Endocrine disorders: the impact of stress and epigenetics

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Endocrine disorders span a range of conditions, from diabetes and thyroid disease to stress-related conditions. Stress has been linked to a number of health problems, with the most recent evidence suggesting its involvement in male infertility, allergies and headache.

During the normal stress response, glucocorticoid hormones secreted by the adrenal glands cause several physiological effects, but chronic stress can result in continual release of these hormones, leading to serious mental and physical health problems.

The impact of stress on chronic disease

In a video Q & A published in BMC Medicine, George Chrousos talks about the impact of stress on chronic non-communicable diseases including obesity, metabolic syndrome, type 2 diabetes, hypertension and anxiety.   George Chrousos

He discusses how psychological and economic factors affect stress and describes how stress can be prevented by eating a healthy diet, being physically active and having a stable sleep-wake cycle.

“So far it seems that one of the psychiatric and psychological methods that are used quite successfully to cope with chronic social stress is cognitive behavioural therapy”, he says.

The prevention and treatment of stress is currently being discussed at the 16th International Congress of Endocrinology and the Endocrine Society 96th Annual Meeting, where Chrousos is receiving The Fred Conrad Koch Lifetime Achievement Award.

The award recognizes his exceptional contributions in endocrinology and stress research, including his groundbreaking work on primary generalized glucocorticoid resistance (more recently termed ‘Chrousos syndrome’), which is a rare genetic condition characterized by insensitivity to glucocorticoids.

In addition to hormonal alterations, epigenetic changes are increasingly being recognized as an important contributor to stress disorders, and Chrousos emphasizes that stress during  the prenatal and early life leaves an epigenetic imprint on the affected child until adulthood and old age.

“Firstly the message needs to be promoted,” he says in his interview. “Secondly, there is a requirement for social and political changes that will guarantee that our children are not exposed to stress but have enriching experiences.”

Epigenetics and type 2 diabetes

istockEmerging evidence also links epigenetics to the mechanisms underlying the development of type 2 diabetes. New research published in BMC Medicine by Charlotte Ling and colleagues from the Lund University Diabetes Center investigates the exposure of human pancreatic beta (β) cells to palmitic acid, a fatty acid present in palm tree oils and in some dairy products. The results show the levels of genes correlate to methylation changes in DNA and include candidate genes for type 2 diabetes and obesity. Furthermore, bioinformatic analyses reveal the insulin signalling pathway is enriched in the differentially expressed and methylated genes. Even though this is the first study to suggest mechanisms that may contribute to impaired insulin secretion and type 2 diabetes it will take time before we see the direct clinical implications of the findings.

This is discussed by Delphine Fradin and Pierre Bougnères from Bicêtre Hospital, Paris Sud University in a commentary, which emphasizes that the study helps to understand the epigenetic response of pancreatic beta (β) cells when the metabolic environment is disturbed to pave the way for further research.

Overall, epigenetics will continue to provide breakthroughs in understanding various endocrine disorders to help drive future clinical applications in the treatment and management of stress-related disorders and type 2 diabetes. Future policies to promote healthy lifestyles and wellbeing should aid prevention strategies and alleviate the burden of these debilitating conditions.

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Happiness 1st

Unfortunately, the three stress management recommendations “stress can be prevented by eating a healthy diet, being physically active and having a stable sleep-wake cycle” are dose dependent and research has shown that stressed individuals are less likely to engage in exercise (APA, Stress in America 2012 or 2013), and the research demonstrating that stressed individuals eat comfort foods and/or skip meals and eat more high fat foods is pervasive in the literature. Stress is a major impediment to a good nights’ sleep. The APA’s 2013 research showed an average of over 5 nights per month where stress interfered with adequate sleep.

A better solution is a Primary Prevention approach to stress management and reduction on a population wide basis that is not dose dependent. It is clear–exceedingly so–that society is paying a very high price for the stress burden its members carry. In my book, When Only You Can Prevent Suicide: Transformative Empowering Processes Provide A Better Way to Prevent Suicide I provide processes that reduce stress long before a crisis event and empower individuals to maintain a lower level of stress. With a coupon available on my website the book is currently free on Smashwords.

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