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Covid-19 and Stress

 

What is stress?

 

The study of stress dates back to the early 1900s when Claude Bernard claimed the importance of keeping internal state constant when facing a changing environment. The term homeostasis was coined in 1929, which meant the body pursues equilibrium, or makes sure all physiological processes are balanced. It wasn’t until the 1950s that “stress” was termed as anything that disrupted homeostasis. The perceived threat was coined “the stressor” and the response to the stressor was named the “stress response”. (1)

 

Stress can be something as small as dropping your coffee or as traumatic as losing a loved one. Either way the body responds in the same way. The parts of the body that mediate the stress response include the hypothalamus (part of the brain), the pituitary gland, and the adrenal glands. This trio of anatomical structures are collectively called the HPA (hypothalamic-pituitary-adrenal) axis. In response to a stressor, the hypothalamus secretes corticotropin releasing factor (CRF), which stimulates the pituitary gland to release ACTH (adrenocorticotropic hormone), this compound stimulates the adrenal glands to produce our stress hormone cortisol. (2)

 

What Does Stress Do to Our Bodies?

 

Short term, cortisol helps us to stay awake to meet deadlines at work as it releases stored glucose to power our brains and bodies. It helps us power through lunch when we forget or skip the meal because we have to pick up our kids at school. But when our stress hormone is elevated for long periods of time (think years rather than hours or days) It has been theorized that prolonged stress responses may lead to tissue damage and diseases. Stress can alter how our memory is stored. Interestingly our hippocampus, the part of our brain that is responsible for converting short term memory into long term memory, responds very strongly to stress, as it has many receptors for cortisol. Stress can also affect cognition or the way we make decisions, pay attention and make judgements. In other words, our decision making skills can be compromised by stress. Stress can also impact our immune system, leading to a greater frequency of disease. The existence of an association between stress and cardiovascular disease has also been established. Stress can also have an effect on the gastrointestinal system in two ways. First stress can depress appetite and can change the function of the system including digestive enzyme secretion and absorption of nutrients (3).

 

How Stress is Different Now

 

The coronavirus also known as SARS-CoV-2 is considered a global public health emergency. This state has proven to have severe consequences on people’s lives and their mental health. With the pandemic, financial stress of losing a job, having to work a full time job and home school kids, or the toll of social isolation can all contribute to elevated cortisol levels. (4)

 

Elevated levels of cortisol has been theorized to increase the inflammatory response within the body which may trigger a greater response to a pathogen, virus or bacteria that the body comes in contact with (5)

 

Thankfully there are tests that can identify and manage elevated cortisol levels, so they can be identified and managed early to avoid the potential of exacerbating disease symptoms.

 

How Testing Cortisol & DHEA Works

 

Salivary cortisol is frequently used as a biomarker of stress. This non invasive testing method allows for an easy and accurate assessment of current stress hormone levels (6). Cortisol has a natural diurnal or daytime rhythm. It should be the highest in the morning to wake us and it slowly tapers off at night so we can avoid stimulation and go to sleep. This is the reason adrenal salivary tests collect 4 saliva samples throughout the day, clinicians want to see a certain pattern of cortisol. This pattern can help to distinguish chronic stress from more severe stress responses (7).

 

In addition to cortisol, our stress hormone, our adrenal glands also produces DHEA (dehydroepiandrosterone). This hormone is a key player in the body as it is the precursor to all of our sex hormones. It also antagonizes or balances the effect of cortisol. The ratio of DHEA to cortisol is important when assessing how stressed someone is. A normal response to stress is elevated cortisol and normal DHEA, varied ratios may be seen with mood disorders or more extreme effects of stress like adrenal fatigue (8).

 

In the body DHEA is then converted to DHEA-S or Dehydroepiandrosterone sulfate (DHEAS) in the adrenal glands. Fun fact this hormone is the most abundant circulating steroid hormone in the body. DHEA-S is also precursor to many hormones in the body including testosterone and estrogen. So, DHEA has extended clinical significance beyond stress management, it also plays a key role in supporting healthy hormone levels (9).

 

For more information on how most hormones are important to test and keep in balance, visit www.ayumetrix.com or contact info@ayumetrix.com.. AYUMETRIX offers simple and easy at home sample collection for testing hormones to ensure your hormone levels are within the normal/ optimal physiological range.

 

Melissa Anzelone, ND

References

 

1)    Schneiderman N, Ironson G, Siegel SD. Stress and health: psychological, behavioral, and biological determinants. Annu Rev Clin Psychol. 2005;1:607-628. doi:10.1146/annurev.clinpsy.1.102803.144141

2)    Smith SM, Vale WW. The role of the hypothalamic-pituitary-adrenal axis in neuroendocrine responses to stress. Dialogues Clin Neurosci. 2006;8(4):383-395

3)    Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: A review. EXCLI J. 2017;16:1057-1072. Published 2017 Jul 21. doi:10.17179/excli2017-480

4)    Vinkers CH, van Amelsvoort T, Bisson JI, et al. Stress resilience during the coronavirus pandemic. Eur Neuropsychopharmacol. 2020;35:12-16. doi:10.1016/j.euroneuro.2020.05.003

5)    Tan T, Khoo B, Mills EG, et al. Association between high serum total cortisol concentrations and mortality from COVID-19. Lancet Diabetes Endocrinol. 2020;8(8):659-660. doi:10.1016/S2213-8587(20)30216-3

6)    Hellhammer DH, Wüst S, Kudielka BM. Salivary cortisol as a biomarker in stress research. Psychoneuroendocrinology. 2009;34(2):163-171. doi:10.1016/j.psyneuen.2008.10.026

7)    Adam EK, Quinn ME, Tavernier R, McQuillan MT, Dahlke KA, Gilbert KE. Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis. Psychoneuroendocrinology. 2017;83:25-41. doi:10.1016/j.psyneuen.2017.05.018

8)    Kroboth PD, Amico JA, Stone RA, et al. Influence of DHEA administration on 24-hour cortisol concentrations. J Clin Psychopharmacol. 2003;23(1):96-99. doi:10.1097/00004714-200302000-00014

9)    Neunzig J, Bernhardt R. Dehydroepiandrosterone sulfate (DHEAS) stimulates the first step in the biosynthesis of steroid hormones. PLoS One. 2014;9(2):e89727. Published 2014 Feb 21. doi:10.1371/journal.pone.0089727

 

 

 

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