From Cathleen
Henning Fenton,
Your Guide to Panic Disorder.
FREE Newsletter. Sign Up Now!
About.com
Health's Disease and Condition content is reviewed by our Medical Review Board
Researchers at the Veterans Affairs Medical Center (VAMC) in
Cortisol is a hormone that scientists associate with stress as well as chronic mood disorders. During times of stress, cortisol levels rise and then subside as the stress subsides. If stress is chronic or if a chronic mood disorder (anxiety, depression) is present, increased cortisol levels may indicate that the brain has become resistant to cortisol's effects, scientists believe.
One may wonder why, then, people with PTSD or the risk of developing PTSD would have lower cortisol levels. The VAMC research group theorizes that with PTSD, the brain may become hypersensitive to the effects of cortisol. The same area of the brain which may resist cortisol in people with chronic mood disorders, the hypothalamic-pituitary-adrenal (HPA) axis, appears to work differently in people with PTSD or the risk of having PTSD.
The study performed by the researchers at the VAMC involved 35 adult children of Holocaust survivors and 15 comparison subjects. All subjects were evaluated using various standard questionnaires. To determine whether the subjects' parents had PTSD, parents were interviewed directly (in 11 cases) or subjects completed a questionnaire created by the researchers. To test cortisol levels, urine samples were collected during 24-hour periods during times when subjects did not expect to be under stress.
Using the results of the questionnaire, researchers divided the subjects into three categories:
Researchers made the following conclusions based on the questionnaires and tests:
Ultimately, the researchers were able to determine that the low cortisol levels were associated with parental PTSD rather than the parent's exposure to trauma during the Holocaust. Additionally, the low cortisol levels could be associated with a risk of developing PTSD. Subjects exposed to trauma without developing PTSD did not necessarily have low cortisol levels, so exposure to trauma alone cannot be associated with lower cortisol levels.
The conclusions of the VAMC study will help scientists further understand PTSD and lead to newer treatments. By determining physiological differences in people who develop PTSD, researchers can understand why some people develop the disorder after traumatic experiences but others do not.
Reference: Yehuda R, Bierer
LM, Schmeidler J, Aferiat
DH,
This article is for information purposes only. It is not the intent of this article to diagnose, instruct individuals in self diagnosis or instruct individuals in the treatment of disease. Some Individuals could have a serious medical condition like Addison's or Cushings disease. A physician should be consulted to diagnose or rule out serious medical conditions.
Our adrenal glands are actually two glands in close proximity. The adrenal medula is actually an extension of the nerve cells of the sympathetic nervous system. When stimulated, they secrete adrenaline, a neurotransmitter, which causes specific physiological responses that enable the body to call forth the extreme strength, speed, and reaction time that is necessary for survival when confronted by a saber-toothed tiger. The second part, the adrenal cortex, is stimulated by pituitary hormones to release adrenal cortical hormones, such as cortisol. The adrenal cortical hormones suppress inflammatory processes, healing processes, and the immune system. They also convert glycogen stores into glucose and elevate blood sugar levels. Collectively, these responses put the body on RED ALERT and divert all available energy and raw materials to immediate survival tasks.
When our ancestors were stalking dangerous food or trying desperately to avoid becoming food they would experience a classical stress response through a series of events that had a defined beginning and end. Today, our bodies engage in that same stress response, except that there is no clear end to it. Repeated and prolonged stress exhausts the adrenal glands and other glands and organ systems. Hypoadrenia is one of the results. Hypothyroidism, reactive hypoglycemia, and depressed immunity are often associated with this condition as well. For more information on the Stress Response, read the article on Stress.
There are two hormones of particular interest here, Cortisol and DHEA. Cortisol is a powerful steroid released to "activate" your body in times of stress. You need cortisol to "pump you up"' to meet all the daily challenges of life. Without it you'd have no motivation to even get out of bed in the morning! But if your body produces too much cortisol over a long period of time, it can disrupt your blood sugar metabolism, trigger emotional problems, and make you feel constantly tired and weak. Eventually, chronically elevated cortisol levels can lead to weight gain, muscle and joint pain, insomnia, impaired immune function, and premature aging.
DHEA is the most abundant hormone in your bloodstream. DHEA seems to balance the effects of cortisol by improving the body's ability to cope with stress. It also provides the source material for the production of many other hormones including sex hormones. Clinical studies suggest that DHEA can boost energy levels, strengthen immune function, improve memory, and reduce body fat. Some researchers believe that DHEA acts as a "mood elevator," preventing depression and senile dementia by protecting important neurons in the brain. DHEA levels should be closely monitored when supplementing, however, to prevent potentially harmful imbalances. Also, DHEA supplementation is generally inappropriate for individuals under age 40.
To repeat, chronically elevated cortisol levels contribute to the accumulation of abdominal fat and make it very difficult to get rid of it. The immune system is suppressed and the individual becomes more susceptible to infections, both minor and major. Clearly, we would like for our cortisol levels to return to normal.
Stress reduction is an essential part of all efforts to normalize cortisol. Stress is the stimuli that caused the cortisol levels to get out of hand to begin with. Each individual should explore and find the stress reduction techniques that work best for themselves. Meditation, physical activities, attitude changes, etc., are good paths to explore. Without stress reduction, all therapeutic and support measures will eventually fail.
Rest. This may sound obvious but it must be managed and scheduled as a deliberate strategy, choice, and course of action. Otherwise it gets forgotten in the busyness of life.
A low glycemic diet is important. Sugar handling stress increases cortisol levels. Elevated cortisol, in turn, aggravates the sugar handling situation contributing to the development of high insulin levels and ultimately diabetes.
Nutritional supplementation is very valuable in restoring normal cortisol levels. It is important, however, to recognize if your cortisol levels are high or low. Low cortisol levels are the consequence of adrenal exhaustion or the exhaustion phase of the stress response. High cortisol levels are the result of the response to chronic stress and represent the adaptation phase of the stress response.
For basic adrenal support, include:
One of the best known and most effective ways to lower excess cortisol levels is with the nutrient Phosphatidylserine (PS). Phosphatidylserine is believed to facilitate the repair of the cortisol receptors in the hypothalamus. It is believed that the cortisol receptors get damaged by high cortisol levels reducing the ability of the hypothalamus to sense and correct high cortisone levels. Because Phosphatidylserine helps repair the feedback control apparatus, it is useful in correcting both high and low cortisol levels. Phosphatidylserine is also useful for preventing short-term memory loss, age-related dementia, and Alzheimer's disease. Typical dosages are one to three 100 mg. capsules per day.
Adaptogens are an entire category of herbs that assist the body in coping with stress by restoring hypothalamic cortisol receptor sensitivity. AdaptaPhase I from Vitamin Research Products is one such blend of adaptogenic herbs that is based on Russian research. It is a combination of Siberian ginseng, Manchurian Thorn Tree extract, Hawthorn extract, Echinopanax elatum, and Schisandra. Typical dosages are from 1 to 4 ml. per day. AdaptaPhase II is an anti-catabolic blend of herbs that can be used to enhance the effects of AdaptaPhase.
AdaptaPhase II is a synergistic blend of ingredients designed to help the body overcome the exhaustion that is experienced by people under such extreme stress. The formula includes soy protein isolate, Rhaponticum carthinoides, Tribulus Terrestris, and Adjuga turkistanica. These ingredients exert profound energizing, anabolic, muscle-building effects. This product is best used in cycles, each cycle lasting 10 days with a break of two to three weeks between each 10 day cycle. Dosages range from 4-10 capsules per day depending upon the individual's weight and the amount of physical or psychological stress that individual is undergoing.
CortiTrophin is a combination of adrenal concentrate and glycyrrhizinate. Glycyrrhizinate is a natural cortisol-mimicking extract from licorice. Taking a small amount of CortiTrophin, 25-100 mgs/day, can be beneficial in treating symptoms of adrenal exhaustion and can provide significant relief from the symptoms of chronic fatigue and fibromyalgia. To best mimic the body's own physiology, CortiTrophin should be taken on an empty stomach, first thing in the morning. If a second dose is required, it should be taken before lunch. Since CortiTrophin mimics the action of cortisol, one should be very judicious in using it. It should only be used intermittently and if any adverse effects occur, such as water retention or elevated blood pressure, use should be discontinued immediately. Individuals with high blood pressure should be very cautious with this supplement and should consult their doctor. Saliva testing should be seriously considered when using cortisol simulating supplements.
DHEA is a hormone which acts as a precursor for many other hormones. DHEA levels decline drastically with age. Many anti-aging physicians and programs advocate DHEA supplementation for individuals over 40 years of age. There is some medical controversy regarding this practice. If you are considering taking DHEA supplements, it would be a good idea to use the tests to both determine the need for it and get the dosage adjusted properly. DHEA can also be used empirically to alleviate the symptoms of excess cortisol or hyperadaptosis. DHEA can improve glucose tolerance, convert excess body fat to lean muscle mass, alleviate depression, increase energy and decrease pain in chronic fatigue and fibromyalgia patients, decrease joint pain and fatigue in inflammatory and autoimmune diseases, improve mental clarity, and enhance overall immune function. Typical doses for DHEA are 10 to 25 mg for women, 25 to 100 mg for men, taken in the morning to mimick the bodys natural rhythm. Note: Dosage should be adjusted based on test results. It is important for men to take a prostate PSA test before supplementation. DHEA supplementation could potentially complicate prostate cancer, so professional medical advice is necessary if the PSA level should be elevated.
Adrenal exhaustion is more difficult to resolve. Adrenal exhaustion involves a depletion of energy reserves and a loss of resilience. Symptomatic signs of adrenal exhaustion can be as diverse as fatigue, nervousness, anxiety, severe PMS, depression, brain fog, carbohydrate cravings, allergies, muscular pain and tenderness, joint pain. and irritable bowel syndrome. The goal of nutritional therapy in this situation is to restore the natural, diurnal release of normal levels of cortisol. The theory is if you provide the body with a small amount of a cortisol-like substance, the adrenal glands can take a rest and have an opportunity to regenerate. Then normal cortisol production will be restored.