Low DHEA, low CORTISOL in Rheumatoid arthritis

[SimulateTheHunt]

https://pubmed.ncbi.nlm.nih.gov/11155790/

first post for a lurker coming out from behind the curtain....

I'm Interested in the takeaway from the above summary. It's something I have been suspecting when observing my partners Rheumatoid arthritis. Its been severe for years, controlled with Enbrel (TNF / Etanercept) therapy. It completely disappeared during recent pregnancy and stopped using all medication only to return worse than ever 3 months postpartum. She has the usual associated afflictions,
- lifelong hypothyroid treated with an overdose of T4, moving to T3 now
- severe depression, comes and goes, recently greatly improved with dietary / lifestyle changes / pregnancy
- chronic iron deficiency anemia, poorly supplemented, improved with heme based supplements. Has markers of autoimmune gastritis - poor absorption etc

Interest is in the relationship between chronic stress and severe early life trauma and a dysregulated HPA response.
She has a blunted non reaction to many stressors up to a point where there is a paralyzing over response. She has some of the low cortisol classics like, blurred vision on exercise, low blood pressure, difficulty waking in the morning, total exhaustion.

Given we have corrected the major life stressors as best we can, what do we think is the best approach to resetting ones HPA system?
is hormonally testing for DHEA / cortisol relevant here? how would we correct it in anycase?

Currently breastfeeding also.

Much love to the community.

 

[charlie]

Rheumatoid arthritis is copper and vitamin A toxicity. The reason for the "iron deficiency" is the liver is so poisoned with copper and vitamin A that it cannot regulate the iron. The reason your partner got better during pregnancy is progesterone levels get really high, what this does is signal to the liver to lock up everything toxic that it can like copper and vitamin A and store it in the liver so as to protect the baby. This is the reason it looks like progesterone is working to make someone feel better, its locking up the toxins in the liver. So when your partner had the baby and progesterone goes back to normal, whammo, here we go again. All progesterone is doing is delaying the inevitable, eventually the toxin is gonna win unless you get it out.

 

[youngsinatra]

My mum has/had severe case of rheumatoid arthritis aswell, but she is able to not take corticosteroids (and her other crazy injectable immunosuppressants..) when she adheres to a strict diet. Her triggers are gluten, eggs, pork and dairy.

Full thyroid panel, and testing cortisol & DHEA is good in nearly all cases in my opinion.

 

[SimulateTheHunt]

Rheumatoid arthritis is copper and vitamin A toxicity. The reason for the "iron deficiency" is the liver is so poisoned with copper and vitamin A that it cannot regulate the iron. The reason your partner got better during pregnancy is progesterone levels get really high, what this does is signal to the liver to lock up everything toxic that it can like copper and vitamin A and store it in the liver so as to protect the baby. This is the reason it looks like progesterone is working to make someone feel better, its locking up the toxins in the liver. So when your partner had the baby and progesterone goes back to normal, whammo, here we go again. All progesterone is doing is delaying the inevitable, eventually the toxin is gonna win unless you get it out.

Thanks for your response @charlie, its a perspective I have never fully understood. Iron regulation seems to have very sophisticated control mechanisms that are most often not appreciated, Its clear that her low iron isn't an issue with intake, so it would make sense that something else is driving elevated Hepcidin.

The question in any case is then how to approach a body burdened with Copper and Vit A? there is nothing extreme in our diet or lifestyle that should lead to these being an issue. Anecdotally we did observe a severe flare up one day after a dozen oysters which are of course famously high in copper, though they should be balanced by Zinc.

On a more conceptual level it's never made sense to me that the body would go to such lengths to 'protect' a baby during pregnancy, only to return to a diseased state afterwards. If it has the capacity to regulate itself to a healthy state why wouldn't it always want to do this? So many objective and subjective measure of health improve with pregnancy, there are certainly lifestyle adjustments that happen, but something bigger is certainly happening that has never been properly explained.

Thanks.

 

[SimulateTheHunt]

My mum has/had severe case of rheumatoid arthritis aswell, but she is able to not take corticosteroids (and her other crazy injectable immunosuppressants..) when she adheres to a strict diet. Her triggers are gluten, eggs, pork and dairy.

Full thyroid panel, and testing cortisol & DHEA is good in nearly all cases in my opinion.

Thanks for your reply, we are very reliant on eggs and dairy as easy sources of basic nutrition while breastfeeding. She has had periods without these with no revelation, though its pretty well described that elimination diets can work. At least until one slips up again and its very hard not to.

Its always seemed like a crutch though. There are so many studies and stories explaining in detail how elimination diets work so effectively, but on a mechanical level this is still simply avoidance by reducing gut permeability and thus avoiding whatever it is one is reacting to.

Dr. Zsofia Clemens and Dr. Csaba Toth have done excellent work demonstrating this mechanism and their diet has been shown to be very effective at healing atleast the pathology they describe (increased intestinal permiability). Though the diet is really not sustainably or enjoyable for anyone wishing to participate in life. Their PEG testing is particularly interesting.

But there must be so much more at play to explain a couple of things.
-
Rheumatoid Arthritis affects women 3x more than men, their guts aren't all more permeable by design, possibly by disease.
People with increased permeability don't develop RA more.
The majority of pregnant RA patients see complete remission during pregnancy.

For us acute stress has always brought on definite flares, it's the case that stress will increase gut permeability but it also produces a cascade of hormonal changes that even with perfect enteric health have a dramatic affect on the immune system.

Last months bloods show

T4-23
T3-6
TSH-0.03
waking body temp averaging about 36 / 96.8
cholesterol of 7 or 271mg/dl

(white taking 225mg of levothyroxine, we have reduced this nowto 150 while adding some T3)

Ferritin - 30
Iron Sat - 41

When testing cortisol to use in the CORT/DHEA ratio, is morning serum cort ok?

Thanks to everyone here.

​

 

[mm33]

My wife is currently following a protocol from the 1980s by Dr Thomas McPherson Brown - The Road Back - Rheumatoid Arthritis its cause and its treatment. I think you can get the book on Amazon. Basically the author believes it's caused by mycoplasma and the treatment is basically antibiotic therapy. I believe Harvard has a protocol on this as well. My wife just started but is very enthusiastic about it. The hard part is finding a doctor who'll follow/treat as per the protocol.

Lee Merritt (drleemerritt.com) believes autoimmune diseases are caused by parasites, so she's big on treating parasites and has a protocol on her website.

Not sure these would help your partner but definitely worth looking into imo.

 

[Ania]

I have suffered from RA since I was 17.(Now 51) I head identical situation, all symptoms disappeared during pregnancy, but came back much worse 3 months after giving birth. Later, when I was about 35 I discovered it was totally connected to diet. I discovered dairy was my trigger. I have been symptom free with elimination diet. I regained pain free life. Please, try experimenting. In each case it might be a different trigger, sometimes more than one. Later I got intolerant to many different foods, but then I discovered HOW I make myself intolerant. Here is my story Rheumatoid Arthritis Managed With Fruit And Protein Diet

 

[charlie]

I discovered dairy was my trigger

Dairy is extremely high in many different kinds of toxic "vitamin A", especially goat milk dairy. You basically went on a much lower toxic vitamin A diet and healed. Rheumatoid arthritis is from toxicity plain and simple. :)

The question in any case is then how to approach a body burdened with Copper and Vit A?

A low toxic "vitamin A" diet along with low copper and other toxin diet along with repleting the essential minerals magnesium, potassium, selenium, molybdenum, zinc and then the amino acid nicotinic acid fixes this.

Anecdotally we did observe a severe flare up one day after a dozen oysters which are of course famously high in copper, though they should be balanced by Zinc.

The zinc is there to protect the oyster from toxic copper. It is not enough to protect a person as you can see.

 

[Ania]

Dairy is extremely high in many different kinds of toxic "vitamin A", especially goat milk dairy. You basically went on a much lower toxic vitamin A diet and healed. Rheumatoid arthritis is from toxicity plain and simple. :)

I do not think so. I get intolerant to everything that goes through my digestive system more than once daily for about 2 weeks. Before I discovered this pattern I got intolerant to many things including Progest E, so now I can use it only topically. However, I still consume liver without issue. This is some crazy defect of my immune system which reognizes practically everything as an offender as long as I ingest it twice daily. I even started having reaction to my tap water. Now I can only drink ultra pure water and I can do it only once a day.
Despite this knowledge I still get intolerant to some thing that just do not come to my mind like rinse aid from dishwasher or stainless steal cookware. Now I know better and it got very complicated, but for me life without debilitating pain is worth the hardship.

 

[SimulateTheHunt]

I have suffered from RA since I was 17.(Now 51) I head identical situation, all symptoms disappeared during pregnancy, but came back much worse 3 months after giving birth. Later, when I was about 35 I discovered it was totally connected to diet. I discovered dairy was my trigger. I have been symptom free with elimination diet. I regained pain free life. Please, try experimenting. In each case it might be a different trigger, sometimes more than one. Later I got intolerant to many different foods, but then I discovered HOW I make myself intolerant. Here is my story Rheumatoid Arthritis Managed With Fruit And Protein Diet

thanks for your response, your past thread is a great reference for us.

 

[SimulateTheHunt]

Dairy is extremely high in many different kinds of toxic "vitamin A", especially goat milk dairy. You basically went on a much lower toxic vitamin A diet and healed. Rheumatoid arthritis is from toxicity plain and simple. :)
A low toxic "vitamin A" diet along with low copper and other toxin diet along with repleting the essential minerals magnesium, potassium, selenium, molybdenum, zinc and then the amino acid nicotinic acid fixes this.
The zinc is there to protect the oyster from toxic copper. It is not enough to protect a person as you can see.

Thanks Charlie, were going to give the elimination diet another go while trying to maintain carbohydrates this time and specifically avoiding high copper / Vit A foods. See how we go.

Ive been reading alot about the copper RA interactions and although its very well described that copper elevates in relation to disease activity, its not clear that the elevation causes the disease. An interesting population study in China shows an increase in RA where copper levels in farms are higher, any how, worth a try.

https://www.sciencedirect.com/science/article/pii/S0929664615003393

Circulating Level of Blood Iron and Copper Associated with Inflammation and Disease Activity of Rheumatoid Arthritis - Biological Trace Element Research

Certaintainly a history of copper IUD and estrogen contraception will have a long term influence on copper balance.

RA is really such a destructive horrible disease, it deeply affects quality of life and can be chronically disabling. Typical mainstream treatments can be powerfully effective but come with serious systemic side effects and are certainly not a long term solution. Some extreme elimination diets can help but also have their side effects (slowed metabolism/ hypothyroidism/ deficiencies etc). I'm Surprised to not have heard of that many people actually completely coming of RA meds and finding long term remission, the disease has affected us for likely thousands of years now, evidence exists of its presence in ancient egypt and all through classical and medieval times. Of interesting note is in population studies looking at Masai (dairy consuming) and adjacent non dairy consuming tribes, although improved overall health, they suffer from arthritis which their dairy free neighbours dont.
Interesting read, very different to what you hear in the carnivore world, that just praises the meat and blood diet eaters, they forget to mention that the Maasai woman suffer such fertility issues that the men resort to stealing woman from neighbouring tribes!

Kikuyu-Maasai Nutrition and Colonial Science: The Orr and Gilks Study in Late 1920s Kenya Revisited
"that eighty percent of Maasai complained about constipation and arthritis, but few suffered from the four main maladies of the Kikuyu"


diet will look like:

Would love to know everyones thoughts.

Would love to reintroduce dairy if all goes well and some bulky starches at some point, because potatoes are fun :)

Thanks all

 

[Ania]

thanks for your response, your past thread is a great reference for us.

No problem. I hope it is at least something to consider and experiment a little bit. Might be completely different case, but at least give it a try.