Stress Response and HPA

Can you help me understand the link between the typical Fight-Flight Stress response and something my doctor called the HPA—I feel bad because I didn’t quite understand it .

 Avoid feeling bad! The Hypothalamic-pituitary-adrenal axis, also known as the HPA, is very complex. The biology dictionary describes it as a complex feedback system of neurohormones that are sent between the hypothalamus, the pituitary, and the adrenal glands. This triad axis regulates the physiological mechanisms of stress reactions (and incidentally also impacts the immune system and fertility). When the brain-body experiences stress and the HPA is activated, it’s job is to prepare the body to engage in the fight-flight response. The HPA releases cortisol, that increases the level of glucose in the blood, raises blood pressure, and sends more blood to muscles. Cortisol also puts some body functions “on hold” because they would be unhelpful in responding to the stress.

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The Cortisol-Alcohol Link

The theory has been that alcohol may affect brain chemicals that signal the adrenal glands to produce more cortisol. To study this, researchers at the Veterans Affairs North Texas Health Care System in Dallas recorded the breath alcohol concentrations and cortisol levels in three groups of patients: a group of alcohol-dependent patients who were abstinent and participating in a residential treatment program, a group who were intoxicated and in the treatment program, and a group who were going through withdrawal. The study found:

·       Both the intoxicated group and the withdrawal group had increased cortisol levels compared to the abstinent group

·       Cortisol concentrations actually increased during the progression from intoxication to withdrawal

·       Alcohol consumption increases the body's production of cortisol, not only while the person is intoxicated, but also when the drinker is withdrawing from the effects of intoxication; cortisol does remains elevated throughout the drinking cycle

·       A high level of intoxication can cause a state of general stress—as alcohol is viewed as a toxin by the brain—which can stimulate cortisol release. 

How are you for belly fat?

Cortisol is the stress hormone released when your brain recognizes a ‘stressor.’ Designed for short-term emergencies cortisol is made in your adrenal glands and increases blood pressure, impacts immune function, and raises blood sugar to give you fast energy. That’s the good news. Cortisol levels that stay high for too long are linked with increased risks for diabetes, high blood pressure, brain memory issues, insomnia, and increased belly fat, to name a few. Belly fat cells reportedly have four times as many receptors for cortisol compared to fat cells at other locations in your body. Researchers at the Osher Center for Integrative Medicine, University of California, San Francisco, California, studied the effects of a mindfulness program for stress eating on Cortisol Awakening Response or CAR and abdominal fat. Study results showed that Improvements in mindfulness, chronic stress, and CAR were associated with reductions in abdominal fat.

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Good News about Nicotine

The good news is that anyone can choose to not smoke and anyone can kick the habit if they want to bad enough. Nicotine is nicotine—however it is delivered. Smoking remains the leading preventable cause of sickness and mortality, responsible for over 400,000 deaths in the United States each year. The worst health consequences associated with smoking (e.g., cancer and heart disease) are linked to the inhalation of tar and other chemicals produced by tobacco combustion; the pleasurable, reinforcing, and addictive properties of smoking are produced mostly by the nicotine contained in tobacco. [Using PET Scans, researchers at the University of Michigan (in the first human study) showed that (like heroin and morphine) smoking cigarettes stimulates the brain's production of dopamine and chemicals known as opioids. Smoking cigarettes triggers the release of addictive feel-good brain chemicals, notably dopamine and opioids. It appears that smokers have an altered opioid flow all the time, when compared with non-smokers.] According to WebMD, e-cigarettes are already a booming, billion-dollar industry, on track to outsell tobacco products within a decade. If you don’t smoke, never start. If you do smoke, get help to quit—for your life and health and the life and health of those whom you love.

A new AUDIO podcast is posted every Saturday morning

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Happy Thanksgiving in the USA

Thanksgiving is a time to celebrate the quality of being grateful—and to practice it! Neurobiologically, gratitude is right up there with awe and wonder. The benefits are myriad. Doctors have pointed out that when you pause to appreciate and show caring and compassion, the more order and coherence you experience internally. When your heart is in an ‘internal coherence state,’ studies suggest that you enjoy the capacity to be peaceful and calm yet retain the ability to respond appropriately to stressful circumstances. I choose to practice gratitude on a daily basis. What makes Thanksgiving Day more unique than any other day? On this day I pause to be specifically grateful for those individuals who love me enough to give me quality time throughout the year by phone, text, email, snail mail—and sometimes in person (how deliciously rewarding). I refer to them as my ‘family-of-choice’ because a gift of time is a personal choice. It is the only thing your brain can give another brain that no one else can. For their quality time I am truly grateful. Wherever you are and whatever you are doing, my wish for you today is that you both give and receive the gift of ‘quality time.’

E-cigarettes and Increased risks

The National Institutes of Health funded a study to evaluate whether exposure to E-cigarettes increased one’s risk for initiation to smoking regular tobacco cigarettes. Recently, Dr. Nora Volkow, NIDA Director, released the results of the study. Researchers found that teenagers who use E-cigarettes are more likely to start smoking tobacco. Teenagers who smoke E-cigarettes are reportedly at three times higher risk for smoking regular cigarettes within about a year—when compared with teenagers who do not use E-Cigs. Another study revealed that the students who have used e-cigarettes by the time they start 9th grade are more likely than others to start smoking traditional cigarettes and other smokable tobacco products within the next year. 

E-cigarette Down Sides

Although they do not produce tobacco smoke, e-cigarettes still contain nicotine and other potentially harmful chemicals. Nicotine is a highly addictive drug. Recent research suggests that nicotine exposure may also prime the brain to become addicted to other substances. Testing of some e-cigarette products found that the vapor contained known carcinogens and toxic chemicals (such as formaldehyde and acetaldehyde), as well as potentially toxic metal nanoparticles from the vaporizing mechanism. The health consequences of repeated exposure to these chemicals are not yet clear. Another worry is the refillable cartridges used by some e-cigarettes may expose themselves to potentially toxic levels of nicotine when refilling them. Cartridges could also be filled with substances other than nicotine, thus possibly serving as a new and potentially dangerous way to deliver other drugs.

E-cigs and the Brain

Not long ago a young man told me proudly that he had quit smoking cigarettes. I was on the point of commending his choice when he said, “E-cigarettes are much better!” Really? Think again. I referred him to the NIDA, the National Institute on Drug Abuse fact sheet. Also known as ENDS (Electronic Nicotine Delivery Systems)e-cigs typically consist of a power source, which is usually a battery; some type of vaporizer or heating device; and a liquid that contains nicotine along with flavorings such as candy, fruit, mint, and coffee, and other chemicals. In many e-cigarettes, puffing activates the battery-powered heating device, which vaporizes the liquid in the cartridge. The resulting aerosol or vapor is then inhaled (called ‘vaping’).Because they deliver nicotine without burning tobacco leaves, many tout them as a safer and less toxic alternative to traditional cigarettes. Very little is actually known about the long-term health risks of using these e-cigarette devices. Even in States that have banned the sale of e-cigarettes to minors, teens have been obtaining them by simply ordering the devices online. Particles breathed into the lung from the tobacco and other chemicals take up space that would have been used by oxygen-filled air, which means the brain is frequently partly anoxic: not getting enough oxygen to adequately fuel processes in the brain.        http://www.drugabuse.gov/publications/drugfacts/electronic-cigarettes-e-cigarettes

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WHO Key Facts in 2022

This is what the World Health Organization has to say:

- Tobacco kills more than 8 million people each year. 

- More than 7 million of those deaths are the result of direct tobacco use while around 1.2 million are the result of non-smokers being exposed to second-hand smoke.

- Over 80% of the world's 1.3 billion tobacco users live in low- and middle-income countries.

- In 2020, 22.3% of the global population used tobacco, 36.7% of all men and 7.8% of the world’s women.

To address the tobacco epidemic, WHO Member States adopted the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2003. Currently 182 countries have ratified this treaty. Measures in line with the WHO FCTC are in place in some areas. They have been shown to reduce costs from averted healthcare expenditures and to save lives.

 

Tobacco Epidemic

The other day I was chatting with a dear little first-grader. A person walked by on the sidewalk and blew out a cloud of cigarette smoke. The breeze carried it toward us. She vigorously fanned her little hands, trying to push it away. “I hate the smell,” she continued. “My daddy and my grandpappy both smoke. It gives me a headache. Why do people still smoke?” Good question. According to the World Health Organization (WHO), the tobacco epidemic is one of the biggest public health threats the world has ever faced. All forms of tobacco are harmful, and there is no safe level of exposure to tobacco. Cigarette smoking is the most common form of tobacco use worldwide, killing more than 8 million people a year, including around 1.2 million deaths from exposure to second-hand smoke. Therein lies a big problem. It is one thing to choose to smoke yourself. It is another to expose loved ones and friends to your side smoke, which increases their risk of disease and death, especially for babies and children in one’s home who have no way of escape, as well as other family members.

 

Ancestry Bottom Line

IIf it were possible to go back far enough, we just might discover that most of us (if not all of us) are related to most of us (if not all of us) in some way or another. Interesting concept. Since our brains and hearts are all the same color, all the nonsense about ‘better than’ or ‘less than’ is just that: nonsense. No doubt DNA research will continue to advance and we will learn more about who we are related to. For me it, is exciting because each person brings something unique to the great table that is Planet Earth. I am happy to be at that table. As a child growing up in Canada, part of the Commonwealth, diversity was present in many different ways from how Thanksgiving and X-mas were celebrated to preferred foods and you name it. We enjoyed telling each other about our “roots” and learning about “their roots.” DNA research has added another dimension to this.

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My Paternal Line

As with everyone else, I also have a paternal line. My patrilineal ancestry reportedly goes back to an African male known as ‘’’Y-Chromosomal Adam.’ Two initial descendants from this male were the Haplogroup A and the Haplogroup BR. Reportedly both of these groups are found today in Sub-Saharan Africa in select populations. There were, of course, migrations out of Africa and a variety of other mutations occurred that split into Haplogroup F, Haplogroup P, and eventually Haplogroup R (distinguishable by its M207 mutation). Haplogroup F descendants appear to have taken the admonition to ‘be fruitful and multiply’ quite literally. Tibet, Kazakhstan, Mongolia, Japan, Polynesia, and Indigenous Australians are said to have the only populations out of Africa that are not descendants of this prolific Haplogroup F. A M9 mutation from Haplogroup F resulted in Haplogroup K, which had a M4-5 mutation into Haplogroup P that in turn had a M207 mutation that started the Haplogroup R line. My paternal line appears to be aligned with a section of this group known as Haplogroup R1b, reportedly related to a man in Iberia (modern day Spain) now known as ‘the Patriarch,’ who carried the genetic marker that designates the Haplogroup R1b. 

Maternal Line Ancestors

Haplogroup N had additional mutations and branchings. A woman classified as ‘Helena’ (meaning light in Greek) reportedly marked the beginning of my mitochondrial branch or type: Haplogroup H. One of the most famous of my Haplogroup H ancestors (that can be traced back to Bertha Von Putelendorf who died 1190) is reported to be the French queen Marie Antoinette—who, unfortunately, ‘lost her head.’ Because that family was quite prolific, some others in Haplogroup H include Marie-Louise of Austria (Napoleon’s wife), the Empress Alexandra Fyodorovna (wife of the last Russian tsar Nicolas II), and Britain’s Queen Victoria. Hmmm.

 

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My Maternal Line

I decided to bite the bullet and send in some of my white blood cells to see what I might learn about my biological history—and to be analyzed for mitochondrial DNA. Unlike chromosomal DNA that is inherited from both parents, you get all your mitochondrial DNA from your mother. Mutations accumulate in mitochondrial DNA more quickly than in chromosomal DNA, so it's possible to trace your maternal ancestry way back beyond any relatives you may know by name—simply by tracking the inheritance of mutations in mitochondrial DNA. In due time the results came back. The markers that DNA Solutions identified show I belong to Haplogroup H, the most common Haplogroup in Europe, occurring in 40-60% of the population. My common female ancestor supposedly is a woman known as Mitochondrial Eve. Four initial groups of descendants known as Haplogroups Lo-L3 are related to Mitochondrial Eve. Group Lo apparently is now extinct, but Group L-3 divided into two subtypes: M and N. A DNA marker at position 10875T of my mitochondrial DNA, shows that I am a descendent of Haplogroup N. 

DNA Misspellings

A mutation is a change in the spelling of a typical DNA sequence (think of your body as having a spell-check for DNA sequences and that for some reason or other spellcheck fails). A misspelling slips through, if you will. Your DNA contains mutations that typically are quite harmless. Some, however, are harmful and may be responsible for triggering abnormal conditions and specific diseases. For example, sickle cell anemia can be caused by a change in one single gene! Although 99% of your DNA is located in your chromosomes, the remaining 1% of your DNA is located in the mitochondria. The mitochondria in human cells are the energy factories that produce the energy-rich molecule known as ATP or adenosine triphosphate. Scientists are linking mitochondrial DNA defects with a wide range of age-related diseases including neurodegenerative disorders, some forms of heart disease, diabetes, and various cancers. 

A 64-letter Alphabet

According to Dr. John Stamatoyannopoulos, University of Washington, associate professor of genome sciences and of medicine, for over forty years it has been assumed that DNA changes affecting the genetic code solely impacted how proteins were made—now it appears that this basic assumption about reading the human genome missed half of the picture. New findings highlight that DNA is an incredibly powerful information storage device, which nature has fully exploited in unexpected ways. For example, DNA consists of a 64-letter (codon) alphabet that spells out the genetic code. The letters (codons) are organized into words and sentences called genes. About 15% of the 64-letter (codon) alphabet are dual-use letters known as duons. They simultaneously specify both amino acids and something called transcription factor (TF) sequences. This means that many DNA changes that appear to alter protein sequences may actually cause disease by disrupting gene control programs or even both mechanisms simultaneously. What happens to trigger mutations?

 

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DNA Ancestry

As you may already know from high school biology, your complete set of genetic information is encoded within 23 pairs of chromosomes in the nucleus of your cells—the 23^rd pair typically being a XX or a XY pattern. Not all cells have a nucleus, by the way. Red-blood cells, for instance, have no nucleus. A chromosome is a single piece of coiled DNA or deoxyribonucleic acid, a biomolecule that holds the blueprint for how living organisms are built. 99% of all DNA in your body is found in your chromosomes. Segments of DNA called genes are passed down from parents to child and confer traits to the offspring. Humans have on average between 25,000-30,000 genes, usually in pairs (one from each parent). More recent research has shown that some individuals have an extra 1, 2, or 3 X chromosomes or extra Y chromosomes. Those additional patterns can alter some typical human biological functions. 

Genealogy, Geneology, Geneaology, or Genology

Shows such as ‘Finding Your Roots’ and ‘PBS Genealogy Roadshow’ seem to have heightened interest in biological ancestry. There appears to be some misunderstanding of which word actually represents the multiple spellings of the work genealogy. Data from WordTracker reported that over a two-month period:

·       10,722 searches were done for ‘genealogy’

·       5,988 searches were done for ‘geneology’

·       711 searches were done for ‘geneaology’

·       302 searches for “genology"

 For 25% of the population who are believed to have their “brain bent” in the right frontal lobe (where there are little if any written language functions) creative spelling comes with the territory. It’s easy for me to exhibit very creative spelling. Therefore, I checked several dictionaries and every one of them listed genealogy as the preferent spelling. (I’m not sure I ever used that specific spelling!) Anyway, it definitely got me thinking about the topic.

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Are Race and Ethnicity Synonyms?

Although they are often used as synonyms, they are not identical in meaning. The short answer is that race typically refers to a person’s physical appearance. Ethnicity generally referrers to a person’s cultural markers, not their physical appearance. Admittedly my brain struggles to understand some of the current problems surrounding race or ethnicity—ethnic differences as I am told is now the correct term. I grew up believing that most anthropologists recognize only 3 or 4 main races on this planet—although a 1998 study published in the Scientific American estimated there were 5,000 ethnic groups—although we’re all members of the same species, Homo sapiens. I also grew up believing that abusive, violent, and destructive behaviors are unacceptable, period; and that those who engage in them need to understand that the way they are perceived by others results from the observation of their behaviors. I know that my life has been completely enriched through collaboration, interaction, and friendship with brains that are housed in bodies that have different racial or ethnic differences from mine. Our brains and hearts are all the same color. Cellular memory differs, too, but then epigenetics differs for every person on the planet because every brain is different. Differences are what makes the world go around! 

What does APD look like?

Antisocial Personality Disorder or APD is defined by the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, fiftth edition, as "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood." These individuals may be witty, charming, and fun to be around; they may also disregard social norms and laws, repeatedly lie, place others at risk for their own benefit, and demonstrate a profound lack of remorse. In severe forms it may be referred to as sociopathic personality disorder or sociopathy. Technically the individual must be at least age eighteen for a diagnosis of APD to be made. Genetics and other biological factors, brain defects and injuries during developmental years, and growing up in a traumatic or abusive environment may be linked with APD. According to WebMD, individuals who break the law are at higher risk for having APD. For example, as many as 47% of male inmates and 21% of female inmates have the disorder. Fire-setting and cruelty to animals during childhood may be seen in the development of APD. Additional co-occurring disorders and complications may include imprisonment, drug abuse, violence, and attempted suicide or successful suicide. It is estimated to affect 0.6% of the population with APD more commonly diagnosed in males.

What does BPD look like?

According to the National Institute on Mental Health (NIMH), Borderline Personality Disorder or BPD likely arises from a combination of inheritable and environmental factors. BPD is a serious mental illness marked by unstable moods, behavior, and relationships problems. In 1980 it was included in the Diagnostic and Statistical Manual for Mental Disorders, Third Edition(DSM-III) for the first time as a diagnosable mental illness. Most psychiatrists and other mental health professionals use the DSM to diagnose mental illnesses. Reportedly it was called ‘borderline’ initially because those with severe BPD may have brief psychotic episodes believed to be versions of other mental illnesses and challenges. Common symptoms revolve around problems with regulating emotions and thoughts, impulsive and reckless behavior, and unstable relationships with other people. Individuals with BPD tend to have high rates of other co-occurring disorders, such as depression, anxiety disorders, substance abuse, and eating disorders, along with self-harm, suicidal behaviors, and sometimes successful suicides. BPD is more common than both bipolar disorder and schizophrenia, affecting two percent of adults, mostly young women.

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BPD or APD

Recently several young people approached me and asked if I could help them understand the difference between BPD and APD—because they had heard that these two mental disorders varied in incidence based on gender. With all the acronyms floating around these days I thought it prudent to ask what those two acronyms referred to in their vocabularies. After all, they could stand for bad puppy dog or AWOL puppy dog! They laughed and said, "We wondered if you would make an assumption or ask a question." [They had heard me talk about JOT behaviors, the 'J' representing 'jumping to conclusions.'] It turned out that a classmate had been diagnosed with Borderline Personality Disorder or BPD and they wanted to know how that differed from Antisocial Personality Disorder or APD. Interestingly enough, I had just spent some time with a cousin of mine who happens to have spent the last fifty years as a practicing psychiatrist; and who went into the field after a student at the same University committed suicide. In the conversation my cousin mentioned that in his experience BPD is diagnosed much more commonly in females and that likely APD is the male equivalent, it being diagnosed much more commonly in males.