Adrenal and Thyroid Hormones APM Flashcards
order to look at hormone dysfunction
- adrenal
- thyroid
- sex
PTSD
Production - what are building blocks + essential nutrients
Transport - i.e. SHBG
Sensitivity
Detoxification - T/E
what is RLS in steroid hormone synthesis
getting cholesterol into mitochondria
mitochondrial health = key for Production of hormones
pathways by which stress impact cortisol
increases ACTH
slows 17,20 lyase
adrenal cortex produces which hormones
aldosterone, glucocorticoids, sex hormones
adrenal medulla produces which neurotransmitters
norepi, epi
Factors that decrease SHBG
obesity, insulin, androgens, corticoids, hypothryoid
in PCOS this leads to more free T (T carried by SHBG)
Factors that increase SHBG
pregnancy
HRT/OCP
hyperthyroid
allostasis
maintaining stability through physiologic/behavioral change
allostatic load
wear and tear or “cost” of maintaining allostasis
“cortisol steal”
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
Selye’s General Adaptation Syndrome
Stage 1
Arousal: cortisol and DHEA increased with episodic stress but returns to baseline
Selye’s General Adaptation Syndrome
Stage 2
Adaptation: cortisol chronically elevated, DHEA declines, loss of diurnal curve
stress, anxiety, “wired and tired”
Selye’s General Adaptation Syndrome
Stage 3
Exhaustion
low cortisol, low DHEA
depression, fatigue
Symptoms of elevated cortisol
irritability, fatigue, insomnia, anxiety, VMS, increased susceptibility to infection, shakiness bet meals/suagr cravings, weight gain
PE findings with elevated cortisol
postural hypotension, pupil contraction, Sergant’s white line, Rogoff’s sign, swollen ankles
Nutraceuticals and botanicals for hypercortisol state
phosphatidylserine
rhodiola
ginseng
Nutraceuticals and botanicals for hypocortisol state
Panax ginseng, licorice
Nutrients needed for proper thyroid hormone Production
iron iodine tyrosine zinc selenium vit E B2 B3 B6 vit C vit D
Factors that inhibit proper thyroid hormone Production
stress infection trauma radiation fluoride toxins + heavy metals AI e.g. Celiac
Factors that increase T4 to RT3
stress trauma low calorie diet inflammation toxins infections liver/kidney dysfunction medication
Factors that increase T4 to T3 conversion
Selenium
zinc
Factors that improve cellular Sensitivity to thyroid hormone
vit A
exercise
zinc
elevated cortisol’s effect on thyroid hormones
decrease in T3
increase in rT3
decrease in TSH
17,20 lyase is responsible for which two reactions
17-OH pregnenolone to DHEA
17-OH progesterone to adrostenedione
17 a hydroxylase is responsible for which two reactions
pregnenolone to 17-OH pregnenolone
progesterone to 17-OH progesterone
17,20 lyase downregulated by these three factors
stress
hyperinsulinemia
inflammation
