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  • This is Dr. Lam and welcome to today's session on the discussion of the

  • neuroendocrine basis of Adrenal Fatigue Syndrome.

  • First we need to understand

  • that stress enters our sphere through a small area of the brain called the locus coeruleus or the LC.

  • Discovered in the eighteenth century,

  • this area of the brain stem deals with the physiological responses to stress and panic.

  • An important homeostatic control center of the body, the LC receives input from a variety of sources

  • from our senses it is then routed through the hypothalamus, the amygdala,

  • the cerebellum as well as the prefrontal cortex.

  • Emotional pain and stressors from the outside world enters our inner world through these pathways.

  • Once arrived, excitatory signals trigger production and release of norepinephrine from the LC.

  • Now, norepinephrine has two functions. In the brain, it acts as a central neuro-transmitter

  • and keeps us aroused: we become alert.

  • Norepinephrine released from the LC also increases the sympathetic

  • discharge and inhibits parasympathetic tone in the peripheral nervous system,

  • which we will go into later. At that point it exerts its excitatory effect directly on

  • the target organs such as the heart.

  • So as a result, the heart rate as well as the heartbeat force goes up.

  • Aside from being the principal production site of the brain norepinephrine,

  • the LC is also connected on the output side to many parts of the central nervous system;

  • including the spinal cord, brain stem, cerebellum, hypothalamus, amygdala as well as the cerebral cortex.

  • So as you can see, it is a two-way street with many many directions and a

  • collaborative network of information flow, to the LC and out of the LC.

  • Collectively, the LC and areas of the CNS (or the central nervous system),

  • affected by the norepinephrine it produces, are described as the LC-NA system,

  • which stands for locus coeruleus-noradrenergic system.

  • Noradrenergic is the same as norepinephrine and that is what it connotates here.

  • Now the distribution as we talked about of the LC-NA system is ubiquitous

  • and is consistent with the prominent role that norepinephrine plays

  • in a variety of central nervous system functions,

  • as well as behavior that includes locomotor functions, cognitive functions, motivation and attention

  • Now what is important is that once the LC-NA system is activated

  • it is responsible for much of the psychological effects we see in Adrenal Fatigue Syndrome.

  • They can include fear, anxiety, alertness, memory changes and REM sleep dysregulation.

  • Psychiatric research has documented that the role the LC plays in cognitive function

  • in relation to stress is complex and is multi-modal: there is no one direct link,

  • multiple factors are involved.

  • From a neuroendocrinological perspective it is clear

  • that the body's multiple stress response pathways are all for it

  • in a redundancy pattern to handle stress in many many cases,

  • it has ensured the survival of our species for quite some time.

  • What is confusing clinically is that in Adrenal Fatigue Syndrome,

  • these pathways can be activated few at a time

  • all at once, or quickly or slowly as the body sees fit.

  • The body's truly in control but the symptoms are so convoluted because

  • it depends on what stage and how the body perceives stress.

  • Different parts of different systems are being activated all at the same time as necessary.

  • To fully appreciate the body's heroic effort to rescue us from stress,

  • it is important to first understand that our brain is in control,

  • the pathway is through the neuroendocrine system.

  • What one person perceives as stress may not be for another person.

  • Based on what is perceived as stress by the mind, the body automatically activates

  • any or all of the anti-stress mechanisms in place.

  • In order for us to fully grasp the big picture,

  • clinicians need to take a step back,

  • because it is easy to be confused when you look too close.

  • The picture from afar is quite clear.

  • We see a body in trouble, unable to maintain homeostasis

  • and trying to use all its ways and means to recover on its own, using the methods that it knows.

  • By activating any or all of the built-in stress response systems

  • modulated by the neurological and endocrine systems working in tandem.

  • The more severe the stress,the more other systems

  • such as musculoskeletal, psychiatric, cardiac and immune systems are also affected adversely.

  • Remember, that the body is a closed system.

  • Severe dysregulation of one system invariably impacts other systems.

  • This is inescapable.

  • Despite this clinical chaos,

  • we can see a controlled collapse that is logical and systematic from the body's perspective.

  • Symptoms are simply the messages

  • or signs the body sends us warning of such impending danger and

  • thereby alerting us to take appropriate action.

  • If stress is never really resolved or let go,

  • then even despite a loosing battle,

  • The mind continues to be ultimately in charge throughout this ordeal

  • through its various endocrinological stress response pathways

  • The neuroendocrine basis of Adrenal Fatigue is quite clear and solid.

  • Evidence-based scientific research has proven

  • beyond a doubt that stress can kill.

This is Dr. Lam and welcome to today's session on the discussion of the

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副腎疲労症候群の神経内分泌基盤』プレビュー (Preview of The Neuroendocrine Basis of Adrenal Fatigue Syndrome)

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    鍾佳芳 に公開 2021 年 01 月 14 日
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