Menopause related allergies, or the connection between gynecology and allergology.

Women are more likely to suffer from food allergies, pollen, sensitivity to Tabaco smoke, and asthma. Fluctuations in the hormones cortisol, estrogen and progestogen and Testosterone, which women have, though considered a male sex hormone, all play a role in how the female body reacts when it comes to allergies (1).

When there are fluctuations in sex hormones within the female body, adult onset allergies may result. Here women experiencing hormone related changes like pregnancy or menopause, and in the case of girls, the onset of puberty, estrogen may increase the inflammatory cells reaction too, and sensitively too, allergens.

Here, a previously harmless substance is suddenly viewed as threatening by the body’s immune system.  The body develops what are called (igE) antibodies to protect against the substance at the same time it is developing the same antibodies in reaction to hormonal (estrogen and progesterone) fluctuations (2;3).  These (IgE) antibodies cause the body to release histamine into the blood causing an allergic reaction.  These antibodies cause the body to release histamine into the blood, causing itching, sneezing and nasal drip.

Besides increasing the production of histamine, estrogen can lower (down-regulate) the production of the enzymes diamine oxidase (DAO) and monoamine oxidase (MAO). These two enzymes eliminate histamine, so estrogen both increases the production of histamine and slows down its dissipation in the body (4).  Making matters worse, histamine can encourage the production of luteinizing hormones (LH), which in turn makes more estrogen (4) starting, or supporting, a vicious cycle.

Progesterone also plays a role in histamine production, but by inhibiting the release of histamine from what are called mast cells, even during an allergy attach (4). If a woman’s production of progesterone slows, as it does in menopause, allergic reactions can become more problematic.

Even though testosterone is considered to be a male hormone, women do produce it. During the menopause transition testosterone production may decline (5).  Testosterone does have a protective effect regarding allergic reactions (6).   Testosterone may be an immunosuppressant, meaning it suppresses the immune response, stopping it from overacting to the point where an allergy, or asthma, develops (7).

In non-menopausal women, the reactions are typically as follows: joint pain, premenstrual asthma, interstitial cystitis, menstrual migraines, and fibromyalgia (2;4). A low doe of progesterone may be helpful in some situations (2).

For women going into menopause: be aware of never before experienced coughing and wheezing. Menopause may engender the onset of never before experienced asthma.  If this happens seek medical attention.  You may wish to look into temporary hormone replacement therapy (8).

Asthma: Take for instance asthma, which more women than men have, and which more women than men are hospitalized for, or die from.   The reason is the sex hormone estrogen.  Here the fluctuation of estrogen before a menstrual cycle or during the onset of menopause can cause inflammation, which can trigger an attack of asthma like symptoms.  In this case a treatment focused on stabilizing estrogen levels (estrogen replacement therapy) may be recommended.  Keep in mind that estrogen replacement has been associated with an increased risk of stroke and heart disease (8).

For women with irregular cycles and asthma: be aware of your symptoms, use a peak flow meter to measure your lungs ability to push out air. If you see a decrease in the meter’s numbers, it may indicate the onset of a menstrual cycle.  Avoid allergy triggers at this point (8).

Autoimmune problems: The immune system can also increase inflammation, leading to or exacerbating, autoimmune diseases.  Again, these can be linked to reactions within the body brought on by fluctuations in sex hormones (9).

The hormone cortisol is associated with allergies and autoimmunity. Cortisol is produce by the body in a natural cycle (high in early morning, and lowering throughout the day) and when the body is under stress, including good stress like exercise or excursion.  Acute, or short term, stress is protective, it helps humans to survive and thrive.  Long-term, or chronic, stress may have a negative effect on the body, including making allergies and asthma worse (10).  Prolonged production of cortisol leads to the body failing to synthesise or make testosterone, which is protective in reference to allergens (6).  Many women going through menopause experience heightened levels of cortisol, or unusual fluctuations in cortisol from day to night (11).  The higher levels of cortisol may result from estrogen that is either made within the body (endogenous) or as a reaction to estrogen made outside of the body (exogenous) that the body comes into contact with, like hormone therapy, birth control pills or foods high in estrogen like substances called estrogenic or Phyto-estrogens, as well as estrogen like chemicals called Xenoestrogens.  Be aware that a constant release of cortisol can lead to adrenal fatigue, which in turn allows a greater histamine, or allergic, reaction (12).

Phyto-estrogen foods include the following: soy, legumes, chickpeas; flaxseed, bran, alcohol; clover and alfalfa.

Chemicals that react in the body like estrogen, called Xenoestgrogens, can also impact the endocrine system (13) which produces cortisol. These are found in cleaning products, plastics, and food preservatives (propyl gallate, 4-hexyl resorcinol) as well as in pesticides, animal feed/medications and beauty products (14;13).  For a list go to www.balancedconcepts.net/tips_avoid_xenoestrogens.pdf.

During the transition into menopause the body may make more of what is called follicle-stimulating hormone (FSH), which is meant to prompt the ovaries to produce eggs. FSH also signals the body to make oestradiol, a major type of estrogen (11).  The body reacts to the extra estrogen by producing more cortisol, hormone replacement therapy can also have this effect (11).  Hot flashes may also bring on a production of cortisol.

Conversely, a lack of cortisol, which ideally helps the immune system fight allergens, can negatively affect the immune system, leading to a greater reaction to allergens (6).   The preferred is a balance of cortisol, not too much and not too little, produced in a cyclical manner in sync with the body’s needs. Ideally cortisol levels should be highest in the morning and taper off through the day. Sighs that your cortisol levels are out sync are as follows:

Peaking too early: sleep disruptions, irritable and hostile in the morning, mind racing on awakening, and the experience of a sever energy lull mid-morning (15).

Not tapering off through out the day: If you are experiencing the following your cortisol may be up through out the day, but your adrenal glands are fatiguing: feelings of irritation and a lack of interest in things, overly fast speech, called pressurized speech, feeling hyper yet tired, or feeling like you are always behind and trying to gain ground (15).

Higher than average levels at night: combative attitude, worry-prone in evenings, not being able to fall asleep easily, trying to distract self with devices (15).

Too low levels throughout day: feeling of flatness, being tired no matter the amount of sleep gotten, falling asleep repeatedly, using stimulants to no avail (15).

Ways to alleviate dysregulated cortisol:

Use of the following supplements: vitamins B5 and C (1000 mg) and omega-3 fatty acids.

Try the herbs ginseng, ashwagandha, rhodiola, and eleuthero.

Drink plenty of fluids.

Behaviourally, get plenty of sleep, be aware of when you exercise as this can raise cortisol levels, and practice relaxation techniques like meditation (15).

To get cortisol release back in sink try eating a low carbohydrate meal in the morning, a moderate amount of complex carbohydrates mid-day, and a higher amount of complex carbohydrates during the evening meal.

Hormone allergy: Some women may suffer from what is called a hormone allergy.  This is an allergic reaction to the individual’s hormones, unrelated to any actual allergens (9).  This reaction, in spite of no allergens, may be linked to chronic inflammation and autoimmunity problems (9).

Hormone allergy can present as the following problems (9):

Premenstrual syndrome, loss of short term memory, premenstrual asthma, mood swings, menstrual migraine, weight problems, fatigue, skin problems, fibromyalgia, lowered sex drive, anxiety and panic attacks, interstitial cystitis, infertility, arthritis and chronic fatigue syndrome.

Tips for being aware of allergy and asthma related symptoms:

If you are going to get allergy tests do it on days 12-16 of the menstrual cycle, as these days are consistent with peak estrogen levels. This is important as immune response within the female body changes throughout the menstrual cycle (9).

In order to diagnose hormone allergy, it is necessary to have a medical professional take a full menstrual history including symptoms. Skin testing with bioidentical hormones can be done, just like for any other allergy test.  You can have a screening done for anti-hormone specific antibodies.  Regarding allergies and reproductive complaints, even if your tests come back “normal” or within normal limits ask to have hormone allergies investigated (9).

Keep in mind that estrogenic substances, or foods and supplements that have an estrogen like effect on the body, may also impact allergic reactions in women (3).

Regarding women with regular cycles: avoid known allergens before the onset of your menstrual cycle (8).

Bioidentical hormones administered sub-lingually, or under the tongue, have been shown to be successful in treating allergic reactions due to hormone imbalance in some cases (9).

Regarding hormone therapy and things like birth control pills, these change hormone levels which can then trigger allergic reactions like eczema, acne (or worsen it), breathing problems, and joint pain or migraine headaches (16).

Vitamin B6, the connection: Vitamin B6 is very important to many bodily functions, especially hormonal health (17). It is used by over 100 enzymes in the body. It is used for estrogen metabolism, the immune system, the endocrine system, which regulates hormones and the neurological (brain, nerves, spinal cord) systems, and in the process of methylation (18).

Methylation is described as the process by which the body takes three hydrogen atoms and one carbon atom (methyl group). The body utilizes this mix to produce a great number of necessary bodily functions including fighting the following: allergies, low immunity, and fibromyalgia (19).  The last is associated with diseases of inflammation (20). A disruption in methylation may be associated with allergies as it effects neurotransmitter balance (21) which, in turn, plays a role in allergic reactions. Here, dopamine, if produced by the brain in excess can have an antihistamine like effect.  This is as the enzyme Aromatic L-amino acid decarboxylase, made from B6, is needed to metabolize both dopamine and histamine (7).

B6 for histamine: Vitamin B6 effects histamine production, and so allergies and asthma, and autoimmune problems in a round about way.   Vitamin B6 is necessary to the production of an amino acid called Aromatic L-amino acid decarboxylase, or AADC (22).   This amino acid in turn is necessary for histamine production.  The enzyme catalyzes the conversion of histidine to histamine, as well as L-dopa to dopamine, and 5-hydroxytryptophan to serotonin (22). If histamine production uses up too much of the enzyme, not enough is left over to produce the neurotransmitters associated with emotional wellbeing (25) dopamine (7), serotonin, norepinephrine (23) and GABA.  This can lead to allergy and sinus related depression or anxiety.

The lack of B6 may explain why many people feel less alert when experiencing an attack of allergies or sinusitis.

B6 is necessary for the production of serotonin and norepinephrine (23) which are significant in protecting people from feeling depressed, as well as being necessary for cognitive functions like learning and memory (24).

B6 is used in the central nervous system, CNS, to help produce GABA, an amino acid associated with happiness. A mild deficiency of B6 can lead to the down regulation, or slowing in production of both serotonin and GABA (25).

B6 also helps produced the neurotransmitter acetylcholine which helps in the production of memory, dreams and thought processes.

B6 is imperative for the production of fatty acid DHA, or Docosahexaenoic acid, needed by the body for brain health, especially the health of the cerebral cortex. The cerebral cortex is very important for cognitive processes like attention, perception, memory, awareness, thought process, language and consciousness. Not surprisingly, DHA deficiency is associated with cognitive decline (26).

B6 for estrogen balance: B6 is needed by the liver to remove surplus estrogen from the body. Estrogen dominance contributes to autoimmune problems (27).  Further complicating matters, the body may mistake low progesterone for estrogen dominance, as the two sex hormones are needed to work together by the body.

B6 for progesterone: Progesterone is the product of the ovarian gland corpus luteum, it is produced after the egg is released during a menstrual cycle. Vitamin B6 is essential for the corpus luteum to work properly. Vitamin B6 deficiency may result in a progesterone deficiency (17).  B6 can help raise low progesterone levels (27).  This may be significant in the development of allergies during the menopause transition as progesterone helps to emolliate an allergic reaction, lessoning the likelihood of an actual allergy developing.

B6 deficiency is associated with allergies, asthma, and diseases of inflammation like osteoporosis and arthritis as well as emotional problems (23).

Sources of B6.

Fish (salmon, wild tuna) beef, chicken, garlic, sweet potato, spinach, bananas (438). Green leafy vegetables and fruits with high pigmentation (21). Other sources include brewer’s yeast, eggs, organ meat, carrots, peas, wheat germ, and walnuts (23).

Exercise may help the body produce the active form of vitamin B6 (23).

Side effects of taking too much B6 include numb or cold extremities (feet and hands) and poor circulation, hostile or irritable mood, and an irregular or rapid heart rate (21). Very high doses of B6 may result in toxic effects on the nervous system and on skin (28).

Causes of B6 deficiency include vegetarianism; the modern, nutrient deficient, diet, and eating processed or over cooking foods and consuming alcohol; Having diabetes, estrogen dominance, or taking contraceptive medication (birth control); and over working the adrenal glands by being under too much emotional and physical stress (including over exercise) for too long or by consuming too much caffeine (17;27). Medications associated with B6 deficiency are contraceptives, hormone replacement therapies and antidepressants (23).

THIS INFORMAITON IS FOR EDUCAITONAL AND ENTERTAINMENT PURPOSES ONLY.  PLEASE CONTACT A QUALIFIED HEALTHCARE PROVIDER FOR ANY HEALTH PROBLEMS YOU MAY HAVE.

Sources:

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