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MaryO'Note: I found this article very simplistic. What do you think? This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle. Imagine the heart-pounding rush of adrenaline you’d get while bungee jumping or zip lining — that’s what Angela Yawn felt all the time before receiving her diagnosis. In a span of six years, the 49-year-old gained 52 kg (115 lbs) and suffered from joint swelling, headaches, skin redness and a racing heart. “I would put my hand on my chest because it made me feel like that’s what I needed to do to hold my heart in,” Yawn, who lives in Griffin, U.S., told Today. “I noticed it during the day, but at night when I was trying to lie down and sleep, it was worse because I could do nothing but hear it beat, feel it thump.” Yawn recalled being the most frustrated with the weight gain, as she’d put on 1 kg (2 lbs) a day while only eating 600 calories. “I was going crazy,” she said. After dozens of doctors couldn’t piece together her seemingly unrelated symptoms, Yawn sought out the help of an endocrinologist in February 2021. Blood tests and an MRI confirmed that Yawn had a tumour in her pituitary gland — a small, pea-sized organ at the base of the brain — that caused the gland to release excess adrenocorticotropic hormones. As a result, she became inundated with cortisol, a steroid the body releases in response to danger or stress. This combination of factors led to her diagnosis — Cushing’s disease. Read on to learn more about Cushing’s disease, signs and symptoms as well as how it can be prevented. What is Cushing’s disease? “Cushing’s disease is a rare but serious condition that is caused by a pituitary tumour," a specialist from the University of California, Los Angeles (UCLA) pituitary team tells Yahoo Canada. "The gland releases excessive adrenocorticotropic hormones and cortisol into the blood over a long period of time. It’s a hormonal disorder that is sometimes called hypercortisolism, and you will need to see an endocrinologist or someone who specializes in hormonal-related diseases to confirm your diagnosis and to help you receive proper care.” Cushing’s disease is not the same as Cushing’s syndrome, which refers to elevated levels of cortisol in the blood and is much more common than Cushing’s disease. Unlike the disease, Cushing’s syndrome can be caused by taking medications that have cortisol such as prednisone, asthma inhalers and joint steroid injections. Who is at risk for Cushing’s disease? Cushing’s disease is incredibly rare, resulting in only 10 to 15 new cases per million people in the United States each year, according to UCLA Health. “It’s most commonly found in people between the ages of 20 and 50, and affects about three times more women than men,” the UCLA source, who asked not to be named, says. “However, you might be more at risk if you have high blood pressure, if you’re overweight or if you have type 2 diabetes.” What are the signs and symptoms of Cushing’s disease? Although each person may have a unique combination of symptoms, patients typically experience changes to their physical appearance, according to Mayo Clinic. “It’s very common to see rapid weight gain, red cheeks and bruising of the skin,” the UCLA source says. “I’ve also seen patients with generalized fatigue, depression, high blood pressure, a rapid heartbeat and loss of vision.” “The symptoms can seem random or unrelated, which is why it can be so hard to diagnose,” they add. To establish if you have the disease, your doctor will conduct a physical exam and ask you about your symptoms and medical history. Generally, the first step in diagnosing Cushing's disease is determining the state of excess cortisol in the blood. Afterwards, an MRI will determine if a pituitary tumour is visible. If you have symptoms of Cushing’s disease, you should make an appointment to see a doctor or endocrinologist. How is Cushing’s disease treated? In the last decade, treatment options have changed thanks to several breakthroughs in pituitary science. “Surgery to remove the tumour is normally the first treatment option. It’s minimally invasive, has a fairly high success rate and it’s the only long-term cure for Cushing’s disease at the moment,” explains the UCLA source. If surgery isn’t an option or doesn’t solve the problem, medication and radiation therapy are other ways to treat the disease. “No matter the stage of the disease at the time of diagnosis, treating it requires an experienced specialist or team of doctors familiar with pituitary tumours,” the UCLA source adds. How can I prevent Cushing’s disease? “There’s no tried and true method of preventing the condition,” the source explains. “But if you’re at risk or if you think you have the disease, I always recommend having a doctor monitor your cortisol levels on a regular basis.” The UCLA source also recommends implementing healthy lifestyle changes that can help prevent high blood pressure. Examples include reducing stress, getting adequate sleep, exercising regularly and eating a healthy diet that's rich in fruits, vegetables and whole grains. Adapted from https://ca.news.yahoo.com/what-is-cushings-disease-experts-warn-rare-serious-condition-120015725.html
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Researchers in Europe say they have shown for the first time that the SARS-CoV-2 virus attacks the human stress system by limiting how our adrenal glands can respond to the threat of Covid-19. According to a study, the coronavirus targets the adrenal glands, thereby weakening the body’s ability to produce the stress hormones cortisol and adrenaline needed to help battle a serious infection. Part of the body’s defence mechanism, these glands are indispensable for our survival of stressful situations, particularly with a coronavirus infection. The research was published by a group of scientists in London, United Kingdom; Zurich, Switzerland; and Dresden and Regensburg in Germany, in the journal The Lancet Diabetes and Endocrinology last month (November 2021). “The results of our latest work now show for the first time that the virus directly affects the human stress system to a relevant extent,” says Dr Stefan Bornstein, director of the Medical Clinic and Polyclinic III and the Centre for Internal Medicine at the University Hospital in Dresden. Whether these changes directly contribute to adrenal insufficiency, or even lead to long Covid is still unclear, he says. This question must be investigated in further clinical studies. Pointing to recent research showing the effect of inhaling steroids to prevent clinical deterioration in patients with Covid-19, the researchers say certain drugs may be able to help limit this effect of the SARS-CoV-2 virus. “This evidence underlines the potentially important role for adrenal steroids in coping with Covid-19,” scientists at the University of Zurich say. The researchers analysed the data of 40 deceased Covid-19 patients in Dresden and found that their tissue samples showed clear signs of adrenal gland inflammation. From https://www.thestar.com.my/lifestyle/health/2021/12/22/how-the-sars-cov-2-virus-undermines-our-bodys-039fight039-response
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So do we need to get our bones checked too? https://www.sciencealert.com/our-bones-provide-our-bodies-with-a-secret-weapon-that-saves-us-in-times-of-danger Bizarre Discovery Shows Your Bones Could Be Triggering The 'Fight-or-Flight' Response MIKE MCRAE 13 SEP 2019 When faced with a threat, hormones flood our bodies in preparation either for battle or a quick escape - what's commonly known as the 'fight-or-flight' response. For decades, we've generally thought this response was driven by hormones such as adrenaline. But it now seems that one of the most important of these messengers could come from a rather unexpected place – our skeleton. We usually think of chemicals like cortisol and adrenaline as the things that get the heart racing and muscles pumping. But the real star player could actually be osteocalcin, a calcium-binding protein produced by our bones. As a response to acute stress, steroids of the glucocorticoid variety are released by the body's endocrine system, where they manage the production of a cascade of other 'get ready to rumble' chemicals throughout various tissues. Researchers from the US, the UK, and India argue there's one tiny problem with this explanation of the fight-or-flight reaction. It isn't exactly fast. While nobody is disputing that our bodies produce cortisol when stressed, the fact their main action is to trigger cells into transcribing specific genes – a process that takes time – makes it an unlikely candidate for a rapid physiological response. "Although this certainly does not rule out that glucocorticoid hormones may be implicated in some capacity in the acute stress response, it suggests the possibility that other hormones, possibly peptide ones, could be involved," says geneticist Gerard Karsenty of Columbia University. So Karsenty and colleagues went on the hunt for something a little more expedient, focussing on proteins released by bone cells that would potentially have a more immediate effect on animal metabolism. Looking to the skeleton as a source might not be as weird as it first seems. After all, our bones evolved as a way to protect our squishy bits from being squashed, either by predator or accident. "If you think of bone as something that evolved to protect the organism from danger – the skull protects the brain from trauma, the skeleton allows vertebrates to escape predators, and even the bones in the ear alert us to approaching danger – the hormonal functions of osteocalcin begin to make sense," says Karsenty. Osteocalcin isn't in any way new to science, either. We've understood its function in bone development for nearly half a century, and in recent years begun to suspect it also has a hand in regulating our energy levels by affecting glucose metabolism. It also seems to give an ageing memory a boost, at least in lab rodents. All useful things in moments of danger. But it's still a surprising discovery that osteocalcin might also help to kickstart our acute stress response. "It completely changes how we think about how acute stress responses occur," says Karsenty. To test their suspicions, the researchers put lab mice under duress by restraining them for a 45 minute period. During that time, osteocalcin levels in the peripheral blood rose by half, while other skeletal hormones barely budged. In another test, just 15 minutes after a few harmless (but uncomfortable) shocks to the feet, osteocalcin levels in the stressed mice jumped by a whole 150 percent. Giving the test subjects a whiff of a chemical found in fox urine also elevated their peripheral osteocalcin levels. Importantly, these went up before their corticosterone levels began to climb, starting a few minutes after exposure and remaining high for another three hours. Just to make sure it wasn't only a mouse thing, the team also checked the hormone in humans who volunteered to do a public speech and undergo a pulse-raising cross-examination. Sure enough, up the osteocalcin went. In yet another series of tests, the team used rodents that were genetically engineered to lack the usual corticosteroid and other stress hormones, and found these animals continued to present a stress response. In addition, a shot of osteocalcin in otherwise unstressed mice was all they needed to get twitchy, raising their heart rate, temperature, and levels of circulating glucose. "Osteocalcin could explain past observations of an intact flight-or-flight response in humans and other animals lacking glucocorticoids and additional molecules produced by the adrenal glands," says Karsenty. With the evidence building for the bone protein as such a strong motivator for dealing with stress, it stands to ask why we need hormones like cortisol at all. The researchers plan to unravel this mystery in future investigations. This research was published in Cell Metabolism.
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