Cushing s syndrome. Control over cortisol. Cortisol hormone. Information I ll assume that you know:

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Cortisol hormone Information I ll assume that you know: Anabolic vs Catabolic Cortisol inhibits glucose uptake, stimulates protein degradation, promotes both lipolysis & gluconeogenesis Gluconeogenesis:
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Cortisol hormone Information I ll assume that you know: Anabolic vs Catabolic Cortisol inhibits glucose uptake, stimulates protein degradation, promotes both lipolysis & gluconeogenesis Gluconeogenesis: conversion of amino acids into carbohydrates at liver Control over cortisol ACTH from anterior pituitary stimulates cortisol secretion Negative feedback from cortisol inhibits hypothalamus and anterior pituitary Cushing s syndrome Excessive cortisol - often due to tumor at pituitary or adrenal gl. Excessive gluconeogenesis 1 Cortisone injections: Patients take cortisone (converts to cortisol) for anti-inflammatory effects (allergies, arthritis, trauma). Immune system is suppressed. Chronic (continual) release of stress hormones Stress responses: SNS effects (vasoconstriction, anxiety) Fat, sugar blood levels (diabetes, arterioscl) Fluid retained, BP (hyperten, heart disease) Immune system fxn, sexual fxn, digestion all decrease (infertility, irritable bowel, ulcers, vomiting) Adrenal gland: sex hormones DHEA from adrenal cortex is a source of opposite sex hormone in men and women ACTH controls adrenal androgen secretion DHEA testosterone in women 2 Adrenal medulla Functions as a modified postganglionic neuron of the sympathetic NS. It stores and secretes epinephrine and norepinephrine In addition to FOF responses, stimulates glucagon secretion and inhibits insulin secretion. Pancreas: endocrine hormones Islets of Langerhans Alpha cells release glucagon Beta cells release insulin Insulin:storage and anabolism Insulin signals to fat and other tissues to take up glucose (GLUTs). Prevents the mobilization of fat. Liver takes up fatty acids, makes glycogen GH, cortisol, epinephrine, and glucagon inhibit insulin. How the body controls metabolism Nutrients must be stored then released between meals. The brain needs a constant supply of glucose Most conversion of molecules occurs in the liver. Nutrients that cannot be formed this way are essential nutrients and must come from diet. 3 Storing energy in the body Excess glucose glycogen in liver and muscles (or adipose when there is much glycogen) Excess fatty acids triglycerides, in adipose Excess amino acids triglycerides, in adipose Glycogen (pink) in liver cells Blood glucose levels Glucose levels are consistent over the day, range about 10-15%, through action of insulin and glucagon Blood glucose Blood glucose levels and glycemic index With simple carbs (high glycemic index) glucose absorbed to blood rapidly - insulin spike that follows is large. Glucose reduced in blood Insulin Between meals, body cells can burn fatty acids to spare glucose for the brain. 4 Blood glucose levels and glycemic index With simple carbs (high glycemic index) glucose absorbed to blood rapidly - insulin spike that follows is large. Glucose reduced in blood With lower glucose levels, may crave food again What is diabetes? Inadequate insulin action = diabetes mellitus (hyperglycemia) Apple vs. Pear Type I juvenile diabetes - body cannot produce insulin autoimmune disease Type II adult diabetes too little insulin made, or target cells are insulin resistant 5 Adipose and insulin resistance Diabetes, insulin resistance (IR) is associated with obesity, lack of exercise When storage at fat cells is exceeded, free fatty acids (FA) in blood increase Adipose and insulin resistance High FA may cause muscle and adipose to diminish their response to insulin (IR) Insulin less able to clear glucose from blood, still helps store fat. Appetite-related hormones (just for your own interest...not for exam) Ghrelin released at stomach, duodenum when absence of food. Stimulates appetite. Peptide YY released by ileum, colon in response to presence of food. Inhibits appetite. (eating protein can boost PYY) Leptin released by adipose, inhibits appetite. (Obese people can have decreased response to it, still have lower levels when wt. lost) Mouse w/ leptin mutation 6
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