This is Dr. Lam. The endocrine system is made up of eight different glands located strategically
throughout the body. Each of these glands releases numerous hormones that has far-ranging
effects systematically throughout the body's organ function. In addition, each of these
organs are tied together by various axes. We have, for example, the hypothalamus, pituitary,
adrenal axis or the HPA axis that ultimately governs how the adrenal functions. There is
also an axis called ovarian adrenal thyroid axis, which is seldom paid attention to, but
it is a critical axis for, and it has to be functioning very well. When happens when these
three glands, as we look a little closer, is that when you have a diseased state of
each of these glands, conventional medicine usually picks it up. For example, if you are
having a problem with adrenal dysfunction, then if it is severe enough, it will be classified
as Addison's disease. If it is too low cortisol or if it's too high, it'll be Cushing's
disease. Same thing with thyroid. If your thyroids are not working well, it could be
classified and diagnosed as hypothyroidism. Ovarian problem can manifest itself in extreme
states as estrogen related type of cancer. Now, what happens if a person has these systems
in the body that is not quite at the diseased state but yet is still bothersome, in other
words, they are in a subclinical state symptomatically they are very, very, in trouble, but clinically
they don't fit the diagnosis criteria of conventional medicine. This subclinical state
of dysfunction needs to be addressed. Let's look closely first at the adrenal system.
For a person who is exposed to physical stress, emotional stress, the subclinical state is
called Adrenal Fatigue. This is a person that does not fit into the diagnosis of Addison's
disease, but is symptomatic, they are quite mild relative to Addison's disease. Causes
can be physical or emotional stress, toxic relationships, infections, over-exercise,
high sugar diet, lack of sleep, or over work. What are the symptoms? They include fatigue,
anxiety, weight gain, salt craving, hypoglycemia, insomnia, joint pain, palpitations, and adrenalin
rushes. Adrenal Fatigue can actually be divided into four stages clinically, starting with
stage 1, which is "alarm reaction," going into stage 2, with "resistance response,"
where the body tries to put up more cortisol. Stage 3, when the adrenals is in exhaustion
as the cortisol level start to go down, that's divided into phase A through D, with 3B, stage
3B phase as having the hormone of the OAT axis imbalance. After you reach stage 4 with
adrenal failure, then progressively it gets worse into Addison's disease. So you have
causes and symptoms of Adrenal Fatigue that we have just covered. Now, as far as the ovaries
are concerned, what do you get? Ovarian dysfunction can be caused by stress, can be caused by
environmental factors, taking hormone replacement medically, sugar, obesity, this causes imbalance
of estrogen versus progesterone. We need to remember in the ovaries, is not only the absolute
value of the estrogen level, but it's the balance between estrogen and progesterone
that's important. When the body, and particularly the ovaries, are under stress, usually the
end result is high estrogen relative to progesterone. Because progesterone tends to neutralize estrogen
and when the neutralization effects not there, then even though the estrogen level in absolute
terms is not high, in relative term it becomes dominant and the subclinical state of what
we see is called estrogen dominance. The symptoms include PMS, foggy thinking, irregular menses,
breast tenderness, PCOS, no spark in life, and in extreme cases, fibroid, endometriosis,
as well as cancer, especially breast cancer of estrogen origin.
Now, let's look at the thyroid. The thyroid gland usually is responsible for the metabolic
functions of the body and those people who have primary hypothyroid or hypothyroid caused
by other issues, such as infections or autoimmune diseases, can have symptoms such as low body
temperature, sluggishness, weight gain, hair loss, constipation, high cholesterol, and
dry skin. If you give thyroid medication, these symptoms should go away, except probably
low body temperature. If the low body temperature remains low over a consistent period of time
and the symptoms does not seem to go away and require more medication, then we have
to start thinking that maybe the hypothyroidism is caused by something else, or what we call
secondary hypothyroidism. Now, in the case of Adrenal Fatigue and ovarian axis, we're
dealing with three clinical subclinical states, starting with adrenal, which is Adrenal Fatigue.
The ovaries, which is estrogen dominance, and in hypothyroid, it'd be subclinical
hypothyroid. The presentation is convoluted because the symptoms are so overwhelming.
Now, let's look at the interconnection. When the adrenal is weak, the progesterone
is low. When the progesterone is low, it fails to oppose the estrogen in the ovaries and
therefore, as we talked about before, you have estrogen dominance, which is exaggerated.
On top of that, high estrogen increases the level of cortisol binding globulin and bounds
up the cortisol, therefore making less cortisol available, therefore it contributes to a reduced
level of cortisol in the adrenal glands, so we go backwards. On top of that, high estrogen
also contribute to a phenomenon called "organ resistance," in the adrenal glands, where
the adrenal glands becomes less responsive and blunted to the response of control from
the hypothalamus. At the same time, if you look at adrenals, a low cortisol, which is
characteristics of the stage 3 and beyond, causes a contribute to organ resistance in
the ovary, as well as a thyroid, both. So both thyroid and the ovaries are going to
be more resistant to hormonal response and on top of that, the Adrenal Fatigue lead to
a low free T3, a low free T4, although clinically it can be normal, and that is a problem. The
adrenal, when the adrenal is in fatigue, the thyroid binding globulin goes up, they are
metabolically linked. So when the thyroid binding globulin goes up, the thyroid are
bounded and therefore the amount released is reduced, so therefore, it contributes to
a lower thyroid function. Now on top of that, the low free T3 and the low free T4 can also
affect the sexual hormone binding globulin, as well as GNRH and prolactin and that affects
the ovaries and that's why many people with hypothyroidism will find that their period
may be missing and very difficult to get pregnant. On top of that, furthermore, the low thyroid
hormones can contribute to a lower level of progesterone, which then also swings around
and increase the estrogen dominance. So you can see, all these three glands, the ovarian,
adrenal, and thyroid, are all intertwined and if one is not well balanced, it's almost
impossible to get the other balanced. It's like three angles of a triangle or three legs
of a stool. Now, if you look at this diagram, you can see quite evidently that the cortisol
is really the key and that the adrenal is where the main control is. So the good news
is, if you can able to normalize adrenal function and the cortisol level goes up, then organ
resistance of the ovaries and the thyroid will be reduced. The thyroid hormone will
come up because the thyroid-binding globulin will then go back down. Similarly, when the
adrenals are normalized, the progesterone will go up and when that happens, the estrogen
is being opposed more appropriately and the estrogen dominant symptoms normally can be
reduced. So by normalizing the adrenal function, the estrogen dominance in the ovarian system
will go down and the secondary hypothyroidism symptoms will also tend to improve. So the
key is to work on the adrenals. If you don't do that and you're working on the other
symptoms without fixing the adrenals first, then it's oftentimes a strategy that is
futile and oftentimes can fail. So if you have symptoms suggestive of hypothyroidism,
such as dry skin, sluggishness, as well as PMS and endometriosis, breast tenderness and
then also Adrenal Fatigue such as sugar imbalances, obesity and salt craving, and you have all
these symptoms and no one can figure out for you what is going on, you may want to consider
the OAT axis imbalance as one of the causes. I hope this brief introduction has been helpful.
This entire article can be available to you, free, at no charge, if you go to my website,
Dr. Lam, that's www.DrLam.com, and look for the article called, "OAT Axis Imbalance:
Ovarian, Adrenal, Thyroid Axis Imbalance."