Perimenopause x fibro update

I'm always amazed by how the universe and Divine Timing work.✨

Six years after discovering Alex Howard (check him out in my posts "The tinnitus, hormone imbalance, and fibro relationship" and "The gut-brain connection") I'm listening to a webinar he's having with Kirsty Cullen, his CEO, and she's talking about the link between perimenopause and fibro. 🫨

I'm transcribing her words because it took me a few listens to get things straight (I think!) and I don't want to misrepresent anything. 

First, please remember three things: 

1. I am not a doctor or any kind of medical professional and I'm not suggesting any medical intervention. I'm only sharing information. 
   
   
2. When we talk about fatigue when it relates to fibro, we're talking about cellular fatigue, not being tired.
   
   
3. When we talk about cellular fatigue, we're addressing how our bodies change on a cellular level - mitochondrial change.

I've mentioned these in previous posts. 

Ok, here we go:

In perimenopause, our estrogen levels fluctuate, high and low and high and low, until we hit menopause and, eventually, they drop off. 

An increase in estrogen can trigger mast cells - they're immune cells - to release more histamine*. That's a common and well-researched link.

Now, that histamine can be problematic in the body. But, at the same time as we've got this increase in estrogen coinciding with an increase in histamine.

So at the same time as we've got higher estrogen levels and higher histamine levels, actually high estrogen levels also reduce the enzyme that we need to break histamine down. 

So we've got a double whammy going on here that results in a higher level of histamine.

What happens next is that high level of histamine can trigger more inflammation and oxidative damage in the body. And that inflammation and oxidative damage can then impact on our mitochondria and actually decrease the level of ATP** that we make. (Kirsty had talked about ATP earlier and I've put a bit of info about it below.)

So this is the perfect recipe for mitochondrial dysfunction.

...

Mitochondrial dysfunction in itself can then cause us to release even more histamine. So again, you're doubling down and you're increasing this histamine-dominant picture. 

Our ability to manage histamine is also energy-dependent. So at a time when histamine is decreasing our amount of energy production, we need more to manage the histamine. 

And as that energy production declines, those mast cells become more disregulated and more prone to releasing histamine. 

So [the] more histamine we produce, [the] more inflammation, [the] more mitochondrial disregulation. 

And that's an example of one of the perpetuating loops that we might see ...

Now ... remember we started this cycle with high levels of estrogen - and this is where biochemistry becomes really nuanced - because estrogen in itself can be very protective of mitochondria and our ability to produce ATP.

But when estrogen levels rise, either acutely or chronically, that can start to impair our mitochondrial function. 

So this is just an example of how these feedback loops happen and then end us in that perpetuating cycle. 

- end -

Well, phew! I had noticed, years ago, that fibro pain got worse about a week before my period - usually my back would hurt more - so I'd clocked a relationship between my hormones and my fibro. I didn't know it wasn't just me. Because, remember, fibro is a very personal thing to have. It presents differently for those of us who have it. And, in fact, later in the conversation, Alex and Kirsty do make the point that it's very important for any medical practitioner to work with each client as an individual. Yes, they can try the same things with different people, but they cannot and must not determine that if what worked for one person doesn't work for another, there's nothing else that can be done. 

You'll remember this was one of my biggest challenges with the medical profession → oh, well if that didn't work for you, there's nothing I can do/I can't help you/go home and live with it. 

I'm also now thinking (hoping!!) that once I'm menopausal, because there won't be anymore fluctuating estrogen levels ... dare I say it?? ... I WILL HAVE NO PAIN!!!

*Histamine

For those of you who, like me, wondered why histamine made it into the conversation (I only know histamines to be related to season allergies and that's when I take my handy-dandy anti-histamines), according to the Cleveland Clinic (note: bold text is mine): 

Histamine is a signaling chemical your immune system releases to send messages between different cells.

Your body mainly stores histamine in mast cells in tissues ... Mast cells are a type of white blood cell (Note from me: Remember high school bio class? White blood cells are the cells that fight infections.) that’s present in connective tissues throughout your body, especially:

• Under your skin.
• Near blood vessels and lymph vessels.
• In nerves
• In your lungs and intestines (remember the gut-brain connection??)

Histamine regulates countless bodily functions and plays a key role in your body’s inflammatory response.

Histamine intolerance occurs when you have a high level of histamine in your body. It can happen if your body can’t break down histamine properly. It causes a variety of symptoms, including:

• Headaches or migraines (I've had migraines that last for up to two weeks since I was 14)
• Nasal congestion
• Fatigue
• Hives
• Digestive issues
• Irregular periods (My periods were only regular when I was on the pill in my 20s and at some point in my mid-30s)

Wow! There really was no escape for me, huh?? 🤯🤯🤯

**ATP (adenosine triphosphate)

I'm consolidating information from a handful of resources to explain ATPs role in our bodies. 

Think of ATP like our body's battery. It's ATP that provides energy to and between our cells. Its relevance in the fibro context is related to the facts that our nerve cells use it in their functions, our muscles use it to move, and it's mainly produced in our mitochondria.

The fragility of the situation is in maintaining the necessary store of ATP. ATP is used up very, very quickly and isn't stored - we make it and use it up. So we need to be able to reproduce it super fast. 

Well ... since it's mainly our mitochondira that produce ATP and since our bodies with fibro have changed on that deep, cellular level, our ATP levels are generally lower than they are in a normal (or otherwise healthy) body.

Signs of lower ATP levels include: fatigue, muscle pain/weakness/cramps, difficulty concentrating, and memory challenges (hello fibro fog 😶‍🌫️)