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    <head><title>Blocking Tissue Destruction</title></head>
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        <h1>
            Blocking Tissue Destruction
        </h1>
        <p>
            There always seems to be a rough balance between tissue regeneration and tissue degeneration, with growth
            and repair occurring when the equilibrium shifts in one direction,and with atrophy or degeneration occurring
            when the balance shifts in the other direction. If we can understand the mechanisms of atrophy, and how to
            retard or to block tissue destruction, then we can restore the balance to a degree which might allow
            regeneration to occur, even if we don't clearly understand the mechanisms of growth.
        </p>
        <p>
            Skin and bones are such different types of tissue that it will be useful to start with them, because if we
            can see similar processes of degeneration or regeneration in them, then the chances are good that the same
            processes will occur in other tissues too. Bone is a relatively stable tissue, while skin is a tissue whose
            cells divide rapidly.
        </p>
        <p>
            It is common medical knowledge that cortisone and realted glucocorticioid-type hormones cause skin to
            atrophy, becoming thinner. Using topical applications of a synthetic derivative of cortisione,CM Papa and A
            M. Kligman showed that the atrophy extended to the pigment cells,reducing theirr size and eliminating most
            of their dendritic branches. Some animal studies have found that estrogen caused the skin to become thinner.
            The other steroids they tested,progesterone, testosterone,and pregnenolone, acted in the opposite direction,
            making aged and atrophied skin thicker and more regular. They also made the pigment cells larger, and
            increased their branchinhg.l Since these hormones were already known to have protective actions against
            cortisone and estrogen, these results were not too surprising, though they did directly contradict the
            claims of people who made estrogen-containing cosmetics.
        </p>
        <p>
            Since progesterone and pregnenolone do not cause healthy, young skin to thicken, their effect in damaged
            skin is probably partly to replace the deficiency of that type of steroid which occurs with aging, and to
            offset the damaging effects of the catabolic hormones, whose influence does not decrease with age.
        </p>

        <p></p>
        <p>
            Many years ago it was found that in old age a woman's estrogens were increasedd relative to the 17-keto
            steroids adrenal androgens. Later, it was found that the conversion of androgen to estrogen increases with
            age in both men and women, and that this occurs largely in fat cells. Several years ago, P. K. Siiteri found
            that low thyroid modified the enzymes of fat cells in a way that would tend to increase the conversion of
            androgen to estrogen. More recently, it was found that adding progesterone to the enzymes had the opposite
            effect of aging and hypothyroidism, protecting the androgen from conversion to estrogen. These researchers
            (C. J. Newton and colleagues, of London) concluded that the decreased output of progesterone after the
            menopause might account for the increased production of estrogen.3 Since progesterone declines in aging men,
            too, this could account for the same process in men.
        </p>
        <p>
            Vitamin A's effect on the skin opposes that of estrogen.4 There are several mechanisms that could account
            for this. Vitamin A is used in the formation of steroids, and since the skin is a major site of steroid
            metabolism, vitamin A might help to maintain the level of the anti-catabolic steroids. A deficiency of
            vitamin A causes excessive release of the lysosomal enzymes, acid hydrolases, resulting in tissue
            catabolism.5 Also, vitamin A is necessary for the proper differentiation of cells in skin and other
            membranes. A deficiency tends to cause an increased rate of cell division, with the production of abnormal
            cells, and a substitution of keratinized cells for other types. Estrogen also promotes keratinization and
            speeds cell division. A deficiency of vitamin A can cause leukoplakia in the mouth and on the cervix of the
            uterus; although this is considered "pre-cancerous," I have found it to be very easily reversible, as I have
            discussed elsewhere.6 I suspect that the intracellular fiber, keratin, is produced when a cell can't afford
            to do anything more complex. Adequate vitamin A speeds protein synthesis,7 and allows it to be used more
            efficiently.
        </p>
        <p>
            Prolactin (which is promoted by estrogen, and inhibited by progesterone) increases with stress and with age.
            It probably affects every tissue, but it seems to have its greatest efects on the secretory membranes. It is
            known to have strong effects on the kidney, gut and skin (sweat and oil glands, hair follicles, and feathers
            inbirds), and on the gills of fish. Its involvement with milk production suggests that it might mobilize
            calcium from bones, and inf fact it does contribute to osteoporosis. This was foreseen by G. Bourne, in his
            book on the metabolism of hard tissues, when he suggested that estrogen, acting through the pituitary, might
            be expected to promote osteoporosis.
        </p>
        <p>
            Since reading Bourne's book, I have doubted that it was rational to use estrogen to prevent osteoporosis,
            especially when it is known to be carcinogenic and when the ratio of estrogen to and
        </p>
        <p>
            androgens and progesterone increases after menopause. Now that several publications have appeared clearly
            showing that estrogen increases prolactin, that prolactin increases with
        </p>
        <p>
            cancellous bone; adrenal androgens. Thyroid. Rate of formation, overall metabolic rate.
        </p>
        <p>
            <strong>ARTHRITIS AND NATURAL HORMONES</strong>
        </p>
        <p>
            A very healthy 71 year-old man was under his house repairing the foundation, when a support slipped and let
            the house fall far enough to break some facial bones. During his recovery, he developed arthritis in his
            hands. It is fairly common for arthritis to appear shortly after an accident, a shock, or surgery, and Han
            Selye's famous work with rats shows that when stress exhausts the adrenal glands (so they are unable to
            produce normal amounts of cortisone and related steroid hormones), arthritis and other "degenerative"
            diseases are likely to develop.
        </p>
        <p>
            But when this man went to his doctor to "get something for his arthritis," he was annoyed that the doctor
            insisted on giving him a complete physical exam, and wouldn't give him a shot of cortisone. The examination
            showed low thyroid function, and the doctor prescribed a supplement of thyroid extract, explaining that
            arthritis is one of the many symptoms of hypothyroidism. The patient agreed to take the thyroid, but for
            several days he grumbled about the doctor 'fixing something that wasn't wrong' with him, and ignoring his
            arthritis. But in less than two weeks, the arthritis had entirely disappeared. He lived to be 89, without a
            recurrence of arthritis. (He died iatrogenically, while in good health.)
        </p>
        <p>
            Selye's work with the diseases of stress, and the anti-stress hormones of the adrenal cortex, helped many
            scientists to think more clearly about the interaction of the organism with its environment, but it has led
            others to focus too narrowly on hormones of the adrenal cortex (such as cortisol and cortisone), and to
            forget the older knowledge about natural resistance. There are probably only a few physicians now practicing
            who would remember to check for hypothyroidism in an arthritis patient, or in other stress-related
            conditions. Hypothyroidism is a common cause of adrenal insufficiency, but it also has some direct effects
            on joint tissues. In chronic hypothyroidism (myxedema and cretinism), knees and elbows are often bent
            abnormally.
        </p>
        <p>
            By the 1930's, it was well established that the resistance of the organism depended on the energy produced
            by respiration under the influence of the thyroid gland, as well as on the adrenal hormones, and that the
            hormones of pregnancy (especially progesterone) could substitute for the adrenal hormones. In a sense, the
            thyroid hormone is the basic anti-stress hormone, since it is required for the production of the adrenal and
            pregnancy hormones.
        </p>

        <p>
            A contemporary researcher, F. Z. Meerson, is putting together a picture of the biological processes involved
            in adapting to stress, including energy production, nutrition, hormones, and changes in cell structure.
        </p>
        <p>
            While one of Selye's earliest observations related gastrointestinal bleeding to stress, Meerson's work has
            revealed in a detailed way how the usually beneficial hormone of adaptation, cortisone, can cause so many
            other harmful effects when its action is too prolonged or too intense.
        </p>
        <p>
            Some of the harmful effects of the cortisone class of drugs (other than gastro-intestinal bleeding) are:
            Hypertension, osteoporosis, delayed healing, atrophy of the skin, convulsions, cataracts, glaucoma,
            protruding eyes, psychic derangements, menstrual irregularities, and loss of immunity allowing infections
            (or cancer) to spread.
        </p>
        <p>
            While normal thyroid function is required for the secretion of the adrenal hormones, the basic signal which
            causes cortisone to be formed is a drop in the blood glucose level. The increased energy requirement of any
            stress tends to cause the blood sugar to fall slightly, but hypothyroidism itself tends to depress blood
            sugar.
        </p>

        <p>
            The person with low thyroid function is more likely than a normal person to require cortisone to cope with a
            certain amount of stress. However, if large amounts of cortisone are produced for a long time, the toxic
            effects of the hormone begin to appear. According to Meerson, heart attacks are provoked and aggravated by
            the cortisone produced during stress. (Meerson and his colleagues have demonstrated that the progress of a
            heart attack can be halted by a treatment including natural substances such as vitamin E and magnesium.)
        </p>
        <p>
            While hypothyroidism makes the body require more cortisone to sustain blood sugar and energy production, it
            also limits the ability to produce cortisone, so in some cases stress produces symptoms resulting from a
            deficiency of cortisone, including various forms of arthritis and more generalized types of chronic
            inflammation.
        </p>
        <p>
            Often, a small physiological dose of natural hydrocortisone can help the patient meet the stress, without
            causing harmful side-effects. While treating the symptoms with cortisone for a short time, it is important
            to try to learn the basic cause of the problem, by checking for hypothyroidism, vitamin A deficiency,
            protein deficiency, a lack of sunlight, etc. (I suspect that light on the skin directly increases the skin's
            production of steroids, without depending on other organs. Different steroids probably involve different
            frequencies of light, but orange and red light seem to be important frequencies.) Using cortisone in this
            way, physiologically rather than pharmacologically, it is not likely to cause the serious problems mentioned
            above.
        </p>
        <p>
            Stress-induced cortisone deficiency is thought to be a factor in a great variety of unpleasant conditions,
            from allergies to ulcerative colitis, and in many forms of arthritis. The stress which can cause a cortisone
            deficiency is even more likely to disturb formation of progesterone and thyroid hormone, so the fact that
            cortisone can relieve symptoms does not mean that it has corrected the problem.
        </p>
        <p>
            According to the Physicians' Desk Referenc, hormones similar to cortisone are useful for treating rheumatoid
            arthritis, post-traumatic osteoarthritis, synovitis of osteoarthritis, acute gouty arthritis, acute
            nonspecific tenosynovitis, psoriatic arthritis, ankylosing spondylitis, acute and subacute bursitis, and
            epicondylitis.
        </p>

        <p>
            Although cortisone supplementation can help in a great variety of stress-related diseases, no curewill take
            place unless the basic cause is discovered. Besides the thyroid, the other class of adaptive hormones which
            are often out of balance in the diseases of stress, is the group of hormones produced mainly by the gonads:
            the "reproductive hormones." During pregnancy these hormones serve to protect the developing baby from the
            stresses suffered by the mother, but the same hormones function as part to the protective anti-stress system
            in the non-pregnant individual, though at a lower level.
        </p>
        <p>
            Some forms of arthritis are known to improve or even to disappear during pregnancy. As mentioned above, the
            hormones of pregnancy can make up for a lack of adrenal cortex hormones. During a healthy pregnancy, many
            hormones are present in increased amounts, including the thyroid hormones. Progesterone, which is the most
            abundant hormone of pregnancy, has both anti-inflammatory and anesthetic actions, which would be of obvious
            benefit in arthritis.
        </p>
        <p>
            There are other naturally anesthetic hormones which are increased during pregnancy, including DHEA, which is
            being studied for its anti-aging, anti-cancer, and anti-obesity effects. (One of the reasons that is
            frequently given for the fact that this hormone hasn't been studied more widely is that, as a natural
            substance, it has not been monopolized by a drug patent, and so no drug company has been willing to invest
            money in studying its medical uses.) These hormones also have the ability to control cell division, which
            would be important in forms of arthritis that involve invasive tissue growth.
        </p>
        <p>
            While these substances, so abundant in pregnancy, have the ability to substitute for cortisone, they can
            also be used by the adrenal glands to produce cortisol and related hormones. But probably the most
            surprising property of these natural steroids is that they protect against the toxic side-effects of
            excessive adrenal hormones. And they seem to have no side-effects of their own; after about fifty years of
            medical use, no toxic side effects have been found for progesterone or pregnenolone.
        </p>
        <p>
            Pregnenolone is the material the body uses to form either progesterone or DHEA. Others, including DHEA,
            haven't been studied for so long, but the high levels which are normally present in healthy people would
            suggest that replacement doses, to restore those normal levels, would not be likely to produce toxic side
            effects. And, considering the terrible side effects of the drugs that are now widely used, these drugs would
            be justifiable simply to prevent some of the toxic effects of conventional treatment.
        </p>
        <p>
            It takes a new way of thinking to understand that these protective substances protect against an excess of
            the adrenal steroids, as well as making up for a deficiency. Several of these natural hormones also have a
            protective action against various poisons; Selye called this their "catatoxic" effect.
        </p>
        <p>
            Besides many people whose arthritis improved with only thyroid supplementation, I have seen 30 people use
            one or more of these other natural hormones for various types of arthritis, usually with a topical
            application. Often the pain is relieved within a few minutes. I know of several other people who used
            progesterone topically for inflamed tendons, damaged cartilage, or other inflammations. Only one of these, a
            woman with rheumatoid arthritis in many joints, had no significant improvement. An hour after she had
            applied it to her hands and feet, she enthusiastically reported that her ankle had stopped hurting, but
            after this she said she had no noticeable improvement.
        </p>
        <p>
            We often hear that "there is no cure for arthritis, because the causes are not known." If the cause is an
            imbalance in the normal hormones of adaptation and resistance, then eliminating the cause by restoring
            balance will produce a true cure. But if it is more profitable to sell powerful drugs than to sell the
            nutrients needed to form natural hormones (or to supplement those natural hormones) we can't expect the drug
            companies to spend any money investigating that sort of cure. And at present the arthritis market amounts to
            billions of dollars in drug sales each year.
        </p>
        <p>
            © Ray Peat 2006. All Rights Reserved. www.RayPeat.com
        </p>
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