» blood pressure

Can Elevated Adrenal Hormone (Cortisol) Cause a Heart Attack?

Dr. G. Pepper — Fri, 11 Jun 2010 20:47:57 +0000

The adrenal glands sitting on top of the kidneys make several hormones critical to life. The central part of the adrenal makes the hormone we refer to as adrenalin, technically from the group known as catecholamines. This is the stress responsive hormone causing rapid heart rate, sweating, increased mental alertness, preparing the body for “fight or flight”. The outer portion of the adrenal makes the hormone cortisol, also known as cortisone. Cortisol maintains, among other things, the blood pressure, fluid and salt balance. Without sufficient cortisol production by the adrenals, life cannot be sustained. What is surprising is that excess cortisol can be as harmful to health as insufficient cortisol.

Deficient cortisol production is referred to as adrenal insufficiency (Addison’s disease is one form of this), while excess adrenal function is termed Cushing’s Syndrome. During certain types of stress such as severe infection the adrenal gland can produce up to 10 times the normal amount of cortisol. If cortisol levels remain elevated for prolonged periods of time the hormone’s destructive nature is revealed by the break down of soft tissue such as skin and muscle and weakening of the immune system with frequent and aggressive infections occurring sometimes with fatal outcome. Heart disease has not been associated with high cortisol levels until a recent study suggested this possibility.

Researchers from the U.K. examined morning cortisol levels in 1066 men and women with Type 2 diabetes participating in the Edinburgh Type 2 Diabetes Study. A positive relationship was discovered between cortisol levels and the occurrence of heart disease such as heart attack and angina. The higher the cortisol levels were the greater the risk of heart disease. Cortisol levels in diabetics were found to be higher than in non-diabetics, in general. The researchers could not explain why the cortisol levels caused heart disease or why levels were higher in diabetics. (From the April edition of the Journal of Clinical Endocrinology and Metabolism 95:1602-1608).

‘Adrenal fatigue’ is a recently proposed diagnosis used to explain a variety of general symptoms such as fatigue, moodiness, muscle aches, and diminished mental function. Supposedly, adrenal fatigue results from mild impairment of cortisol production. Practitioners who diagnose “adrenal fatigue” are prescribing synthetic versions of cortisol as treatment. The possibility of heart disease resulting from excess cortisol should be a factor that patients and medical professionals must consider before embarking on adrenal “supplementation” programs.

This information is for educational purposes only and is not intended as medical advice or treatment.

Gary Pepper, M.D.
Editor-in-Chief, Metabolism.com

Floating Our Way to Fatness on a “Bloat”

Dr. G. Pepper — Mon, 16 Nov 2009 18:06:44 +0000

Imagine locking the family dog in a cage for a week with an endless supply of its favorite treats. What would you expect at the end of the week? It’s obvious, isn’t it? A fat and possibly very ill pooch.

Subject a human counterpart to similar conditions and expect the same thing to happen. Yet, unbelievably, there is a huge industry devoted to creating this kind of environment and we pay a fortune to support it. It’s called the cruise industry.

During summers thirty years ago in the New York metropolitan area, many of my parent’s friends spent their vacation time in the Catskills. The Catskills is an area of rolling hills and farms and at that time years ago also the scene of a vibrant hotel industry. Hot, tired and stressed New Yorker could eat and drink themselves silly for a week or two while feeling they were healthier for breathing the fresh, cool mountain air. Because the hotels were set in an apparent wilderness vacationers had no guilt about never moving their bodies outside the compound. Eating, “schmoozing” and taking in the nightly Borscht Belt entertainment were the only activities available.

Fast forward to the present. The Catskill hotels have been replaced by mammoth floating hotels called cruise ships. The original beauty of these ships as a method of refined transportation to Europe or the islands has been lost. In transforming from Borscht Belt hotel to gigantic cruise ship merely substitute ocean for mountains. Sequestered on board the ship with no risk of being required to move more than a few hundred steps in any direction, what else to do but consume what is constantly in your face…massive quantities of food and drink and passive entertainment.

It is my impression (supported by numerous studies) that the average weight of our population is growing steadily. Paralleling the phenomena of the growing size of the average person is the ever increasing size of the cruise ships. Last week the most obscenely massive cruise ship of them all made its debut in Florida. Oasis of the Seas is 40% bigger than the next largest cruise ship and 5 times bigger than the Titanic. Oasis of the Seas will confine together 6300 passengers and 2800 crew members. Despite its size, being alone on this ship will be like trying to find a quiet corner in Times Square on New Years Eve. Looking at the ship one wonders how something so big could float. It is oddly shaped, no sleekness to this vessel with more vertical than horizontal lines. Maybe we shouldn’t call it a boat, at all. In fact I would put it into a different category altogether…something I would call a “bloat” for being a really big, big, floating boat.

I am troubled by the existence of the ‘bloat’ because as the size of the population and cruise ships increases so has the incidence of diabetes. Since I treat diabetes as a profession, I get the feeling my job is increasingly hopeless as more and more of my patients jump on board the cruise craze. As cruising has become a generally accepted way of vacationing with a vast advertising budget glamorizing this lifestyle, my advice about diet and exercise is drowned out. Once on board, there are few people who could resist the urge to say, “I paid for this, so I might as well do what everyone else is doing”.

I expect more bloats to be commissioned in the future, each one a miracle of engineering and excess. If things continue in this direction we may wind up wiping ourselves out with metabolic diseases like diabetes, coronary disease and high blood pressure. In our wake we will leave behind colossal deserted monuments of our civilization, pyramids of the sea.

Dr. DeSilva Wants to Aid in Weight Gain

Dr. G. Pepper — Mon, 06 Apr 2009 12:05:30 +0000

Dr. DeSilva posts a great question about someone with high blood pressure and thyroid disease who needs to gain weight.

Dr. DeSilva asks:

I would like your advice about a lady who is hypothyroid and is taking the T3/T4 and is very underweight, 80-100 lbs. she also has some hypertension and is on drugs for this. can you suggest a way for her to gain weight?? please let me know.thanks

More on Estrogen Benefits: Brain function and blood pressure

Gary Pepper M.D. — Sat, 01 Mar 2008 18:57:37 +0000

In a recent blog at metabolism.com (http://metabolism.com/2007/11/12/estrogencant-live-with-it-cant-live-without-it/) we reviewed information suggesting women who had their ovaries removed or who began early menopause before the age of 50 may preserve brain function as they age by using estrogen replacement. I have just reviewed new research which could help explain why. Researchers gave post-menopausal women one dose of inhaled estrogen while measuring blood flow to their brain. They discovered that the estrogen caused an increase in blood flow to the brain. Diminished blood flow to the brain is one reason people develop impaired memory and thinking as they get older. Could estrogen prevent or slow this process?

In other areas of estrogen research it was found that daily estrogen use can significantly lower blood pressure in post-menopausal women. Healthy post-menopausal women without high blood pressure were given sequential estrogen/progesterone treatment for one year. At the end of the year blood pressure was significantly lower in women using estrogen compared to those who did not. The fall in blood pressure was equal to the benefits of some popular blood pressure medications such as verapamil (Verelan, Calan, Isoptin).

Stay abreast of further estrogen related developments at metabolism.com.

Be advised that this information is not meant as medical advice. Starting or changing medications should be done only under the supervision of your own physician or medical provider.