Stress and Fatigue Flashcards
Which type of ketone is measured in the blood?
Beta-hydroxybutyric acid
Which infectious organism is implicated in the proposed aetiologies of chronic fatigue syndrome and ME?
Epstein-barr virus
Which nutrient Is a cofactor in the serotonin melatonin pathway supporting mood and sleep?
Magnesium
Mitochondria make over what percentage of the body’s energy as ATP?
90%
What vitamin has been shown to reduce stress-induced cortisol release?
Vitamin C
Continued stress can eventually result in ________ that is associated with various disorders including chronic fatigue syndrome, fibromyalgia and arthritis.
hypo-activation of the HPAA (due to adrenal fatigue)
Ongoing stress with prolonged ______ and cortisol release leads to a depleted state (referred to as ‘adrenal exhaustion’) with an impaired stress response and loss of resiliency.
DHEA
What is the typical macronutrient ratio to support nutritional ketosis in CFS/ME?
75% fat, 20% protein, 5% carbohydrate.
Elevated levels of which hormone have a direct inhibitory effect on the reproductive axis?
Corticotropin-releasing hormone
What ratio of potassium to sodium should a client suffering with stress be aiming for?
Greater than 5:1
List the 4 categories of the causes of stress (with an e.g. for each)
- Poor nutrition (alcohol, highly-processed foods)
- Personal Stress (financial problems)
- Poor body functions (allergy, thyroid disorders, slow detoxification)
- Environmental (radiation, household chemicals)
Give the definition of ‘stress’
a non-specific response of the body to any disturbance/demand - triggering the ‘stress response’
What controls and regulates the body’s stress response?
The adrenal glands
What are the stages of the stress response called and who coined the term?
The general adapation syndrome
Hans Selye
What are the three stages of stress in the General Adaptation Syndrome
- Alarm phase (fight or flight)
- Resistance phase (return to balance)
- Exhaustion phase (in cases of prolonged stress)
What is released in the alarm phase of a stress response (from where?)
Adrenaline and noradrenaline (adrenal medulla)
ACTH (anterior pituitary)
Cortisol (adrenal cortex)
What is activated by adrenaline that increases oxidative stress?
Inflammatory cytokines
Give 3 actions of cortisol
- provides additional glucose
- increases pain threshold
- Inhibits immune responses
Receptors for cortisol are called….
Where are they found in the body?
Glucocorticoid receptors
Expressed in most organs/tissues (brain, sympathetic nerves, immune cells)
Why is it important to test cortisol levels
To see if the client is in a hyper-activation of the HPAA or a hypo-activation of the HPAA stage
Issues associated with HPA hyper-activation
- Depression
- Anxiety disorders
- Metabolic syndrome (hyperglycaemia, hypertension, dyslipidaemia, central adiposity)
Issues associated with HPA hypo-activation
- Fatigue
- Irritability
- Pain and associated disorders:-
- Chronic fatigue syndrome
- Fibromyalgia
- Arthritis
7 conditions linked ti chronic stress
- Anorexia nervosa
- Asthma
- Autoimmunity
- Cancer
- CVD
- CFS
7.T2DM
6 symptoms of stress
- Insomnia
- Fatigue
- Depression
- Irritability
- Headache
- GIT issues
7 effects of prolonged cortisol secretion
- Increased risk of IR and T2DM
- Weight gain with central adiposity
- Suppresses reproductive function
- Impaired immune function
- Supresses thyroid function
- Suppressed GIT function
Downregulates the endocannabinoid system
Describe the process by which cortisol resistance can occur
Excessive or prolonged cortisol secretion leads to desensitisation of glucocorticoid receptors to cortisol (cortisol resistance)
- Explain the role of inflammation in stress states
- Why is the body’s stress response pro-inflammatory?
- Repeated surges of cortisol can lead to cortisol dysfunction which results in unmodulated inflammation
- The sympathetic response to stress is pro-inflammatory which is useful in the short-term (to destroy pathogens and foreign bodies
3 actions of cortico-releasing hormone (hormones involved)
- CRH increases mast cell activation
2.CRH causes the release of noradrenaline - CRH upregulates glutamate in the amygdala (promotes fear-based response to stress)
Explain why prolonged cortisol secretion increases the risk of insulin resistance (2 ways)
- Cortisol increases gluconeogenesis and decreases glycogen synthesis - causing hyperglycaemia
- Cortisol inhibits beta cell insulin secretion and impairs glucose uptake
2 ways cortisol causes weight gain and central adiposity
- Stimulates appetite and stress eating
- causes redistribution /accumulation of fat in visceral fat cells
- Impairs insulin response/keeps blood sugars high - sending hunger signals to the brain (over-eating)
Explain how prolonged cortisol secretion supressed reproductive function
CRH supresses the secretion of GnRH (thus disrupting the release of FSH and LH and subsequently oestrogen, progeterone and androgens)
2 ways cortisol impairs the immune system
- Decreases T-cells
- Downregulates T-helper cell receptor expression (required for Th1 immune response)
- Inhibits neutrophils, macrophages, NK cells, lymphocytes
How does cortisol inhibit thyroid function? 4 ways
- HPA axis activation and increased cortisol, reduces TSH production
- Glucocorticoids inhibit the enzyme that converts T4 to T3
- T4 is shunted into inactive rT3
- Adrenal fatigue means low cortisol which downregulates T3 receptors
4 ways cortisol supresses the GIT function
- Reduces gut motility - impairing digestion and elimination
- Reduces Hcl production
- Increases intestinal permeability (leading to mast cell degranulation and mucin depletion)
- Negatively effects the microbiota
What is the role of the endocannabinoid system?
A network of receptors and enzymes involved in pain sensation, appetite, memory and mood.
The communication link betweek the gut (microbiome) and the brain.
What is the role of DHEA in stress response?
Released in higher amounts in response to stress
- protection against negative consequences of stress
- protects against neurotoxic effects of cortisol
- reduces anxiety and depression
5 signs and symptoms of adrenal exhaustion
- Fatigue
- Reduced resilience to stress
- Anxiety
- Reduced libido
- recurrent infections