Lose Weight By Controlling The Fat Storage Hormone

Trouble Spot Nutrition

Created by Janet Hradil, Trouble Spot Nutrition is a 3 Phase Hormonal Solution That Melts Away Trouble Spot Fat In Less Than 15 Minutes A Day. Leptin, cortisol, and testosterone all have an influence on our weight issues, but not many of us know it. Janet Hradil has created Trouble Spot Nutrition with the intent of teaching people how their hormones affect their weight loss efforts, and how nutrition can easily correct hormone issues and help fight fat faster than ever before. In each of your fat cells, there is an enzyme, 11 beta-hydroxysteroid dehydrogenase-1 (Hsd), that takes inactive cortisone (a hormone) and turns it into cortisol, a fat storing compound. If you have high amounts of Hsd, you will have high amounts of fat storage. While Hsd is genetically determined, you can use nutrition to reduce levels and stop the unwanted fat storage, even on your trouble spots. Read more...

Trouble Spot Nutrition Summary

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Adherence to components of the extracellular matrix

One of the principal functions of the ECM is to serve as substrate for the adherence of eukaryotic cells within animal tissues. The ECM is composed of polysaccharides and numerous proteins including fibronectin, vitronectin, laminin. elastin, collagen, fib-rinogen, tenascin, entactin, and others. Thin flexible mats of specialized ECM, known as basal laminae or basement membranes, underlie all epithelial cells and surround individual fat cells, muscle cells, and Schwann cells. Binding of ECM proteins is one of the primary mechanisms used by many pathogenic bacteria to adhere to host tissues. Bacterial adhesins have been identified which recognize specific components of the ECM and a few adhesins, such as the Opa50 protein of Neisseria and the YadA adhesin of Yersinia enterolitica, are able to recognize multiple ECM components. Some bacterial adhesins preferentially recognize immobilized, cell-bound ECM components over soluble forms. The YadA adhesin expressed by Y. enterolitica, for...

Functional Implications

From all the anatomic foundations described above, recent physiological experiments can be placed in context. As mentioned earlier, orexin neurons themselves can detect and respond to metabolic cues such as glucose, ghrelin, and leptin (18,78). Finally, it is interesting to speculate that orexin neurons may utilize a complex combination of both hypothalamic and subhy-pothalamic effectors through both receptor subtypes to direct integrated responses and maintain metabolic and autonomic homeostasis, in addition to their role in regulating sleep wake states.

Cortex limbic See limbic system

Corticotropin-releasing factor A chemical secreted by the hypothalamus that stimulates the anterior pituitary to produce adrenocorticotropic hormone (acth). In turn, ACTH stimulates the adrenal cortex to produce glucocorticoids (primarily cortisol), which in turn stimulates the release of amino acids. The releasing of corticotropin-releas-ing factor is an important component of the brain's response to stress.

Mechanisms That Mediate Orexininduced Feeding

Increases in adiposity result in higher circulating leptin levels, which cross the blood-brain barrier to suppress feeding via neurons that express the signal-transducing leptin receptor Ob-Rb (14,15). The arcuate nucleus (ARC), which contains neuropeptide Y (NPY) agouti-related protein (AgRP)-coexpressing neurons as well as pro-opiomelanocortin (POMC) cocaine and amphetamine-regulated transcript (CART)-coexpressing neurons, is a major site of leptin's action and is regarded as an important region that regulates feeding behavior (16). NPY AgRP neurons stimulate feeding, whereas POMC CART neurons suppress feeding. Leptin-medi-ated inhibition of NPY AgRP neurons and excitation of POMC CART neurons are thought to be the major mechanisms of suppression of feeding by leptin (16,17). Orexin neurons densely project to the ARC (5,18,19) (Fig. 2), and Fos expression was induced in NPY neurons of the ARC by icv injection of orexin, suggesting that orexin-stimulated feeding may occur at least...

The Hypertensive Accountant

Cortisol (P) (nmol L) By the last day, the patient required seven slow-release KCl tablets every 6 hours (q6h) to maintain normokalemia. Failure of upright plasma aldosterone to suppress to < 165 pmol L by day 4, despite suppression of renin, and in the absence of a rise in ACTH (inferred from Cortisol) between 0700h and 1000h which may have prevented aldosterone suppression, confirmed PAL. Aldosterone (P) Cortisol (P) Aldosterone Cortisol Comparison of adrenal with peripheral venous aldosterone cortisol ratios (rightmost column) revealed definite production of aldosterone by the right adrenal gland, but suppression of aldosterone production by the left, consistent with right adrenal APA.

Correlates of immunitycorrelates of protection

Cortisol A glucocorticoid hormone secreted by the adrenal gland to moderate stress. Among other things, glucocorticoids promote the breakdown of protein stores in the body to produce sugar (glucose) and can decrease immune system activity. Cortisol levels are high in people with HIV infections, and the hormone has been implicated in wasting syndrome. Recent studies have found that blocking cells' glucocorticoid receptors reduces the proliferation of Kaposi's sarcoma tissue, and that blocking these receptors also might inhibit HIV itself.

Confirmation of Diagnosis and Subtype Differentiation

Considered specific for BAH among patients with PAL. However, similar responsiveness is also observed in the All-responsive variety of APA, which accounts for over 50 of APAs in some series. Hybrid steroid concentrations (18-hydroxy- and 18-oxo-cortisol), elevated in FH-I and All-unresponsive APA, are normal in both BAH and All-responsive APA, and are therefore of only limited value in differentiating BAH from APA. For these reasons, adrenal venous sampling is the only dependable way to differentiate bilateral from unilateral PAL. Some centers therefore perform this procedure in all patients with PAL (other than those with FH-I). To avoid effects of posture and diurnal variation on steroid concentrations, sampling should be performed in the morning after overnight recumbency, and stress should be avoided, with any venous cannulation delayed until the start of the procedure. An adrenal to peripheral venous cortisol gradient of at least 3.0 indicates successful cannulation. Calculation...

Post Traumatic Stress Disorder PTSD

Ring, intrusive memories of the traumatic event. These memories are highly persistent and interfere with the process of acquiring new information, consolidating memories, and remembering information that is unrelated to the trauma. Sustained levels of stress stimulate the release of a hormone called Cortisol, which can ultimately damage brain structures that are important for memory. In fact, patients with PTSD have been found to have structural changes in the hippocampus and possibly other areas of the limbic system. High levels of cortisol can also cause memory problems in people without PTSD. In one study, healthy adults were given a supplemental dose of cortisol once a day for four days. The people were divided into two groups. One group was given a low dose of cortisol about the level that the body naturally releases in response to ordinary stressful events, such as getting stuck in traffic and being late for an appointment. The other group received a high dose of cortisol. All...

Arousal Circuits Activated By The Hypocretins

Even though the effect of the hypocretin peptides on food intake may be weak and transient, there is strong evidence demonstrating that hypocretin neurons are important sensors of metabolic signals. The connectivity between neuropeptide Y (NPY)-positive neurons in the arcuate nucleus and hypocretin neurons has been demonstrated (27,28). These studies also showed that hypocretin neurons contain leptin receptors and that they are contacted by pro-opiomelanocortin (POMC)-containing inhibitory neurons. Furthermore, hypocretin neurons are sensitive to glucose, leptin, ghrelin, and triglycerides (29-32). In an elegant study, Hara et al. (33)

Social And Procedural Context

The majority of neuroimaging studies to date may be classified as brain mapping studies, in which investigators are exploring the patterns of activity elicited by a particular psychological process or condition. Brain mapping has been used to investigate virtually every field of study in human psychology and psychiatry, including (for example) attention, perception, memory, learning, emotion, reward, depression and other mood disorders, psychopathy, and Parkinson's and other neurological disorders. Recently, this trend has broadened to include mapping of social processes such as representations of the self and of others' intentions, economic principles such as expected utility and risk, and emotional self-regulation. Another approach particularly relevant here is the mapping of brain regions that correspond with changes in the autonomic and endocrine systems as measured by heart rate (Critchley, 2003), electrodermal responses (Critchley, 2000), pupil dilation (Siegle, 2003), and...

Circadianhomeostatic Regulation Of Sleep

It is often assumed that the pressure to sleep (sleep propensity) is lowest shortly after awakening, increases during the day, peaks at bedtime, and declines during sleep. However, if one stays awake all night, sleepiness, and therefore sleep propensity, increases until a specific cir-cadian time point, usually the individual's customary morning awakening time, at which time he she will feel less sleepy again for a while. This second signal, of circadian origin, interacts with the sleep debt to maintain alertness evenly across the day. Several models have tried to integrate these two factors. The most established model is Borbely's two-process model (24), whereby one process, process S, measures the homeostatic sleep pressure (Fig. 1). Process S is thought to be dependent on the amount of prior wakefulness and is reflected by the amount of electroencephalograph (EEG) slow-wave activity (0.5-4.5 Hz). Process S increases during extended wakefulness, thereby increasing sleepiness with...

Cortical layer See cortical meshwork

Corticosteroids Steroid hormones produced in the adrenal cortex. Formed in response to adreno-corticotrophin (ACTH). Regulate both carbohydrate metabolism and salt water balance. Glucocorticoids (e.g. cortisol, cortisone) predominantly affect the former and minerocorticoids (e.g. aldosterone) the latter.

Human Behavioral Commonality

A new breed of Social Darwinists sees evolutionary causation in such correlations. Doesn't it make sense, they ask, that humans should be programmed genetically to perceive as attractive any features in the opposite gender that signal reproductive potential, and to interpret as unattractive features that signal ill health Breasts and muscles are appealing, tumors appalling. Other features that men reportedly perceive as beautiful in women include high symmetry between the left and right sides of the face (a purported sign of developmental stability), facial normalness, and gender-pronounced facial features in directions perhaps indicative of high estrogen levels (full lips) and low androgen levels (small lower jaw). To a mate-prospecting male, these and other feminine features supposedly telegraph a healthy partner and desirable genes for potential offspring. Likewise, women reportedly show preferences for particular features in men.15

Tobaccoderived Carcinogens 2231 Tobacco Components

Higher metabolizing capacity and formed primarily (R)-NNAL, the levels of which were only slightly reduced by glycyrrhizic acid (GA), an inhibitor of 11p-hydroxysteroid dehydrogenase, the enzyme that facilitates conversion of NNK to NNAL.74,75 The second group displayed a lower reductive metabolic capacity, but formed primarily (S)-NNAL and its rates of formation were inhibited by 60 to 80 upon treatment with GA. By contrast to microsomes, no discernable pattern of NNAL formation in cytosolic preparations was found and (S)-NNAL was the predominant product. Menadione, an inhibitor of carbonyl reductase, blocked NNAL formation by approximately 95 in incubations of two cytosolic samples. These results demonstrate the capacity of the human pancreas to metabolically activate NNK and suggest the existence of individual differences in both the activity and stereochemical nature of carbonyl reduction.

Reasons for elevated ffa levels in insulinresistant states

The release of FFA into the circulation is directly proportionate to the size of fat cells. Thus, increasing adiposity is accompanied by greater release of FFAs into the circulation. A chronically elevated FFA level is believed to be a cause of IR. This is illustrated by the observation that IR can be induced in normal subjects by the infusion of Intralipid (Pfizer, New York, NY) for several hours, which raises the FFA concentration, mimicking the obese state. The mechanisms that are responsible for the effects of a chronically elevated FFA level on insulin sensitivity are beyond the scope of this review, but the interested reader is referred to a recently published review on this topic (10).

Psychosocial stress and socioeconomic differences

Migration can be associated with maladjustment or isolation and stress on the one hand, but also with acculturation and integration on the other. It has been suggested that increased corticosteroid and cytokine activation may be potential links between stress and the metabolic syndrome (Yudkin etal., 2000 Brunner etal., 2002). In a study of 509 subjects in India there was evidence of an interaction between cortisol

Relevant Findings Of Preclinical And Clinical Studies

The hypocretin neurons are at a crossroad, interacting with numerous systems that have already been implicated in the physiology of mental illness. Evidence suggests that bidirectional hypocretin interactions exist with virtually all known neurochemical determinants of mental illnesses, including all of the centrally active monoamine pathways (dopamine, nor-epinephrine, and serotonin), histamine and acetylcholine pathways, and also peptide transmitters. The monoamine pathways interact closely with hypocretin neurons. Hypocretins excite serotonergic neurons in the dorsal raphe (6), noradrenergic neurons in the locus coeruleus (7), and dopaminergic neurons in the ventral tegmental area (8). Central hypocretin administration suppresses prolactin (PRL) and growth hormone (GH) release (4,9), suggesting that, if it is acting alone, a deficit in hypocretin could be permissive for release. However, secretion of both PRL and GH may be altered in narcolepsy. In a comparison of four drug-free...

General Interpretation And Discussion

The data on the HPA axis strongly suggest that the master pacemaker dictating circadian timing is intact in narcoleptic patients. The circadian timing of HPA output is generally recognized to be a close reflection of pacemaker activity (52). The timing and amplitude of the acrophase of ACTH and cortisol in plasma were similar in patients and controls. The circa-dian distribution of body temperature fluctuations, another reliable measure of endogenous time keeping by the biological clock (53), is also normal in narcoleptic humans (54), which supports the notion that the master pacemaker is unaffected by the disease. However, the distribution of sleep and wakefulness, which is primarily determined by clock timing, is severely disturbed in narcoleptics. To reconcile these facts, it has been proposed that inputs from the SCN into hypocretin neurons drive clock-dependent alertness in healthy humans and that destruction of these neurons therefore abrogates the impact of an intact master...

Hypothalamopituitaryadrenal axis

A negative feedback system controls the HPA axis. This regulates the release of corticosteroid-releasing hormone from the hypothalamus and subsequent release of glucocorticoids through the axis. In the context of low birthweight maternal nutritional imbalance, experimental evidence suggests changes to circulating cortisol, glucocorticoid receptor density and altered cortisol metabolism. When nutritional deprivation in utero in rat and sheep led to hypertension, an increase in glucocorti-coid receptor sensitivity in peripheral tissues was demonstrated (Bertram etal., 2001). Levels of corticotrophin-releasing hormone were raised in cord blood taken from growth-restricted foetuses, suggesting increased HPA activity (Goland etal., 1993). Low birthweight is associated with increased serum and urinary glucocorti-coid concentrations in children and raised basal cortisol concentrations and responsiveness to adrenocorticotrophic harmone (ACTH) in adults (Clark, 1998). Men born with lower...

Association for Retarded Citizens ARC A

Atherosclerosis A disease of the arteries characterized by buildup of fat deposits on the inner walls, eventually obstructing blood flow. Atherosclerosis is one of the primary causes of stroke, the third most common cause of death (after cancer), which occurs when blood flow to the brain is reduced or cut off.

Medulla oblongata Full name of the medulla

Melatonin A hormone released by the pineal gland that induces sleep and influences circadian rhythms experts now believe an abnormal level of melatonin may also suppress mood and mental quickness. The human body is regulated by a biological clock that sets the pace for everyday rhythms of sleep, activity, temperature, and cortisol and melatonin release. Most people maintain a certain flexibility in their biological clock, allowing them to synchronize their system to environmental changes. But experts suspect that some people do not synchronize their clocks so easily. It could be that some people are out of step with the world's 24-hour rhythm, so that melatonin is released too early (causing early-evening sleepiness and early-morning awakening) or too late (causing insomnia and trouble waking up). Normally, melatonin is produced in the dark during sleep, and its production peaks during the winter months.

Glucose6phosphate dehydrogenase G6PD deficiency 201

Glitazones Being studied for the treatment of lipodystrophy, glitazones belong to a class of drugs called the thiazolidinediones and are best known for their ability to make cells more sensitive to insulin. Glitazones have also been shown to help correct the function of adipocytes (fat cells).

Regulation Of Zp Expression

Zebrafish Oocyte

While estrogen regulation of ZP is widespread among teleosts, it was shown that the estrogenic response could be altered by cortisol in Arctic char (Salvelinus alpinus) (Berg et al., 2004). The known stress hormone, cortisol, was potentiating the estrogen-dependent ZP induction. This is however not general in fish as neither gilthead sea bream nor zebrafish ZP expression is altered by cortisol (Modig et al., 2006). Although estrogens appear to be a major inducing factor for teleost ZP expression, androgens have been suggested to regulate ZPs in fish (Japanese eel, Anguilla japonica) and birds (Japanese quail, Coturnix japonica) (Miura et al., 1998 Pan et al., 2001). In cell cultures testosterone induce high ZPC mRNA expression in quail, while 11-ketotestosterone suppressed ZP mRNA transcriptions in eel. Not all fish species have ZP proteins that are regulated by estrogen receptors. E-boxes have been identified in the ZP promoters of winter flounder (Lyons et al., 1993), carp (Chang et...

The Hypothalamuspituitaryadrenal Hpa Axis

Difference Between Raas And Hpa Axis

CRH and AVP neurons are located in the parvocellular hypothalamic PVN. CRH appears to be more involved in acute stress, whereas AVP is more important in chronic stress (36). The HPA axis is under control of the hypothalamic suprachiasmatic nucleus (SCN), which produces the circadian rhythm in cortisol (corticos-terone in rats) secretion. Stress is relayed to the PVN from peripheral nerves via neurons in the brainstem. It is possible that the orexins affect the HPA axis by stimulating arousal or influencing cir-cadian input to the HPA axis. Part of the arousal response to orexins may be mediated by activation of the HPA axis. The temporal basis for the orexins to influence plasma corticosterone physiologically has been little studied, but changes in cortisol were not correlated with CSF orexin-A in the squirrel monkey model (46). Most patients with narcolepsy-cataplexy have a deficiency in orexin neurotransmission (2,47,48). Higuchi et al. (49)...

Cyclic Vulvovaginitis Candida Vaginitis Pruritus Vulvae

There have long been indications that the incidence of Candida vaginitis is hormone dependent (2,33). Thus, a Candida infection is observed more frequently in pregnant women than in nonpregnant women. The use of ovulation inhibitors, in particular, those with a high estrogen content, also increases the risk of an infection. In postmenopausal women who do not use estrogen replacement therapy, the incidence is low. Relapses of a Candida infection with pruritus vulvae occur frequently in the luteal phase prior to the onset of menstruation. Kalo-Klein and Witkin demonstrated an inhibition of the cellular immune response to C. albicans during this phase, which they attributed to variations in the progesterone and estradiol levels (33). However, even independent of the menstrual cycle, patients with relapsing Candida vaginitis were shown to have a reduced Candida-specific T cell reaction. In vitro, both a reduced T cell proliferation and a reduced interferon-gamma secretion were...

Rapporteurs Primary Jennifer Obernier Secondary Stephen W Barthold

The informal introductory comments of Drs. Baumans and Vandenbergh stimulated immediate discussion. Dr. Baumans discussed the pros and cons of enrichment, emphasizing the necessities for taking into account the normal behavior of each species and for evaluating enrichment methods. Dr. Vandenbergh elaborated on this point noting that guidelines must have a positive strategy they should identify a scientific basis and measure outcome appropriately and they should be performance based. This combination of requirements poses larger issues in that it is difficult to define what to measure, what the approach should be, and how to interpret the findings. Cortisol, for example, is not the Holy Grail to indicate the extent of animal welfare. Stress and steroid responses have both good and bad effects, depending on circumstance. Dr. Vandenbergh further indicated that guidelines must not be based on subjective measurements they must garner respect of the scientific community and must have...

Type Of Pancreatitis Initial Damage In The Pancreas And Fibrosis Pattern

It has been shown that the initial event in alcoholic pancreatitis is focal autodigestive necrosis of interstitial fat cells, which may involve adjacent vessels, especially veins, and other tissue compartments of the pancreas.18 The inflammatory reaction and the hemorrhaging that follows the tissue necrosis initiate fibrosis (Figure 16.2).19 As discussed above, the most important known mediators of fibrosis are cytokines. The cells from which fibrogenic cytokines such as transforming growth factor (TGF) p1 and platelet derived growth factor (PDGF)6,7 may be released are macrophages and other inflammatory cells, which accumulate in large numbers around the necrotic areas, and platelets in areas of hemorrhagic necrosis. The cytokines generated by these cells mainly exert their paracrine effects on

Orexin Neurons May Integrate Sleepwake Behavior With Other Hypothalamic Functions

Anatomic and physiologic studies highlight the multifunctional nature of the orexin system. The orexin neurons directly respond to neuromodulators implicated in feeding such as ghrelin and leptin (169,170) and send projections to appetite-regulating regions including the arcuate, paraventricular, and ventromedial nuclei of the hypothalamus (86). Central injection of orexin during the light period dose-dependently increases feeding (84,89,171-173), whereas blockade of orexin receptors suppresses feeding (169,174). The orexin neurons innervate cells in autonomic regulatory regions such as the LH, ventrolateral medulla, nucleus of the solitary tract, and intermediolateral cell column (86,175,176), and ventricular injection of orexin increases sympathetic activity and modulates body temperature (177-181) Through their projections to the arcuate nucleus and median eminence, the orexin neurons also influence neuroendocrine responses (182). Few of these physiologic studies have controlled...

Regulation Of Pancreatic Secretion

The enteroinsular axis has also been characterized. GIP is also called glucose-dependent insulinotropic polypeptide. On absorption of glucose, galactose, sucrose, or fat (corn oil), the duodenum secretes GIP.29-32b GIP has been identified as a possible incretin, which is an endocrine factor from the gut with insulinotropic activity. The direct metabolic effects of GIP include antagonizing the lipolytic action of glucagon in fat cells, reducing glucagon-induced increase of cyclic adenosine monophosphate, and reducing hepatic glucose output without a concomitant rise in plasma insulin.33 Incretins are released by nutrients and stimulate insulin secretion in the presence of elevated blood glucose levels. The connection between the gut and the pancreatic islets has been coined the enteroinsular axis. Because the enteroinsular axis acts as a feedback loop for suppression of pancreatic secretion, Isaksson and Ihse34 have proposed its use in the treatment of pain induced by pancreatic...

Definition of the Disease

Congenital adrenal hyperplasia (CAH) is a group of diseases that result from reduced or absent activity of one of the five enzymes of cortisol synthesis in the adrenal cortex (Fig. 20.1). Each enzyme deficiency produces characteristic alterations in the concentrations of the particular steroid hormones that are substrates for, or products of, metabolism by the defective enzyme.1,2 Approximately 90 of cases of CAH are attributable to deficiency of 21-hydroxylase, a microsomal cytochrome P450 enzyme required in the pathways leading to cortisol and aldosterone but not required in the production of sex steroids. In the presence of a defect in 21-hydroxylase, the synthesis of cortisol is blocked. This leads to disruption of the normal feedback mechanisms and overproduction of ACTH. The result is adrenal hyperplasia, the oversecretion of Figure 20.1 Pathways of steroidogenesis within the adrenal gland. Enzyme nomenclature is given inside boxes common names of steroid intermediates are...

Cytoarchitecture of the Wall of Air Sacs

The wall of the ASs consists mainly of a simple epithelium supported on a thin layer of connective tissue (e.g.Walsh and McLelland 1974).The epithelium consists of squamous cells but, near the ostia, ciliated cuboidal and columnar cells occur (e.g. Fletcher 1980). In the domestic fowl, pseudostratified, ciliated columnar epithelium with goblet cells extends as a broad band from the PB into the AAS (Cook and King 1970). On the surface of the CaTAS, Cook et al. (1987) observed a pseudostratified, ciliated, cuboidal-to-columnar epithelium. In penguins, the epithelium of the ASs is generally tall, almost cuboidal. The epithelial cells are joined by junctional complexes at the luminal aspect and laterally by interdigitation. Microvilli project into the luminal space and electron-dense lysosome-like granules occur in the cytoplasm (e.g. Carlson and Beggs 1973 Walsh and McLelland 1974). Scanty muscle cells and clusters of fat cells have been reported in the walls of the ASs of some species...

Roles Of Orexin In The Regulation Of Feeding Behavior And Body Weight Homeostasis

Upregulation of prepro-orexin mRNA suggests that orexin neurons monitor the animal's nutritional status (4). Indeed, our electrophysiological studies on orexin neurons showed that leptin robustly inhibited most orexin neurons, causing hyperpolarization and a decrease in firing rate. Furthermore, leptin administration depresses orexin expression in the hypothalamus of normal mice. We also showed that ghrelin activates a population of isolated orexin neurons by depolarization with increases in action potential frequency. Circulating ghrelin, as well as ghrelin-containing neurons (30), may in part mediate the activation of orexin neurons such as that occurring during food restriction. Induction of food intake by ghrelin, which counteracts reduction in body weight, may be mediated in part by orexins (31).

Differential Diagnosis

While the 1-hour cosyntropin test was used in this patient to diagnose glucocorticoid insufficiency, other tests are available such as the cortisol response to insulin-induced hypoglycemia, prolonged cosyntropin stimulation test, and the metyrapone test. Because of its diurnal variation, measurements of ACTH are of limited value in differentiating primary from central adrenal insufficiency. If the physician wants to directly measure aldosterone, it can be measured in blood or in a timed urine collection. In timed urine collections, sodium excretion should also be measured with creatinine measured as an index of the completeness of the collection. If measured in blood, a renin measurement should be paired with the aldosterone measurement. Isolated mineralocorticoid insufficiency is a rare inborn error. Renin deficiency can occur in cases of longstanding diabetes but is otherwise uncommon.

Body Weight And Food Intake

A number of recent studies carefully evaluated body weight of narcoleptic patients (21,22). The association between narcolepsy and obesity was clearly confirmed in all these studies. In addition, circulating leptin levels appeared to be relatively low in narcoleptic patients, despite their increased body weight (23). As leptin is critically involved in the control of energy balance and leptin deficiency leads to severe obesity in mice and humans (24,25), it was suggested that relative hypoleptinemia may be involved in the pathogenesis of obesity in nar-coleptic humans. It has also been proposed that hypocretin deficiency plays a role. A first hint came from the observation that narcoleptic patients who still have measurable hypocretin levels in their spinal fluid (a small minority of the total patient population) tended to be less obese than patients with explicit hypocretin deficiency (26). A subsequent study in a large group of typical narcoleptic patients, known to have...

Neuroendocrine Studies

We describe here the principal results of a comprehensive study of the activity of various neuroendocrine ensembles in hypocretin-deficient patients (28-31). Seven male narcoleptic patients with typical cataplectic attacks, typical multi sleep latency test (MSLT) findings, and undetectable hypocretin levels in the CSF were studied. They were compared with seven controls who were carefully matched for age, sex, BMI, and body composition. The participants were medication free. On average the subjects were overweight (BMI 28.3 kg m2), and the percentage of total body fat ranged from 12.9 to 30.4 . Plasma concentrations of leptin, GH, TSH, T3 T4, ACTH, and cortisol were measured in blood samples that were collected every 10 min for 24-h Circadian plasma profiles and hormone secretion rates were quantified using sensitive assays, pulse detection algorithms, deconvolution techniques, and cosinor fitting. Subjects remained sedentary during the studies, and standardized meals were served....

Examples of Evolved Psychological Mechanisms

Attractive features also serve as hormone markers, indicating higher levels of estrogen in females and testosterone in males. Research generally supports the evolutionary hypothesis that men prefer women with a low waist-to-hip ratio, an observable cue to high estrogen levels associated with greater fertility. In most studies, the ideal ratio of waist to hips is near the .7 that experts consider optimal for reproduction, but in Uganda, even larger hips attract men, probably as part of a general preference in that culture for large-bodied women (Bereczkei, 2000 Furnham, Moutafi, & Baguma, 2002). For their part, women are attracted to men whose faces show masculine bone structure features, such as a strong chin, that are produced by higher testosterone levels especially when the women respond to researchers' questions during their most fertile phase (Fink & Penton-Voak, 2002).

VTG Gene Clusters and Their Expression in Fish

E2 is considered the most potent steroid in inducing hepatic Vtg synthesis. The administration of this hormone to juvenile and male teleost fish induced Vtg accumulation in their bloodstream (Mommsen and Walsh, 1988). This hormonal induction may be also performed in the other so-called fishes of the Craniata lineage, e.g. the Mixiniformes Lampetra fluviatilis (Mewes et al., 2002). A different sensibility of vtgs to estrogens within the same genome, was observed, e.g. in Japanese goby (Ohkubo et al., 2004) and tilapia (Takemura and Kim, 2001). The level of circulating Vtg reflects the level of estrogen in the plasma, as observed, for example, in Sparus aurata, where high levels of both Vtg and E2 were found concomitantly in pre-spawning and spawning females. In this model, the plasma Vtg concentration reflects a balance between the protein produced by the liver and the one sequestered by growing oocytes (Mosconi et al., 1998). Vtg assessment is currently considered a useful approach to...

Differential Diagnosis and Screening

11 b-Hydroxysteroid dehydrogenase type 2 deficiency production), consumption of a high-salt diet, advancing age (during which renin levels gradually fall as renal function declines), chronic renal impairment (in which renal renin-producing capacity is reduced and salt retention contributes to renin suppression) and the presence of other salt-dependent, low-renin forms of hypertension may all be associated with renin suppression. The latter group includes (1) Liddle's syndrome, in which genetic mutations of the epithelial sodium channel (ENaC) lead to constitutive channel activation causing salt retention and potassium loss (2) congenital or acquired (e.g., through ingestion of licorice) deficiency of 11 -hydroxysteroid dehydrogenase type 2 (11bHSD2), an enzyme that normally prevents cortisol from gaining access to and causing excessive stimulation of the mineralocorticoid receptor by converting it to inactive cortisone (3) hypertensive forms of congenital adrenal hyperplasia caused by...

Trivalent Chromium Supplementation Syndrome X And Weight Loss

In a similar study, the effect of niacin-bound chromium in combination with HCA-SX and a standardized Gymnema sylvestre extract on weight loss was evaluated in moderately obese subjects 59 . A randomized, double-blind, placebo-controlled human study was conducted in 60 moderately obese subjects (aged 21-50 years, BMI > 26 kg m2) for 8 weeks. One group was administered a combination of 4 mg niacin-bound chromium, 4667 mg HCA-SX, and 400 mg Gymnema sylvestre extract, while another group was given placebo daily in three equally divided doses 30-60 minutes before meals. All subjects received a 2000 kcal diet day and participated in supervised walking program. At the end of 8 weeks, body weight and BMI decreased by 5-6 . Food intake, as well as total cholesterol, LDL, triglycerides, and serum leptin levels were significantly reduced, while HDL levels and excretion of urinary fat metabolites increased 59 . In another related study, 30 moderately obese subjects received the same...

The Role of Intensive Glycemic Control in the Management of Patients who have Acute Myocardial Infarction

It is not clear whether stress hyperglycemia predisposes one to a worse prognosis or is simply a marker for more extensive myocardial damage. Acute hyperglycemia in AMI probably is not related simply to stress-mediated release of coun-terregulatory hormones (catecholamines, gluca-gon, and cortisol) because glucose levels that are measured upon hospital admission do not

The Hypocretins Set The Arousal Threshold

Representation of the intrahypothalamic network and schematic interactions between hypocretins (HCRT) and the HPA axis. Hypocretin neurons lie in an area known to be critical for metabolic control. They receive input from NPY- and POMC-positive cells and are directly modulated by leptin, glucose, and triglycerides. The hypocretinergic system also receives input from CRF neurons in the PVN and amygdale, and it may contribute to the arousal effect associated with the stress response. Abbrevations ARC, arcuate nucleus of the hypothalamus MT medial thalamus NTS, nucleus tractus solitarius LC locus coeruleus PVN, paraventricular hypothalamus, central nucleus of amygdale VMH, ventromedial hypothalamus DMH, dorsomedial hypothalamus PF, periforni-cal area LH, lateral hypothalamus CRF, corticotropin-releasing factor NPY, neuropeptide Y POMC, pro-opiomelanocrotine AGRP, agouti-related protein MCH, melanin-concentrating hormone LR, lep-tin receptor, CRFR1, corticotropin-releasing factor...

Obesity and body fat distribution

A recent study found that transgenic mice selectively overexpressing 11P-hydroxysteroid dehydrogenase type 1 (11BHSD-1) in adipose tissue developed abdominal obesity and exhibited insulin-resistant diabetes (Masuzaki etal., 2001). Extrapolating this to humans one might speculate that 11BHSD-1 activity is raised in the adipose tissue of groups such as South Asians, leading them to develop central obesity and the metabolic syndrome (Das, 2002). If this was the case, then

Summary And Future Prospects

The follicle and are associated with the Z3 layer. J. Exp. Zool. 251 56-73 (1989). Berg, A.H., Westerlund, L., Olsson, P.E. Regulation of Arctic char (Salvelinus alpinus) egg shell proteins and vitellogenin during reproduction and in response to 17beta-estradiol and cortisol. Gen. Comp. Endocrinol. 135 276-285 (2004). Blaxter, J.H.S. Development eggs and larvae. In Hoar, W.S., Randall, D.J. (eds.), Fish Physiology, Vol. 3, Reproduction and Growth Bioluminescence, Pigments, and Poisons. Academic Press, New York, pp.177-252 (1969). Bleil, J.D., Wassarman, P.M. Structure and function of the zona pellucida identification and characterization of the proteins of the mouse oocyte's zona pellucida. Dev. Biol. 76 185-202 (1980). Bork, P. A trefoil domain in the major rabbit zona pellucida protein. Protein Sci. 2 669-670 (1993). Bork, P., Sander, C. A large domain common to sperm receptors (Zp2 and Zp3) and TGF-beta type III receptor. FEBS Lett. 300 237-240 (1992).

The Extracellular Matrix

The extracellular matrix is composed of fibers and macromolecules with associated cells. Fibroblasts constitute a major cell type. In the normal situation, small numbers of macrophages, neutrophils, and lymphocytes may lie scattered at random. Mast cells, plasma cells, and fat cells may be present. Collagen fibers and to a lesser extent elastic fibers are distributed in the matrix.

The Role Of Hypocretin In Vigilance Controls And Their Interaction With Other Regulatory Systems

Experimental evidence has suggested that the manipulations listed in the table are associated with high or decreased hypocretin tonus. It is not known whether these factors directly affect hypocretin tonus or are secondary to other effects, and some of these changes are also tightly connected with each other. Neurotransmitters activating hypocretin tonus are also known, including glutamates and acetylcholine. Ghrelin also activates hyocretin neuronal activity. In contrast, norephinephirnie and serotonin, as well as leptin, inhibit hypocretin activity. Some of the mechanisms for the activation of hypocretin neurons during fasting are also becoming elucidated by in vitro electrophysiological studies. The results of these studies revealed that peripheral humoral factors related to energy metabolism modulate the activity of hypocretin neurons the activity of isolated hypocretin neurons is inhibited by glucose and leptin and stimulated by ghrelin (14).

Environment and Neurodegenerative Diseases

The situation with regard to stress and the aging human brain is by no means clear, but some studies on aging people suggest a relation between stress hormones and difficulties with memory tasks. In one study, 11 healthy subjects in their sixties or seventies were followed for four years. Of these, six showed increased levels of cortisol, one of the main glucocorticoids released from the adrenal gland in stress. The other five had stable or decreased levels of cortisol. The six whose cortisol levels increased over the four years had difficulty with certain memory tasks such as navigating a maze or remembering a list of words. Those whose cortisol levels remained low or even decreased somewhat performed these tests with no difficulties. A subsequent fMRI study showed that the hippocampi of subjects with higher cortisol levels were smaller by about 14 percent.

Stress

As I mentioned before, an intense stress response triggers a surge in cortisol release, which can interfere with memory. Although short-term effects are reversible, we do not know how many days, weeks, months, or years of high-level stress it takes to cause persisting memory impairment.

Role of Bone Markers

Concentrations vary seasonally with higher levels observed in winter months and in northern latitudes. Intraindividual variation within a given day can be high, especially for those measured in urine. These factors complicate the use of the bone markers and require that collection be standardized in much the same way that we have standardized collection of cortisol or microalbumin.

Summary

Beyond the effects on glucose and insulin, Cr supplementation has clearly affected serum cortisol levels in multiple species. Whether this is a direct effect of Cr on the adrenal gland or an indirect effect via alterations of insulin is not determined. However, the adverse effects of excess glucocorticoids such as cortisol are well known. The excesses inhibit fibroblasts which can lead to a loss of collagen and connective tissue, which then can manifest itself as easy bruising and poor wound healing. Negative effects can also be observed on bone formation and calcium absorption, as well as general growth and development in children. A host of other effects related to immunocompetence, renal function, cardiovascular function, and decreased libido are known. But, while these effects of gross glucocorticoid excess are known, whether the smaller moderations that result from Cr supplementation will have effects on long-term health and well-being are less certain. Time dose relationships...

Progesterone

The blood supply to the skin increases in the second phase of the menstrual cycle. Harvell, et al. (11), demonstrated that the basal blood flow at the time of maximum progesterone secretion was significantly higher than on the day of maximum estrogen secretion. In another study, researchers observed a gradual dilation of the venous lumen, which reached its maximum diameter approximately one week prior to the onset of menstrual bleeding. This phenomenon also may be responsible for the subjective symptoms of chronic venous insufficiency in patients with varicose veins, in whom symptoms often increase in the second half of the cycle (12). In the premenstrual phase, not only does progesterone reach its highest level, but a high estrogen concentration is present as well the combined effect of both hormones may be causally responsible for dilation of the vessels (12). More recent studies demonstrate that the combination of high estrogen and gestagen levels, such as seen in the middle of the...

Parental Behavior

Parents who nurture their children enhance the survival of their genes. Other family members, aunts and uncles, grandparents and others, who share some of these genes, also have an investment in the child's survival to reproductive maturity. Stepchildren, who are not the genetic offspring of the parent, are more often abused or neglected (Belsky, 1993) and they receive less financial support for education (Zvoch, 1999)- Families can provide a supportive environment for the mother and child, with long-term consequences for the child's psychological health. On the other hand, children who are exposed to stressed or depressed mothers during their preschool years have elevated Cortisol levels later, indicating that they have developed a physiological sensitization to stress (Essex, Klein, Cho, & Kalin, 2002).

FollowUp Treatment

Nits should not be confused with hair debris such as fat plugs or hair casts. Fat plugs are bright white irregularly shaped clumps of fat cells stuck to the hair shaft. Hair casts are long, thin cylinder-shaped segments of dandruff encircling the hair shaft they are easily dislodged.

Manage Stress

It's difficult to concentrate when you're under severe stress, and poor attention is one of the main barriers to effectively encoding new memory. The physiological features of the fight-or-flight response interfere with mental focusing in the moment. Living with chronic significant stress can impair your memory over the long term high levels of cortisol, a stress hormone, are harmful to the hippocampus. You can't control all the stressful events in your life, but you can control your reactions to them.

Hippocampal function

Hippocampal lesions elevated cortisol secretion under a variety of stressful and nonstressful conditions (Jacobson and Sapolsky, 1991), although the results are not entirely consistent (e.g., see Bradbury, Strack, and Dallman, 1993 Jacobson and Sapolsky, 1991). Glucocorticoid implants into the hippocampus affect HPA activity in ways that are consistent with a feedback role of the hippocampus in HPA regulation (see Jacobson and Sapolsky, 1991). However, lesion and steroid-implant experiments also reveal an equally important role for the medial prefrontal cortex in HPA regulation (Diorio, Viau, and Meaney, 1993). The anatomical links from the hippocampus and medial prefrontal cortex to the hypothalamus are postulated to be via the bed nucleus of the stria terminalis and preoptic area, with an output from these structures to the paraventricular nucleus via inhibitory GABAergic projections (Herman and Cullinan, There is another linkage of the hippocampus with elevated cortisol...

Rewriting History

Females with a genetic disorder called congenital adrenal hyperpla-sia have a condition in which the steroid cortisol is not produced, causing the overproduction of other steroids. Female fetuses with this recessive trait produce too many steroids and often develop genitals that appear to be male, with large clitorises or even penises. Such females are often mistaken for boys at birth. Males with androgen insensitivity syndrome develop as females without internal male sexual organs because the body's tissues are completely insensitive to androgens.

Diagnostic Testing

Positive screening tests may suggest the presence of Cushing syndrome, but further testing is needed. Various conditions such as alcoholism, obesity, and depression are well recognized causes of pseudo-Cushing syndrome where there is basal hypercortisolism in the absence of true Cushing syndrome (e.g., in pseudo-Cushing syndrome cortisol suppression typically occurs in response to low dose dexamethasone see discussion below). The formal dexamethasone suppression test is carried out in three stages baseline (2 days), low dose dexamethasone suppression (2 days), and high dose dexamethasone suppression (2 days). First, two baseline 24-hour urine specimens are collected for UFC excretion or 17-hydroxycorticosteroid (17-OHCS) excretion. 17-OHCS are the urinary breakdown products of 11-desoxycortisol and cortisol. Urinary creatinine excretion is also determined to validate that a 24-hour urine collection was obtained. On days 3 and 4, 0.5 mg of dexamethasone is administered orally every 6...

Herpes Gestationis

Herpes gestationis (HG) is a rare pruriginous, blister-forming disorder that occurs, in most cases, in the second or third trimester of pregnancy (37). It can also occur in association with a cystic mole or a chorionic carcinoma (37). Both in pregnancy and in the presence of trophoblastic tumors, the immune system is confronted with foreign antigens of the sex partner, which may potentially play an important role in the pathogenesis of HG. In addition to a certain constellation of human leucocyte antigen (HLA) antigens in the mother and father, hormonal effects also have an important pathogenetic influence. For example, administering oral contraceptives with a high estrogen level to treat trophoblastic tumors cam exacerbate HG. Furthermore, the ovulation phase of the cycle may cause an exacerbation of HG, possibly because of estrogen's immunostimulating effects at certain concentrations (37). In most patients, however, an exacerbation of HG occurs more frequently in the premenstrual...

Scopolamine

The body is regulated by some sort of biological clock that sets the pace for everyday rhythms of sleep, activity, temperature, and cortisol and mela-tonin release. Most people maintain a certain flexibility in this system, allowing them to synchronize this biological clock to environmental changes. But experts suspect that some people perhaps those prone to depression do not synchronize their clocks so easily. It could be that their internal clock is out of step with the world's 24-hour rhythm so that melatonin is released too early (causing evening sleepiness and early morning awakening) or too late (causing insomnia and problems awakening).

Stroke 297

Stress and Memory Intense emotions triggered by a stressful or emotional event helps preserve memories of that experience primarily by activating a class of stress hormones (including cortisol) responsible for storing emotionally laden information, according to scientists at the University of California at Irvine. Drugs used to treat high blood pressure block these hormones and apparently worsen memories of emotional and exciting events. In general, the stronger the emotional experience, the stronger and more reliable the memory of that experience. The scientists explain that emotional experiences trigger the release of adrenergic hormones, which strengthen memories of events. The process may foster the intrusive memories that haunt people suffering from post-traumatic stress disorder. on the other hand, while people with high concentrations of cortisol in the blood remember what they learned long ago, they may forget things they have just been told. In a McGill University study,...

Bruce S Mcewen

1990 Wolkowitz, Rubinow, and Doran, 1990 Marti-gnoni et al., 1992 reviewed in Lupien and McEwen, 1997), and verbal memory scores correlated negatively with elevated Cortisol and positively with MRI measures showing decreased hippocampal volume (Starkman et al., 1992). Moreover, the hippocampus is vulnerable to degenerative effects of stress and loss of neurons during aging as well as in response to ischemia, seizures, and head trauma (Hsu and Buzsaki, 1993 Lowenstein et al., 1994 Sloviter, 1994 Landfield and Eldridge, 1994 Sa-polsky, 1992).

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