Re: HPA Dysregulation

Thanks for the post. It is a reminder about the complexity of the body.

However, people don't have to feel hopeless and overwhelmed by this. There are things we can do to investigate and look for leads.

4x saliva cortisol
http://www.canaryclub.org/adrenal-article-980/706-cortisol-1-or-4.html

Blood test for pregnenolone, the grandmother of the adrenal cortex hormones and a sex hormone profile--DHEA, Testosterone, Estrogen. Progesterone is usually included for females, but if a woman's cycle is irregular, maybe pregnenolone, the immediate precursor, is more interesting.

You can see a diagram of them here. Note DHEA is not abbreviated.
http://en.wikipedia.org/wiki/File:Steroidogenesis.svg

Stalactite's post does not get into the possible impact of problems with liver detox and heavy metals; although the post does hint at ways that they could be involved.

This article on phenols and liver sulfation related to high norepinephrine was big for me. I came across it in the Files of the Yahoo Autism-Mercury group. Stress tolerance is often difficult for kids on the Autism spectrum. The list of high phenol foods matched me quite well.
http://www.newtreatments.org/ga.php?linkid=252

Sulfation is involved in breakdown of catecholaines such as epinephrine.

Selenium is involved in T4 to T3 conversion but Se also binds well with heavy metals. This provides some protection from the HMs but also would likely leave less Se available for T3 production and antioxidant protection of thyroid gland.

Boyd Haley, former chair of the chem dept of the U of KY, once said in a talk on heavy metals that mercury binds with the hormone receptor for pituitary stress/sex hormones ACTH, FSH, etc about as well as anything can bind with Hg. He says the receptor has 4 thiol groups in the catcher's mitt and 6 more in the hinge region. Thiol (SH) groups can be thought of as mercury magnets. HM detox supplements and medications such as DMSA, DMPS, lipoic acid and glutathione contain SH groups. For example
http://lpi.oregonstate.edu/infocenter/othernuts/la/lastructure.html

Andrew Cutler, author and consultant on heavy metal detox, indicates in his writings that mercury affects adrenals and related systems in a number of ways, including the brain's control of them.

The article mentions a link involving high testosterone. In the heavy metal detox groups it is more common to hear about low testosterone and low cortisol, especially in middle aged and older folks. They often don't tolerate much of the precursor supplement DHEA, maybe due to poor sulfation.

The low iron mentioned in the article might also be related to inflammation from heavy metals. This also might be a link with candida that may also be problematic.
http://www.wellnessresources.com/weight/articles/stunning_discoveries_regarding_iron_obesity_candida_thyroid/

Low Lithium might be involved in poor balance of norepinephrine and other brain chemicals. I discussed that in another recent post.

It seems the author is not convinced that a single medication such as hydrocortisone is now always the answer. I agree. It would be nice to get to a more fundamental cause such as a liver problem, gut problem, etc, however, until that is identified, it makes sense to me to try to address the problems in several ways.

For example, A. Cutler in his book Amalgam Illness, lists a number of supplements that can be stacked to help people with adrenal insufficiency.

I'm not surprised that a psychologist would consider stress to be the "entry point". Stress is a normal part of life to some extent. Healthy people can handle reasonable amounts. We can even enjoy it for brief periods--roller coaster ride.

However if there is a physiological problem with the liver, a toxin, etc we might not be able to handle normal amounts of stress.




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