Documentos de Académico
Documentos de Profesional
Documentos de Cultura
DR.KANAK SONI
3RD YEAR M.D.CLINICAL NATUROPATHY
SDM COLLEGE OF NATUROPATHY &
YOGIC SCIENCES ,
UJIRE .
The mind-body-hormones
connection is one of the hottest
topic in medicine today.
Documented by enormous
amounts of data regarding
hormone effect on the brain and
behaviour.
Lets see what is that !!!
Psychoneuroendocrinology
Psychoneuroendocrinology
emphasized
the importance of exploring the
inter-relationships between
mind, brain, and hormones.
It is the clinical study of
hormone fluctuations and their
relationship to human behaviour.
Comprehensively understand
Psychiatry
Neurology Endocrinology
To treat
Psychiatric illnesses
PNEC refers to structural and
functional relations between
hormonal and CNS and the behaviours
that modulate and arise from it.
Psycho-Neuroendocrinology
anxiety
stress
Stress
depression
conflict
bereavemen
t
personality
nervous system
Endocrine
system
HEALTH
immune system
Neuroendocrine
Interaction
between the
nervous system
and hormones
released by the
endocrine
glands
Fight or flight
response
HPA axis
The
sympathetic
nervous
HPA Axis
Chronic
Stress
Psycho
sis
Neuron
Contains the
nucleus and
cytoplasmic
organelles
The site of
protein
synthesis
and
processing,
including
synaptic
vesicles
Neuron
Hair-like
cytoplasmic
extension
of the
neuron
Conducts
electrical
impulses or
releases
chemical
messengers
Monoamine
neurotransmitt
ers
Amino
acids
Ltrypt
opha
n
5HTP
Ltyros
ine
LDop
a
serotonin
dopa
mine
nor
epinephri
ne
epinephrin
e
Neurotransmission
Neurotransmission
Synaptic
transmission, is the
process by which
signalling molecules
calledneurotransmit
tersare released by
aneuron(the pre
synaptic neuron),
and bind to and
activate
thereceptorsof
another neuron (the
postsynaptic
neuron).
Neurotransmission
is essential for the
process of
communication
between two
neurons
Neuronal organization
.
2. Excitatory
neurotransmitters
generally increase the
flow of information. It is
the balance between the
inhibitory and excitatory
neurotransmitters that
has the greatest effect on
body functions.
Inhibitory
There are several inhibitory
NTs in the body, but the two
that are thought to have the
greatest and widest reaching
effects are serotonin and
GABA (gamma amino butyric
acid)
Serotonin
Serotonin is in relation to
mood and a class of drugs
known as selective
serotonin reuptake
inhibitors (SSRIs)
Approx 90% serotonin is
produced and found in the
intestine and remainders is
mostly found in the brain
and CNS.
Conti.
soybeans or milk
potatoes
and asparagus
Swiss chard
GABA
It reduce anxiety, calming the
mind and release tension.
Some anti-anxiety medications
like benzodiazepines and
barbiturates as well as many
sleep medications work
primarily by increasing the
amount of GABA released in a
neuron.
Nutritional Influences
Taurine and vitamin B6 boost the
production of GABA.
N-acetylcysteine (NAC) influences
GABA.
Calming herbs such as passionflower
and valerian promote GABA production.
L-theonine found in green tea and
oolong tea increases GABA.
Excitatory
Dopamine
Norepinephrine
Epinephrine
glutamate
Dopamine
Pleasure , focus, concentration,
memory, motivation, achieve
heightened arousal and do much of
our learning is done by dopamine .
Every type of reward increase the
level of dopamine transmission in
the brain
Cocaine, amphetamines act
directly on the dopamine
Disease: Parkinson, schizophrenia,
restless leg syndrome, ADD/ADHD.
seeds, avocado
powder
asparagus
Norepinephrine
Made from Dopamine
This and epinephrine is
responsible for fight-or-flight
response to stress
Affects blood pressure, heart rate
Alertness, arousal, decision
making , attention, focus.
Medicines amphetamines ,
venlafaxine, duloxetine,
bupropion.
Epinephrine / Adrenaline
Responsible for fight-or-flight
response.
Regulate heart rate,
breathing ,blood pressure
Imbalance can lead to
adrenaline junkies= people
that seem to enjoy stress
and stressful activities.
Suffer from constant need for
urgency, have trouble
relaxing or sleeping .
Glutamate
Most abundant excitatory
neurotransmitter in the
human brain
Learning and memory like
cognitive functions
Imbalance in glutamate
levels are associated with
Alzheimer's disease, seizures
and autism.
Flavour enhancer in MSG.
Nutritional Influences
Mercury and other heavy metals increase
glutamate.
Homocysteine, aracadonic acid and
inflammatory cytokines all increase
glutamate.
Excessive sympathetic nervous system
activation (cortisol) increases glutamate.
Vitamin D blocks glutamate.
Taurine and Vitamin B6 convert
glutamate to GABA.
Anxiety
NT systems are partially
controlled by the serotonincatecholamine systems.
GABA-Glutamate NT system
is associated with control of
anxiety and panic attacks.
Some food rich in tryptophan
can help to treat anxiety
and/or panic attacks work on
GABA receptors.
Tryptophan-rich foods
Tryptophan is a routine
constituent of most protein-based
foods or dietary proteins.
It is particularly plentiful
inchocolate, oats, dried dates,
milk,yogurt,cottage cheese,red
meat, eggs,fish,poultry, sesame,
chickpeas, almonds, sunflower
seeds, pumpkin seeds,buck
wheat, spirulina, bananas, and
peanuts.
4mg per kilo of body weight
Thyroid
Metabolism
Adrenal
Stress
Causes of neurotransmitter
imbalances
Hormone metabolism
Imbalanced Neurotransmission
due to SSRIs
Exer
cise
Socia
l/
Spiri
tual
Mass
age
Diet
Envir
on.
Influ
ence
s
Arom
a
ther
apy
Integrative
Treatment
of PNEC
Diseases
Herb
al
Drug
s
Psyc
ho
logic
al
Slee
p
Hydr
othe
rapy
Naturopathy medicine
Nature
Cure Body
heals
itself
Health
Realization
Mind heals
itself
mental /
Psychological
needs
Fulfillment of
physical needs
Love
Care and affection
Peace
Security and safety
Socialisation
Companion
Rest / Sleep
Satisfaction
Achievement
Motivation
Positivity
Faith and belief
Role model
Surrenderance
Leisure activity
Recognition
Social need
glucose
kinases
receptors
Our entire
toxins
organism is a
flowing
network of
energy and
information
What happens during Massage ?
nerves
blood
peptides
nutrients
chemicals
stem cells
dopamine
BDNF
hormones
oxygen
seratonin
mRNA
adipocytokines
glutamate
cytokines
synapses
macrophages
DNA
neuropeptides
ATP
Sleep
Good sleep is essential for physical and mental health.
There is strong evidence demonstrating that inadequate
sleep is associated with a multitude of health problems,
including cognitive impairment, mood disorders,
parasitical infections, cardiovascular diseases and
compromised immunity such as cancer.
Imeri L, Opp MR. How (and why) the immune system makes us sleep. s.l.: Nat Rev Neurosci
2009;10(3):199-210.
CA, Smyth. Evaluating sleep quality in older adults : the Pittsburgh Sleep Quality Index can be used to
detect sleep disturbances or deficits. s.l.: Am J Nurs 2008;108(5):42-50.
Meerlo P, Sgoifo A, Suchecki D. Restricted and disrupted sleep : effects on ANS function, neuroendocrine
stress systems and stress responsitivity. s.l.: Sleep Med Rev 2008;12(3):197-210.
Novati A, Roman V, Cetin T et al. Chronically restricted sleep leads to depression-like changes in NT
receptor sensitivity and neuroendocrine stress reactivity in rats. s.l.: Sleep 2008;31(11):1579-85.
Preston BT, Capellini I, McNamara P et al. Parasit resistance and the adaptive significance of sleep.
s.l.: BMC Evol Biol 2009;9:7.
Sleep
Melatonin is our natural sleep hormone and it is known to
decrease with increasing age. Recent studies have shown
that melatonin has an immune-modulating effect.
It stimulates the production of NK cells and CD4+ cells and
inhibiting CD8+ cells. It also stimulates the production of
granulocytes and macrophages, as well as the release of
various cytokines from NK cells and T-helper lymphocytes.
Cardinali DP, Esquifino AI, Srinivasan V et al. Melatonin and the
immune system in aging. s.l.: Neuroimmunomodulation 2008;15(46):272-8.
Acupuncture
Acupuncture has been used for centuries to
prevent and treat various conditions and to
simply maintain good health. In addition to its
known effects on the nervous system, emerging
evidence suggests that it may also effectively
modulate the innate immune system which
plays important roles in inflammation, pain,
metabolism, cell proliferation and apoptosis.
Acupuncture and immune modulation. Cabioglu MT, Cetin BE.
s.l.: Am J Chin Med 2008;36(1):25-36.
Acupuncture and innate immunity. G, Peng. s.l.: Zhen Ci Yan
Jiu 2008;33(1):49-52.
The messengers from PNS to CNS: involvement of
neurotrophins and cytokines in the mechanisms of A. J, Du.
s.l.: Zhen Ci Yan Jiu 2008;33(1):37-40.
Aromatherapy and
PNEC
Food is information
Food contains messages or
directions to the systems of the
body about function.
Function as single systems as well
as interconnected/interdependent
systems.
Focus should be on foods to
include rather than foods to
exclude.
Magnesium
Function
Needed for healthy bones
Initiates muscle release
Promotes healthy blood
vessels
May lower blood pressure
Involved in temperature
regulation
Needed for serotonin
production
Involved in nerve
transmission
Activates energy synthesis
Inhibits platelet
aggregation
Increases HDL cholesterol
Helps control blood sugar
Enhances immune function
Functional Nutrition
Looks for core underlying
imbalances.
Faulty digestion, impaired
detoxification, oxidative stress,
hormonal imbalances, altered
immunity and inflammation.
Dysfunction and disease arise
from diet, nutrient balance,
environment, trauma, stress,
attitude, beliefs, mind and spirit.
Integrative
Medical Model
Sur
ger
y
Che
mot
her
apy
Rad
ioth
era
Pharmaceuticals
py
Nutrients/Herbs
Macrobiotic Diet
low fat, high fibre, mainly vegetarian diet emphasising whole grains and
vegetables and rich in phyto-oestogens from soy.
And so on
Collins SM, Bercik P. The relationship between intestinal microbiota and the central nervous system in
normal gastrointestinal function and disease. Gastroenterology. 2009 May;136(6):2003-14. Epub 2009 May 7.
Pathways
involved in
bidirectional
communicatio
n between the
gut microbiota
and the brain.
A
Stress occurs!
Yikes!!!!!
Whew
!
B
Stress response
begins in the brain
(lots of chemistry)
D
Stress response
ends and stress
hormones
dissipate
C
Fight or Flight
Figure 1.1
The normal stress response
Yikes !!!
Yikes !!!
E
Stress could lead to
health problems
Modern stressors
do not permit
Fight or Flight
Figure 1.2
The Type C personality (The HUMAN stress response)
0.25
co rtiso l (u g /d l)
HighWHR
0.20
0.15
STRESS
0.10
50
100
Minutes (Session 1)
150
200
Cortisol
50
Norepinephrine
18
1400
1300
16
30
20
14
1200
1100
12
1000
900
NE(ng/l)
40
Cortisol(g/100ml)
ACTH(pg/ml)
ACTH
10
8
500
400
10
stress
0
10 10 30 50 70
Trier Social Stress Test
(public speaking &
800
700
600
300
200
stress
0
10 10 30 50 70
100
stress
0
10 10 30 50 70
6AM
8AM
10AM Noon
2PM
4PM
6PM
8PM
10PM
Mid
2AM
Scientific Evidence
The Relationship Between Elevated body responses to
everyday stresses and health
Cholesterol and
Mood: Whats the
Link?
Abdominal Obesity
P<0.05
24
22.5
3.7
23
21.5
4.1
cm 22
21
0.34
0.5
0.4
nmol/L 0.3
20.6
2.2
0.15
0.6
0.2
20
0.1
19
<10
P<0.05
0.5
11-20
>21
Years in work
0.04
0.3
<10
11-20
>21
r = .76
Abdominal fat
r = -.86
r = -.63Cortisol rhythmicity
30
20
10
-20
-10
10
Additional Research
Elevated Cortisol and Osteoporosis
How common is
the condition?
Prevalence of
insomnia- 6.5% in
Pre menopause,
56.6% in Peri
menopause,
50.7% in Post
menopause
Prevalence of Hot
Flashes
100%
50%
Perimenopause 79%
Postmenopause 39%
Premenopause 14%
0%
Oxidative Stress
Positive Correlation with Chronic Disease and Aging
Chronic psychological stress appears to accelerate biological aging, and oxidative damage is an important potential
mediator of this process. However, the mechanisms by which psychological stress promotes oxidative damage are
poorly understood. This study investigates the theory that cortisol increases in response to an acutely stressful event
have the potential to either enhance or undermine psychobiological resilience to oxidativedamage, depending on the
body's prior exposure to chronic psychological stress. In order to achieve a range of chronic stress exposure, fortyeight post-menopausal women were recruited in a case-control design that matched women caring for spouses with
dementia (a chronic stress model) with similarly aged control women whose spouses were healthy. Participants
completed a questionnaire assessing perceived stress over the previous month and provided fasting blood. Three
markers of oxidative damage were assessed: 8-iso-prostaglandin F2 (IsoP), lipid peroxidation, 8-hydroxyguanosine (8oxoG) and 8-hydroxy-2'-deoxyguanosine (8-OHdG), reflecting oxidative damage to RNA/DNA respectively. Within
approximately one week, participants completed a standardized acute laboratory stress task while salivary cortisol
responses were measured. The increase from 0 to 30min was defined as "peak" cortisol reactivity, while the increase
from 0 to 15min was defined as "anticipatory" cortisol reactivity, representing a cortisol response that began while
preparing for the stress task. Women under chronic stress had higher 8-oxoG, oxidative damage to RNA (p<.01). A
moderated mediation model was tested, in which it was hypothesized that heightened anticipatory cortisol reactivity
would mediate the relationship between perceived stress and elevated oxidative stress damage, but only among women
under chronic stress. Consistent with this model, bootstrapped path analysis found significant indirect paths from
perceived stress to 8-oxoG and IsoP (but not 8-OHdG) via anticipatory cortisol reactivity, showing the expected
relations among chronically stressed participants (p.01) Intriguingly, among those with low chronic stress exposure,
moderate (compared to low) levels of perceived stress were associated with reduced levels of oxidative damage.
Hence, this study supports the emerging model that chronic stress exposure promotes oxidative damage through
frequent and sustained activation of the hypothalamic-pituitary-adrenal axis. It also supports the less studied model of
'eustress' - that manageable levels of life stress may enhance psychobiological resilience to oxidative damage.
increaseinskinthickness(%baseline)
70
60
50
40
30
20
10
0
increaseinskinthickness(%baseline)
70
control
60
chroniccorticosterone
50
40
30
Too much
stress/cortisol makes
you thin-skinned!
20
10
Time(daysafterinduction)
Dhabhar&McEwen,1999,PNAS,96:1059.
Example of
Obesity
NIDDM
HTN
PCOS
PMS and Depression
Psoriasis
Hypo and Hyperthyroidism
Common Anti-Stress
Solutions
Valerian
Kava Kava
Melatonin
Tyrosine
None of these supplements directly address cortisol control
REFERENCES
http://psycnet.apa.org/?&fa=main.doiLanding&doi=10.1037/02786133.26.4.456
http://blog.alanjacobsmd.com/
http://www.ncbi.nlm.nih.gov/pubmed/2654128
http://www.psyneuen-journal.com/article/S0306-4530(04)001209/abstract?cc=y=
http://www.sciencedirect.com/science/article/pii/S0306453003000982
http://www.sciencedirect.com/science/article/pii/S0306453000000214
http://www.sciencedirect.com/science/article/pii/S0306453002001464
http://www.bioxbio.com/if/html/PSYCHONEUROENDOCRINO.html
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC284388/
http://www.sciencedirect.com/science/article/pii/S0306453003000994
http://www.ncbi.nlm.nih.gov/pubmed/6117245
http://www.sciencedirect.com/science/article/pii/S0306453003000969
http://www.ncbi.nlm.nih.gov/pubmed/2970959
http://www.sciencedirect.com/science/article/pii/S0306453000000214
http://www.ncbi.nlm.nih.gov/pubmed/2852463
http://www.ncbi.nlm.nih.gov/pubmed/1749461
Thank you
BY
DR.KANAK