The Beginning of a Disease for Man and Animal

Second stage (adrenal maladaption) In this phase the adrenals begin to reduce their production and all function of the endocrine system begins to slow down. 

When forced to respond to continued chronic stress the adrenal glands enter a compensated phase in which the production of the stress hormones is divergent. Their output of regulatory hormones has been diminished by over-stimulation.
Because of the difference in response to ACTH, the production of DHEA fails as cortisol remains elevated. The negative feedback of cortisol on the hypothalamus is lost as higher cortisol is required to shut dowse adrenal responses and bring ACTH into the normal range.
This progression has been called 'stress fixation'. Output of DHEA falls from high to normal to low followed by the same progression for cortisol.  If the stress is prolonged, the production of both hormones falls into the low levels.

Signs of Adrenal Maladaption

• Impaired energy production (insulin sensitivity drops)

• Reduction in glucose utilization and in amino acids due to enhanced gluconeogenesis

• Increased bone resorption and osteoporosis

• Fat accumulation at the waist

• Increased protein breakdown

• Salt and water retention

• General immune suppression

• Increased rate of infection

• Reduced vitality

• Hunger

The body does its best to make up for the under-functioning adrenal glands, but it does so at a price.

Health Conditions Associated with the Maladaption

This stage of resistance or maladaption is characterized by restoration to normalcy. Neuroendocrine hormones, although temporarily excessive, endeavor to compensate for the physiologic changes of the alarm stage. The usual outcome is a return to homeostasis (balance of the bodily functions). If stress is protracted, however, resistance efforts remain activated. Consequently one or more organs or physiologic processes may lead eventually to increased vulnerability for stress-related disorders or progressing to the stage of exhaustion.

To explain the whole process a bit praxis related, let's look at a Headshaking horse, which started suffering of a pollen allergy. Btw over 60 % of all HS horses do hyper-react to some kind of triggers, be it pollen or mold, aso., they often become hyper sensitive as a result of HS, other again reacting with HS on an established allergy. (see idiopathic HS)

Essentially, the body of this horse is out of balance; any pollen can upset the body's delicate mineral balance and start a chain reaction that impairs the immune system. These pollen damages the cell tissues and the body needs 3 to 4 days between inhaling the allergen to recover. Since the pollen is flying around not only for one day but for several days, even weeks, depending on the species and over long distances, the overloaded immune systems never gets a break.

Now you may ask, why my horse and not the other 4 horses running with him on the same pasture? Researchers have yet to clearly understand why some mammals immune systems over-react to exposure to pollens while others do not suffer from this problem. Symptoms of the so called "hay fever" or pollen allergy are partly a result of inflammation that, in turn, is activated by the immune system. The immune system is either over-reacting, responding to a false alarm or it is suffering an autoimmune disease, where the system's recognition apparatus broke down and the body began to manufacture T-cells and antibodies directed against its own cells and organs. The body is suffering from either one type, and it is assumed, the latter one can develop from the first type.

One fact is clear our horse's system is already stressed by the pain of HS, the immune defense is low. Now add the extra stress of the new disease called allergy

Inhaled allergens trigger sneezing and inflammation of the nose and mucous membranes (conjunctiva) of the eyes. The nose, roof of the mouth, eyes, and throat begin to itch gradually or abruptly after the onset of the pollen season. Tearing, sneezing, and clear, watery nasal discharge soon follow the itching. Headaches and irritability may also occur. HEADACHES! The poor thing already has headaches. Also allergies provoke immediate antibody reactions in the bloodstream.
Why does the horse has so many different symptoms? The one symptom common to all allergies is inflammation. If it occurs in the brain cells the horse ends up with mental or emotional symptoms. These can include dizziness, poor memory, seizures, agitation, and panic attacks. Inflammation manifests in joints as arthritis. What makes an allergy choose one part of the body over another? Most allergic mammals have a toxic bowel, preventing the body from eliminating irritants the natural way. This burdens other channels of elimination, especially skin and lungs - which explains mysterious eczema or awful asthma.  Scientists estimate in over 75% of allergic reactions, cells in tissues under attack are actually destroyed. Arthritis are examples of an autoimmune diseases that may start as simple allergies. 

- ALLERGIC
This is the most commonly occurring level of reaction to environmental exposures to which individual susceptibility and maladaptation exists, as withdrawal effects come to predominate over stimulatory levels.  Dr.Theron G. Randolph, the father of the environmental medicine was the foremost pioneer in his day of allergy theory, diagnosis, and treatment

The level of cortisol can be tested with the Adrenocorticotropic Hormone Test

Definition

Adrenocorticotropic hormone test (also known as an ACTH test or a corticotropin test) measures pituitary gland function.

Purpose

The pituitary gland produces the hormone ACTH, which stimulates the outer layer of the adrenal gland (the adrenal cortex). ACTH causes the release of the hormones hydrocortisone (cortisol), aldosterone, and androgen. The most important of these hormones released is cortisol. The ACTH test is used to determine if too much cortisol is being produced (Cushing's syndrome) or if not enough cortisol is being produced (Addison's disease).

Precautions

ACTH has diurnal variation, meaning that the levels of this hormone vary according to the time of day. The highest levels occur in the morning hours. Testing for normal secretion, as well as for Cushing's disease, may require multiple samples. For sequential follow-up, a blood sample analyzed for ACTH should always be drawn at the same time each day.

ACTH can be directly measured by an analyzing method (immunoassay) in many large laboratories. However, smaller laboratories are usually not equipped to perform this test and they may need to send the blood sample to a larger laboratory. Because of this delay, results may take several days to obtain.

Description

ACTH production is partly controlled by an area in the center of the brain (the hypothalamus) and partly controlled by the level of cortisol in the blood. When ACTH levels are too high, cortisol production increases to suppress ACTH release from the pituitary gland. If ACTH levels are too low, the hypothalamus produces corticotropin-releasing hormone (CRH) to stimulate the pituitary gland to make more ACTH. ACTH levels rise in response to stress, emotions, injury, infection, burns, surgery, and decreased blood pressure.

Preparation

An ACTH level is determined from a blood sample. The patient must fast from midnight until the test the next morning. This means that the patient cannot eat or drink anything after midnight except water. The patient must also avoid radioisotope scanning tests or recently administered radioisotopes prior to the blood test.

Risks

The risks associated with this test are minimal. They may include slight bleeding from the location where the blood was drawn. The patient may feel faint or lightheaded after the blood is drawn. Sometimes the patient may have an accumulation of blood under the puncture site (hematoma) after the test.

Normal results

Each laboratory will have its own set of normal values for this test. The normal values can range from: Morning (4-8 A.M.) 8-100 pg/mL or 10-80 ng/L (SI units) Evening (8-10 P.M.) less than 50 pg/mL or less than 50 ng/L (SI units)

Abnormal results

In Cushing's syndrome, high levels of ACTH may be caused by ACTH-producing tumors. These tumors may be either in the pituitary or in another area (like tumors from lung cancer or ovarian cancer). Low ACTH levels may be caused by adrenal enlargement due to high levels of cortisol and feedback to the pituitary.

In Addison's disease, high levels of ACTH may be caused by adrenal gland diseases. These diseases decrease adrenal hormones and the pituitary attempts to increase functioning. Low levels of ACTH may occur because of decreased pituitary function.

Key Terms

Adrenal gland

A pair of endocrine glands that lie on top of the kidneys.

 

Pituitary gland

The most important of the endocrine glands, glands that release hormones directly into the bloodstream; sometimes called the master gland.

Books

• Jacobs, David S., et al. Laboratory Test Handbook. 4th ed. New York: Lexi-Comp Inc., 1996.

• Pagana, Kathleen Deska. Mosby's Manual of Diagnostic and Laboratory Tests. St. Louis: Mosby, Inc., 1998.

Source: Gale Encyclopedia of Medicine, Published December, 2002 by the Gale Group

In the following chapter we are going to look at the Trigeminal Nerve and different types of Headshaking and I'm certain, now, where you know all about pain, stress and immune system, you will understand your horse's condition a whole lot better.    Next page

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References

- Kelly, G. S. Nutritional and botanical interventions to assist with the adaptation to stress. 1999
- Donna Gates, The Body Ecology Diet: Recovering Your Health & Rebuilding Your Immunity; 6th Edition
- Dr Mackarness, Not All in the Mind, 1976
- Holmes HM, Alexander W. Hay fever and vitamin C. Science 1942
- Theron Randolph & Moss, "An Alternative Approach to Allergies" 1990; "Ecologic Mental Illness - How Interest
   Developed 1949 -1950" by Theron Randolph, MD, Spring 1993
- Barragry JM, Mason AS, Seamark DA, Trafford DJ, Makin HL. Defective cortisol binding globulin affinity in association
   with adrenal hyperfunction: a case report. Acta Endocrinol (Copenh), 1980;
- Stahl F, Dorner G. Responses of salivary cortisol levels to stress-situations. Endokrinologie, 1982;
- Jusko WJ, Slaunwhite WR, Jr., Aceto T, Jr. Partial pharmacodynamic model for the circadian-episodic secretion of
   cortisol in man. j Clin Endocrinol Metab, 1975;
- Williams LL, Kiecolt-Glaser JK, Horrocks LA, Hillhouse JT, Glaser R. Quantitative association between altered
- Calder, P. C., & Jackson, A. A. (2000). Undernutrition, infection and immune function. Nutrition Research Reviews

The terms once again, a short definition.

Adrenal (Adrenal Gland, Adrenals)
The adrenal glands sit on top of each kidney and consist of an outer cortex and an inner medulla. Of the 50 or so hormones the adrenals make, only cortisone and adrenaline are recognized by most people. Some of these hormones must be produced to preserve life, while others help resist stress. Other hormones from the adrenals control normal energy output (along with the thyroid) and govern the breakdown of stored energy into quick energy sources. The medulla produces epinephrine and norepinephrine, which are specifically designed to help the body deal with stressful situations. The adrenals control the body's potassium/sodium balance, which is vital for energy production. They also produce sex hormones in minute amounts, which is important for later years when the gonads drop or cease their production.

Adrenal Insufficiency (Adrenal Exhaustion, Low Adrenal Function)
A condition in which the adrenal gland is compromised in its production of epinephrine, norepinephrine, cortisol, corticosterone or aldosterone. Symptoms include primarily fatigue, weakness, decreased appetite with ensuing weight loss, as well as nausea, vomiting, abdominal pain, diarrhea or constipation, or increased pigmentation of the skin. Cortical insufficiency (low or no corticosteroids) produces a more serious condition called Addison’s Disease, characterized by extreme weakness, low blood pressure, pigmentation of the skin, shock or even death.

Cortisol
A hormone. Its most important function is to help the body respond to stress. It also helps regulate your body's use of protein, carbohydrates and fat; it helps maintain blood pressure and cardiovascular function; it stems inflammation.

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