Endocrine System:

By: Jon Barron
Dated: 5/31/2010
The Endocrine System: Hypothalamus, Pituitary, & Pineal Glands

Today, we begin our exploration of the endocrine system. In many ways, the endocrine system can be viewed as a partner, or complement, to the nervous system. Whereas the nervous system uses nerve impulses that last milliseconds to control short term events in the body, the endocrine system uses hormones that can sometimes take minutes, hours, or even days to take effect and control events. And sometimes those effects can last a lifetime.

Once you understand how important the endocrine system is in controlling every aspect of your life, from your moods to your sexuality to your energy levels to your ability to grow and be strong, you realize how important it is to keep it optimized. And yes, there are things you can do to keep it optimized.

Introduction

The endocrine system is comprised of a group of ductless glands that secrete hormones directly into the spaces surrounding their cells. From there, the bloodstream picks them up and circulates them throughout the body -- ultimately reaching the organ or cells designed to respond to a particular hormone. It is the ductless nature of the glands that defines them as part of the endocrine system. As for hormones, they are the body's chemical messengers that tell the body what to do, and when. Hormones produced by the endocrine system are necessary for normal growth and development, reproduction, and maintaining bodily functions (homeostasis). In humans, the major endocrine glands are the hypothalamus, pituitary, pineal, thyroid, parathyroids, adrenals, the islets of Langerhans in the pancreas, the ovaries, and the testes.

Secretion of hormones in the endocrine system is controlled either by regulators in a particular gland that detect high or low levels of a biochemical and inhibit or stimulate secretion or by a complex mechanism involving the brain, the hypothalamus, and the pituitary.

It should be noted again that the nervous system and the endocrine system are complementary -- both in terms of form and function. Both systems share a primary function of coordinating the activities of the body's many systems. For example, the nervous system tells muscles when to contract and relax, whereas adrenalin tells the body how to respond to stress or threats. The primary difference is that nerve impulses execute their effect in milliseconds, and the effects tend to be short lived. The endocrine system, on the other hand, takes substantially longer for hormones to wend their way from the gland that produces them, through the bloodstream, and ultimately to the organ or cells where they take effect. In addition, the actions of hormones are much longer lasting than the milliseconds of nerve impulses. Another way of putting this is to say that the nervous system directs the body's short term responses, whereas the endocrine system directs the body's longer term responses.

One other point of note is that both systems are mutually interconnected. For example, when the nervous system needs to control things longer term, it acts through the endocrine system by stimulating the release or inhibition of hormones themselves from the endocrine organs. On the other hand, adrenalin, released by the adrenal glands, acts upon the brain to stimulate the fight or flight response.

General Definitions

Endocrine Gland Locations

Hormones

As we mentioned earlier, the endocrine system releases chemical messengers called hormones (hormone = "urge on"), which act on other organs in different parts of the body. Effectively, hormones are the body's chemical messenger system -- they tell the body what to do and when. Some hormones promote or inhibit nerve impulses, while others (epinephrine and norepinephrine, for example) may act as neurotransmitters themselves in certain parts of the body. Then again, these hormones act as hormones (rather than as neurotransmitters) in other places. (This will be much easier to understand when we explore the adrenal glands in a subsequent newsletter.)

Also, as we mentioned earlier, hormones may take seconds, minutes, or hours to work their effects, and their duration of action may be short- or long-lived. How long?

Consider that once estrogen tells a fetus to become a girl, the effect lasts an entire lifetime -- unless a doctor intervenes at some point. In general, though, hormones regulate growth, development, reproduction, metabolism, mood, and tissue function.

General Properties Of Hormones

Although they may reach all the cells of the body via the bloodstream, each of the 50+ hormones in the human body affects only a tiny handful of very specific cells. This selectivity is key to the functioning of the endocrine system. How is it accomplished?

Each target cell has up to 100,000 receptors for a given hormone. When there is an excess of that hormone, the number of receptors decreases, reducing sensitivity. This reduction of sensitivity is known as "down regulation." Also, as just explained, chemical and phyto mimics can fill receptor sites on a cell making those sites unavailable to the actual hormones -- thus down regulating the cell. Or in the case of some chemical mimics, up regulating them. (Note: cells contain receptors for multiple hormones, not to mention neuropeptides produced by the brain, and other kinds of receptors too. Thus a single cell may actually have millions of receptor sites on its surface.)

If an abnormally low number of hormone molecules is circulating, the number of receptor sites on individual cells will increase to raise the level of sensitivity and thus compensate. This is known as "up regulation."

Locally Acting Hormones:

These hormones do not enter the general circulation. There are two types -- one of which, in particular, is of special concern to us.

Now that we have a basic understanding of what the endocrine system is, what it does, and how it works, let's start making our way down through the body and begin by taking a look at the three endocrine glands in the human brain: the hypothalamus, the pituitary, and the pineal glands.

Hypothalamus

The hypothalamus is located below the thalamus and posterior to the optic chiasm. In humans, the hypothalamus is roughly the size of an almond. But within that small size, it contains a number of small nuclei with a variety of functions. One of the most important functions of the hypothalamus is to link the nervous system to the endocrine system via the pituitary gland. The hypothalamus actually controls the pituitary gland; and it integrates many messages from parts of the brain based on feedback from all over the body and tells the pituitary what to do.

Communication between the hypothalamus and the pituitary is effected through a portal blood capillary system, which connects the two glands over a very short distance. This provides a direct venous to venous connection. The advantage of this type of direct connection is that a portal flow allows blood-borne molecules from the hypothalamus to act on the pituitary before they are diluted with the blood in larger vessels, thus it takes very, very few molecules to direct the pituitary.

The hypothalamus synthesizes and secretes neurohormones, often called hypothalamic-releasing hormones, and these in turn stimulate or inhibit the secretion of pituitary hormones. Among other things, the hypothalamus, through its action on the pituitary, controls body temperature, hunger, thirst, fatigue, childbirth, emotions, growth, milk production, salt and water balance, sleep, weight, and circadian cycles. It is responsive to light (the length of the day for regulating both daily circadian and seasonal rhythms). It is also responsive to olfactory stimuli (including pheromones), steroids, neurally transmitted information (from the heart, stomach, and reproductive system, stress, changes in body temperature caused by infection, and blood-borne stimuli (including leptin and ghrelin (appetite regulating hormones), angiotensin, insulin, pituitary hormones, cytokines, and glucose, etc.)

For the most part, the hypothalamus functions pretty much problem free for the vast majority of people. However, any of the following can cause it to malfunction: anorexia, bulimia, malnutrition, too much iron, bleeding, head traumas, infections, inflammation, genetic disorders, tumors, radiation, and surgery.

Pituitary Gland

At one time, the pituitary gland, also called the hypophysis, was once thought to be the "master gland" that controlled all the other endocrine glands. But, as mentioned above, we have since learned that the hypothalamus actually controls the pituitary gland; and it integrates many messages from parts of the brain based on feedback from all over the body and tells the pituitary what to do. In any case, the two glands are tightly integrated. Together, they regulate all processes having to do with primitive reactions, such as stress, rage, flight, body temperature, thirst, hunger, sexual activity, and survival in general. And between them, they secrete 16 hormones.

The pituitary is about 1 cm in diameter, and it lies in the sella turcica ("Turkish saddle") at the base of the brain, directly behind the optic chiasm. It is divided into two embryologically and functionally different parts: the anterior pituitary and the posterior pituitary. Embryologically refers to what tissue the gland developed "out of" starting as an embryo. The anterior pituitary evolved anatomically up from the floor of the mouth. The posterior pituitary, on the other hand, evolved downward from the base of the brain. In fact, the two parts of the pituitary don't even talk to each other.

Anterior Pituitary

The anterior pituitary gland is also called the adenohypophysis, and it makes up 75% of the pituitary gland -- the remaining 25% belonging to the posterior pituitary. Seven releasing hormones (including growth hormone releasing hormone and growth hormone inhibiting hormone) are secreted by the hypothalamus and are responsible for the release or inhibition of the anterior pituitary hormones. They are generally controlled by negative feedback mechanisms.

Once triggered by the hypothalamus, hormones released by the anterior pituitary flow into the general circulation for action in far parts of the body. Like the hypothalamus, anterior pituitary hormones are also controlled by negative feedback from the brain and the target organ. That is, when the target organ responds to the activating hormone from the pituitary, it will release its own hormone back into the blood, which will travel back to the brain through the circulatory system, which in turn triggers the hypothalamus to turn off production of the stimulating hormone in the anterior pituitary. For example, the pituitary stimulates the thyroid to release thyroid hormones, which travel throughout the bloodstream stimulating metabolism in select parts of the body as required. Through the negative feedback loop, the brain learns that the metabolism has been activated enough (in other words, that enough thyroid hormones have been released) and tells the hypothalamus/pituitary to stop stimulating the thyroid. This completes the negative feedback loop.

Principal Anterior Pituitary Hormones

Human Growth Hormone

The rejuvenating powers of growth hormone (GH) are no secret to the wealthy and professional athletes: for the last 30 to 40 years, GH has been available from doctors and requires two injections a day, and costs up to $1,800 a month. Over the last few years, however, several alternatives for the rest of us have become available. And while I could never recommend the injections (for a variety of reasons), I can endorse the alternatives. Many fantastic claims are made for the effects of growth hormone, even claims of "almost" eternal youth. Would that it were so! Although the effects are more subtle for most people, they are nevertheless wide ranging:

The most important function of GH, however, is telling the liver to produce insulin-like growth factor 1 (IGF-1), the main key to anti-aging. Specifically, the benefits of GH can be measured in terms of how much it increases the body's production of IGF-1 (above a 20 percent increase starts to be significant
in terms of effectiveness).

There is some concern that, because it increases IGF-1 levels in the body, GH may increase the risk of prostate cancer. A simple reality check, however, calls these observations into question. First, both GH and IGF-1 levels decline as we age, yet the incidence of prostate cancer increases as these levels decline -- the exact opposite of the expressed concern. In addition, in numerous studies involving thousands of patients receiving growth hormone over many years, there were no observed increases in prostate cancer. In fact, based on real-life observation, there is evidence that growth hormone supplementation may reduce the risk of prostate cancer.

Supplementing With Growth Hormone

Most supplement formulas will increase IGF-1 levels by a minimum of 20 percent, with some even approaching 100 percent. But keep in mind that just one 30-minute aerobic session can easily increase IGF-1 levels by 100 percent, and a solid session of weight training can increase levels by an incredible 400--800 percent. Injections, on the other hand, which work directly on the liver (almost like a massive "pulse"), can increase IGF-1 production by only 20--40 percent. A downside to injections, in addition to cost, is that they can give too much GH to the body, shock the body, and can stop the pituitary from producing its own GH. This may explain why injectable GH produces more immediate results, yet ultimately plateaus in terms of effectiveness.

Incidentally, you can no longer actually buy true hGH or human growth hormone. Technically, only growth hormone actually taken from human beings can be called "human" growth hormone. Thirty years ago, the sole source of growth hormone was human cadavers, but that was abandoned when it turned out that growth hormone taken from people had a major downside (in addition to cost) -- it occasionally caused the human equivalent of mad cow disease.

Fortunately, at around the same time, recombinant DNA technology came into its own and scientists learned how to alter the DNA of a single-cell yeast plant, and more recently from bacteria, so that they could produce large amounts of growth hormone (molecularly identical to real hGH), safely and inexpensively. Because this growth hormone is identical to hGH, people often use the terms growth hormone and human growth hormone interchangeably, but it should be referred to as a "plant based growth hormone."

Given this good, inexpensive source of growth hormone, another problem remained: the growth hormone molecule is so large (containing 191 amino acids) that it cannot be absorbed orally. That meant it could only be administered by injection, which required a doctor and was very expensive. Because of the cost, growth hormone injections became known as the secret youth formula of movie stars, athletes, and the very rich.

For most people, then, the best alternative to GH injections is the use of amino acid-based precursor formulas (also called a GH secretagogues). Typically, these formulas contain ingredients such as glutamine, tyrosine, GABA, arginine, and lysine. Although not as powerful as growth hormone injections, these formulas can be quite effective, provided your pituitary is functioning well, and they carry none of the downside of injections.

Things That Sometimes Go Wrong With The Anterior Pituitary Gland

Not surprisingly, since the pituitary is so involved with regulating growth, some of the key problems associated with a malfunctioning pituitary are related to growth. These include:

Posterior Pituitary Gland

As I mentioned earlier, the posterior pituitary gland (AKA the neurohypophysis) is anatomically derived from a down growth of the brain and is not technically a gland since it does not synthesize hormones, but rather, stores and secretes two hormones actually made in the brain. These two hormones, oxytocin and vasopressin, are transported from the brain in small packets for storage in the posterior pituitary -- to be released as needed.

Pineal Gland

The pineal gland is about the size of a grain of rice, is shaped like a tiny pine cone (hence its name), and is located in the center of the brain in a tiny cave, behind and above the pituitary gland. For years, mystics considered it to be the seat of the mystical third eye, whereas the medical community considered it vestigial and, thus, pretty much non-functioning. Since then, the mystics have not necessarily been refuted, but the medical community has been. The pineal gland is now known to be the major source of melatonin production in the body. It is full size in children, a size it maintains throughout adulthood -- although its weight can drop significantly starting with puberty. And it is not unusual for the gland to literally calcify in many adults. The gland most likely plays a significant role in sexual maturation, circadian rhythm and inducing sleep, and in seasonal affective disorder and depression. In animals, it plays a key role in hibernation.

Melatonin

The trigger for production and release of melatonin is total darkness -- any light in the room will inhibit this process. Today, however, living in a world with nightlights in the bedroom or streetlights sneaking through the window, we actually have an epidemic of people with insufficient melatonin production, even at a very young age. The problem doesn't just come from light falling on our eyes while we sleep, but from light falling on any part of the body. Even if you wear an eye-mask, if any light is falling on your arms or chest or feet, that's enough to slow melatonin production. Without artificial light, we would normally be in total darkness 8--12 hours a night, producing melatonin during all of those hours. Living in a city or suburban area may cut the hours of total darkness to six or less, and in many cases, zero. Melatonin levels also decline significantly as we age. Since its discovery in 1958, melatonin has been studied extensively and shown to be widely beneficial to the body. The benefits of supplementation to compensate for abnormally low production in the body include:

Third Eye

While the physiological function of the pineal gland remained unknown until recently, mystical traditions and esoteric schools, have long considered the pineal gland to be the connecting link between the physical and spiritual worlds and the seat of extrasensory perception. I am not here to argue the spiritual qualities of the pineal gland, nor talk about its extrasensory capabilities, excepting one: its sensitivity to light.

As medically theorized, the pineal gland responds to the ebbs and flow of light entering our eyes during the day. In the evening, the pineal gland reacts to the diminishing levels of daylight and starts to produce melatonin, which is then released into the blood and flows through the body making us drowsy. Its secretion peaks in the middle of the night during our heaviest hours of sleep. In the morning, bright light shining through the eyelids reaches the pineal gland which reacts by switching off the production of melatonin, thus removing the desire to sleep. And we wake!

But this description is incomplete in one significant aspect. As it turns out, the pineal gland can be diminished not only by light shining on the eyelids, but by light shining anywhere on the body. Literally, light striking any part of your skin can reduce production of melatonin from the pineal gland. It seems the pineal can "see without eyes." How's that for ESP? Even more interesting is the fact that in some lower vertebrates the pineal gland actually has a well-developed eye-like structure and is considered by some scientists to be the evolutionary forerunner of the modern eye. In other vertebrates, though not organized as an eye, it functions as a light receptor -- effectively a third eye.

In any case, the key when it comes to the pineal gland and melatonin is that it's important to sleep in a darkened room, with no light coming through the curtains or night lights turned on in the room. And wearing eyeshades won't help as the pineal can sense any light shining on your skin. Failure to sleep in a darkened room will inhibit melatonin production, which presents a series of health problems, not the least of which is an inability to sleep deeply. But beyond that, if continued for too long, it will literally shut down the pineal and cause it to atrophy. At that point, your only choice will be to use melatonin supplements.

Conclusion

We'll pause here and pick up our discussion of the endocrine system in the next newsletter with an exploration of the thyroid and parathyroid glands. One of the interesting things you'll notice is that as we move down through the body, you'll find that you have progressively more options for altering the behavior of your endocrine glands. That said, you can nevertheless consider using the following supplements to assist the hyopthalamus, the pituitary, and the pineal glands in the optimal performance of their basic functions.


Date: 06/14/2010
By: Jon Barron

The Endocrine System: Thyroid And Parathyroid Glands

In our last newsletter, we began an exploration of the endocrine system by examining the three endocrine glands in the brain: the hypothalamus, the pituitary, and the pineal gland. In this issue, we move down the body to examine the five endocrine glands found in the neck: the thyroid and the four parathyroid glands. The thyroid gland regulates the rate and intensity of the body's chemical/metabolic reactions, and the parathyroid glands regulate the amount of calcium and phosphorus in the blood. As it turns out, malfunctions in these glands are not that uncommon, can produce serious problems such as over excitement of the muscle and nervous systems, bony demineralization, high calcium levels, duodenal ulcers, kidney stones, and behavioral disorders. And if left unchecked, they can kill you. Fortunately, there are things you can do to minimize the chances of these problems occurring in the first place, or relieving them through alternative means if you get them.

Thyroid Overview

In essence, the thyroid gland is the thermostat of the body. It regulates both the rate and intensity of chemical/metabolic processes. It is one of the largest endocrine glands in the body and specifically controls how quickly the body uses energy, how it makes proteins, and the body's sensitivity to other hormones. The function of the thyroid gland is to take iodine and convert it into thyroid hormones -- primarily, thyroxine (T4) and triiodothyronine (T3). As it turns out, thyroid cells are the only cells in the body which can absorb iodine. These cells combine iodine and the amino acid tyrosine (as bound to thyroglobulin) to make T3 and T4. (We will cover this process in more detail a little later.) T3 and T4 are then released into the bloodstream and transported throughout the body, where they control metabolism (i.e., the conversion of oxygen and calories to energy). Every cell in the body depends upon thyroid hormones for regulation of their metabolism.

Anatomically speaking, the thyroid is a butterfly shaped gland (two larger lobes connected by a narrower isthmus) located between the Adam's apple and the clavicle. When viewed from the front of the body, the thyroid totally covers the trachea. Nevertheless, a normal thyroid gland cannot be felt externally. If a doctor can "see" it or "feel" it when touching the neck with his fingers, it's enlarged. Under normal circumstances, it's soft and flat.

Not surprisingly for such an important organ, it is richly serviced by multiple arteries and veins, which makes surgery on the thyroid that much more difficult. In addition, surgeons face further complications since the nerves that service the vocal cords run right next to the arteries that provide blood to the thyroid. Bottom line is that the thyroid is intricately entwined with key nerves and blood vessels. And it's not just surgery on the thyroid that presents problems. Tracheotomies, for example, must be performed either above or below the thyroid gland. It is also the main reason doctors prefer to "kill" the thyroid with radioactive iodine rather than remove it surgically (a procedure we will talk more about later).

At the micro level, the thyroid is primarily comprised of spheres called follicles. The follicles themselves are primarily composed of two types of cells:

  1. On the outside circumference of the follicles are the cuboidal follicular cells. The follicular cells produce two iodine based compounds, thyroxine (tetraiodothyronine, also known as T4) and triiodothyronine (also known as T3). On the inside circumference, or lumen of the follicle, is a brush border composed of hairlike extensions (not visible in the slide below). This allows for the easy deposit and removal of key hormonal components into the follicular lumen (see slide below) as required for production of T3 and T4.
  2. The parafollicular cells (C cells) sit scattered about the outer edge of the follicles on top of the follicular cells and produce calcitonin, a minor regulator of calcium in the body.

Thyroid Hormones

When Talking About Thyroid Hormones, We're Actually Talking About Four Bio-chemicals:

As we discussed previously, thyroid chemistry is an iodine based chemistry; iodine must be ingested because it can't be manufactured in the body; it is an element, not a compound. In fact, follicular cells actively trap virtually all iodine/iodide molecules in the body. Any iodine you ingest is trapped exclusively by cells in the thyroid to be used for manufacturing thyroglobulin and, ultimately, T3 and T4. This fact is exploited by endocrinologists when it comes to treating several thyroid disorders. (We will talk more about this later.) If iodine is not present in sufficient amounts, the body will develop a benign goiter (enlargement of the thyroid) over time. It is common in areas where iodine does not naturally occur in food.

In the early 1900's, Western countries began adding iodine to salt to combat this problem. And it worked, in the sense that goiters are now uncommon in the Western world. But using iodized salt presents its own problems. Surprisingly, a number of "older" societies recognized the connection between iodine and goiters. The ancient Greeks, for example, consumed iodine-rich seaweed to successfully combat goiters -- without the problems associated with iodized salt. Sometimes grandma really does know best.

The thyroid stores something called colloid (which is manufactured in the follicular cells) in the center (lumen) of the follicles in large quantities. Although colloid contains some T3 and T4, it is primarily comprised of thyroglobulin, which is converted to T3 and T4 and released into the body when triggered by thyroid stimulating hormone (TSH), released by the pituitary. In fact, a healthy thyroid stores about a three-month supply of thyroglobulin at any given moment in time.

As we touched on in our last newsletter, thyroid-stimulating hormone (TSH) from the anterior pituitary regulates the processes via a negative feedback loop. That is to say, thyroid releasing hormone (TRH) from the hypothalamus stimulates the pituitary to release TSH into the bloodstream, which stimulates thyroid follicular cells to add iodine to the amino-acid (tyrosine) component of thyroglobulin (which, once again, is stored as colloid within the lumen of the thyroid follicles). Once converted, the T3 and T4 hormones are released into the bloodstream. This arrangement essentially works as a reserve system for thyroid hormones, allowing it to release active hormones into the body on an as needed basis. As more thyroid hormones are produced, blood levels of T3 and T4 rise. Ultimately, these hormones make their way through the bloodstream back to the hypothalamus, telling the hypothalamus that enough is enough and to stop releasing TRH, which stops the pituitary from releasing TSH -- shutting down the cycle.

It should be noted that the thyroid hormones are slow acting. Unlike adrenalin, for example, it takes awhile for anything to happen with thyroid hormones.

Thyroid Hormone Functions

Thyroid Hormones Regulate The Following Activities:

Iodine Uptake And Control

Iodide (I) ions circulating in the blood are actively taken into follicular cells through capillaries and become trapped in the endoplasmic reticulum inside the follicular cells. Once iodine is present, the follicles begin synthesizing thyroglobulin. Vesicles (small transport membranes) transport some of the iodide further into the follicles, where it is combined with thyroglobulin to produce the amino acid tyrosine. This combination of thyroglobulin and tyrosine is bound into colloid, which can be transformed into T3 and T4 as needed.

Incidentally, the thyroid's ability to trap iodine can be used clinically.

Thyroid Dysfunction

The two main types of thyroid disease fall into hyperthyroidism (Graves' disease), and hypothyroidism (Hashimoto's thyroiditis).

Hyperthyroidism

Hyperthyroidism causes increased heart rate, increased blood pressure, high body temperature and sweating, nervousness, diarrhea, heat intolerance, and weight loss despite high caloric intake. In other words, the metabolic processes are up regulated to dangerous levels. Also, it can lead to severe neurotic behavior. Graves' disease, a specific form of hyperthyroidism, is an autoimmune disorder in which antibodies mimic the effects of TSH but are not constrained by the negative feedback system for turn-off and control; thus, they continue to drive the thyroid to release stimulating T3 and T4 hormones without letup. This disease causes goiter, enlargement of the thyroid, and exophthalmos (bulging eyeballs caused by the build-up of fat behind the eye). Curing the diseases (often involving the destruction or removal of the thyroid followed by the lifelong administration of synthetic hormones) may not cure exophthalmos, which may leave the eyes open to injury. When talking about Graves' disease and bulging eyes, the late actor, Marty Feldman almost immediately comes to mind.

Hypothyroidism

Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone. Early symptoms include:

There are two fairly common causes of hypothyroidism. The first is a result of inflammation of the thyroid gland which leaves a large percentage of the cells of the thyroid damaged (or dead) and incapable of producing sufficient hormone. The most common cause of thyroid gland failure, however, is called autoimmune thyroiditis (aka Hashimoto's thyroiditis), a form of thyroid inflammation caused by the patient's own immune system. (Think of it as the flip side of Graves' disease.)

Dr. Lee covers hypothyroidism in What Your Doctor May Not Tell You about Menopause. First, he points out that thyroid problems are far more common in women than in men -- a strong indicator that we're dealing with an estrogen issue. Then he points out that for most women, when they start using progesterone creame, their need for thyroid supplements is greatly reduced -- and often even eliminated. Note: just because it is more common in women, does not mean that men cannot have estrogen problems also -- caused by exposure to chemical estrogens.

If you suffer from hypothyroidism, removing your thyroid or blasting it with radiation or trying to balance it out with synthetic medication are not your only options. There are natural progesterone creames (for both men and women), which easily can be found by searching the net. Also, immunomodulators such as cetyl-myristoleate and L-carnosine might make sense in case the problem is associated with an autoimmune disorder. And finally, thyroid extracts such as Standard Process' Thytrophin PMG can be helpful in rebuilding lost thyroid function.

Cretinism

Hypothyroidism during fetal development totally disrupts normal development patterns, leading to dwarfism, mental retardation, and physical deformities. (Now usually called "thyroid dwarfism.")

Thyroid Cancer

Cancerous thyroid tumors (nodules) are most often associated with patients who have had their faces irradiated (at one time this was done to treat acne -- really), but these cancers are easily curable by simply removing the cancerous nodules. Other risk factors include:

The Parathyroid Glands

The four parathyroid ("beside the thyroid") glands are located on both sides of the thyroid but have functions totally unrelated to the thyroid. This physical relationship of the parathyroids to the thyroid is typical of the endocrine system. Last issue we saw that the pituitary, although extremely small, is comprised of two parts -- anterior and posterior -- that have totally unrelated functions, that develop out of entirely different parts of the body despite their close proximity, and that are for all intents and purposes entirely separate glands. When we explore the adrenals, we will see the same disparate relationship between the adrenal cortex and the adrenal medulla. The bottom line is that the only connection the parathyroids have with the thyroid is their physical location.

Specifically, the parathyroid glands are located behind the thyroid, and they are intimately connected to the covering of the thyroid gland. There are two on each side. They are supplied by the same blood vessels that supply the thyroid. Each parathyroid is about the size of a large kernel of rice. They can be extremely difficult for surgeons to locate and identify. And something that can make the job even harder is that the parathyroid glands sometimes "disengage" from the thyroid gland and migrate down into the chest cavity, making them difficult to find and remove.

So what do the parathyroids do? The chief cells (principal cells) produce parathormone (PTH, parathyroid hormone). The oxyphil cells produce? In fact, the function of the oxyphil cells is as yet unknown.

Parathormone, PTH, Parathyroid Hormone

PTH has one simple function. It regulates the levels of calcium and phosphorus in the blood. It accomplishes this by increasing the cells of the bone (osteoclasts), which reabsorb calcium. It also increases urinary re-absorption of calcium by the kidneys. In addition, it causes the kidneys to form calcitrol, a hormone made from vitamin D that increases absorption of calcium from the GI tract.

And finally, it increases excretion of phosphorus by the kidneys (which, in turn increases calcium levels). Calcium and phosphorus always go in opposite directions -- in a defined relationship called the solubility constant. Bottom line: parathormone increases calcium levels.

Note: Calcitonin (from the thyroid gland) participates in the negative feedback system that regulates the parathyroids by forcing calcium back into the bones.

Pathology Of Parathyroid Dysfunction

Hyperparathyroidism refers to increased PTH production, usually because of a benign tumor of one or more of the parathyroid glands (parathyroid adenoma). If PTH is produced in excess, calcium is reabsorbed from the kidneys, bones, and stomach back into the blood. This leads to a condition that many endocrinologists call "Stones, bones, groans, and moans." This terminology refers to the classic set of four symptoms associated with hyperparathyroidism: kidney stones, de-mineralized bones (osteoporosis), groans of pain from intestinal distress (including duodenal ulcers), and the moans of psychosis.

Hyperparathyroidism is almost always caused by parathyroid adenoma. Removing a parathyroid adenoma, a fairly simple surgery, can cause an immediate and drastic return to normal function and the disappearance of all symptoms.

Another form of hyperparathyroidism is called parathyroid hyperpiesia, in which all four parathyroid glands overproduce PTH for no obvious reason. In other words, there is no adenoma causing the problem. Surgeons usually attempt to fix the problem by removing most of the parathyroid glands.

On the other hand, if the surgeon makes a mistake and removes too much (or all) of the parathyroid tissue by accident, you can end up with hypoparathyroidism. Hypoparathyroidism leads to low serum calcium levels and an elevated state of excitement for nerves and muscles, resulting in twitching and over-activity of the muscular and nervous systems. In the extreme, this can lead to convulsions and death. Again, it is caused primarily by inadvertent surgical removal. This is an extremely difficult condition to live with, as it is almost impossible to self regulate. Fortunately, there is one medical alternative that works in some cases, if the surgeon recognizes the error in time.

Removed parathyroid glands can be chopped up and implanted into muscle tissue in other areas of the body (such as the forearm), where sometimes, they will survive and start producing PTH again. If that doesn't work, hypoparathyroid patients require lifelong calcium and vitamin D injections, which are almost impossible to manage accurately.

Conclusion

When it comes to maintaining the health of the thyroid and parathyroid glands, you want to address several key issues.

In our next issue, we'll move on down the body into the pancreas. In our previous newsletters on the digestive system, we explored the pancreas' production of digestive enzymes. But the pancreas has two distinct functions in the body. In addition to producing digestive juices, it also is part of the endocrine system and produces several key hormones, most notably insulin and ghrelin (the appetite hormone). We will explore those hormones in our next newsletter.


Date: 07/11/2010
By: Jon Barron

The Endocrine System: The Pancreas & Diabetes

Several months ago, we explored the anatomy and physiology of the pancreas in terms of its role in the digestive process. But the pancreas is one of a handful of organs in the body that functions in two distinct modes. It is not only an exocrine digestive organ, but it also functions as part of the endocrine system and, to a significant degree, controls the metabolism of sugar in the body and its use as a source of energy for every single cell and organ in the body. In this newsletter, we examine the endocrine functions of the pancreas. As an endocrine organ, the pancreas produces two sugar regulating hormones: insulin and glucagon. After reviewing the functions of insulin and glucagon and the four cell types that comprise the endocrine pancreas, we'll examine in detail the main disease associated with the pancreas, diabetes mellitus.

The Pancreas Functions In Two Modes.

As mentioned above, the pancreas functions in two distinctly different modes. It is both an exocrine digestive organ that secretes digestive juices and enzymes into the duct of Wirsung that runs down the middle of the pancreas and empties into the duodenum at the head of the pancreas. But the pancreas is also an endocrine organ, producing insulin, glucagon, and somatostatin that flow directly into the bloodstream, eventually reaching virtually every cell in the body.

Anatomy Review

We explored the anatomy and physiology of the pancreas in some detail in our newsletter focused on that topic, but a quick review would be appropriate before discussing the gland's endocrine function.

Physically, the pancreas is located in the upper abdominal cavity, towards the back -- in the C curve of the duodenum. It is about 12 inches long and tapers from right to left. (Remember, anatomically speaking, left and right are referenced from behind the body so they are actually reversed in most diagrams that view the body from the front.) The thick part, the head, comprises almost 50% of the mass of the pancreas and lies to the right, nestled in the C-curve of the duodenum. As for the body of the pancreas, it moves up and to the left, tapering into what is known as the tail of the pancreas, which terminates at the junction of the spleen.

As might be suspected for such an important organ, the pancreas is richly supplied with arteries and veins. It is served by branches from the hepatic artery, the gastroduodenal artery, the pancreaticoduodenal artery, the superior mesenteric artery, and the splenic artery.

Ninety nine percent of the pancreas is made of acini, clusters of cells that resemble a many lobed "berry" (acinus is Latin for berry). The acini produce exocrine digestive juices that flow out of the acini through small ducts that eventually join together and feed into the duodenum through the pancreatic duct. But today, we are not interested in that ninety nine percent. We are interested in the one percent of the pancreas that is made up of several million cells scattered throughout the pancreas, grouped together in globules known as islets of Langerhans. It is these cells that contain the endocrine functioning of the pancreas. A healthy human pancreas contains about one million such globules, which are distributed throughout the organ like tiny islets in a vast ocean of acini -- hence their name. Their combined mass is a mere 1 to 1.5, grams.

Physiology Of The Endocrine Pancreas -- Four Cell Types

A single islet of Langerhans is actually comprised of four distinct types of cells (alpha, beta, delta, and gamma), two of which are primary: alpha and beta.

Alpha Cells

Alpha cells constitute 20% of the islet's cells. They secrete the hormone glucagon, a polypeptide of 29 amino acids, which raises blood sugar to maintain normal levels. For the most part, glucagon does not present the same problems as insulin and will not raise blood sugar much above normal -- 80-100 mg of sugar per 100 ccs of blood. For obvious reasons (diabetes), we don't want blood sugar to go too high. But for the brain, we don't want it to go too low either (hypoglycemia). The brain does not store sugar and has no reserves. If blood sugar falls too low, the brain is affected in minutes, possibly even seconds. Note: all of the islet cells are serviced by an abundant network of capillaries that carry their "products," including glucagon, out into the bloodstream.

The production and release of glucagon in the pancreas is regulated by chemoreceptors throughout the body that constantly measure the amount of sugar in the blood. Whenever blood sugar gets too low, the chemoreceptors signal the alpha cells in the pancreas to release more glucagon. Glucagon in turn travels through the bloodstream to the liver, where it acts on hepatocytes (cells in the liver) to break down glycogen (the stored form of glucose) into glucose through a process called glycogenolysis. Also, if required, the body can convert amino acids and/or fat into intermediate metabolites that are ultimately converted into glucose through a process called gluconeogenesis. In either case, the glucose makes its way into the bloodstream where it is available to be used by cells for energy.

Correspondingly, higher-than-normal blood sugar turns off the release of glucagon.

It should also be noted that stimulation of the sympathetic nervous system in preparation for stress, or flight (or in response to fright) also affects glucagon release; it increases it. This is accomplished through both neural and hormonal signals coming down into the pancreas. Hormonally, we're talking about epinephrine and norepinephrine, which stimulate the release of glucagon, thus raising blood sugar levels.

And finally, glucagon secretion is inhibited by amylin, a peptide of 37 amino acids, which is secreted by the beta cells of the pancreas.
Injections of glucagon are sometimes given to diabetics suffering from an insulin reaction in order to speed the return of normal levels of blood sugar. All of glucagon's actions tend to counter those of insulin, which works to reduce the level of glucose in the blood. Incidentally, glucagon, like insulin, is readily available thanks to genetically engineered bacteria and recombinant DNA technology. This is done by inserting the human gene for insulin into E. coli bacteria, which then "grow" genuine, bio-identical, human insulin in culture tanks. For those squeamish about E. coli, this process is also done by some manufacturers using yeast instead of bacteria.

Beta Cells

Beta cells constitute approximately 80% of islet cells. They secrete insulin, which lowers blood sugar -- also in response to chemoreceptors. Higher-than-normal blood sugar stimulates beta cells to release insulin. Sustained high blood sugar is bad not only for the blood but also for organs and cells.

Beta cells have channels in their plasma membrane that serve as glucose detectors. Beta cells secrete insulin in response to a rising level of circulating glucose (i.e. "blood sugar").

Insulin

Insulin is a small protein that affects virtually every single cell in the body and most organs -- primarily by regulating how every cell in the body utilizes glucose. Seventy-five percent of that glucose is ultimately used by the body to sustain brain function. The remaining 25% is divided between muscle function, red blood cell production, and powering every single cell in the body. Actually, glucose does not power those cells directly, but rather, through a process known as glycolysis, it is used in the creation of pyruvate, which is then turned into adenosine triphosphate (ATP), the actual energy source within the cell.

Again, insulin is a primary regulator of sugar in the body. For example, it stimulates skeletal muscle fibers to take up glucose and convert it into glycogen, which is the storage form of glucose and is utilized in muscle tissue to produce ATP by the muscle itself. Insulin also works inside muscle tissue to extract amino acids from the blood and stimulate their conversion into protein, thereby causing the muscles to "grow."

Insulin also acts on liver cells, stimulating them to take up glucose from the blood and convert it into glycogen while inhibiting production of the enzymes involved in breaking glycogen back down into glucose and inhibiting the conversion of fats and proteins into glucose. In this way, insulin helps regulate the body's energy storage system. It should be noted that when the dietary intake of high glycemic carbohydrates is excessive, this leads to an excess of stored fat in the liver, which ultimately compromises liver function. This is further compounded by the fact that insulin acts on fat cells to stimulate their uptake of glucose and the synthesis of fat.

In each case, insulin triggers these effects by binding to the insulin receptor -- a transmembrane protein embedded in the plasma membrane of the responding cells.

Taken together, all of these insulin actions result in the storage of the soluble nutrients absorbed from the intestine into insoluble, energy-rich products (glycogen, protein, fat) and a drop in the level of blood sugar. Specifically, insulin is glucagon's opposite and acts on the cells of the body to:

Lower than normal blood glucose turns off the output of insulin. But there are other factors that also affect insulin release. The parasympathetic nervous system can stimulate insulin release to aid in recovery and rest. Glucagon itself causes insulin release to balance its effect in a negative feedback loop. And finally, gastric inhibitory peptide (GIP) from the enteroendocrine cells of the small intestine responds to glucose in the lumen of the gut, thereby signaling the "preparatory" release of glucose-dependent insulin from pancreatic beta cells. It should be noted that the effect of GIP on the pancreas is diminished by Type 2 diabetes.

And finally, beta cells also produce insulin-like growth factors (specifically, IGF-2), which is found in many body tissues at concentrations far higher than insulin itself. It shares the molecular structure and shape of insulin and is involved in growth. As a side note, IGF-1 (produced in the liver) and IGF-2 are used by cancer cells to stimulate growth.

Delta Cells

Delta cells constitute less than 1% of pancreatic islets. They secrete somatostatin, the same growth-hormone-inhibiting hormone secreted by the hypothalamus. This hormone inhibits insulin release and slows absorption of nutrients from the GI tract.

Gamma Cells (F Cells)

Gamma cells also constitute less than 1% of pancreatic islets. They secrete a pancreatic polypeptide that inhibits the release of somatostatin. In other words, Delta cells and Gamma cells work to regulate each other.

Diabetes Mellitus ("Sweet Urine")

Diabetes mellitus is actually not one disease, but a group of disorders in which glucose levels are elevated in the blood. It is called a protean (widespread) disease because it affects every system in the body. (For more on this concept, check out Diabetes -- The Echo Effect -- highly recommended.) By itself, it ranks somewhere between fourth and sixth as a leading cause of death in the US -- and climbing the charts throughout the rest of the world. But when considered as a major factor in cardiovascular disease and kidney failure, its true impact is probably much higher. Its name, sweet urine, comes from the fact that it was originally diagnosed by tasting (not testing) the patient's urine. The word "mellitus" is Latin for honey-sweet. Elevated glucose levels make the urine sweet. Back then, doctors truly earned their fees.

Doctors often refer to the clinical manifestations of diabetes as the "three polys":

There are two main types of diabetes. Type I is insulin dependent diabetes mellitus and Type II is non-insulin-dependent diabetes, formerly known as maturity-onset or adult onset diabetes. There is also a third, less common, type of diabetes that results from mutant genes inherited from one or both parents. We will discuss all three types.

Type I Diabetes

Type I represents about 10 to 20% of all diabetes cases. It is suspected that it is an autoimmune disease in which the body becomes allergic to its own beta cells and destroys them. What triggers this attack is still unknown, although a prior viral infection may be the culprit. In any case, the net result is that there are simply too few beta cells left to make enough insulin to fulfill the body's needs, and the patient ends up with an absolute deficiency in the quantity of insulin available. Type I diabetes is also known as juvenile-onset diabetes because it often appears in childhood.

Standard "medical" treatment is daily insulin injections to give patients the insulin their bodies are not providing. Unfortunately, because insulin demands fluctuate so frequently during the day, it is very hard to regulate "external" insulin in a way that keeps sugar and insulin levels consistently balanced in the body. For example, injections after vigorous exercise or long after a meal may drive the blood sugar level down to a dangerously low value causing an insulin reaction. The patient becomes irritable, fatigued, and may lose consciousness. In response, doctors have developed experimental treatments such as inhalable insulin, pancreatic transplants, islet cell transplants, immune suppression, and insulin pumps. To this point, none of these alternatives is without significant problems. On the other hand, although it cannot be controlled with diet and exercise, there are indeed alternative options that can prove helpful. we'll talk about those a little later.

In addition to the immediate problems associated with excess blood sugar, diabetes also presents other problems. For example, patients are in a chronic state of starvation, unable to use nutrients without injections of insulin. In addition, cataracts of the lens of the eye and diabetic retinopathy are related to high blood sugar. The excess sugar diffuses into the eye and forms a cloudy glycoprotein with the lens. Another problem associated with diabetes is if the body is unable to utilize blood sugar as energy for the cells of the body, it will try and convert as much of the excess glucose as possible into fat to store the energy. This not only leads to fatty livers, but to an excess of fat in the blood. High levels of fat in the blood, over long periods, leads to atherosclerosis. Other physical problems related to high blood lipids and blood vessel damage (also caused by blood sugar) include strokes, heart attacks, kidney failure, peripheral vascular disease, and increased rates of infection, not to mention, a high rate of amputation.

There is another problem associated with Type I diabetes. Since diabetics cannot use glucose for energy effectively, their bodies shift to using fatty acids to produce cellular energy. This results in an excess of fatty acid wastes called ketones. Ketones are very, very acidic, and they cause a shift to acidity in the blood. This condition is called ketoacidosis. You can smell acetone on the breath of a diabetic suffering from ketoacidosis. Uncorrected, ketoacidosis is rapidly fatal.

It's probably worth mentioning that low carb diets work by turning dieters into "controlled" diabetics so that their bodies can shift from sugar burning to fat burning. Effectively, low-carb diets interrupt the Krebs cycle by denying the body the 100 grams of glucose it needs to prime the pump for sugar burning. As I mentioned, this process essentially turns dieters into controlled low-level diabetics and produces a mild form of ketoacidosis. As a side note, if a dieter eats protein and fat, then triggers the Krebs cycle, all excess material will be turned into fat anyway -- so ultimately, little is gained unless one chooses to remain permanently a low level diabetic.

Type II Diabetes

At one time, Type II diabetes was known as adult onset diabetes because almost all its victims tended to be over 40 years of age. But those days are long gone, and now, thanks to catastrophic dietary changes in the developed world (and with developing countries struggling to imitate us) Type II diabetes is now appearing in many children. So it has been renamed. It is now called non-insulin-dependent diabetes and accounts for some 90% of all diabetes cases. In fact, children now account for 20% of all newly diagnosed cases of Type II diabetes and, like their adult counterparts, are usually overweight. Sadly, it is almost always a self-inflicted disease -- most often triggered by high glycemic diets and excessive weight. Fortunately, because it is self-inflicted, it is usually much milder than Type I diabetes (at least if caught in the early stages) and is much easier to control. In fact, many patients have normal insulin levels. The problem is that because the body has had to pump out so much insulin over time to combat the high glycemic foods dominating so many diets, the cells of the body have become progressively less sensitive to the action of insulin. They have, to use the common term, become insulin resistant.

Although virtually every single cell in the body survives by converting glucose to energy, skeletal muscle is the major "sink" for removing excess glucose from the blood and converting it into glycogen). But in a Type II diabetic, the ability of skeletal muscle to remove glucose from the blood and convert it into glycogen may be only 20% of normal. This, again, is called insulin resistance. Fortunately, vigorous exercise increases the ability of skeletal muscle to transport glucose across its cellular membrane, thus reducing the effect of insulin resistance. Or to put it another way, people who lead sedentary lives are more likely to develop Type II diabetes.

Symptoms of Type II diabetes are similar to that found in Type I and include the three polys mentioned above.

Treatment options include:

On the other hand, if patients are lax and do not control their disease early on, symptoms become more severe over time. It is as though after years of pumping out insulin in an effort to overcome the patient's insulin resistance, the beta cells become exhausted.

Note: there is a close relative of Type II diabetes called gestational diabetes. It usually results from transient elevations in blood glucose during pregnancy. It causes the same problems as Type II diabetes for the fetus.

Inherited Forms Of Diabetes Mellitus

A very small number of cases of diabetes result from mutant genes inherited from one or both parents. These genes can cause diabetes in several different ways.

While the symptoms of inherited diabetes usually appear in childhood or adolescence, patients with inherited diabetes differ from most children with Type 2 diabetes in that their families have a history of similar problems and they are not necessarily obese. But again, inherited diabetes represents only a small percentage of diabetic patients.

Natural Treatments For Diabetes

Ultimately, Type I and Type II diabetics end up at the same place even though they arrive there through very different means. In Type I diabetes, you end up with high blood sugar because your body can't produce enough insulin to drive the sugar into cells where it can be used for energy production. In Type II diabetes, your body can produce more than enough insulin (at least in the beginning), but because cells become resistant to the effects of that insulin, sugar stays in the blood because it can't get transported into the cells of the body. Thus, the alternative methods for dealing with both types of diabetes are similar -- with a couple of additions for Type I diabetes to deal with the autoimmune factor.

Natural Protocol For Dealing With Diabetes

Beyond modifying your diet and exercising, you might want to inhibit absorption of high glycemic foods, without creating unwelcome responses in the intestinal tract, such as those experienced using metformin. This drastically reduces the amount of insulin your body requires and minimizes the chances of having both sugar and insulin spikes. It can be accomplished with the following herbs:

Naturally reverse insulin resistance so less insulin is required. Again, the benefits for both Type I and Type II diabetes are obvious:

Repair beta cells in the islets of Langerhans in the pancreas to optimize insulin production reserves as opposed to forcing the cells to dramatically overproduce as with glyburide, which leads to inevitable burn out. This is a "sine qua non" for Type I diabetes and is essential if you want to prevent prolonged Type II diabetes from "burning out" the beta cells through forced overproduction of insulin.

Lower blood sugar levels through proper diet and herbal supplementation:

Reduce stress. Remember, adrenaline suppresses the release of insulin.

Specific For Type I Diabetes

Since it is strongly suspected that Type I diabetes results from an out of control immune system that attacks and destroys the beta cells in the islets of Langerhans, it is essential that you try and modulate your immune system to minimize, or even eliminate, this factor.

Immunomodulators Natural immunomodulators retrain your immune system to not overreact -- and without deadly side effects.

Taking On Viruses

There is steadily mounting evidence that a virus may be responsible for triggering the autoimmune response that causes Type I diabetes. If so, then you will want to use antipathogens to help reduce or eliminate that viral load.

Additional Steps

Diabetes potentially affects almost every organ in the body -- many of which, as they degrade, can exacerbate the original diabetic problem. Therefore, anyone suffering from diabetes will want to do whatever is necessary to protect those organs.

Protect organs and proteins from damage caused by higher than normal levels of sugar through a mixture of antioxidants and nutraceuticals such as:

Protect organs from damage caused by higher than normal insulin levels by cleaning the blood by using:

And that concludes our exploration of the endocrine functions of the pancreas. In our next newsletter, we will conclude our exploration of the endocrine system by examining the adrenal glands.


Date: 7/26/2010
By: Jon Barron

The Endocrine System: The Adrenal Glands

And driving all of these billions and billions of dollars in sales in stimulant drinks is the underlying condition of adrenal fatigue. In today's newsletter, we will explore the anatomy and physiology of the adrenal glands, and how the abuse of these glands has led to a dependency on stimulants that goes far beyond the world's illicit drug trade.

General Anatomy

The adrenal glands are located on top of each kidney; hence, the terms "ad renal" -- as in "added" to the renal glands. They are small glands, about 2 inches (5 cm) in length, and weighing about 5 gm each. As part of the kidneys, they are located way, way to the back of the body (as any good martial artist knows) and are abundantly supplied by three sets of blood vessels to ensure redundancy:

Like the pituitary gland, the adrenal glands are composed of two entirely separate sections (the cortex and the medulla), and like the pituitary gland, the two sections actually evolve during embryology from two entirely different types of tissue. The adrenal cortex evolves from fetal mesodermal cells (essentially cells that produce connective tissue). The adrenal medulla, on the other hand, evolves from the nervous system. In fact, the adrenal medulla actually consists of modified neurons (neural crest cells). In the fifth week of fetal development, neuroblast cells migrate from the neural crest to form the sympathetic chain and preaortic ganglia. The cells then migrate a second time to the adrenal medulla. Forgetting all the technical names of cells and cell sources, the key point to remember here is that the two parts of the adrenal glands form two entirely different types of cells and share little in common -- other than location.

The adrenal glands, or at least the cortex of the glands, are absolutely essential for life. Then again, although it is possible to survive without the inner layer, the adrenal medulla, the quality of life would be severely compromised.

Let's now examine the adrenal cortex and medulla in more detail.

Adrenal Cortex

The adrenal cortex produces three hormones in three separate zones.

Mineralocorticoids
Aldosterone is 96% of this group, and it controls water and electrolyte (sodium and potassium) balance in the body. Without the action of the mineralocorticoids in maintaining electrolyte homeostasis, you would die since this has a direct effect on regulating blood pressure. The action of the mineralocorticoids is on the kidneys, which under the direction of these hormones excrete sodium or potassium as required to maintain optimal balance. Adrenal adenomas (benign, actively secreting growths in the cortex) cause hyper-production of aldosterone, which may account for as much as 25% of high blood pressure patients. Treatment involves removal of the tumor, and positive results are virtually instantaneous. The trick, of course, is arriving at the correct diagnosis. Most adrenal adenomas are discovered by chance when an abdominal computed-tomography (CT) or magnetic-resonance imaging (MRI) scan is done for unrelated symptoms.

Glucocorticoids
Cortisol (also called hydrocortisone) is 95% of the total, plus corticosterone, and cortisone.

Addison's disease results from acute adrenocortical insufficiency.

Cushing's syndrome, on the other hand, results from excessive adrenal cortical function. It results in spindly arms and legs, a moon-face,a buffalo hump on the back, flushed skin, hypertension, osteoporosis, and decreased resistance to infection or stress.

Androgens
Androgens are masculinizing hormones that occur in insignificant amounts in the adult male. The primary and most well-known androgen is testosterone. In men, the vast majority of androgens are produced in the testes, but in women, the adrenal glands are responsible for the overwhelming quantity of androgen production. Surprisingly, for women, the masculinizing hormones produced by the adrenal glands are essential for well being. In females, androgen accounts for sexual drive, energy, and "joie de vivre." It is converted into female hormones (estrogens) after menopause.

Incidentally, old treatments for breast cancer involved removing the pituitary gland to prevent the adrenal glands from producing estrogen by stopping release of ACTH that would normally have stimulated the adrenals. Nowadays, this is accomplished with pharmaceuticals.

Adrenal Medulla

Hormones in the medulla are produced in the chromaffin cells ("chromium + affinity"). They get their name from the fact that they stain readily in the presence of chromium salts. Chromaffin cells are neuroendocrine in that they are activated by neurotransmitters released by nerve cells located in the autonomic nerve fibers coming directly from the central nervous system. In response to this input, the chromaffin cells of the medulla release hormone messenger molecules into the blood. In this way, they integrate the nervous system and the endocrine system, a process known as neuroendocrine integration.

Because the chromaffin cells are directly activated by the nerve fibers from the autonomic nervous system, they respond very quickly -- as is necessary in a system that responds to emergency situations. On the other hand, chromaffin cells continue to secrete adrenal hormones "long" after nervous stimulation has passed. In fact, hormonal effects can last up to ten times longer than those of neurotransmitters. In a sense, neurotransmitters respond in the short term to emergencies, whereas the medullary hormones cover the longer term. In this way the sympathetic division of the autonomic nervous system and the medullary secretions function together.

So which hormones are we talking about?

The adrenal medulla releases two hormones: adrenaline (80%) and noradrenaline (20%), more commonly known among the medical establishment as epinephrine and norepinephrine. Collectively, they are called catecholamines. As I mentioned earlier, unlike the adrenocortical hormones, the medullary hormones are not essential for life -- at least when the body is in the resting state. Without stress, you don't need these hormones -- with one primary exception. Standing up from a reclining or sitting position would entail an unsustainable drop in blood pressure, as blood pooled in the feet and legs, if not for a compensating action governed by the medullary hormones. (We will talk more about this in a moment.)

Adrenaline

Epinephrine (also known as adrenaline) increases heart rate, contracts blood vessels, dilates air passages and participates in the fight-or-flight response of the sympathetic nervous system. As a hormone, epinephrine acts on nearly all body tissues. Its actions vary by tissue type and by the differing responses of the various receptor sites scattered throughout the body. For example, epinephrine causes smooth muscle relaxation in the airways, but causes contraction of the smooth muscle that lines most arterioles.

Noradrenaline

Norepinephrine (also known as noradrenaline) both complements the actions of adrenaline and adds its own stimulus to the brain. Along with adrenaline, noradrenaline also responds to the fight-or-flight stimulus by directly increasing heart rate, triggering the release of glucose from energy stores, and increasing blood flow to skeletal muscle. In addition, though, noradrenaline affects parts of the brain where attention and responding actions are controlled. Noradrenaline also works as an anti-inflammatory agent in the brain.

I've Fallen Down, And I Can't Get Up

When a healthy individual stands up, gravity, if not accounted for, would cause approximately 10-15% of their blood to settle in the stomach and limbs. This blood pooling would mean that less blood reaches the brain -- resulting in lightheadedness, seeing stars, tunneled vision/darkening, and even fainting. In healthy individuals, however, this does not happen because special pressure sensors in blood vessels instantaneously act (via the involuntary nervous system) to trigger important responses in the body. These responses maintain normal blood pressure and flow to the brain and body primarily by pumping adrenaline and noradrenaline into the bloodstream. As we discussed earlier, these hormones cause the smooth muscle that lines most arterioles to contract. They also cause the veins of the lower body to contract. The net result of all this contraction is the raising of blood pressure and the forcing of blood up into the head. Also, the heart is stimulated to increase its output by increasing the number of heart beats per minute, the volume of blood pumped per beat, and the force with which each beat squeezes. We can actually feel this happening, from time to time. (Pay special attention and check it out the next time you stand up.) The end result is more blood returning to the brain and heart. Usually, if all components of the circulatory reflexes are working properly, the move from lying to standing proceeds without symptoms.

Common Adrenal Problems

For the most part, the adrenal glands function so well, and can handle almost any abuse we throw at them, that we barely give them a thought. But if pushed too far, they will crack. Addison's disease, which we've already discussed, is the primary "disease" of the adrenals, but there are several "lesser" problems worth discussion. Although not normally recognized by the medical community, they actually represent the vast majority of adrenal problems people face in today's high stress world. We're talking about non-clinical adrenal fatigue, weight gain, and caffeine addiction.

Adrenal Fatigue

According to the Mayo Clinic, adrenal fatigue is a term applied to a collection of nonspecific symptoms, such as body aches, fatigue, nervousness, sleep disturbances, and digestive problems. The term often shows up in popular health books and on alternative medicine Web sites, but it isn't an accepted medical diagnosis. The "unproven theory" behind adrenal fatigue is that your adrenal glands are unable to keep pace with the demands of perpetual fight-or-flight arousal. As a result, they can't produce quite enough of the hormones you need to feel good. Existing blood tests, according to this theory, aren't sensitive enough to detect such a small decline in adrenal function -- but your body is. That's why you feel tired, weak, and depressed. However, the only real, diagnosable, medically accepted form of adrenal fatigue is Addison's disease (discussed earlier).

But is that true?

What I find absolutely delicious in the Mayo Clinic's commentary on adrenal fatigue is their conclusion. "Unproven remedies for so-called "adrenal fatigue" may leave you feeling sicker, while the real cause -- such as depression or fibromyalgia -- continues to take its toll." How wonderful to include fibromyalgia as a "real" condition. Lest anyone forget, it was just a few years ago that the medical establishment was dismissing fibromyalgia as an alternative health fantasy, just like adrenal fatigue. And many doctors still dismiss it as such. So with that in mind, what is adrenal fatigue?

First of all, contrary to what the Mayo Clinic claims, adrenal fatigue probably affects as many as 80% of adults at some point in their lives. These patients often end up going from doctor to doctor trying to find out why they feel exhausted and sick. Too often they're told after extensive testing, as the Mayo Clinic would do, that there is nothing wrong with them -- or perhaps that they are suffering from stress and need to relax more. The problem is that, from a medical point of view, adrenal fatigue has a broad spectrum of non-specific, yet often debilitating symptoms, including:

The bottom line is that being consistently under stress eventually exhausts the ability of the adrenal glands to produce sufficient amounts of hormones -- particularly cortisol. As the Mayo Clinic indicated, because they are prepared only to diagnose extreme dysfunction in the adrenals such as Addison's disease, conventional endocrinologists and medical tests cannot diagnose adrenal fatigue. But that does not mean that it is untestable. Beyond the symptoms themselves, natural healers can conduct a saliva cortisol test to evaluate your adrenal function. This will pick up more subtle dysfunctions in your adrenal glands than the typical medical tests.

If you are diagnosed with adrenal fatigue, or simply believe you have it, you will want to consider the following steps.

Weight Gain

Cortisol is elevated in response to stress. The adrenal glands are not particular, any kind of stress will do. The stress can be physical, environmental, chemical, dietary, or imaginary. The human brain is hard wired with automatic responses to protect the body from harm. All forms of stress produce the same physiological consequences.

As we mentioned earlier, one of the primary roles of cortisol is to promote the conversion of triglycerides into stored fatty acids. It also promotes glucose formation (gluconeogenesis). The bottom line is that chronically elevated cortisol levels contribute to the accumulation of abdominal fat and make it very difficult to eliminate.

Caffeine

Last year, I devoted an entire newsletter to caffeine. In summary, the way caffeine works on the adrenal glands is as follows:

Caffeine works by blocking adenosine's ability to slow nerve cell activity in preparation for sleep, and instead increases the speed of nerve cell activity and of the neuron firing in the brain. (The caffeine molecule is structurally similar to adenosine, and binds to adenosine receptors on the surface of cells without activating them -- an "antagonist" mechanism of action.) The pituitary gland "sees" all of the increased neuron firing in the brain and thinks some sort of emergency must be occurring, so it releases hormones that tell the adrenal glands to produce adrenaline, which gives your body a boost, so it can remain active and alert in response to the perceived "emergency."

If you're drinking five, six, ten cups of coffee a day, or if you're slugging down five or six energy drinks a day, you've put your body in a state of continual "alert." This produces a constant drain on the adrenals -- eventually leading to adrenal fatigue.

So yes or no on consuming caffeine? Unfortunately, when it comes to caffeine, the devil is in the details.


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