Adrenal and Thyroid Hormones APM

Question 1

order to look at hormone dysfunction

Answer 1

1. adrenal
2. thyroid
3. sex

Question 2

PTSD

Answer 2

Production - what are building blocks + essential nutrients
Transport - i.e. SHBG
Sensitivity
Detoxification - T/E

Question 3

what is RLS in steroid hormone synthesis

Answer 3

getting cholesterol into mitochondria

mitochondrial health = key for Production of hormones

Question 4

pathways by which stress impact cortisol

Answer 4

increases ACTH

slows 17,20 lyase

Question 5

adrenal cortex produces which hormones

Answer 5

aldosterone, glucocorticoids, sex hormones

Question 6

adrenal medulla produces which neurotransmitters

Answer 6

norepi, epi

Question 7

Factors that decrease SHBG

Answer 7

obesity, insulin, androgens, corticoids, hypothryoid

in PCOS this leads to more free T (T carried by SHBG)

Question 8

Factors that increase SHBG

Answer 8

pregnancy
HRT/OCP
hyperthyroid

Question 9

allostasis

Answer 9

maintaining stability through physiologic/behavioral change

Question 10

allostatic load

Answer 10

wear and tear or “cost” of maintaining allostasis

Question 11

“cortisol steal”

Answer 11

when cortisol is increased, may decrease Production (by stealing precursors) and Activity of P, E, DHEA, T and aldosterone

acute stress inhibits 17 a hydroxylase and 17,20 lyase

Question 12

Selye’s General Adaptation Syndrome

Stage 1

Answer 12

Arousal: cortisol and DHEA increased with episodic stress but returns to baseline

Question 13

Selye’s General Adaptation Syndrome

Stage 2

Answer 13

Adaptation: cortisol chronically elevated, DHEA declines, loss of diurnal curve
stress, anxiety, “wired and tired”

Question 14

Selye’s General Adaptation Syndrome

Stage 3

Answer 14

Exhaustion
low cortisol, low DHEA
depression, fatigue

Question 15

Symptoms of elevated cortisol

Answer 15

irritability, fatigue, insomnia, anxiety, VMS, increased susceptibility to infection, shakiness bet meals/suagr cravings, weight gain

Question 16

PE findings with elevated cortisol

Answer 16

postural hypotension, pupil contraction, Sergant’s white line, Rogoff’s sign, swollen ankles

Question 17

Nutraceuticals and botanicals for hypercortisol state

Answer 17

phosphatidylserine
rhodiola
ginseng

Question 18

Nutraceuticals and botanicals for hypocortisol state

Answer 18

Panax ginseng, licorice

Question 19

Nutrients needed for proper thyroid hormone Production

Answer 19

iron
iodine
tyrosine
zinc
selenium
vit E
B2
B3
B6
vit C
vit D

Question 20

Factors that inhibit proper thyroid hormone Production

Answer 20

stress
infection
trauma
radiation
fluoride
toxins + heavy metals
AI e.g. Celiac

Question 21

Factors that increase T4 to RT3

Answer 21

stress
trauma
low calorie diet
inflammation
toxins
infections
liver/kidney dysfunction
medication

Question 22

Factors that increase T4 to T3 conversion

Answer 22

Selenium

zinc

Question 23

Factors that improve cellular Sensitivity to thyroid hormone

Answer 23

vit A
exercise
zinc

Question 24

elevated cortisol’s effect on thyroid hormones

Answer 24

decrease in T3
increase in rT3
decrease in TSH

Question 25

17,20 lyase is responsible for which two reactions

Answer 25

17-OH pregnenolone to DHEA

17-OH progesterone to adrostenedione

Question 26

17 a hydroxylase is responsible for which two reactions

Answer 26

pregnenolone to 17-OH pregnenolone

progesterone to 17-OH progesterone

Question 27

17,20 lyase downregulated by these three factors

Answer 27

stress
hyperinsulinemia
inflammation