Identify the important anatomical structures/organs involved in this situation, hormones secreted, and physiological reactions/adjustments taking place due to the Endocrine System functions.

Question

Explain in detail how the endocrine system is reacting during these given situations to bring the body back to homeostasis or may be causing adverse physiological effects.

Case Study

Anthony lives in Western Washington and is currently staying at home due to Covid-19 and his job will not allow him to work on site, therefore he has an at home office. Over the last couple weeks Antonio has experienced increased stress, fatigue, cravings for foods heavy in carbohydrates and fat, and a feeling of despair. Normally Anthony loves to exercise, socialize, and have fun, but lately he is much more likely to just lay down and sleep. His body feels heavy and lethargic and he has little motivation to go outside. Anthony doesn't realize it, but due to his current situation his immune system is being inhibited due to physiological responses in the body. Anthony has lived in Western WA for the past 14 months and prior to that he lived in California. 

Answer 1

In this case study, based on my knowledge, several anatomical structures/organs, hormones, and physiological reactions/adjustments related to the endocrine system are involved:

Anatomical Structures/Organs Involved:

1. Hypothalamus: The hypothalamus plays a crucial role in regulating stress responses and appetite.
2. Pituitary Gland: The pituitary gland, often called the "master gland," controls the release of hormones from other endocrine glands.
3. Adrenal Glands: The adrenal glands produce stress-related hormones, including cortisol and adrenaline.
4. Thyroid Gland: The thyroid gland regulates metabolism and energy production.
5. Pancreas: The pancreas secretes insulin, which regulates blood sugar levels.

Hormones Secreted:

1. Cortisol: Elevated stress levels trigger the release of cortisol from the adrenal glands. Cortisol helps the body respond to stress by increasing glucose levels and suppressing the immune system.
2. Adrenaline: Adrenaline, also known as epinephrine, is produced by the adrenal glands in response to stress. It increases heart rate, boosts energy, and prepares the body for a "fight or flight" response.
3. Thyroid Hormones (T3 and T4): These hormones are released by the thyroid gland and regulate metabolism.

Physiological Reactions/Adjustments:

1. Stress Response: Increased stress triggers the "fight or flight" response, leading to the release of cortisol and adrenaline. These hormones increase heart rate, redirect blood flow to muscles, and prepare the body to respond to perceived threats.
2. Appetite Changes: Stress can lead to changes in appetite, including cravings for high-carbohydrate and high-fat foods. This is often a response to the body's perceived need for quick energy.
3. Fatigue and Lethargy: Chronic stress can lead to fatigue and lethargy as the body remains in a state of heightened alertness for extended periods, leading to physical and mental exhaustion.
4. Depression and Mood Changes: Prolonged stress can lead to feelings of despair and depression, affecting mood and motivation.
5. Immune System Suppression: Chronic stress can suppress the immune system by reducing the production of immune cells and impairing their function. This can make the individual more susceptible to infections.

Bringing the Body Back to Homeostasis or Causing Adverse Effects: In this situation, the body's endocrine system is reacting to prolonged stress. While the stress response is a natural and adaptive mechanism, chronic stress can have adverse effects on health. The elevated levels of cortisol and adrenaline can lead to conditions like anxiety, insomnia, and high blood pressure. The immune system suppression can make Anthony more vulnerable to infections, including respiratory illnesses like Covid-19. To bring the body back to homeostasis, it's essential for Anthony to find ways to manage and reduce his stress levels, engage in regular exercise, maintain a balanced diet, and seek emotional support. These actions can help restore hormonal balance and overall well-being.

Please share your thoughts with me

Answer 2

Hi Raven, happy to help!

A few things can be going on here.

First, Anthony has COVID-19, binding to the ACE2 (Angiotensin-converting Enzyme 2) receptor, which has widespread expression in many tissues, allowing viral entry into host cells and inflammation causing immune consequences of the disease. This includes the effects the virus has on endocrine cells, possibly causing adrenal insufficiency, damage to the pituitary system, and deficiency in cortisol production. Cortisol regulates stress response; the body's use of fats, proteins and carbohydrates and metabolism; suppression of inflammation; blood pressure; blood sugar; and sleep-wake cycle. With deficiencies in cortisol, all of these systems can be disrupted.

In addition to cortisol's effects on blood glucose, insulin production is also disrupted by COVID, potentially leading to new cases of type II diabetes mellitus by causing high blood glucose levels in some patients. This could directly affect Anthony's appetite.

People with vitamin D deficiency may additionally be more susceptible to COVID, which could be a correlation or causation question in this case. It's possible that Anthony's move farther north with fewer hours of sunlight affected his intake of vitamin D from the sun. This move could secondarily be doubling his symptoms as a cause of seasonal affective disorder, as symptoms of stress, fatigue, appetite disturbance, and feelings of despair are similarly symptoms of this depressive disorder.

Steroids are indicated for the treatment of patients with adrenal insufficiency, particularly as cortisol is a steroid hormone. Seasonal affective disorder can be treated with CBT, psychoeducation, and/or first-line medication treatment with SSRIs. I would also prescribe vitamin D if he has a deficiency due to lack of sunlight. COVID can have other psychological effects in long covid, including chronic fatigue syndrome, too.

SUMMARY:

Important anatomical structures:

-Adrenal glands

-Pituitary system

-Hypothalomo-pituitary-adrenal axis

-ACE2 receptors

Hormones secreted:

-Cortisol deficiency

-Insulin insensitivity

-Vitamin D deficiency

-You might also want to mention low levels of ACTH released due to adrenal insufficiency

Physical reactions/adjustments: (treatments)

-Steroids (adrenal insufficiency, cortisol deficiency)

-Insulin (T2DM)

-Fluoxetine (seasonal affective disorder)

-Vitamin D (vitamin D deficiency)

Some argue that COVID elevates levels of cortisol, particularly in patients with severe infections, but here are two sources supporting diminished levels of cortisol from the endocrine society and Nature (both very reputable sources):

Endocrine Journal:

https://www.endocrine.org/news-and-advocacy/news-room/2020/coronavirus-damages-the-endocrine-system#:~:text=%E2%80%9CThe%20virus%20that%20causes%20COVID,gain%20entry%20to%20the%20brain.



Nature:

https://www.nature.com/articles/s41574-022-00700-8

There is evidence supporting a correlation between elevated cortisol levels and anxiety in COVID patients and higher mortality rates.

I hope that helps!

-Carly