Hormonal problems in CFS - a clinical picture - the ectomorph
[UPDATED NOVEMBER 2023]
Update November 2023
Since first writing this page, I have added much to my knowledge concerning hormonal issues in CFS sufferers. Without wishing to overwhelm the reader, I list these new pages below, but first, please see my new book, which contains the whole picture, regarding the thyroid, adrenal and pineal glands:
See also Our Book Green Mother - families fit for the future for the full picture regarding female sex hormones.
I now recommend the use of thyroid and adrenal glandulars to resolve these issues but I am including pages below that describe prescription medications also, by way of completeness.
The pages referred to above are as below:
THYROID
- Hypothyroidism - diagnosis of
- Hypothyroidism - A Common Hormonal Problem in CFS
- Thyroid - the correct prescribing of thyroid hormones
- Thyroid disease - how to persuade your GP to diagnose and treat
- Thyroid hormone test
- Thyroid - the correct prescribing of thyroid hormones
- Thyroid profile: free T3, free T4 and TSH
ADRENAL
- Adrenal Gland - the gear box of the car (DHEA and cortisol) – underactive
- Adrenal Stress Profile test result - What does it mean?
- Common Hormonal Problems in CFS - Adrenal
- Hydrocortisone - how to use it safely and without causing adrenal suppression
- Adrenal Stress Profile test result - What does it mean?
- Adrenal stress profile - salivary
THYROID AND ADRENAL
PINEAL
FEMALE SEX HORMONES
- Female sex hormones - what to do if levels are low
- The serious complications of taking the Pill and HRT
- Menopause – possible causes of hot flushes and what we can do to mitigate them
- Menopause - problems and how to tackle them
- Female hormone profile (Oestrogen, progesterone and testosterone levels in saliva)
Introduction
It is now quite clear that there is a distinct hormonal disturbance in CFS sufferers with abnormalities in the hypothalamic-pituitary-adrenal axis. There is plenty of evidence to suggest abnormalities of the thyroid glands. Two papers in the Journal of Environmental and Nutritional Medicine clarified my thinking in this area - please see the section immediately below. More recent papers have confirmed these hormonal disturbances - for example, see A Review of Hypothalamic-Pituitary-Adrenal Axis Function in Chronic Fatigue Syndrome which lists a further 101 studies.
CFS sufferers are often Ectomorphs
The first is a paper from an Australian psychiatrist Paul Holman, who noticed that very slim individuals seem particularly prone to chronic fatigue, anxiety and environmental sensitivity. He then reviewed the literature and discovered reports from doctors who tried to classify people in terms of their constitution.
Of most interest was that done by Sheldon in 1940 when he published The Varieties of Human Physique, where he described three dominant types - the endomorph, the mesomorph and the ectomorph.
- See Downloadable PDF of 'The varieties of human physique' and Amazon.com Link for The varieties of human physique
It is the ectomorph who interests us because he/she seems susceptible to CFS. Sheldon noted ectomorphs were introverts under 'strong inhibitory control'. They tend to be extremely sensitive to noise and 'distractions'. They usually revealed histories of allergies, skin complaints, chronic fatigue and insomnia. They needed to eat more and oftener than other types, needed protein in 'large quantities' and had difficulty adjusting to changes in climatic conditions.
A similar description is given by Tintera, who described a group of 200 patients whom he characterised as having suboptimal adrenal cortical function. These individuals showed an asthenic habitus, crowded lower incisors, cold extremeties, postural hypotension and tenderness in the adrenal angle. Their commonest complaints were anxiety, depression, headaches, salt and sugar craving, drug reactions, allergies, pre-menstrual syndrome, gastrointestinal problems (particularly alternating constipation and diarrhoea) and dermatoses. Laboratory findings included a flat glucose tolerance test, eosinophilia and low urinary 17-ketosteroids. Tintera hypothesised that the main problem for these people rested in a constitutional adrenal weakness which expressed itself in symptoms when the person was chronically stressed. His treatment was a high protein diet, low refined carbohydrates, more salt, hydrochloric acid (to help protein digestion), B vitamins, vitamin C and whole adrenal gland injections.
- LOOK FOR "The hypoadrenocortical state and its management" BY John W. Tintera. [1955] if you can find it. Full Reference details here - The hypoadrenocortical state and its management
The ectomorph has a constitution associated with anxiety and insomnia. These people are more 'aroused' and have a higher demand for nutrients, energy requirements and repair of body tissues. Normally the body repairs damaged tissues during sleep. Hormonally this is marked by a switch from cortisol and adrenalin in the day to testosterone and growth hormone at night, catabolic or breaking down by day to anabolic or building up by night.
We know that carbohydrates (such as sugar, wheat, potato etc), stimulate the thyroid gland, reduce pain thresholds, and elevate mood in the sort term (combating anxiety and depression) and so the ectomorph is likely to be tired and stressed, likely craves sweet foods in an attempt to attain calmer alertness. However excess carbohydrate in the long term raises metabolic rate, is stimulating, depletes nutrients (vitamins and minerals) and eventually damages the body resulting in chronic fatigue.
Treatment for Ectomorphs
Holman's advice to ectomorphs is that prevention is better than cure. He suggests:
- Ectomorphs learn the virtues of relaxation, regularity and stress management at an early age.
- Maintain good regular sleep. This is of paramount importance and insomnia should be seen as an early warning sing of hyperarousal.
- Protein in the middle of the day is essential to prevent the 'catabolic run down of mid to late afternoon'. Animal protein in stews or casseroles is best as ectomorphs are poor digesters. Vegetarians should supplement their diet routinely with amino acids.
- Ectomorphs should be wary of food sensitivity, especially to wheat and legumes.
- Ectomorphs need more of everything - food, vitamins, minerals, antioxidants (i.e. vitamins A,C,E and selenium), water (they tend to dehydrate readily), amino acids. (To this I would add essential fatty acids and salt). Modest exercise to build muscle mass is helpful. Avoid refined carbohydrate, and alcohol.
- Recovery takes time and often thyroid and adrenal supplements are needed. See Pattern of recovery
The way in which I implement these suggestions is:
- Getting enough rest - an essential part of managing CFS
- Sleep is vital for good health - especially in CFS
- The Paleo Ketogenic Diet - this is a diet which we all should follow
- PLUS my advice on the above pages and books
In general, see Overview of CFS/ME protocol
Related Tests
- Thyroid profile: free T3, free T4 and TSH
- Adrenal stress profile - salivary
- Female hormone profile (Oestrogen, progesterone and testosterone levels in saliva)
Related Articles
- My Book - The Underactive Thyroid - Do it yourself because your doctor won't
- Our Book Green Mother - families fit for the future
- Hypothyroidism - diagnosis of
- [[Hypothyroidism - A Common Hormonal Problem in CFS
- Thyroid - the correct prescribing of thyroid hormones
- Thyroid disease - how to persuade your GP to diagnose and treat
- Thyroid hormone test
- Thyroid - the correct prescribing of thyroid hormones
- Adrenal Gland - the gear box of the car (DHEA and cortisol) – underactive
- Adrenal Stress Profile test result - What does it mean?
- Common Hormonal Problems in CFS - Adrenal
- Hydrocortisone - how to use it safely and without causing adrenal suppression
- Adrenal Stress Profile test result - What does it mean?
- Conducting the CFS orchestra How to put yourself in charge
- Female sex hormones - what to do if levels are low
- The serious complications of taking the Pill and HRT
- Menopause – possible causes of hot flushes and what we can do to mitigate them
- Menopause - problems and how to tackle them
- Melatonin - the sleep hormone
- Getting enough rest - an essential part of managing CFS
- Sleep is vital for good health - especially in CFS
- The Paleo Ketogenic Diet - this is a diet which we all should follow
- Pattern of recovery
- Overview of CFS/ME protocol
References
- A Review of Hypothalamic-Pituitary-Adrenal Axis Function in Chronic Fatigue Syndrome
- Treating the Ectomorphic Constitution
- Downloadable PDF of 'The varieties of human physique'
- Amazon.com Link for The varieties of human physique
- The hypoadrenocortical state and its management
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