Estrogen and Autoimmune Disease
Autoimmune diseases are much more prevalent in women; 75% of autoimmune diseases affect women, while 25% affect men. This statistic makes it seem like estrogen is involved in some way. We know that estrogen affects the immune system, because all immune cells have estrogen receptors and these hormones also encourage your immune cells to begin to make too many antibodies. The role of estrogens in autoimmune diseases has been well studied in women with lupus, where research has shown that oral contraceptives and the use of post menopausal hormone replacement therapy (HRT) increased the risk of lupus and that the incidence of lupus increases after puberty and drops after menopause when estrogen levels are lower. (1) These findings make sense because estrogen causes a shift toward Th2 (lymphocytes that make antibodies), and women with lupus are already Th2 dominant, thus the extra estrogen makes the disease worse. The severity of symptoms in patients with lupus often gets worse as estrogen levels climb, like during the menstrual cycle and during pregnancy.
We are beginning to understand that there are different kinds of estrogens in the body and they each have different effects on your cells and health. The idea that toxic (“bad”) estrogen metabolites made in the liver could be responsible for triggering lupus or making it worse has been supported by many human clinical observation studies and experimental animal studies. (2) Therefore, testing for estrogen metabolites (collectively, the 2, 4 and 16 estrones) and improving the ratios of the good to bad, should be part of the functional medicine treatment for treating autoimmune disease. This approach is reviewed in detail in my book, The Immune System Recovery Plan: A Doctor’s 4-Step Program for Treating Autoimmune Disease.
Aisha Lateef and Michelle Petri. Hormone replacement and contraceptive therapy in autoimmune diseases. J Autoimmun. 2012 May;38(2-3):J170-6. Epub 2012 Jan 18.
TE McAlindon, et al. Indole-3-carbinol in women with SLE: effect on estrogen metabolism and disease activity. Lupus (2001) 10, 779–783.