Stress, cortisol and weight gain

If you’ve got your finger on the pulse of health trends, it’s likely you’ve been hearing the current buzzwords “cortisol creates belly fat” and “cortisol causes muscle wasting and fat storage.” These are the type of catch phrases that gain momentum every few years. And although some of the fads and trends showing up seasonally in fitness are myths, this caution about chronically elevated cortisol is true. Cortisol is also deeply connected with the dangers of chronic inflammation, which I described in another article, “Inflammation Creates Diseases.”

Like many hormones, cortisol has an effect on a wide variety of functions in the body. Although it’s getting particularly demonized lately, cortisol serves some very important and positive functions in the body. It’s an essential component of the flight or flight response, so it gives us energy, focus, strength, motivation and courage. But, like with sugar or caffeine, it comes with a crash that feels like an emotional, psychological and physical drain. Cortisol is important for survival, but we didn’t evolve to have high levels of it all the time.

According to hormone.org, cortisol isn’t only a stress hormone: “Because most bodily cells have cortisol receptors, it affects many different functions in the body. Cortisol can help control blood sugar levels, regulate metabolism, help reduce inflammation and assist with memory formulation. It has a controlling effect on salt and water balance and helps control blood pressure. In women, cortisol also supports the developing fetus during pregnancy. All of these functions make cortisol a crucial hormone to protect overall health and well-being.”

There are many symptoms of chronically elevated cortisol levels. With that said, the way a spike of cortisol gives you a jolt of energy is by raising blood sugar. It does this by way of gluconeogenesis. This literally means “creating new sugar,” and it happens by way of breaking protein down into amino acids that are then turned into sugar by the liver. What is a large source of protein in the body? Yep, muscles. This is what is meant by “cortisol causes muscle loss.” This in turn contributes to muscle weakness. Whereas normal levels of cortisol help to regulate blood sugar levels by breaking down only a little muscle (which can be replaced with exercise), excessive levels cause muscle wasting.

Why does cortisol cause fat gain? Remember those cortisol receptors most cells have? Fat cells have four times as many, so they are particularly responsive to cortisol. Okay, remember all that glucose the cortisol surge dumped into your blood for energy? Well, that also came with an insulin response to get your blood sugar levels back down, and insulin causes energy storage. And where do you store the energy? Yep, in those hypersensitive fat cells that cortisol just turned on. And what happens when you have too much insulin over time? Yep, diabetes. Also, another reason stress can cause emotional and/or binge eating is because cortisol also fires up your sense of purpose, as well as your appetite. So now stress has made you feel motivated…to eat.

Emotionally and psychologically, chronically high cortisol can exacerbate depression, anxiety, irritability and lack of emotional control. Cortisol triggers a release of tryptophan oxygenase. This enzyme breaks down tryptophan. Tryptophan is required for creating serotonin. Serotonin gives us the ability to feel happiness, and it also affects appetite, sleep and sexual desire. Since extended exposure to high levels of cortisol inhibits the production of serotonin, all the symptoms of low serotonin become problematic (decreased appetite, insomnia, impotence, etc.). In short, prolonged stress causes depression.

Cortisol also plays a role in the circulatory system. It manipulates blood pressure by acting as a diuretic. Excess cortisol causes an electrolyte imbalance, whereby sodium is retained, but potassium is excreted. Let me take you back to your high school biology days: Muscles fire because of the sodium potassium pump. The sodium potassium pump also effects the firing of nerves, including those impulses that cause your heart to beat and your kidneys to take in water for filtration. That sodium potassium pump is important throughout the entire body, across many of its biological functions. Because cortisol increases the concentration of sodium in your body, it has a direct impact on your blood pressure. Remember why excess salt can cause high blood pressure? Because it contains sodium. For all these reasons and more, chronically elevated cortisol also causes muscle weakness (ironic, since short bursts of it temporarily increase strength).

Cortisol has other effects on minerals. According to the Hindawi Journal of Sports Medicine, “Cortisol triggers bone mineral resorption (removal) in order to free amino acids for use as an energy source through gluconeogenesis. Cortisol indirectly acts on bone by blocking calcium absorption, which decreases bone cell growth.” As you can see, excess cortisol causes osteoporosis. It also exacerbates other bone mineral density diseases, which means cortisol can leave you literally brittle with stress.

Practically anything can become a stressor in the right conditions, and fight or flight is our only biological response to stress. Some triggers of stress include conflict, worry, alcohol and drug consumption, processed foods, excess exercise (especially prolonged and repeated sessions of low-level steady-state cardio training), sleep deprivation, thirst and hunger. As much as possible, protect yourself from stress with rest, relaxation, meditation, play time and healthy foods full of antioxidants, which reduce inflammation and thus the risks for practically all diseases.

Jack Kirven completed the MFA in Dance at UCLA, and earned certification as a personal trainer through NASM. His wellness philosophy is founded upon integrated lifestyles as opposed to isolated workouts. Visit him at jackkirven.com and INTEGRE8Twellness.com.

Adapted from https://goqnotes.com/61597/stress-cortisol-and-weight-gain/

Blood Sample from Tributary Adrenal Gland Veins May Help to Diagnose Subclinical Cushing’s Syndrome

Researchers report a new technique for collecting blood samples from tiny veins of the adrenal glands, called super-selective adrenal venous sampling (ssAVS). The technique can be used to help diagnose diseases marked by excessive release of adrenal hormones, such as subclinical Cushing’s syndrome (SCS) or primary aldesteronism (PA).

The study, titled “A Novel Method: Super-selective Adrenal Venous Sampling,” was published in JOVE, the Journal of Visualized Experiments. JOVE has also made a video that demonstrates the procedure.

The adrenal glands are a pair of glands found above the kidneys that produce a variety of hormones, including adrenaline and the steroids aldosterone and cortisol. Excessive production of cortisol in the adrenal glands is the cause SCS, and aldosterone of PA.

These glands have central veins running through them, and three tributary veins (veins that empty into a larger vein). Conventional AVS collects blood from the central veins, but these veins have blood from the adrenal glands as well as blood in wider circulation flowing through them.

ssAVS uses tiny catheters — very long, narrow tubes inserted into blood vessels, called microcatheters — to collect blood from the tributary veins in both adrenal glands. Only blood from the adrenal glands flows through the tributary veins, making analysis of hormone levels easier, and pinpointing the region, or segment, of the gland that is not working properly.

A medical imaging technique, known as angiography, is used to track the positions of the microcatheters. Angiography is a procedure widely used to visualize the inside of blood vessels and organs, and takes roughly 90 minutes.

The paper reported on the use of ssAVS in three patients with adrenal gland disorders, and one (case #2) was diagnosed with SCS and PA. “Overall, in Cases #1 and #2, the ssAVS method clearly indicated segmental adrenal hormone production, not only for aldosterone, but for cortisol, and enabled these patients to be treated by surgery,”  the researchers reported.

Conventional AVS measures hormone levels in whole glands. It is useful for identifying which of the two glands is diseased, and the type of hormone that is overproduced. But sometimes both glands are affected, and only removal of the diseased parts in both glands is safe and effective.

That’s one of the reasons why ssAVS is so useful. By sampling the smaller, tributary veins in three different regions of each gland, the diseased parts can be identified. The diseased parts can then be removed from both glands, if medically advisable, leaving the healthy parts of the glands intact and functional.

ssAVS is also useful because it collects samples of blood coming directly from the adrenal glands, making analysis of hormone levels more reliable.

Researchers concluded that ssAVS is useful in both the diagnosis of adrenal gland disorders and for research that might lead to new therapies.

“Between October 2014 and September 2015, two angiographers … performed ssAVS on 125 cases … with a 100 % success rate and within a reasonable time (58 – 130 min) without adrenal rupture or thrombosis that required surgery,” they wrote. “The ssAVS method is not difficult for expert angiographers, and, thus, is recommended worldwide to treat PA cases for which cAVS does not represent a viable surgical treatment option.”

From https://cushingsdiseasenews.com/2017/10/17/subclinical-cushings-syndrome-may-be-diagnosed-via-blood-from-tributary-adrenal-gland-veins/

An Amusing Look At Hormones And The Pituitary Gland

A moment in the scheming mind of Professor Pituitary and his sidekick, Dr. Hypothalamus!! And… their minions, the Hormonal Kitties!

8 Things You Should Know About Addison’s Disease

adrenal-insufficiency

 

Cortisol gets a bad rap these days. (Guilty!) Yes, this hormone surges when you’re stressed. And yes, chronic stress is bad news for your health. But while too much cortisol can lead to all sorts of stress-related side effects, too little cortisol is equally debilitating.

Just ask someone with Addison’s disease. If you suffer from this condition, your adrenal glands fail to make adequate amounts of cortisol, says Betul Hatipoglu, MD, an endocrinologist at Cleveland Clinic.

Cortisol plays a role in regulating your blood pressure, heart function, digestion, and a lot else, Hatipoglu explains. So if your adrenal glands poop out and your cortisol levels plummet, a lot can go wrong. (In as little as 30 days, you can be a whole lot slimmer, way more energetic, and so much healthier just by following the simple, groundbreaking plan in The Thyroid Cure!)

Here’s what you need to know about this condition—starting with its craziest symptom.

It can make your teeth appear whiter.

Hatipoglu once met with a patient who was suffering from fatigue, belly pain, and mild weight loss. “Her doctors thought she was depressed,” Hatipoglu recalls. Toward the end of their appointment, Hatipoglu noticed the woman’s teeth looked very white. She realized they looked white because the woman’s skin was tan. “I asked her if she’d been on vacation, and she said she hadn’t been in the sun, and that’s when I knew,” Hatipoglu says. Some Addison’s-related hormone shifts can make the skin appear darker, almost like a tan. “Addison’s is the only disease I know of that can cause darkening of the skin,” she says.

Its (other) symptoms are popular ones.

 Along with darker skin, other symptoms of Addison’s include nausea, mild-to-severe abdominal or bone pain, weight loss, a lack of energy, forgetfulness, and low blood pressure, Hatipoglu says. Of course, those same symptoms are linked to many other health issues, from thyroid disease to cancer. “It’s very easy to confuse with other disorders, so many people see a lot of doctors before finally receiving a proper diagnosis,” she says. (One exception: For young women who develop Addison’s disease, loss of body hair is a warning sign, Hatipoglu adds.)
It’s rare.
Doctors also miss or misinterpret the symptoms of Addison’s disease because it’s very uncommon. “I’m not sure if it’s quite one in a million, but it’s very rare,” Hatipoglu says. “It makes sense that many doctors don’t think of it when examining a patient with these symptoms.”
It’s often confused with adrenal insufficiency.

A lot of online resources mention Addison’s disease and adrenal insufficiency as though they were two names for the same condition. They’re not the same, Hatipoglu says. While a thyroid issue or some other hormone-related imbalance could mess with your adrenal function, Addison’s disease refers to an autoimmune disorder in which your body attacks and destroys your adrenal glands.

That destruction can happen quickly.

While it takes months or even years for some Addison’s sufferers to lose all hormone production in their adrenal glands, for others the disease can knock out those organs very rapidly—in a matter of days, Hatipoglu says. “That’s very uncommon,” she adds. But compared to other less-severe adrenal issues, the symptoms of Addison’s tend to present more dramatically, she explains. That means a sufferer is likely to experience several of the symptoms mentioned above, and those symptoms will continue to grow worse as time passes.

Anybody can get it.

Addison’s is not picky. It can strike at any age, regardless of your sex or ethnicity, Hatipoglu says. While there’s some evidence that genetics may play a role—if other people in your family have the disease or some other endocrine disorder, that may increase your risk—there’s really no way to predict who will develop the disease, she adds.

Screening for Addison’s is pretty simple.

If your doctor suspects Addison’s, he or she will conduct a blood test to check for your levels of cortisol and another hormone called ACTH. “Usually the results of that screening are very clear,” Hatipoglu says. If they’re not, some follow-up tests can determine for sure if you have the condition.

There are effective treatments.

Those treatments involve taking oral hormone supplements.  In extreme cases, if the patient’s body does not properly absorb those supplements, injections may be necessary, Hatipoglu explains. “But patients live a normal life,” she adds. “It’s a treatable disease, and the treatments are effective.”

From http://www.prevention.com/health/addisons-disease-symptoms

The Pituitary Gland: Small But Mighty

The pituitary gland works hard to keep you healthy, doing everything from ensuring proper bone and muscle growth to helping nursing mothers produce milk for their babies. Its functionality is even more remarkable when you consider the gland is the size of a pea.

“The pituitary is commonly referred to as the ‘master’ gland because it does so many important jobs in the body,” says Karen Frankwich, MD, a board-certified endocrinologist at Mission Hospital. “Not only does the pituitary make its own hormones, but it also triggers hormone production in other glands. The pituitary is aided in its job by the hypothalamus. This part of the brain is situated above the pituitary, and sends messages to the gland on when to release or stimulate production of necessary hormones.”

These hormones include:

  • Growth hormone, for healthy bone and muscle mass
  • Thyroid-stimulating hormone, which signals the thyroid to produce its hormones that govern metabolism and the body’s nervous system, among others
  • Follicle-stimulating and luteinizing hormones for healthy reproductive systems (including ovarian egg development in women and sperm formation in men, as well as estrogen and testosterone production)
  • Prolactin, for breast milk production in nursing mothers
  • Adrenocorticotropin (ACTH), which prompts the adrenal glands to produce the stress hormone cortisol. The proper amount of cortisol helps the body adapt to stressful situations by affecting the immune and nervous systems, blood sugar levels, blood pressure and metabolism.
  • Antidiuretic (ADH), which helps the kidneys control urine levels
  • Oxytocin, which can stimulate labor in pregnant women

The work of the pituitary gland can be affected by non-cancerous tumors called adenomas. “These tumors can affect hormone production, so you have too little or too much of a certain hormone,” Dr. Frankwich says. “Larger tumors that are more than 1 centimeter, called macroadenomas, can also put pressure on the area surrounding the gland, which can lead to vision problems and headaches. Because symptoms can vary depending on the hormone that is affected by a tumor, or sometimes there are no symptoms, adenomas can be difficult to pinpoint. General symptoms can include nausea, weight loss or gain, sluggishness or weakness, and changes in menstruation for women and sex drive for men.”

If there’s a suspected tumor, a doctor will usually run tests on a patient’s blood and urine, and possibly order a brain-imaging scan. An endocrinologist can help guide a patient on the best course of treatment, which could consist of surgery, medication, radiation therapy or careful monitoring of the tumor if it hasn’t caused major disruption.

“The pituitary gland is integral to a healthy, well-functioning body in so many ways,” Dr. Frankwich says. “It may not be a major organ you think about much, but it’s important to know how it works, and how it touches on so many aspects of your health.”

Learn more about Mission Hospital. Learn more about Dr. Frankwich.

From http://www.stjhs.org/HealthCalling/2016/December/The-Pituitary-Gland-Small-but-Mighty.aspx

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