quite a while, but the corticosteroids released by the adrenals in response can affect metabolism, and let's face it, my metabolism hasn't been normal for a while. I need to look this up in more detail.
- Growth hormone-releasing hormone (GHRH) or growth hormone-inhibiting hormone (GHIH). These regulate growth hormone production. I wouldn't normally give this a second thought, except that I had already noticed that my weight seems to be shifting more toward my belly than it has been in the past. It used to be that I gained it on my thighs, upper arms, and hips, but now it seems to be gained and lost largely in front. I would chalk that up to testosterone except I'm not taking any (and my levels are female-normal).
- Thyrotropin releasing hormone (TRH). This is what stimulates the production of TSH. Remember how a bunch of you have asked at various times whether I've had my thyroid checked? Remember my primary-care doc who told me flat-out that it wasn't necessary to test anything else if TSH looked okay? Wonky TRH or pituitary dysfunction would be how you can get a low TSH and still have inadequate thyroid response. I don't have a classic hypothyroid profile, but I have a lot of symptoms which overlap with it, and it may be misregulation rather than outright failure.
- On a related note, the hypothalamus (through the thyroid and pituitary) controls body temperature, blood pressure, thirst, hunger, and blood sugar, all of which have been strange for me off and on (well, on the blood-pressure front, it's hard to tell, but it could be responsible if I do indeed have high blood pressure). My body temperature in particular is highly variable; I've had hypothermia in the past which made me pretty much unable to function until I reset my thermostat. With three organs in the picture it gets very messy, which might explain why I've rarely managed to find any sort of pattern to any of it... at one point eating chicken livers could pretty reliably drop my core temperature, but that was years ago and the effect vanished. My responses to blood sugar have been very strange since about the same time my period went weird, a year ago last October.
- Oxytocin. In the "okay, that's just weird" category, oxytocin just happens to be in charge of uterine contractions. Like the cramps I've been getting (that creep through even when I'm taking grapeseed extract). Apparently, high estrogen makes the uterus sensitive to oxytocin, which induces labor-type cramps, which are long, sustained spasms of the uterus rather than the short-term cramps of menstruation. Sound familiar? (By the way, the side-effect of synthetic oxytocin (Pitocin) is nausea, which probably doesn't help my morning sickness.)
ADH and oxytocin are stored by the pituitary. GH, FSH, LH, ACTH, and TSH are produced by the pituitary. Hell, it may just be a pituitary problem; I already know that there's something defective in my brainstem (oxygen regulation has been wrong since I was tiny), and brainstem swelling was something I experienced several times in early- to mid-2015 as a result of mycotoxin exposure. The pituitary is right in that neighborhood.
It's hardly a slam-dunk, but between the sex-hormone madness and this "oh, and by the way" list, I'd like to investigate further. I don't know whether there are any treatments for poor hypothalamus or pituitary performance, but if nothing else it might uncover something like irregular thyroid which *could* be treated. (Hell, this might be linked to my suspected defective amino acid synthesis, which is the reason I need animal protein, either as a cause or an effect.) It would also give me an idea of what else I might anticipate. It would validate my claims as well, of course, but I'm trying to keep that out of the picture. Mostly, I want knowledge I don't have. If I can get that through the internet, fine, but complex systems are hard to debug by reading research papers. If only I had access to an endocrinologist...
