How stress is adding to your current symptoms
Stress - How are you adding to your stress?
There are many antecedents/triggers of stress. Some are listed below:
trauma-emothional +/or physical
acute physical stress/over exercise
Common mediators of stress i.e something that adds to the stress response are:
food sensitivities (gluten intolerance)
poor nutrition (typical western diet)
treating symptoms and not the cause
ongoing exposure to toxins
“The adrenals are the glands of stress but are the first glands to fail under stressful conditions” - Hans Selye (Pioneer in Stress Physiology)
Cortisol is a hormone released from the adrenal cortex in response to stress and low blood-glucose concentration.
Cortisol deficiency symptoms:
cold body temp
low blood sugar
Cortisol Excess symptoms:
loss of muscle mass
DHEA is also a hormone made by the adrenal gland and functions as a metabolic intermediate in the biosynthesis of androgen and estrogen sex steroids.
DHEA deficiency symptoms:
DHEA excess symptoms:
excess facial and body hair
increased risk of breast/prostate cancer
When you experience short term stress the body reacts with a flight or flight response. What actually happens in your body is listed below:
- increase blood sugar
- increase BP
- increase breathing rate
- increase metabolic rate
- change in blood flow – blood shunted away from non-essential processes e.g. gut!!
Today's stresses include sitting in traffic, running late, bad relationships, etc but we still respond with a fight or flight reaction every time we experience stress several times a day
Long term response to stress
kidneys retain sodium and water
increase in blood volume and blood pressure
proteins and fats broken down to glucose to maintain elevated blood sugar
potential suppression of immune system
Circadian rhythm of cortisol
Normally we have a circadian rhythm off cortisol which means we have high levels of cortisol in the morning so we can wake up and get on with our day. In the middle of the day our levels are half of the level before and at its lowest in the night as we prepare to sleep.
Stress response is the body's non-specific response to generic unpleasantness which takes into consideration the impact of the usual and customary stresses of everyday life, as well as the cumulative impact over time of unusual and extreme stresses. The body has to continue to restore its balance of both acute and chronic stress. This is called the three stages of dysfunction by Hans Selye (1956).
The Steroidogenic Pathway
Cholesterol starts the whole pathway which converts to pregnenolone and then to progesterone. These are the precursors to DHEA and cortisol which will get us through the pathway to produce testosterone and andosterone, estrone and estradiol. This happens in a normal functional adrenal cortex. But then we have increasing stress the adrenal cortex takes the pregnenolone and progesterone and converts it to coritsol. As a result, the production of DHEA and androstenedione are short changed. This is called CORTISOL STEAL. In other words as continued stress creates the precursors to cortisol it produces more cortisol at the expense of DHEA and androstenedione.
One can have their "stress" tested through the adrenal cortex stress test. There are 4 readings (7am-9am, 11am-1pm, 3pm-5pm, 10pm-12am).
See picture below which relates to the description that follows.(NB the picture shows results of a patient who has adrenal dysfunction - The black line on the graph are not normal ranges)
Yellow area = width of reference range
Green area = optimal range
Red area = out of range
At 7am-9am cortisol is supposed to be at its highest in the day within the green area
At 11am-1pm and 3pm-5pm the levels will be half of the 7am-9am scores.
At 10pm-12am the levels will be at its lowest.
The test also measures DHEA at 7am-9am. This shows the balance between DHEA and cortisol.
Alarm Stage – heightened arousal and mobilisation of the body's defenses in the interest of self protection with rapid increases in cathecholamines (adrenaline) and slower increases in corticosteroids
A patient in this stage would present with waking cortisol at its highest with little impact on the rest of the day and no impact on the DHEA. Hence, the adrenalcortex is producing more cortisol during the morning level (7am-9am) but it can still make enough DHEA to balance it out
As the stress load continues over time we will see a shift in cortisol and DHEA production.
Here we see resistance and adaptation. There is emphasis on the body's defensive efforts to fend off the stressor OR to make whatever internal adjustments are necessary to live (adapt to) the stressor. Adaptation results in sustained increases of corticosteroids and alarm molecules as well as alterations in glucose tolerance, blood pressure, thyroid hormones and sex hormone metabolism.
Stage 2 early
The adrenal cortex cannot maintain the high levels of morning cortisol for so long. Even though cortisol is still high it can not maintain the high levels we saw in stage 1 for too long. The adrenal cortex will also find it difficult to keep the DHEA in balance so we now see the DHEA lowering at 7am-9am.
Stage 2 mid
Cortisol is within the reference range but the DHEA is low at 7-9am. At 11am-1pm the cortisol is less than half of the 7-9am which shows there are stressors affecting the levels.
Stage 2 late
Cortisol is even lower at 7-9am. DHEA is lower and the graph is looking more like a horizontal line. We will now see the patient presenting with a lot of fatigue, drinking a lot of coffee to get out of bed in the morning, eating a lot of sugar for energy to get through the day
The ability to adapt is lost. The sighs and symptoms are consistent with physiological collapse, accompanied by progressive deterioration in structure and function. Patient describes themselves as exhausted which can lead to degenerative diseases as a result of the adverse influence of sustained high levels of corticosteroids and alarm molecules The adrenal cortex has minimal ability to maintain any cortisol or DHEA levels. All levels are in the red area.