Hormone and pro-hormone therapy

Due to the nature of chronic disease, it is common for patients suffering from chronic diseases to have low levels of hormones. This is often due to high levels of the vitamin D metabolite 1,25-DPrimary biologically active vitamin D hormone. Activates the vitamin D nuclear receptor. Produced by hydroxylation of 25-D. Also known as 1,25-dihydroxycholecalciferol, 1,25-hydroxyvitamin D and calcitirol. which interferes with the production of hormones such as T3, testosterone, etc. Because the vitamin D system is dysregulated in chronically ill patients, supplementing with other hormones tends to further dysregulate the receptors rather than increase hormonal expression. Thus, hormone supplementation is contraindicated. If the patient is already on hormone “replacement” therapy, judicious use of low-dose hormone therapy (to relieve intolerable symptoms) may be necessary until the patient is able to wean from the hormones.

Marshall Protocol (MP) patients are advised to work with their doctor to use the lowest dose of medication that is effective.

As patients begin to kill the Th1 pathogensThe community of bacterial pathogens which cause chronic inflammatory disease - one which almost certainly includes multiple species and bacterial forms. causing their disease, vitamin D metabolism restabilizes and 1,25-D's effects on hormonal stabilization becomes less of an issue. Once this happens, there is no longer a need to take extra hormone supplements, and patients can then wean off their steroids.

Steroid hormones are molecules produced and secreted by endocrine glands in the body. These hormones are released in the blood stream and travel to other parts of the body where they bring about specific responses from specific cells. Steroid hormones are derived from cholesterol and are lipid-soluble molecules.

Steroid hormones cause changes within a cell by first passing through the cell membrane of the target cell. Once inside the cell each steroid hormone primarily binds with its specific receptor in the cytoplasm of the target cell. The receptor-bound-steroid-hormone then translocates into the nucleus of the cell. The steroid-receptor complex causes the production of messenger RNA (mRNA) molecules from DNA genes through transcription. The mRNA molecules are then transported to the ribosomes. The mRNA molecules code for the production of proteins through translation.

Steroid hormones can be grouped into five groups by the receptors to which they bind: glucocorticoids, mineralocorticoids, androgens, estrogens, and progestagens. Vitamin D derivatives are a sixth closely related hormone system with homologous receptors, though technically sterols rather than steroids.

The following types of hormone supplementation are discussed:

When the Vitamin D Receptor (VDRThe Vitamin D Receptor. A nuclear receptor located throughout the body that plays a key role in the innate immune response.) becomes blocked by 25-DThe vitamin D metabolite widely (and erroneously) considered best indicator of vitamin D "deficiency." Inactivates the Vitamin D Nuclear Receptor. Produced by hydroxylation of vitamin D3 in the liver., bacterial ligands, or other compounds, the Receptor can no longer transcribe an important enzyme that keeps the active D metabolite, 1,25-D, in the correct range. As 1,25-D rises without a feedback system to keep it in check, the hormone dysregulates the nuclear receptors including PPAR-gamma which control the body's hormones and affects the levels of hormones including the male, female, and thyroid hormones.¹⁾

When a patient takes exogenous (supplemental) hormones including the male, female, and thyroid hormones, those hormones enter the blood stream with some leaching into the cell. It is not known how exactly hormones affect activity of the body's nuclear receptors. However, it may be the case that just as with elevated levels of 1,25-D, the presence of supplemental hormones triggers a feedback pathway which leads to reduced production of that hormone.

For example, if a patient is given testosterone, some of that testosterone enters the cell. Increased levels of testosterone may reduce the transcriptional activity of the Androgen Receptor, the nuclear receptor which produces it. One possibility is that with reduced production of testosterone, the Androgen Receptor also reduces transcription in other ways, leading to a reduction in the production of certain families of antimicrobial peptides, which many active Type I nuclear receptors also produce.²⁾ Therefore, hormone replacement therapy may compromise innate immune function in dose-dependent fashion. Research is needed to validate this theory.

Research into estrogen plus progestin therapy showed increased risks, 7 more CHD events, 8 more strokes, 8 more PEs, and 8 more invasive breast cancers. (16608 healthy postmenopausal women studied over 5 years) ³⁾

Discontinuation of hormone supplements is not required for MP patients as long as the extra hormones are making up for a marked deficiency observable on a blood test. However:

There is a big difference between a body's hormonal control system producing a hormone under feedback control, and an attempt to change the operation of the control system by supplying exogenous drug (HRT). Another example is the use of exogenous Prednisone or cortisol to try and modulate the immune system - it is fraught with secondary problems.

Trevor Marshall, PhD

Many symptoms attributed to hormonal imbalance are actually due to immunopathology. Before a patient assumes she needs HRT (hormone replacement therapy) she should be sure to try the suggestions for managing immunopathology.

For those patients and their doctors who decide to use HRT, the prevailing recommendation is to take hormones at the lowest effective dose only as needed for intolerable symptoms unrelieved by management of the MP medications. Reports suggest that a bio-identical product is preferable.

It is impossible to know for sure what effect using HRT has on the recovery process but sometimes compromises must be made in order to be comfortable enough to stay on the MP and make any progress.

As patients begin to kill the Th1 pathogens causing their disease, vitamin D metabolism restabilizes and 1,25-D's effects on hormonal stabilization becomes less of an issue. This means over the course of treatment, patients who could not produce adequate thyroid hormone begin to produce it naturally. Once this happens, there is no longer a need to take extra hormone supplements.

My suggestion would be to wean a steroid down slowly, and see what the effect is, bit by bit.

Trevor Marshall, PhD

When I started the MP, I was also taking DHEA, pregnenolone, progesterone and testosterone. When I tested them again in December, the DHEA and pregnenolone were back to normal and I had to reduce the progesterone! I was able to stop progesterone and testosterone a few months ago as well!

Alayne

My wife gets HRT due to surgery to remove fibroid tumors. She's had to lower the dose to the smallest available while on the MP. HRT is simply sometimes necessary, and the MP can be done in combination with the HRT. However, you do need to be able to change the dose level of the HRT as the MP changes things.

Chris

Soon after I got sick in '09, after going through what I thought was menopause, a doctor I was seeing got me onto Bio-Identical progesterone and estrogen Creams. It was call the Wylie Protocol. I began having cycles again like I did when I was in my 20's.

When I started the MP about a year ago, I abruptly stopped the progesterone but continued the estrogen. My cycles dissipated and stopped completely. I slowly weaned off the estrogen and have not used either for I think about 5 months now.

My epiphany is that, If I had not gone onto the Wylie Protocol, and forced my body to cycle, maybe by now, my body would have corrected itself. Due to my forcing things along I think I may have cost some time in my own healing.

I am having hints of PMS symptoms now and then and I do believe I will cycle again, in time, but I think, if I had not used estrogen and progesterone supplementation, my body would have already corrected in this area.

All other areas of my body are showing massive improvements after 10 months except in the female department. I am hoping this will improve soon also.

I write this, not to beat myself up for using assistance but to let anyone else in on my epiphany that is thinking about using hormone replacement therapies. IMO, our bodies know what to do.

They will return to normal balance even faster if we don't interfere.

CousinTC, MarshallProtocol.com