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Managing Pain in the Presence of Autoimmune Disease
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
But the most important item to use is a supplement product called an “adrenal adaptogen.”95 This is a combination of several different herbs and some vitamins that create calm in the adrenal gland. As an “adaptogen,” it is not directional. It is balancing. If a person has a cortisol level that is high, it will help to bring it down. If a level is too low, it will come up. If a person has a combination of high and low, all cortisol levels will tend to move towards the ideal.
Psychological Effects of Exercise for Disease Resistance and Health Promotion
Published in Ronald R. Watson, Marianne Eisinger, Exercise and Disease, 2020
The symptomatology of typical Major Depression, including weight loss and early morning awakening, implicates the neuroendocrine system in the etiology and psychopathology of depression. Patients who are anxious and depressed typically show signs and symptoms of a disrupted HPA axis at rest and during challenge. These signs and symptoms include disturbances of mood, appetite, sleep, motivated behavior, and several indices of autonomic, endocrine, and immune status.56 A common thread that binds these signs and symptoms is hypercortisolism, i.e., abnormally high secretion of cortisol. One of the major functions of cortisol is to maintain blood sugar levels during stress through the liberation and use of stored fat and glycogen and amino acids from muscle cells. In normal physiological concentrations, cortisol helps the body combat stress. However, in very high concentrations cortisol suppresses immune responses to infection and can inhibit healing. Collectively, the evidence57 is consistent with the hypothesis that glucocorticoid regulation and the monaminergic systems reinforce one another’s activity.
The Hypothalamic-Pituitary-Adrenal Axis in Fibromyalgia: Where Are We in 2001?
Published in Robert M. Bennett, The Clinical Neurobiology of Fibromyalgia and Myofascial Pain, 2020
Basal levels of Cortisol have been determined in the saliva [free], plasma [total and free], and urine [free]. Mean salivary Cortisol levels were elevated (24), evening plasma Cortisol levels have been reported as elevated (22,25) or normal (16), and 24 h urine Cortisol levels are low (21,22,25,26) or normal (16). Circadian variation of Cortisol levels is reduced (22,25), but circadian phase as compared to other biological rhythms is normal (27,28).
Recent developments in wearable & non-wearable point-of-care biosensors for cortisol detection
Published in Expert Review of Molecular Diagnostics, 2023
Simran Kaur, Niharika Gupta, Bansi D. Malhotra
Apart from responding to stress levels, cortisol plays an immunosuppressive role and displays anti-inflammatory effects [26]. It also affects growth, digestion, and reproduction abilities [2728]. Elevation in the cortisol level in a recurring pattern of activation is associated with Cushing’s syndrome, which further poses complications like increased fat in the blood, anxiety, obesity, cardiac diseases [729]. These levels can also get elevated during depression and hunger [30]. Additionally, cortisol deficiencies may lead to the Addisonian crisis, distinguished by critical dehydration as well as salt wasting. It is a deadly condition; hence, early detection is of utmost importance. Mild deficiencies have also been found to play an important role but are difficult to diagnose clinically due to the prevalence of non-specific symptoms (Figure. 1). Symptoms of cortisol excess like hypertension, increase in weight, etc., are similar to symptoms of obesity, which may lead to a delay in proper diagnosis. Hence, PoC biosensing devices that provide results in real-time may prove crucial toward cortisol-related pathological conditions.
Dysfunction of the stress response in individuals with persistent post-concussion symptoms: a scoping review
Published in Physical Therapy Reviews, 2022
Gerard Farrell, Sizhong Wang, Cathy Chapple, Ewan Kennedy, Angela Spontelli Gisselman, Kesava Sampath, Chad Cook, Steve Tumilty
The ability to subjectively determine who has dysfunction of the stress response, and in what direction it is dysfunctional, is a significant knowledge gap. Using the HPA-axis as an example, symptoms such as irritability, insomnia, decreased concentration, and blunted cortisol reactivity to stress are common in states characterised by increased secretion of cortisol [98,99]. Whereas symptoms such as fatigue, nausea, apathy, and heightened cortisol reactivity to stress are common in those with reduced secretion of cortisol [8, 100]. Despite different populations, the symptoms of both hyper- and hypo-cortisolism are common with the symptoms of those with PPCS [22], challenging our diagnostic ability of a dysfunctional stress response from symptoms alone. An appropriately powered study, using valid and reliable self-reported outcome measures, in combination with quantifiable measures of ANS and HPA-axis dysfunction, is required to better differentiate between these possible ‘sub-categories’ of the stress response.
An olfactory neuroblastoma presenting as posterior reversible leukoencephalopathy syndrome
Published in Baylor University Medical Center Proceedings, 2021
James J. Doyle, Yasmeen Hashimie, Austin Metting
The patient had a Cushingoid appearance, with truncal obesity, extremity wasting, and abdominal striae. Random and morning cortisol levels were 99.3 mcg/dL and 101.5 mcg/dL, respectively, and 24-hour urine cortisol was above assay limit. Serum ACTH was 1001 pg/mL, inferring ectopic ACTH production, which was confirmed using a dexamethasone suppression test. Her cortisol levels improved with administration of ketoconazole. Spironolactone and lisinopril controlled her blood pressure, but she regularly required additional potassium supplementation to remain normokalemic. With the aforementioned MRI negative for structural pituitary pathology, tumor and lymph node biopsies were consistent with olfactory neuroblastoma, confirming Kadish Stage D metastatic olfactory neuroblastoma. Tumor samples stained strongly positive for ACTH, confirming clinical suspicions that this was an ACTH-secreting olfactory neuroblastoma.