coricosteroids

Cortisol and Alcohol

While doing some research this morning for my upcoming speech on stress, I found an article on About.com that discusses a study correlating cortisol (the ‘stress’ hormone) and alcohol. According to the study by Bryon Adinof, cortisol levels were shown to have increased during several months of heavy drinking, and increased even further after the subjects stopped drinking completely.

“In this study, we show that even persons drinking for several months continue to show elevated levels of cortisol. In addition, levels of cortisol increase even further when the drinking stops. This increase occurs even before alcohol is gone from the body. The daily, heavy drinker may therefore have levels of cortisol two to three times the normal amount throughout the day and night.”

What does cortisol do, anyway?
In my recent post about stress, I outlined some of the effects. At first, cortisol is actually beneficial, it suppresses the immune system, decreasing inflammation response (think allergies and such), increasing cognitive function via aiding in fat, protein and carbohydrate metabolism, and it activates other anti-stress related systems within the body. But, when cortisol is chronically present in higher levels than normal, it has just the opposite effect: increasing inflammation response, decreasing memory capacity, decreasing digestion, increasing blood pressure, and even increasing the chances of cancer and heart disease.

Cortisol can eventually effect sleep, cause mood disruption, cognitive deficits, and diabetes. All of the above effects have also been related to alcohol itself, and it may be that there is an interdependent relationship between this stress hormone and alcohol, working in concert to cause these effects.

“Alcohol can increase cortisol through a variety of mechanisms,” said Adinoff. “Alcohol directly affects many brain chemicals that signal the adrenal glands to produce and secrete cortisol. High levels of intoxication may be interpreted as general 'stress,’ which could stimulate cortisol release. Finally, after drinking a lot of alcohol for a long time, the sudden stopping of drinking can produce a stressful 'withdrawal’ state, which can also increase cortisol production.”

So, Is it really worth it?

Coccidioidomycosis

Also known at: Valley Fever

Only found in Southwest United States, Mexico, and parts of South America.

This is a fungi spore (Coccidioides) that a person inhales, cause some to become sick. It is possible for the spore to enter the body through a open wound as well. This is not something that causes sickness all the time. Certain groups of people are at higher risk though. 

High Risk Groups: Commonly found in adults >60 years of age, people with weakened immune systems (HIV/AIDS, organ transplant pts, or meds like coricosteroids, or TNF-inhibitors), pregnancy, people with diabetes, African American or Filipinos.

S&S

60% of people exposed to the fungus will never develop symptoms. Symptoms appear in 1 to 3 weeks. The symptoms may last a few months, if the infection becomes severe enough. If symptoms present themselves they may present themselves as flu-like:

  • Fatigue
  • cough
  • SOB
  • Headache
  • Night Sweats
  • Achy muscles and joints
  • Rash on upper body and legs

Test

Patients should be asked if they have traveled outside of the area in the past few weeks, which is a common practice. If the pt states they have been in any of the above locations and symptoms appear the same as above, you might one to get an X-ray or CT scan of their lungs, followed by a tissue biopsy. The culture will be examined to see if the fungus is growing. 

Sputum smear or culture may be collected.

Blood test

Treatments

Most times the body will work it’s magic and take care of the infection naturally. Staying at home and bed rest might help a pt heal well. Antifungal medications might assist in the removal as well in pt’s with severe cases (treatment lasting 3 to 6 months). 

Drugs:

  • fluconazole (diflucan)
    • Used for most serious forms of Valley Fever
    • Dosage of 200 mg on first day, followed by 100mg once daily
    • Side effects: nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, diarrhea, juandice, fever, chills, body aches, flu symptoms; easy bruising or bleeding, unusual weakness or seizure.
    • ^BOLD ARE THE MOST COMMON SIDE EFFECTS^
  • itraconazole (Sporanox, Onmel)
    • Oral solution, which is swished vigerously for several seconds and then swallowed.
    • Dosage is 10mL at a time, 20mL daily for 1 to 2 weeks.

Drug sources (X)

Information sources: Mayo Clinic, CDC website

Article by: MedDaily