Fig 1: Location
This article attempts to provide an overview of the functions of the human endocrine system and form a basis for some prescription choices, based mostly on sarcodes and organ therapeutics. The author’s overall prescribing techniques, underlying logic and other observations are given according to individual patient profile and practitioner choice.
Our Endocrine System is summarised by the Gale Encyclopaedia of Medicine as “a system of organs that produces chemicals that go into the bloodstream to reach other organs whose functioning they affect”. This, essentially, is our body’s chemical messenger service.
Hormones, which are these chemicals that circulate in the bloodstream are continuously secreted, but the endocrine glands have a natural tendency to over-secrete and so control of our endocrine secretions is via negative feedback. It is not dependent upon the amount of hormone present, but upon whether or not its intended function is being achieved. One gland produces a hormone which affects a second gland. That gland then produces its own hormone, which in turn influences the first gland’s secretion and so hormones have an increasing effect upon their target cells and organs.
When over-function occurs, the feedback system (usually routed via the Hypothalamus in the brain) causes the endocrine organ in question to halt its production. In under-function, where the target cells or organ are not responding to their hormonal messenger, the body produces an increasing amount of that hormone to compensate for the problem.
Thus, our Endocrine System is an extremely interdependent and intricate set-up: a dysfunction in one gland will certainly result in a disruption elsewhere in the body. Allopathic tests for glandular function usually only address the quantities of hormone levels present in the bloodstream and these occur in minute amounts: 1 picogram per pint of blood. A picogram is a millionth of a millionth of a gram, and so medical and synthetically produced hormonal treatments tend to be rather unsubtle, to say the least: our bodies just don’t react in the same way to what amounts to chemical sledgehammers as they do to natural prompts! Also of course, ordinary medicine may not necessarily consider either the reason behind any endocrine dysfunction, or its actual location/s.
THE GLANDULAR HIERARCHY
The endocrine synergy of regulation and production works within a type of hierarchy driven by the Hypothalamus. The Hypothalamus is often described as the body’s internal eyeball, and I find it helpful to liken its role to that of a Chief Executive of an organisation. The Hypothalamus itself comprises a collection of cells at the base of the forebrain that acts as the receiver of messages via nerve cells from other parts of the brain. It then sends out signals to the Pituitary Gland by substances termed neuro-hormones to stimulate or inhibit glandular secretions somewhere else in the system in response to received information in order to co-ordinate, maintain and control our internal homeostasis.
It can be seen that the endocrine and nervous systems are also closely intertwined: something else that conventional medical concepts tend to de-emphasise. What actually happens is that the endocrine hormones act directly upon our glands and body tissues whilst the autonomic nerves activate the relevant motor nerves of our sympathetic and parasympathetic nervous systems in order to make changes in breathing, heart rate, galvanic skin response and so on, to activate reflex actions (such as blinking) and to carry out bodily processes such as digestion.
This nervous and endocrine mutuality is one reason why stress and our coping mechanisms play such a significant role in a variety of dis-ease. Agrawal (2004) directly links emotions and parts of the body to the endocrine glands, based upon the inter-relationship between the seven chakras, the endocrine glands and our emotionality that traditional Hindu thinking holds, whilst Ambika Wauters (1999) inter alia, has further aligned our chakras to colours as well as emotions, illustrated in the summary table below.
Squire (2003) lists the BCG vaccine nosode, along with Pulsatilla and Tuberculinum as related remedies to the Hypothalamus sarcode, and Hilery Dorrian notes that the Hypothalamus remedy picture can present similarly to that of Puls with the tearfulness, changeability and so on. So we could think of this sarcode in cases where extreme levels of emotional and physical stress have caused a general hormonal imbalance. I have used Rainbow (or Spectrum) quite successfully as a support where I have sensed that a patients’ chakras have been thrown out of alignment and they have reported that the remedy acted as a wonderful pick-me-up. Aside from this, I would say that it is the constitutional remedy of the individual concerned that is the most closely aligned to the Hypothalamus, simply because it is their own ‘boss’.
The Pituitary Gland, located in the base of the brain has two lobes, the Anterior and Posterior. The Anterior lobe is an actual gland in itself, whilst the Posterior lobe consists of a lump of nervous tissue directly connected to the Hypothalamus. The Anterior lobe can be said to be the more important influence upon the functioning of other glands, as it produces six hormones to the Posterior’s two, but essentially the lobes act in concert and are able to compensate for each other.
Anterior Lobe Hormones
The Anterior Lobe produces prolactin, which is a hormone involved in the preparation of the breasts for maternal milk production and to synthesise this following birth. It also produces somatotropin, the human growth hormone that primarily influences the skeletal system, growth rate and maturational size. Under-secretion of this hormone results in dwarfism, whilst over-secretion results in gigantism in children and a condition known as acromegaly in adults (as in the James Bond film character ‘Jaws’). Metabolic effects of somatotropin include the general synthesis of amino acids, assimilation of fat and blood sugar levels.
The Anterior lobe of the pituitary gland also produces a thyroid stimulating hormone (TSH), which influences all aspects of thyroid function and ultimately the regulation of our metabolic rate, fat breakdown and the water content of certain tissues. The follicle-stimulating hormone (FSH) is also created here. FSH controls the maturation of ovarian follicles in females and sperm production in males. Luteinizing hormone (LH) also comes from the anterior lobe of the pituitary. LH contributes to the formation of the corpus luteum and therefore production and synthesis of the egg in women, as well as preparing the breast for lactation.
The equivalent hormone to LH in men produced by the anterior pituitary is the ICSH, or interstitial cell stimulation hormone, which acts on the testes and affects sperm and testosterone (the major male hormone) production. ACTH or adrenocorticotrophine, a hormone affecting various secretions of the Adrenal Gland, also starts life in this lobe. The general metabolic effects of ACTH include the mobilisation of fats, blood sugar and glycogen (muscle fuel) levels as well our body’s resistance to stress.
Posterior Lobe Hormones
The Posterior lobe of the pituitary gland secretes an anti-diuretic hormone called ADH that, to a certain extent, is responsible for the constriction of veins in some cases of high blood pressure, but more importantly affects kidney function. Water is re-absorbed by the kidneys so that less urine is excreted. ADH under-secretion causes the condition diabetes insipidus, where excessive amounts of very dilute urine are excreted but not absorbed. The other hormone secreted by the Posterior Pituitary is oxytocin, which works alongside prolactin in the production and flow of milk and also acts on the smooth muscles of the uterus in pregnancy. Both of these two hormones are actually produced in the Hypothalamus and are only stored and released by the Posterior lobe.
Overall then, the Pituitary Gland extensively affects our wellbeing and lifespan development in general, including our early in utero period. It can therefore be said to act rather like our body’s Managing Director, and is generally known as the master gland of the body because of its action upon the activity of the thyroid and adrenal glands and upon our organs of reproduction: the ovaries and testes, or gonads.
The functions of both lobes of the Pituitary gland, and hence the whole gland are fairly well defined and so choice of the three related sarcodes would mirror whatever was being addressed. As far as my own practice is concerned, Pit Ant has been indicated the most, predominantly in children when maturational markers or behavioural issues have been delayed and has been especially useful as an intercurrent in cases of bedwetting. Baryta-Carb is also very helpful in contexts of delayed development and with childlike presentations in the elderly. Because of its hormonal profile, Folliculinum has an affinity with this gland.
The Thyroid Gland, located in the front and sides of the base of the neck just below the larynx, acts rather like our body’s General Manager. It is a butterfly-shaped gland containing a number of closed follicles and, essentially, it controls the pace of chemical activity and metabolism of every cell of the body. Thus it impacts significantly upon the growth and rate of function of many other bodily systems.
Thyroid cells produce two hormones, thyroxin or T4 and T3 (tri-iodothyronine). Their formation is dependent upon the amino acid Tyrosine (hence the T) and also upon the mineral iodine. These hormones both determine how quickly the body burns energy, makes proteins, and how sensitive the body should be to other hormones, and along with the growth hormone somatotropin, ensure our brain development, urine production, protein breakdown and glucose uptake.
Untreated hypothyroidism (or under-secretion) in children results in the unkindly-named condition of cretinism. In adults it causes myxoedema (non-pitting facial oedema, or swelling). Both conditions also feature a low overall metabolic rate and excess body weight. Untreated hyperthyroidism (over-secretion) increases the metabolic rate generally, and sometimes causes exophthalmos, or protruding eyeballs. Goitre on the other hand is the name for any enlargement of the thyroid gland itself and can be present with or without hyperthyroidism. It is also possible for this two-lobed, follicular gland to be partially under- and partially over- active at the same time and symptoms of both polarities may overlap, for example fatigue, thinning hair, poor libido.
Thyroid therapeutics are perhaps the most well-documented, used and needed raft of remedies in general practice, but rather than reinvent the wheel, some differentiation of available remedies may be useful here.
Thyroidinum, first introduced by Clarke, and useful in both hyper- and hypo-thyroid conditions, is the prepared extract of the thyroid gland of a sheep or calf whereas Thyroiodinum (otherwise known as Iodothyrine) is the pure iodine derived from this source (Murphy 2000). Thyroxine is the allopathic drug also derived from animal glands and is most useful as a tautopathic remedy to support withdrawal. For a human source, Thyroid Gland would be the option.
As a plant based support, the most useful remedy is perhaps Fucus Vesiculosus, or Sea Kelp and can be used effectively as a supplement as well as homeopathically to support the Thyroid gland. It is the primary source of natural iodine, or Iodium, a major hyper-active thyroid remedy. Other useful thyroid supports are Kali Iodatum, or Potassium Iodide which is non-radioactive iodine used to prevent the thyroid gland absorbing radiation in nuclear incidents, and Calcarea Iodata (Iodide of Lime), useful homeopathically for thyroid dysfunction associated with hormonal changes.
Just behind the thyroid are the pea-sized glands of the Parathyroid (usually four, two behind each lobe) that assist calcitonin from the thyroid in metabolising, assimilating and regulating calcium in order that the nervous and muscular systems can function efficiently.
The glands produce parathormone to perform this function. Over-production causes calcium to be moved from the bones into the blood and then excreted in urine, which then can result in brittle bones and kidney stones. Under-secretion causes low calcium levels in the blood, resulting in muscular rigidity and/or spasm (tetany). The latter can sometimes be in evidence following thyroid surgery where the parathyroids have inadvertently been removed (according to Watson 2000) and then calcium is then traditionally prescribed to correct the mistake, something which really inspires confidence in hospital treatment.
The Parathyroid sarcode is helpful in cases of osteoprosis (which is the de-mineralisation and loss of density of bones), bony spurs and also kidney stones. These conditions are caused through non-absorption of calcium and the remedy Calcarea Renalis is potentised kidney stone. The syphilitic connection here is also evident.
Near to and just above the kidneys are the Adrenal (or suprarenal) Glands. Each gland has two distinct zones: the outer cortex and the inner medulla.
Adrenal Cortex Hormones
The mineralocorticoid steroid Aldosterone is produced here. It regulates the relative concentrations of minerals in the body fluids and water content of tissues, in particular our sodium: potassium balance. A deficiency of Aldosterone causes increased secretions of sodium and chloride ions so that too much water is lost from the body in urine. Correspondingly, concentrations of sodium, chloride and bicarbonate in the blood decrease and acidosis (increased acidity and low alkaline content of blood plasma) result.
The central part of the adrenals produces a group of glucocorticoid hormones responsible for efficient carbohydrate metabolism. The most important of these is Cortisol (otherwise known as Hydrocortisone), released in response to ACTH from the Anterior Pituitary and working in conjunction with adrenaline (epinephrine) from the Adrenal Medulla. It releases carbohydrate and protein stores for use as energy and controls our immune responses, including fever and inflammations, and inhibits cell division to promote healing.
Cortisone and corticosterone are the other primary glucocorticoids, mostly involved in preventing allergic reactions and tissue repair, and all three are greatly affected by chronic stress, which increases glucocorticoid production. If this is prolonged, the likelihood of ulcer formation is increased, blood pressure rises and our body’s resistance to stress is lowered via resultant atrophy of lymphatic tissue. Many people ‘break out in a rash’ when stressed, other have an ‘upset stomach’.
Under-secretion of the glucocorticoid and corticoid hormones results in Addison’s disease, where symptoms of anaemia, anorexia, muscle weakness, low blood pressure and sugar levels, bronzing of the skin and mucous membranes occur. Overproduction of glucocorticoid hormones causes the condition known as Cushing’s syndrome, which includes symptoms such as weight gain and oedema on the trunk and face, easy bruising and poor healing, raised blood pressure and pH, osteoporosis etc.
Relatively small amounts of oestrogens and androgens (known as gonadocorticoids from this source) are also produced by the adrenal cortex, although primary production of these hormones occurs the gonads (ovaries and testes). Some progesterone is also manufactured by this chemical transformation process. Adrenal androgens and oestrogens affect the development and functioning of the reproductive organs as well as certain physical and (possibly) temperamental characteristics. Their effects are more apparent in incidences of hyper-secretion, for example an adrenal tumour in a woman may produce deepening of the voice and facial hair growth, which are usually secondary male characteristics. Further, this secondary source of oestrogen is especially important for post-menopausal women when ovarian production of oestrogens tails off.
Further, Melissa Assilem (1996) maintains that the contraceptive pill is responsible for depleting the adrenal cortex because of its interference with the normal production of progesterone by the ovaries, causing them to ‘borrow’ from corticosteroidal sources in the adrenals in order for the menstrual cycle to remain unbroken. Also, this secondary supply of masculinising hormones may be implicated in the over-production of testosterone in some women with polycystic ovary syndrome, where stress and male pattern hair growth are present.
Adrenal Medulla Hormones
The medulla of the adrenal glands produces the two hormones Adrenaline and Noradrenaline (also known as Epinephrine and Norepinephrine respectively) that comprise our body’s ‘fight or flight’ mechanism in response to stress, initiated by the sympathetic nervous system. Adrenaline is 80% of the total hormone production and Noradrenaline 20%. Together they increase the strength and rate of the heart beat, cause the arteries supplying the heart and skeletal muscles to dilate whilst constricting those of other arteries, increase respiration, raise blood sugar levels by converting glycogen (stored sugar) in the liver to glucose (available sugar) in the blood and finally stimulate the general metabolic cellular activity. No mean feat!
We can begin to get some idea of the extent of the negative and all-pervasive effects of chronic stress, which is more accurately perhaps, adrenal ‘burn-out’ when considering these vital and integral functions of our Adrenal Glands.
Obviously, adrenal sarcodes would be appropriate for patients diagnosed with Addison’s Disease and Cushing’s Syndrome. The remedy Adrenalin is described in Murphy as Adrenal Gland and I have prescribed it successfully for ME. It would also have a place in CFS (Chronic Fatigue Syndrome) and Hilery Dorrian recommends it for children diagnosed with ADHD, as the condition could be in part due to inefficient neurotransmission. Since it is a great calmer-down, it is also recommended in combination with Aconitum and Argentum Nitricum as a remedy to help with panic attacks (I have prescribed it for fear of flying), and with Apis Mellifica and Histamine for severe allergic reactions. Adrenalin has been described as a modern Sepia.
Cortisone is such a useful remedy in skin conditions, particularly where there has been any suppression with steroids that needs gentle unblocking in order to get at the underlying miasm. I frequently prescribe it with Carcinosin followed by Tuberculinum, based on Hilery Dorrian’s and Gordon Sambidge’s regimes for the management of eczema (see HIP article Autumn 2006).
I have used a support remedy combination with good results of Borago Officinalis/ Eleutherococcus Senticosus/ Glycyrrhiza Glabra, or commonly Borage/Liquorice Root/Siberian Ginseng in a 3X potency, along with their constitutional or totality remedy for a patient whose adrenal function seemed to be depleted, based on college notes on herbal support remedies.
THE GONADS (OVARIES & TESTES)
The Ovaries and the Testes produce oestrogen and testosterone, which control female and male sexual development and fertility, and progesterone which is another major player in the menstrual cycle and in pregnancy. The synthesis and secretion of oestrogens is stimulated by FSH, which in turn, is controlled by the neurohormone GnRH (Gonadotropin-releasing hormone) from the Hypothalamus. Production of testosterone and of progesterone is controlled by the release of LH prompted by the release of GnRH, see figure 2.
Fig 2: Sex Hormones and the Brain
Oestrogens are a group of steroid hormone compounds, functioning as the primary female sex hormone, although oestrogen is also present in smaller quantities in men. The three major naturally occurring oestrogens in women are oestrone (E1), oestradiol (E2), and oestriol (E3). E2 predominates in non-pregnant women of reproductive age, E1 is produced during menopause, and E3 is the primary oestrogen of pregnancy. E2 is produced from testosterone and levels vary through the menstrual cycle, with levels highest just before ovulation.
Apart from the adrenal oestrogens, primary sources are the developing follicles in the ovaries, the corpus luteum and the placenta. They promote the development of female secondary sex characteristics, are also involved in the thickening of the endometrium and other aspects of regulating the menstrual cycle. In males, oestrogen regulates certain functions of the reproductive system important to the maturation of sperm and may also be necessary for a healthy libido.
Oestrogens also have non-reproductive effects. They antagonize the effects of the parathyroid hormone, minimizing the loss of calcium from bones (hence the emphasis placed upon the likelihood of osteoporosis in our later years) and oestrogen is known to have an inhibitory effect on the thyroid itself. The hormone also promotes blood clotting. Many types of breast cancers, once established, rely on supplies of oestrogen to grow and suppression of oestrogen production is a conventional treatment for these cancers.
As an aside, a range of synthetic and natural substances have been identified that also possess oestrogenic activity. Synthetic substances of this kind are known as xeno-oestrogens and are frequently chemicals derived from pesticides or plastics (!) which mimic or disrupt the action of oestrogens. They are fat-soluble and so, worryingly, can store themselves in the adipose tissues of the body, including animal fat. It has also been established that hormone disruptors not only affect male and female fertility but also deplete our immune system, so here’s another reason for meat eaters to stick to lean and organic!
Testosterone is the principal male sex hormone from the androgen group, primarily secreted in the testes of males and the ovaries of females. It is an essential hormone for the production of sperm and levels decline gradually with age. It is an anabolic steroid, i.e. affecting muscle mass and strength, growth, bone density and maturation. Like other steroid hormones, testosterone is derived from cholesterol. It is also synthesized in far smaller quantities in women by the ovaries, by the placenta and by the adrenal cortex in both sexes.
In men, testosterone also plays a key role in health and well-being and in osteoporosis. On average, an adult human male body produces about forty to sixty times more testosterone than an adult female body. However, overall production ranges for male and female are very wide, such that the respective ranges can overlap at the low end and high end respectively. Testosterone has an interesting effect on insulin, produced by the Pancreas: too little in men will inhibit the action of insulin, whereas in women too much is inhibitory.
Progesterone is produced in the ovaries (specifically after ovulation in the corpus luteum), as well as in the brain and in increasing amounts in the placenta during pregnancy. Initially after conception, the main source of progesterone is the corpus luteum but after the 8th week of pregnancy, production shifts to the placenta. Progesterone is sometimes called the “hormone of pregnancy”, as it fulfills so many functions relating to the development of the foetus.
Progesterone also prepares the endometrium, the vaginal epithelium, cervical mucus and the uterus for implantation. If pregnancy does not occur, progesterone levels decrease, leading to menstruation. Normal menstrual bleeding is thus progesterone withdrawal bleeding.
During foetal implantation and gestation, progesterone decreases the maternal immune response to allow for the acceptance of the pregnancy and strengthens the uterine smooth muscle. Additionally, progesterone inhibits lactation and the fall in levels following birth forms one of the triggers for maternal milk production. The initial drop in progesterone levels is possibly one step that facilitates the onset of labour, whilst the foetus metabolises placental progesterone in the production of its adrenal steroids.
Progesterone and cortisol share the same building block, hence chronic stress can lower progesterone levels as the body steals it to make cortisol. This can result in oestrogen dominance as the extra adrenaline and cortisol enhance the effects of oestrogen at the expense of progesterone.
Ovarian and Testicular Homeopathics
I have found that the most frequently required hormonal remedy in my practice is Folliculinum in varying potencies. This has been either because it has been called for in a regulatory capacity, in which case I normally use a 7C, or because it fitted the patient’s overall presenting picture so aptly. It is a well documented and proved remedy, made from the ovarian follicle, or the cavity where the egg is formed prior to its release at ovulation. Oopherinum is the sarcode obtained by the trituration of the juice of sheep or cow ovary and it was helpful for a patient who’d had a partial ovarectomy with menopausal symptoms.
Almost all other ‘female’ remedies related to the menstrual cycle, birth and pregnancy focus on the uterus, rather than the ovaries themselves, although Ustilago Maydis (or Corn Smut) is associated with ovarian pain, and particularly the left side. It is also worth mentioning that Ustilago is a myco-oestrogen, i.e. a fungus having some oestrogenic activity, as is Secale Cornutum (which is Secale, the ergot found on rye). As a remedy it mainly affects the uterus and is one of the remedies often prescribed for dysmennorhea. However, for menstrual problems, (which of course involve the uterus!) I almost always give the herbal tincture Agnus Castus as well as Folliculinum because as an effective uterine tonic it invariably helps the entire reproductive system.
Testosterone in 6C and 7C has been a useful support remedy for both male and female acne, as the condition so often involves hormonal imbalance or over-production. It is also worth considering as a helper for polycystic ovaries where women may have acne as a side effect, as well as excess facial hair and easy weight gain.
For men specifically, Orchitinum is the sarcode prepared from the testes extract, and is useful for sexual weakness, debility and premature senile decay (Murphy 2000). A better known and (more popular!) plant-based support, especially in prostate problems is Sabal Serrulata, better known as Saw Palmetto and can be either given as a herbal tincture or homeopathically. Conium Maculatum is also another helpful remedy for specifically ‘male’ glandular contexts.
In pregnancy, I invariably prescribe a patient’s constitutional remedy, rather than Progesterone, along with any other remedies that may be required for acute complaints or to enhance a tissue salt pregnancy programme, if required. It could be considered as a useful support however.
The Pancreas monitors the level of glucose in the portal vein and produces its hormones accordingly to either store glucose in the liver or to release it for energy. The gland is located near the liver and behind the stomach and its endocrine function is to produce insulin to encourage glucose uptake by the cells, along with glucogon to prompt tissues to release glucose back into the bloodstream in order to regulate and maintain the body’s requirements. These hormones are produced in area of the Pancreas known as the ‘islets of Langerhans’. The other function of the Pancreas is of course digestive: it produces some of our digestive enzymes and releases these into the small intestine, whereas the hormones pass directly into the bloodstream.
Glucagon is produced by 25% of the islets of Langerhans and secreted in response to a fall in blood sugar levels, stimulating glucose production in order to raise them. Insulin is secreted by the remaining 75% of the pancreatic islets in response to a rise in blood sugar levels, as in after a meal. It then lowers the levels by converting glucose to a safe form (glycogen) for storage by the liver and also by increasing cellular absorption. Blood sugar levels therefore are maintained by a balance between these two hormones as they both affect overall carbohydrate metabolism, with the liver acting as a buffer.
Metabolism of fats and proteins are closely related to that of carbohydrates, and here again we have a situation where a disturbance in one system will affect the others. Constant blood glucose concentration is important because glucose is the only nutrient that can be normally utilised by the brain, retina and the lining of the gonads in sufficient quantities to supply them with required energy.