Chronic Lyme disease can affect nearly every system in the body, and your endocrine system, responsible for producing hormones, is no exception.
Your endocrine system is a messenger system of organs called glands that produce and release hormones into your blood circulation. Once in your circulation, hormones travel to distant target organs, exerting many effects.
Lyme disease is a significant stressor to your body, and a heightened stress response may interfere with hormone synthesis. The inflammation triggered by Lyme disease can also impair normal hormone production and activation.
Hormone imbalances can drive symptoms similar to Lyme disease, including chronic fatigue, depression, anxiety, and cognitive dysfunction.
In addition, unaddressed hormone imbalances may impair your immune system, compromising your ability to fight Lyme disease. Therefore, addressing hormone imbalances is vital for optimizing your Lyme disease recovery.
Read on to learn about the connection between Lyme disease and hormones and the five steps to correct hormone imbalances and restore your health!
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Table of Contents
How Does Lyme Disease Affect Hormones?
Lyme disease can affect hormones by influencing your HPA axis, your thyroid gland, and sex hormone production. Let’s discuss each of these factors in turn.
Lyme Disease Affects the HPA Axis
One of the main ways that Lyme disease influences hormones is by affecting the hypothalamic-pituitary-adrenal axis, or “HPA axis” for short. The HPA axis is the body’s primary stress response system.
The “governor” of the HPA axis is a tiny gland in your brain called the hypothalamus. The hypothalamus, in turn, regulates another gland in the brain called the pituitary, which can then send signals down to the adrenal glands above the kidneys.
Together, these glands coordinate the production and release of corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), cortisol, DHEA, norepinephrine, and epinephrine.
The HPA axis has changed very little since the dawn of humans. It has thus evolved to respond beautifully to acute stressors, the types of stressors humans have predominantly experienced for much of our history, such as getting chased by a lion on the African savannah.
The HPA axis reacts swiftly to an acute stressor and resolves the stress response through a feedback system. However, the HPA axis is poorly equipped to handle chronic stressors, including infections like Lyme disease.
Exposure to chronic stressors activates the HPA axis and, subsequently, the production of stress hormones. However, when the stressor doesn’t disappear promptly but rather remains chronic, such as in the case of a chronic infection, the HPA axis can end up working overtime initially and then eventually peter out.
This means that you may experience a hyper-responsive HPA axis for a period characterized by chronically elevated cortisol levels, followed by chronically low cortisol levels.
Cortisol is a “Goldilocks” hormone; we neither want it to be too high nor too low. Cortisol that is too high can suppress healthy immune function, repair, and regeneration, whereas cortisol that is too low can make it challenging to resolve inflammation.
Through its impact on the HPA axis, Lyme disease can cause a vicious cycle of immune dysfunction and inflammation. Problems with HPA axis function are often called “HPA axis dysfunction” in the functional medicine community.
The inflammation caused by chronic Lyme disease can also directly affect the HPA axis.
Research shows that when Borrelia bacteria infect the brain, the brain’s inflammatory response can compromise HPA axis function. (1) This means that, in addition to affecting the HPA axis through the stress response, the inflammatory response triggered by Lyme can also mess with your hormones.
For more information about the HPA axis and Lyme disease, be sure to check out my blog, The Definitive Guide to Repairing Lyme Disease and Adrenal Fatigue.
Lyme Disease May Alter Thyroid Function
Research also indicates that Lyme disease may trigger thyroid inflammation and dysfunction and possibly even an autoimmune attack against the thyroid gland. (2, 3) This may lead to hypothyroidism or the diagnosis of an autoimmune thyroid disease like Hashimoto’s disease.
Your thyroid makes the hormones triiodothyronine (T3) and thyroxine (T4), which regulate energy levels, body temperature, body weight, and brain function. Thyroid gland dysfunction can reduce the production of these hormones.
In addition, chronic inflammation can impair the activation of thyroid hormone in cells throughout your body. Lyme disease may trigger thyroid dysfunction by promoting dysfunction in the gland and stoking inflammation.
Symptoms of hypothyroidism include:
- Cold hands and feet
- Weight gain
- Difficulty concentrating
- A puffy face
As you can see, there are some similarities between the symptoms of hypothyroidism and Lyme disease!
Lyme Disease May Alter Sex Hormone Levels
Finally, the inflammation caused by Lyme disease may also impair the production of sex hormones, primarily estrogen, progesterone, testosterone, and DHEA. Think about it: If your body is busy fighting an infection, it will probably want to spend less energy creating reproductive hormones!
I often see low testosterone in men and low progesterone and estrogen dominance in women with Lyme disease.
I have also observed that some of my female clients with Lyme disease experience more pronounced PMS symptoms compared to women without Lyme disease. Their heightened PMS symptoms may be due to underlying inflammation and hormone imbalances.
I have also observed that menopause, the time in a woman’s life when sex hormones decline significantly and menstruation ceases, can be much rougher for women with Lyme disease than for women without Lyme. I suspect this is due to the exacerbating effects of Lyme on already declining hormones and inflammation levels.
I have dealt with HPA axis dysfunction, hypothyroidism, and sex hormone imbalances during my Lyme disease journey.
I’m happy to say that, as of this writing, my thyroid function and sex hormone imbalances are resolved. However, supporting my HPA axis is still an ongoing effort because stress never wholly disappears in the modern world!
I support my HPA axis with diet, supplements, and lifestyle practices. I use similar methods to help my clients with Lyme disease and HPA axis dysfunction.
Hormones Influence Immune Function
There exists a strong connection between hormones and immune function. Without healthy hormone balance, your immune system’s ability to fight Lyme disease may be compromised.
For example, cortisol suppresses the immune response when it is chronically elevated. (4) However, chronically low cortisol levels can compromise inflammation resolution, promoting a chronic inflammatory state. (5)
Estrogen also influences immune function. Generally, it has a stimulating effect on the immune system.
Low estrogen levels, such as that which occurs in menopause, may make postmenopausal women more susceptible to contracting Lyme disease compared to younger women with more robust estrogen levels. (6) This has yet to be proven, but it is an interesting theory!
Thyroid hormones also interact with the immune system. (7) Impaired thyroid function may make it harder for the body to fight infections and resolve inflammation.
Testosterone and dehydroepiandrosterone (DHEA) are androgenic hormones with important effects on immune function. Testosterone deficiency is associated with increased inflammation and immune system dysfunction. (8)
DHEA is often considered a “longevity” hormone, but it is also needed for robust immune function; low DHEA levels may cause the immune system to be less competent at fending off pathogens. (9)
A Note About Hormonal Birth Control and Lyme Disease
Approximately 65 percent of reproductive-age women in the United States use birth control. Besides female sterilization, the most common types of contraceptives used by women are oral birth control pills and long-acting reversible contraceptives (most of which are synthetic hormone-based), such as IUDs. (10)
While access to birth control is vital for women, it does not come without risks. For example, oral contraceptive use is associated with increased inflammation in women. (11)
Hormone-based contraceptives also deplete numerous nutrients, including folate, vitamin B2, vitamin B6, vitamin B12, vitamins C and E, magnesium, selenium, and zinc. (12) These are all nutrients necessary for healthy immune function, inflammation regulation, and brain health (among other functions).
Some of these risks of hormonal birth control may be particularly notable for women with Lyme disease who are already dealing with chronic inflammation and nutrient deficiencies.
If you are a reproductive-age woman with Lyme disease, a non-hormonal form of birth control, such as a copper IUD or basal body temperature tracking with an FDA-approved app such as Natural Cycles or a device such as Tempdrop may be a better option.
The copper IUD may pose a small risk of increased inflammation in some women. However, basal body temperature tracking doesn’t involve ingesting or inserting any hormones or other substances into the body. Therefore, it may be a good option for women sensitive to the copper IUD.
How to Test for Hormone Imbalances
The world of hormone testing is controversial, to say the least. Testing options include blood testing and saliva and urine testing.
In reproductive-age women, blood testing on specific days of the woman’s cycle can help determine whether sex hormone production is healthy or whether there are problems with estrogen dominance or progesterone insufficiency.
Thyroid hormone levels are assessed through blood tests. Assessing thyroid hormone function with a comprehensive thyroid panel, NOT just a TSH measurement, is crucial. A complete thyroid panel should at least include TSH, free T3, free T4, reverse T3, thyroglobulin antibodies, and TPO antibodies. Total T4 and total T3 may also be helpful markers to assess.
Furthermore, it is crucial that thyroid hormone labs are interpreted using functional reference ranges, as opposed to just the conventional reference ranges. Functional reference ranges for thyroid markers are the ranges that are associated with optimal health, not merely the ranges that are typical in the general population, which, admittedly, isn’t very healthy!
Here are the functional reference ranges for thyroid labs:
- TSH: 0.5-2.0 mU/L
- Total T4: 6.0-12 mcg/dL
- Total T3: 100-180 ng/dL
- Free T4: 1-1.5 ng/dL
- Free T3: 2.5-4.0 pg/mL
- Reverse T3: 9-21 ng/dL
- TPO antibodies: < 2 IU/mL
- TG antibodies: < 2 IU/mL
Saliva and urine testing can be used to gather information about the body’s cortisol response and sex hormone levels.
For example, Precision Analytical offers the DUTCH Complete, a test that provides a complete picture of your body’s cortisol production throughout the day and night as well as sex hormone levels. This test is far more useful for assessing cortisol than one-off blood cortisol testing, which provides very little actionable information.
Your healthcare provider can also use blood testing to assess levels of sex hormones, including estrogen, testosterone, and progesterone. If you are a woman, then blood testing will need to be performed on specific days of your cycle to accurately assess your hormone levels.
Lyme Disease and Hormones: 5 Steps to Address Imbalances
If we compare the systems in your body to a bus route, hormones are the last “stop” on the bus route. What I mean by this is that hormones tend to be the last thing to change in your body when your health is compromised.
This is why we don’t want to myopically focus on hormones without first addressing the foundations of health that are the first “stops” on the bus route: Nutrition, gut health, sleep, and stress management.
Some people may need thyroid hormone replacement, bioidentical hormones, or other supplements to improve their hormone imbalances. However, applying these strategies alongside nutrition, gut health, sleep, movement, and stress management practices that optimize hormone balance is key.
Let’s discuss 5 steps that you can use to support your hormones in Lyme disease:
Step 1: Optimize Your Nutrition for Healthy Hormones
An anti-inflammatory, nutrient-dense diet is the foundation for healthy hormone balance.
Research shows processed foods can disrupt the HPA axis by triggering leaky gut, blood sugar imbalances, and inflammation. (13, 14) To support your HPA axis, cut out foods made with refined flour, added sugars, and industrial seed oils, which include canola, corn, and soybean oils.
Instead, focus on a minimally-processed, anti-inflammatory diet centered around vegetables, high-quality animal proteins, low-glycemic index carbohydrates such as sweet potatoes and root veggies, and healthy fats like olive oil, avocados, and nuts.
Chronic stress and HPA axis dysfunction can drive deficiencies of multiple nutrients, including magnesium, vitamin C, and B vitamins. For example, magnesium is used by the body to create and metabolize stress hormones; however, magnesium deficiency can also promote chronic stress, creating a vicious cycle of heightened stress. (15)
Optimizing the nutrient density of your diet to emphasize these nutrients is critical. Recording your food for several days in a food tracking app such as Cronometer can help you determine what nutritional gaps exist in your diet.
In my nutrition practice, I have each of my clients complete several days of food tracking before we meet for their initial consultations to determine what nutritional gaps exist in their diet that may be negatively impacting their hormones.
In addition, nutritional testing, such as a NutrEval test, can also help identify nutrient deficiencies that are caused by and contribute to hormone imbalances.
Avoid excessive fasting and eat meals at consistent times each day. These eating patterns support healthy hormones by controlling cortisol and blood sugar.
One additional note for menopausal women dealing with Lyme disease: In menopause, estrogen levels ultimately decline significantly, increasing insulin resistance. (16)
Insulin resistance is a phenomenon in which your body’s cells become less responsive to insulin, making it more challenging to get glucose into cells. As a result, glucose levels rise in the bloodstream, triggering adverse metabolic effects.
The hormonal changes accompanying menopause require nutritional changes beyond just eating an anti-inflammatory, nutrient-dense diet. For example, many menopausal women need to decrease their carbohydrate intake and increase their protein intake to address insulin sensitivity caused by declining estrogen levels.
If you are menopausal, have Lyme disease, and struggle with weight gain, brain fog, and fatigue, you may need to significantly adjust your protein and carbohydrate intakes to improve your insulin sensitivity and metabolic health.
I work with many menopausal women in my practice and would love to help you optimize your diet for menopause and Lyme disease recovery!
Step 2: Improve Your Gut Health
A growing body of research indicates that gut health significantly influences hormones. Your gut’s health (or lack thereof) impacts your HPA axis, thyroid, and sex hormones. (17, 18, 19)
For example, your gut bacteria influence the production of neurotransmitters that regulate your HPA axis function. In addition, your gut’s absorptive capacity affects the absorption of nutrients necessary for producing and activating thyroid hormones.
Building and maintaining a healthy gut is vital for regulating your hormones.
Lyme disease can cause leaky gut and other gastrointestinal symptoms. Leaving these Lyme-induced gut issues unaddressed may cause downstream hormone imbalances.
If you are struggling with Lyme disease and hormone imbalances, I highly recommend working with a functional healthcare provider who can help you identify and correct the gut imbalances to get your hormones back on track.
Step 3: Get Your Sleep on Track
Sleep deprivation is a potent trigger for HPA axis activation. In addition, a chronically active HPA axis can make it difficult to fall asleep. (20) Doing everything you can to optimize your sleep while supporting your HPA axis through diet, lifestyle, and supplementation is crucial for getting restorative, hormone-balancing sleep.
Allocate 7-9 hours of sleep every night. Consume caffeine only in the morning because consuming it later in the day can vastly reduce the restorative quality of your sleep, even if you have no difficulty falling asleep after a 3 pm cup of coffee.
Sleep apnea is an under-recognized problem (it is possible to have sleep apnea even if you don’t snore) that activates the HPA axis. (21) Sleep apnea is stressful to the body because it reduces your body’s oxygen levels, driving up the stress hormone epinephrine.
Sleep is supposed to be a restorative, reparative time for your body. However, if your stress hormones are elevated all night due to sleep apnea, your body will have difficulty repairing and regenerating itself.
I recommend that all of my clients do a sleep study at least once to identify whether they have sleep apnea because, left undiagnosed, sleep apnea can drive chronic hormone imbalances and other chronic health issues, such as blood sugar problems and fatigue.
Step 4: Manage Your Stress
Chronic stress related to work, school, family, and financial matters is a significant stressor to the HPA axis. The stress in our lives will never completely disappear – it is a part of modern-day life. However, it is something that we can manage by engaging in daily practices that help us respond to stress in a healthier, more balanced way.
There are countless ways you can help your mind and body manage stress. Here are a few ideas:
- Guided meditations through an app such as Headspace or Calm
- Taking walks in nature regularly
- Tai chi
- Brain retraining programs, such as Vital-Side
- Having strong social connections
Step 5: Incorporate Supplemental Support for Hormone Balance
Some Lyme disease patients may need to incorporate supplements to support hormone balance during their Lyme recovery processes. Several types of dietary supplements, including adaptogens and nutrients, may be helpful.
Adaptogens for Hormone Balance
Adaptogens are a class of herbs that can be particularly helpful for balancing hormones in Lyme disease. Adaptogens are herbs, roots, and mushrooms that contain compounds that help our bodies adapt to stress. Adaptogens that support healthy hormone balance include Panax ginseng, ashwagandha, and licorice root.
For example, Panax ginseng is a revered adaptogenic herb in Traditional Chinese Medicine (TCM). It contains ginsenosides, phytochemicals that mitigate stress-induced gene expression and bolster DHEA levels, fortifying the HPA axis against chronic stress. (22)
How do adaptogens work? Our understanding of adaptogens is still evolving, but research indicates that adaptogens may support hormone balance through several mechanisms:
- Modulate heat shock protein expression: Heat shock proteins assist with protein folding inside our bodies; properly folded proteins are crucial for the function of every body system, including endocrine function. (23)
- Increase neuropeptide Y expression: Neuropeptide Y is a signaling molecule that acts as a physiological “brake” on the nervous system, toning down stress-response activity. (24, 25) It acts as a “buffer” for the body’s stress response.
- Support AMPK activity: Adaptogens influence the AMPK pathway, a biochemical pathway in all complex life forms, from mice to humans. AMPK is a central regulator of metabolism and energy production and maintains optimal cellular energy levels in the form of ATP. We need ATP to synthesize hormones at the cellular level. (26)
Nutrients for Healthy Thyroid Function and Female Hormone Balance
People with thyroid hormone dysfunction may benefit from supplemental iodine, selenium, and zinc, to support proper thyroid hormone production and metabolism. Your body needs selenium to protect the thyroid gland and zinc to activate thyroid hormone at the cellular level. (27, 28)
However, be cautious with supplemental iodine if you have thyroid autoimmunity, as supplemental iodine can sometimes exacerbate thyroid autoimmunity symptoms. In my clinical experience, food-based iodine (such as that found in edible seaweeds) doesn’t carry the same risk of flaring thyroid autoimmunity.
Women with estrogen dominance symptoms may benefit from taking calcium-d-glucarate and diindolylmethane (DIM), which support healthy estrogen metabolism.
Of course, some individuals will also do well taking prescription thyroid hormones, such as Armour Thyroid, or bioidentical hormone replacement therapy. However, these interventions should ideally be layered on only once nutrition, gut health, sleep, and stress management have been optimized.
The Bottom Line on Lyme Disease and Hormones
Chronic Lyme disease can trigger hormone imbalances, potentially worsening existing Lyme disease symptoms and creating new symptoms.
Hormone imbalances can also compromise immune function, potentially making it more difficult to recover from Lyme disease. Therefore, correcting hormone imbalances is crucial for long-term Lyme disease recovery.
Hormone imbalances develop downstream of problems with nutrition, gut health, sleep, and stress. Optimizing these aspects of your health before resorting to supplements and medications for hormones will often yield more sustainable health improvements compared to relying just on supplements or hormone replacement.
Do you need personalized functional healthcare support in your Lyme disease healing journey? I’d love to work with you one-on-one in my practice! If you’re ready to start, book your free discovery call to learn more about how I can help!