In Part 1, you learned how the body’s survival instincts work to protect you, and also how perceived threats come into the mix. In this post, we move our attention from the endocrine system to the immune system, because it’s all related!

Other Endocrine Glands

Persistent pain can impact other important endocrine glands like the pineal gland. The pineal gland is the size of a grain of rice and resides in your brain to regulate the release of melatonin, which is uber important for sleep. Sleep is often compromised during times of stress and pain, and plenty of evidence states that disturbed sleep patterns negatively impact health and well-being as well as increasing pain intensity. [ref] [ref]

Sleep is also influenced by thyroid function. The thyroid is a butterfly-shaped gland that is located in the front of your neck. It is involved in practically every physiological function of the body and influences your brain, heart, nervous system, bones, gut health, reproductive hormones, mood, metabolism, and pretty much every cell. In other words, it’s a pretty big deal.

Its live-in neighbors, the parathyroid glands, are four tiny little glands nestled within the thyroid that regulate the release of calcium in the bloodstream from bone, kidneys, and your intestines to help with vitamin D synthesis and many other cellular functions that play a role in health, including pain.

There are many chemicals that facilitate or inhibit ‘danger’ message transmission to the brain. In persistent pain, gatekeepers (ion channels on cells) get a little overenthusiastic and leave the gates open too long. When ‘everyone is welcome to the party’ for such a long time, so to speak, it means more calcium and other excitatory chemicals enter the cell. This activates intracellular pathways, including greater excitability of the neuron, which means more information propagated up to the spinal cord and brain.

There needs to be more investigation of the role of the parathyroid in pain but what we do know is that all these systems influence each other, which means it gets complicated!

Stress experienced from persistent pain can alter thyroid function because of the impact of chemicals released under stress (cortisol). Lowered thyroid levels can impact all organs in your body, decrease immune function, libido, and may even impact your pain sensitivity. [ref]

Immune System In Play

Now that we’ve mentioned the immune system, let’s briefly give it the attention it deserves. Our immune system protects us from infections, diseases, stress, and more. It is made up of cells that ‘learn, remember, and recognize’ when you are you and when you’re not. (NOI course, 2017).

The immune system is made up of specialized cells like T cells (immune cells produced by the thymus gland, which is more of an immune organ than endocrine organ that sits behind your breastbone just above the heart), B cells, lymphocytes, toll-like receptors, neutrophils, macrophages, supporting cells of the nervous system called glial cells that are immune helpers, and messenger molecules produced by macrophages like cytokines which influence the brain via the vagus nerve. (Phew, what a mouthful!)

Whenever you get the flu, ever notice how your whole body aches? That’s because these cells are ‘lighting up’ all over your body. Maybe you notice your pain is worse when you’re under a lot of stress? Same kind of thing.

The immune system plays a role in moderating the danger response mechanisms in your body produced in response to physical and/or emotional stress. A physical and/or emotional stressor can result in immune changes. The HPA axis and the sympathetic nervous system release our friend cortisol (who, as you’ll see, pops up again and again). 

This stimulates the production of inflammatory messenger chemicals to help out. There are anti-inflammatory and pro-inflammatory ones. Remember this isn’t a bad thing. In fact, this is a great defense mechanism to have for survival. The nervous system is regulated by your immune system, which means they talk to each other and are influenced by each other. Just like your nervous system, your immune system also receives sensory information from the body and environment, and uses the motor system to respond, which might mean tension in muscles and changes in the way you move and function in the world.

Prolonged Pro-Inflammatory States And The Pancreas

We can’t talk about cytokines without discussing the pancreas. The pancreas is both an exocrine (releases enzymes that help with digestion) and an endocrine organ that lives in your abdomen, snuggled deep behind your intestines.

You may have heard of the pancreas’ role in balancing your blood sugar by releasing the hormone insulin. Insulin helps lower blood sugar. When this is compromised, for example in diabetes, excessive sugar in the bloodstream begins to impact cardiovascular health, nerve health, and your immune system. Prolonged pro-inflammatory states and cellular stress due to physical and/or emotional stress and/or unhealthy lifestyle choices (like eating a diet high in sugar and processed foods) can impact the health of your pancreas (and all the other bodily systems) and vice versa, which can sensitize your nerves, alter immune function and heighten pain.

Insulin resistance and excessive blood sugar levels can activate the HPA axis (see Part 1) and contribute to the stress response mechanism. [ref]

Last But Not Least

By now, perhaps you’re seeing how your bodily systems are all connected. Nothing lives in a vacuum. And the HPA axis is no different and therefore significant in pelvic pain.

The HPA axis also impacts your gonads. The gonads (ovaries and testes) are the reproductive organs responsible for making reproductive hormones like estrogen and testosterone. 

Cortisol can negatively impact the reproductive hormones by signaling to the hypothalamus to inhibit the secretion of a special hormone called gonadotropin-releasing hormone, which then slows the production of hormones secreted from the anterior pituitary that are necessary to produce estrogen or testosterone.

Again, I’m oversimplifying here, as these intricate systems are more complex than I’m describing.

Not only that, but if you’re experiencing pain in your privates, the stress related to pelvic pain in itself can continue the protective mechanism elicited from various bodily systems already mentioned. Long-term stressors, even long after being removed, can affect the reproductive system at any level, from the hypothalamus down to the testicles.

As you can imagine, persistent pain in your privates is no laughing matter. Your brain doesn’t normally receive messages of SOS signals from your underpants, but when it does, this can be seriously alarming.

Remember that fire alarm? Ain’t no room for feeling sexy when that’s sounding, which impacts libido and sexual function. Your brain’s attention is set on hyper-alert and will take your attention down there whenever it can.

We’ve geeked out on the science long enough, so in Part 3, we’ll get to some practical strategies for restoring the body and mind, and calming persistent pain.

This information is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding treatment, medications/supplements, or any medical diagnoses. This information is intended for educational purposes only and is in no way to substitute the advice of a licensed healthcare professional.