Steroidogenic Pathway Part 2

So here I present you with a visualization of the steroidogenic pathway. As you can see, Cholesterol is the father hormone that yields both stress and sex hormones. Note that cortisol, the sex hormone, and DHEA, the anabolic anti-aging hormone (which is also the precursor to the sex hormones) share the exact same precursors. And because of this, there is a constant tug of war between stress and sex!

Steroidogentics Pathway2

As we age the acute stress response is less resilient to subside and results in more of a chronic response with elevated cortisol levels and ultimately decreasing DHEA levels. In the first stage of adrenal fatigue, there is actual hyperactivity of the adrenal hormone cortisol. DHEA remains normal at this stage. But if the stress is not mitigated and the stress response not terminated then a chronic situation arises which demands more and more cortisol. Eventually, the adrenal gland “steals” reserves of DHEA in order to keep up production of cortisol. DHEA production ceases, levels drop and sex hormones and well being are at risk. Low DHEA levels are associated with a higher degree of physical disability and depressive symptoms. At this stage of the chronic stress response all of the adrenal gland activity is to produce more and more cortisol to keep up with the chronic stress.

So, what actually constitutes stress? This term encompasses “fight or flight” responses, fear, anxiety and worry. Depression and feelings of defeat or helplessness constitute stress as do pain syndromes, infection, inflammation, low blood sugar, inadequate sleep, disrupted light cycles and toxic exposure. As you can begin to understand we are surrounded by stressful stimuli. And one needs to remember that it is not the stimulus itself that leads to chronic stress it is HOW WE REACT to the stimulus. As we react negatively to the stress the adrenal gland becomes hyperactive and produces more and more cortisol. This is life saving in the short term as the catabolic effects of cortisol releases energy reserves used to combat the stressful stimulus! But persistent cortisol production leads to immune suppression, hyperglycemia and insulin resistance, central adiposity, hypertension, memory impairment, hyperlipidemia an decreased conversion of T4 to T3 leading to hypothyroid issues.

Eventually the adrenal hyperactivity begins to interfere with the metabolic and homeostatic machinery of the body and the hypothalamus actually “shuts down” cortisol production. This stage is true adrenal fatigue with low cortisol and low DHEA. The patients is not able to mount as stress response and unable to produce adequate sex hormones. Severe lassitude, depression, muscle weakness and fatigue set in. The individual literally drags him/herself throughout the day wondering what the problem is. And so now, we come to the beginning of the end of the story, a story which was written in Adrenal Fatigue 1, 2 and 3.

It is always interesting to point out these scenarios to patients with sexual problems. Stress will decrease your sexual drives and physiologically you now know why this is so. The most important thing to take away from this is that stressful stimuli are omnipresent. It is how you react to these stimuli which will determine the level of the stress response generated and the side effects that follow! As the title of one book states, “Don’t Sweat The Small Stuff”!

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