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reprinted from

"Progressive Health News" Vol. 5, No. 9—Oct. 1, 2002

Poor Immunity & Low Body Temperature Linked to Adrenal/Thyroid Hormonal Imbalances and Deficits. Part 1

Veterinarian treats thousands of pets with multiple illnesses from chronic infections to autoimmune conditions and finds a common anomaly - adrenal/thyroid hormonal-imbalances & deficiencies

The adrenals are a pair of ductless glands that sit atop the kidneys in the lower part of the back. New insights on metabolism and hormonal balance indicate that the adrenals and thyroid have a direct role in energy production, well-being, allergies, immune function and many other areas of human health.

An article by Alfred J Plechner DVM and M. Zucker "Unrecognized endocrine-Immune Defects in Multiple Diseases: An Effective Veterinary model may offer Therapeutic promise for human conditions. A mutual friend, Martin Zucker, sparked my interest in Plechners theories and treatment approach. Zucker stated that Alfred Plechner has developed a simple protocol for treating cats, dogs and other pets that have chronic infections and multiple health problems that do not resolve on their own. The protocol involves diagnostic testing for certain thyroid and adrenal hormones followed by low-dose adrenal and thyroid replacement hormones that are used together rather than separately. The result of the treatment is that Adrenal estrogen production declines and stops binding to thyroid hormones. The end result is that thyroxin is freed-up to increase ATP production in the cells. This normalizes body temperature and cell-mediated immune functions improve.

According to Zucker, Plechner treated dozens of cats with FIV infection. Zucker stated that the treatment restored normal immune function. FIV stands for Feline Immunodeficiency Virus. The equivalent in humans is HIV. I asked Zucker if this treatment approach has ever been used in humans to treat HIV? He said that to his knowledge it has not. One wonders what Plechner's protocol would do for HIV and other immune deficiency diseases including CFIDS, candidiasis, cancer, hepatitis, Lyme disease, lupus, MS, allergies and autoimmune diseases. Will it bring us closer to a cure for AIDS or a control that has little or no side effects?

How and why do deficits and imbalances in endocrine hormones affect the immune system? We know that hypothyroidism (low thyroid function) leaves a person vulnerable to one chronic infection after another. In Wisconsin, Dennis, a local PWA, HIV+ since 1983 has had above normal body temperature all his life and after all these years, still no HIV progression. Never on drugs his viral load is still under 1000.

In a separate phone call to Alfred Plechner, I asked him what exactly is his treatment protocol? Here was his reply.

Alfred: The treatment consists of giving low dose thyroid hormones along with low-dose cortisone.

Mark: You mean low-dose thyroid hormones like Armour Thyroid that provide the thyroid hormone "thyroxin" and Cortone that provide one of the adrenal hormones cortisone or its most active form - hydrocortisone?

Alfred: Yes, the equivalent of these drugs for use in humans is available by prescription for household pets and other animals. The amount given varies according to the weight of the animal and the results of diagnostic tests. If I were treating an adult human, I would start off with 1/2 grain of thyroid (about 60 mg) and 5 mg of cortisone twice a day. You need to monitor blood pressure when giving thyroid as too much could cause it to rise as well as increase the pulse rate. The process of increasing thyroid use has to be gradual. Usually the amount of cortisone used is maintained at a low level.

Mark: I can understand the role of the thyroid hormone as it controls cellular metabolism throughout the body, the production of ATP and will help in normalizing body temperature that is critical for restoring cell-mediated immune responses, but cortisone, is it not immunosuppressive?

Alfred: Absolutely, if you take too much of it. The same is true for zinc. Research has shown that too little zinc or too much is immunosuppressive and this has been shown for other nutrients as well. You absolutely need zinc for your thymus gland to function properly and mature T cells but you don't want too much or too little. Experience has shown that 15 to 30 mg daily is a safe and effective dosage range. Now for cortisone, it is a natural anti-inflammatory hormone and the normal healthy human body produces about 40 mg daily. It is well established that too much cortisone is immunosuppressive, in fact, for this reason alone, cortisone has a bad reputation. What is not known is that too little free cortisol is immunosuppressive. There are many people treated with thyroid hormones that get their body temperature back to normal and many who do not. One reason is that part of the Adrenal glands are exhausted and are not producing enough cortisol and another part of the Adrenal glands are producing too much estrogen that binds to thyroxin. The production of cortisol is controlled through a feedback loop. Note: When cortisone is administered, it is converted to the active form called cortisol that is also known as hydrocortisone.

Mark: What is a feedback loop?

Alfred: Cortisol levels are controlled by a classical feedback loop that involves the hypothalamus-pituitary and adrenal glands. Cortisol, the primary glucocorticoid, is produced in the middle Adrenal cortex layer. We have found a problem in cortisol production that comes from two of three layers of the adrenal cortex. The defect can be genetic or due to other causes (nutritional deficiencies or toxins). Cortisol stimulates several processes that serve to increase and maintain normal glucose levels in the blood, exert a potent anti-inflammatory effect and act as a regulating factor for normal immune function.

Mark: Tell me more about this "loop" and how does normalizing cortisol and estrogen levels affect the functioning of the Thyroid gland and help restore normal body temperature and cell-mediated immune function?

Alfred: "The loop is called the hypothalamus-pituitary-adrenal axis. Cortisol is secreted in response to a single stimulator: AdrenoCorticoTropic Hormone (ACTH) that is produced by the Pituitary gland. ACTH is itself secreted under control of the Hypothalamus and a hormone it secretes called Corticotropic-Releasing Factor (CRF). Cortisol secretion is suppressed or stimulated by classical feedback loops. When blood concentrations rise above a certain threshold, cortisol inhibits CRF secretion. This, in turn, inhibits ACTH and less ACTH reduces adrenal secretion of cortisol.

"However, when the adrenal gland is unable to produce enough cortisol, or for some reason the cortisol is bound, or otherwise inactive, and thus not recognized by the system, the pituitary continues to produce ACTH in order to extract more cortisol from the adrenals.

"The inner cortical layer, where adrenal estrogen is produced, also responds to ACTH. The result of constant ACTH stimulation in a situation where cortisol is bound or deficient produces a release of adrenal estrogen into the system. As cortisol levels fail to reach the threshold to stop the Hypothalamus from secreting CRF, the CRF stimulates the Pituitary to continue to secrete ACTH. The ACTH tries to get the Adrenal gland to produce cortisol but the same ACTH also stimulates the adrenals to secrete estrogen. As a result of an inability of the adrenals to keep up with demand for cortisol, adrenal estrogen levels build up and cause the following:

A histamine-like effect on capillaries, leading to inflammation from blood components spilling into adjacent tissues
Binding thyroid hormone
Further deregulation of lymphocytes and antibodies."

Mark: Elevated histamine levels have been linked to elevated interluken 6 levels in many studies. If the histamine like effects are due to actual elevated histamine levels then should not we also expect IL-6 levels to increase also; and if that were the case, would we not also expect a shift in cytokine profiles from TH1 to the less effective TH2?

Alfred: That is a good question. I have not investigated whether or not IL-6 levels are elevated in these conditions but I have found out that IgA levels are low and these low levels in the digestive tract lead to food allergies and sensitivities as well as malabsorption.

Mark: IgA is a TH1 cytokine needed for mucosal immunity. Bifidobacteria Longum has been found to increase the levels of IgA as does vitamin A. What are some of the benefits of supplementing with low-dose thyroid and cortisone you have observed in your clinical practice?

Alfred: After a trial and error period, I have developed a testing and treatment strategy that has proved to safe and highly effective. The central modality is replacement with physiological doses of cortisone preparations to address the root issue of cortisol deficiency. The low-dose cortisone preparations normalize ACTH levels, stop the overproduction of adrenal estrogen and the accompanying estrogen blockade of the thyroid hormones and reregulates the immune system. The use of low dose cortisone long term has also been reported by Jefferies for treating allergies, autoimmune disorders and chronic fatigue syndrome (1).

The second important modality is the simultaneous use of thyroid hormone. The thyroid hormone is needed because the excess adrenal estrogen has bound some of the thyroid hormone. The low dose thyroid hormone helps increase the metabolic rate and the liver to detoxify as well as process the cortisol. By giving cortisol and thyroid replacement simultaneously, the body is able to effectively utilize and process the former (cortisol) without developing side effects.

Once the testing and low-dose hormone therapy is underway, it is very important to follow a hypoallergenic diet and remove foods to which the animal or person is sensitive. After a few weeks, the sensitive foods may be reintroduced one at a time.

Mark: Have you written and published other articles on this subject?

Alfred: In the late 1970's, I wrote 4 articles (2, 3, 4 and 5) on my experiences and theories but found no germane research in veterinary journals to provide guidance.

Mark: As a general guide for someone who has low body temperature, low cortisol and high estrogen, what would be a safe dose with which to start?

Alfred: For cortisol, 5 mg twice a day. Take at 8am and 2pm. Do not take cortisone supplements in the evening or before bedtime, as it will interfere with the REM state of sleep. We want cortisol levels higher when we are awake and low when we are asleep. In normal subjects, cortisol levels are highest at 8am in the morning. Also, melatonin levels that help promote restful sleep should be lowest during the day and increase after dark and before bedtime. A melatonin spillover in the AM can depress the basal metabolic rate all day. This can be turned off by exposing the eyes to bright natural lights for a few minutes or taking a walk outside without wearing sunglasses.

For thyroid, 1/4 grain (about 15 mg) daily to start and after a few weeks if blood pressure and pulse are not elevated to gradually increase the thyroid amount. The cortisol levels are left the same. The hormonal and immune benefits will accrue and be maintained as long as the person stays on the protocol. A physician's prescription is required for both the cortisol and thyroid hormones. The key here is low-dose for successful long-term use as adverse effects may develop from higher doses. Note: Thyroxine is a strong inducer of IgA, a TH1 cytokine needed for intestinal and mucosal health.

Reference

Jefferies, w. McK.Mild adrencortical deficiency, chronic allergies, autoimmune disorders and the chronic fatigue syndrome: a continuation of the cortisone story. Medical Hypothesis, 1994; 42;183-189
Plechner A.J., Shannon M., Canine Immune Complex diseases. Modern Veterinary Practice, November 1976; 917
Plechner A. J., Shannon M., Epstein A, Goldstein E., Howard E. B., Endocrine-immune surveillance. Pulse. June-July, 1978
Plechner A.J., Theory of endocrine-immune surveillance. California Veterinarian, Jan 1979; 12.
Plechner A.J. Preliminary observations on endocrine-associated immunodeficiencies in dogs? A clinician explores the relationship of immunodeficiencies to endocrinopathy. Modern Veterinary Practice, 1979; 811

Important Highlights from Alfred Plechner's article

35,000 pets treated with this protocol

Alfred Plechner states he has treated over 35000 pets in the past 20 years with this protocol. Plechner reports that low cortisol and thyroid hormone lowers T cell panels in the tests. Estrogen can exert a dramatic blocking effect on cortisol and thyroid hormones, and just a slight variation out of normal is enough to cause hormonal and immune complications. In this case, the relationship is usually low cortisol, high estrogen and deregulated immune cells.
In female animals that are not neutered, testing is done when the animals are not in estrus and are not producing high levels of ovarian estrogen.

Diagnostic Tests used by Plechner

Female Assay

A. Blood tests:
Cortisol
TSH
T3
T4
Total Estrogen
Progesterone
Testosterone (total and free)
Ferritin
IgA, IgM, IgG

B. Urine Tests:
24 hour urine collection
1. Active cortisol
2. Free T3
3. Free T4

C. Basal Metabolic Temperature Test
Take upon waking (Only accurate in a menstruating women from 2nd to 4th day.) See note below on how to take the basal temperature test in the morning.

Male Assay

A. Blood tests:
Cortisol
TSH
T3
T4
Total Estrogen
Testosterone (total and free)
IgA, IgM, IgG

B. Urine Tests:
24 hour urine collection
4. Active cortisol
5. Free T3
6. Free T4

C. Basal Metabolic Temperature (using a digital thermometer)
Traditional method: Shake down thermometer and place on bed stand the night before. Upon awakening in the morning, while still in bed, place thermometer in armpit for 10 minutes before getting up. Normal basal temperature should be between 97.8 and 98.2°F.

Note: Mercury thermometers are no longer being sold due to the hazards of mercury should a thermometer break. A convenient digital thermometer called a "Talking Thermometer" is available from Walgreens for about $10. Just click the button and wait for 3 beeps then it is ready to use. The thermometer will talk to you and tell you your temperature when it stabilizes. Upon awakening, the basal temperature may be taken under the tongue. Manufacturers of thermometers state that the basal temperature taken under the tongue can be done faster and with the same accuracy as under the armpit.

Because of its fast readout, the Talking Thermometer and other digital thermometers will not give you an accurate reading under the armpit and should be taken under the tongue instead. The normal basal temperature range under the tongue upon awakening in the morning is from 97.6 to 98°F or .2 degrees less than the armpit reference range. A basal temperature of 1/2 degree below normal indicates mild hypothyroidism whereas 2 degrees or more below normal is quite serious hypothyroidism.

Testing: National Veterinary Diagnostic Services, Quail Valley, CA; phone 951-543-4678. Check with them to find out about testing of human blood and urine specimens for hormonal levels. Other private labs also offer these types of tests.

Summary of Plechners findings

The presence of high estrogen and low immunoglobulins especially IgA will indicate to the clinician that the cortisol is at least partially inactive.
Binding of thyroid hormone by estrogen can be indicated when both T3 and T4 test normal and the patient has these symptoms - excessive sleeping, sluggishness, hyperkeratosis of the nose and pads of the feet; excess pigmentation in skin of ventral abdomen; high cholesterol; high triglycerides, underweight or overweight.
Suppression of IgA, IgM and IgG but especially IgA. Plechner states that the role of cortisol as an immune regulatory agent has been grossly neglected. An unknown, but probably very large percentage of cats and dogs produce inadequate or bound cortisol as a result of contemporary breeding practices primarily, and, to a lesser degree, stress, aging, poor diet, and other environmental inputs. The cortisol defect triggers a trail of biochemical events that produces elevated estrogen, bound thyroid hormone, and deregulation of major immune system cells. The experience with animals and the work of Jefferies and Plechner and his followers strongly argues for testing these hypotheses in humans that may produce major diagnostic and treatment breakthroughs. Plechner uses plant derived cortisone in low doses and can provide a source for health care professionals if they prefer to use plant derived cortisone. I would recommend that health care professionals click here to order Dr. Plechner's Compendium of Articles.

Note: There are several reports on the internet that natural thyroid works better and with fewer side effects than their manufactured alternatives like Synthroid. If you decide to try a natural formula, avoid any with "pituitary" gland extract, as this is the gland that can spread mad cow disease from infected cows. Pituitary of bovine origin is one glandular to avoid in all supplements. Pituitary of porcine origin (pigs) is not known to contain any risk factors.

What Kind of Thyroid Supplement is best to take - Natural or Synthetic?

Among prescription drugs for the thyroid, there are several choices of brand names but actual two groups - natural or synthetic. Laboratory made synthetic brands like Synthroid or Levothroid only contain the T4 hormone whereas natural Armour Thyroid that is derived from pigs (porcine) contains all 4 types of thyroid hormone, T1, T2, T3 and T4. The problem with the synthetic brands of thyroid is that many patients cannot convert T4 to the active form T3. This is often due to deficiencies of selenium that is required to convert T4 to T3 but could be due to deficiencies of other nutrients like L-tyrosine, iodine, manganese, glutathione levels, Vitamin A, certain B vitamins, C and E.

Most doctors will prescribe a synthetic pharmaceutical thyroid like Synthroid instead of the natural Armour Thyroid that is actually desiccated thyroid glandular of porcine origin. Several case reports on the Internet indicate that hypothyroid persons do better on Natural Thyroid than Synthroid. For those of you who surf the Internet, the source on Thyroid under Holistic Health Topics has a 24 page article on hypothyroidism with 102 scientific references located at http://www.holistichealthtopics.com/HMG/thyroid.html.

The Broda Barnes Foundation continues to educate doctors on the proper use of hormones and can provide references to physicians in your area.

Broda Barnes MD Res. Fdn
PO Box 98
Trumbull, CT 06611
ph No. 203-261-2101
Web Site: http://www.brodabarnes.org

Another list of local physicians trained in using natural hormones can be found at http://www.wilsonssyndrome.com.