The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders

  title={The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders},
  author={Christine M. Heim and Ulrike Ehlert and Dirk H. Hellhammer},

A new view on hypocortisolism

The Emerging Role of Metabotropic Glutamate Receptors in the Pathophysiology of Chronic Stress-Related Disorders

Animal models typically used to analyze acute and particularly chronic stress conditions, including models of psychosocial stress, are described, and accumulating evidence indicates relevance and potential therapeutic usefulness of mGlu2/3 ligands and mGLU5 receptor antagonists in chronic stress-related disorders, and a role for further mechanisms is beginning to emerge.

Minireview: Stress-related psychiatric disorders with low cortisol levels: a metabolic hypothesis.

Several stress-associated neuropsychiatric disorders, notably posttraumatic stress disorder and chronic pain and fatigue syndromes, paradoxically exhibit somewhat low plasma levels of the stress hormone cortisol, implying a vulnerable early-life phenotype may be discernable and indicates potential therapy by modest glucocorticoid replacement.

Biochemical Mechanisms and Methodologies Applied to the Study of Posttraumatic Stress Disorder (PTSD)

  • D. PersikeS. Al-Kass
  • Biology, Psychology
    Proceedings of the 4th Scientific Conference of Hawler Medical University
  • 2018
The purpose of the present study was to present a brief review about the main biochemical mechanisms involved in PTSD and the methodologies applied to assess the disease based on recent literature.

Hyper- and hypocortisolism in bipolar disorder - A beneficial influence of lithium on the HPA-axis?

The hypothalamo–pituitary–adrenal axis in chronic fatigue syndrome and fibromyalgia syndrome

There is no structural abnormality in the endocrine organs which comprise the HPA axis, thus it seems that hypocortisolemia found in the patients with stress-related disorder is functional.

Baseline and acute changes in the HPA system in patients with anxiety disorders: the current state of research

The majority of current data do not point to an alteration of the HPA system in anxiety disorders, but pharmacotherapeutical interventions affecting stress hormones might be promising, not only in augmentation of psychotherapy in a specific phobia, but also for secondary prevention in post-traumatic stress disorder.

Cannabinoids as therapeutics for PTSD.




Sensitization of the Hypothalamic‐Pituitary‐Adrenal Axis in Posttraumatic Stress Disorder a

  • R. Yehuda
  • Psychology, Biology
    Annals of the New York Academy of Sciences
  • 1997
This chapter specifically describes findings of hypothalamic-pituitary-adrenal (HPA) axis alterations in PTSD and contrasts these findings with the well-documented observations of HPA axis dysfunction after stress and in psychiatric disorders such as major depression.

The Role of Early Adverse Life Events in the Etiology of Depression and Posttraumatic Stress Disorder

Increasing evidence indicates that the Occurrence and persistence of PTSD in response to trauma depends on many factors including other stressful life events as well as minor psychosocial stressors and daily stressors before or after the onset of the traumatic event.

Evidence for impaired activation of the hypothalamic-pituitary-adrenal axis in patients with chronic fatigue syndrome.

Although it cannot definitively account for the etiology of the mild glucocorticoid deficiency seen in chronic fatigue syndrome patients, the enhanced adrenocortical sensitivity to exogenous ACTH and blunted ACTH responses to oCRH are incompatible with a primary adrenal insufficiency.

Abuse-Related Posttraumatic Stress Disorder and Alterations of the Hypothalamic-Pituitary-Adrenal Axis in Women With Chronic Pelvic Pain

Women with CPP demonstrate HPA axis alterations, that partly parallel and partly contrast neuroendocrine correlates of PTSD, but show marked similarity to findings in patients with other stress-related bodily disorders.

Altered reactivity of the hypothalamic-pituitary-adrenal axis in the primary fibromyalgia syndrome.

It is suggested that fibromyalgia is related to a neuroendocrine disorder characterized by hyperreactive pituitary ACTH release and a relative adrenal hyporesponsiveness, which might serve clinically as an explanation for the reduced aerobic capacity and impaired muscle performance these patients display.

The role of stress and trauma in rheumatoid arthritis and systemic lupus erythematosus.

  • D. Wallace
  • Medicine
    Seminars in arthritis and rheumatism
  • 1987

Enhanced suppression of cortisol following dexamethasone administration in posttraumatic stress disorder.

The data support earlier studies showing that HPA abnormalities in PTSD are different from those seen in depression and suggest that the low-dose dexamethasone suppression test may be a potentially useful tool for differentiating the two syndromes and further exploring differences in their pathophysiology.

Function of the hypothalamic-pituitary-adrenal axis in patients with fibromyalgia and low back pain.

The present data validate and substantiate the preliminary evidence for a dysregulation of the HPA axis in patients with FM, marked by mild hypocortisolemia, hyperreactivity of pituitary ACTH release to CRH, and glucocorticoid feedback resistance.