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CNM Nutrition 2 S1 > Stress & Fatigue > Flashcards

Stress & Fatigue Flashcards

1
Q

Define stress.

A

The non-specific response of the body to any demand.

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2
Q

Which ‘side’ of the nervous system is activated during stress?

A

Sympathetic - the stress response is characterised by the rapid activation of the sympathetic nervous system.

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3
Q

Which 2 neurotransmitters promote enhanced vigilance, alertness, arousal and attention when the stress response is activated.

A

Adrenaline and nor-adrenaline.

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4
Q

What does aldosterone do in relation to the stress response?

A

Increases water retention for increased BP.

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5
Q

State 3 actions of cortisol in relation the the stress response.

A
  1. Increases glucose production and mobilisation.
  2. Increases protein catabolism from muscle.
  3. Increases vessel sensitivity.
  4. Decreases inflammatory response and Th1 mediated immunity.
  5. Reinforces the autonomic NS response.
  6. Decreases inflammatory response and Th1 mediated immunity.
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6
Q

Elevated levels of circulating cortisol have a direct inhibitory effect on what? State 3.

A
  1. Reproductive axis.
  2. Growth hormone release.
  3. Thyroid axis.
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7
Q

State 4 symptoms of adrenal/HPA axis dysfunction.

A
  1. Afternoon low between 3-4.
  2. Cognitive dysfunction.
  3. Craving salt/sugar.
  4. Decreased libido.
  5. Dark circles under eyes.
  6. Difficulty getting up in a morning/fatigue.
  7. Decreased memory recall.
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8
Q

How does stress suppress the Thyroid function?

A 
Activation of HPA axis resulting in increased CRH and cortisol = decreased production of TSH. 
Glucocorticoids inhibit activity of 5-deiodinase -
converts thyroxine (T4) to biologically active triiodothyronine (T3).
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9
Q

How does stress suppress reproductive function?

A

Reproductive axis is inhibited at all levels by various components of the HPA axis.
CRH suppresses secretion of gonadotropin-releasing hormone (GnRH).

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10
Q

Describe the effect of stress on the immune system.

A

Stress hormones inhibit the function of immuen cells such as neutrophils, macrophages, T and B lymphocytes and NK cells.

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11
Q

What is the link between obesity and stress?

A

Obesity increases stress on the body, it is a chronic stressful state and may cause HPA axis dysfunction. Insulin resistance drives sympathetically mediated thermogenesis.

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12
Q

What is link the link between stress and inflammation?

A

Inflammation stimulates the HPA axis and chronic stress results in an increase in inflammatory cytokines. .

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13
Q

What is the link between oestrogen and stress?

A

High levels of oestradiol increases basal concentrations of cortisol and ACTH.

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14
Q

What does a salivary adrenal stress index test measure?

A

Saliva cortisol and DHEA levels and their ratios throughout the day.

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15
Q

Explain the link between DHEA and ageing.

A

Research suggests the DHEA slows the ageing process. Elderly males with the highest levels of DHEA have the highest level of functioning.

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16
Q

Low levels of DHEA are linked to what? State 3.

A
  1. Osteoporosis.
  2. Depression.
  3. Impaired learning and memory.
  4. Alzheimer’s disease.
  5. Low libido and sexual satisfaction.
17
Q

What effect does magnesium have on the HPA axis?

A

It reduces the activity. Low magnesium status is associated with hyperarousal of the HPA axis. 200-500mg daily.

18
Q

What 3 supplements would you consider for someone with anxiety and why?

A
  1. Magnesium - animal research seems to fairly
    consistently find an association between magnesium deficiency and anxiety.
  2. Omega 3 / fish oil - one study shows a reduction in anxiety symptoms by 20% within 12 weeks in medical students.
  3. B5 / Pantothenic acid - effective in treating fatigue and anxiety.
  4. Taurine - mproves mood for patients who are very anxious.
  5. Inositol - found to be more effective than fluvoxamine.
19
Q

What 2 vitamins might you consider supplementing in someone who has been under long term stress?

A
  1. Vitamin C / ascorbate - during stress the urinary excretion of vitamin C is increased. Low levels may create hypofunction of the adrenal cortex (1000mg bid).
  2. Vitamin E - exposure to stress increases free radical formation, especially in adrenal cortex, Vitamin E has been shown to protect the adrenal cortex from free
    radical damage and reduce cortisol production (400IU bid).
20
Q

How does Rhodiola Rosea help with stress?

A

It works on hypothalamus to increase resistance to toxins and stress. It improves oxygen-carrying capacity of the blood and helps increase stamina and endurance.

21
Q

How does ginseng help with stress?

A

Improves mental fatigue and glutathione levels. Ginseng is rich in a variety of saponins which increases dopamine, serotonin and nor-adrenalin, improving motivation, energy, mood and stress tolerance.

22
Q

How does ashwaganda help with stress?

A

Reduces serum cortisol, this suggests it has use for reducing stress in acute and early resistance phase fatigue.

23
Q

Explain CFS.

A

Chronic Fatigue Syndrome also know as ME. A disorder of unknown cause, likely that multiple factors
involved. Characterised by a state of chronic fatigue that persists for more than 6 months, accompanied by cognitive difficulties.

24
Q

State 5 potential causes/factors involved in the development of CFS.

A
  1. Prescription drugs - OCP, corticosteroids, sedatives etc.
  2. Depression.
  3. Food allergies.
  4. Sleep disturbances.
  5. Chronic inflammation.
  6. Chronic underlying infection - herpes, enterovirus, Epstein-Barr etc.
  7. Cancer.
25
Q

Much of the symptoms of CFS are similar to that of Fibromyalgia, what is the key difference?

A

Fibromyalgia is associated with pain - not just stimulated by physical exertion but can be present all over the body. Neuropathic pain can include weakness, burning, aching, pressure, pins and needles, even stabbing sensations.

26
Q

What is the Limbic Kindling theory of CFS/ME?

A

Person exposed to chronic, low intensity stress with enough consistency eventually leaves the brain in a state of hyper-arousal or hypersensitivity.

27
Q

Explain the link between CFS and the gut?

A

Patients with CFS had reduced biodiversity of gut flora in stools.

28
Q

State 5 basic nutrients needed for mitochondrial energy production.

A
  1. Acetyl-L-Carnitine.
  2. Alpha Lipoic Acid (red meat, organ meat, broccoli, beets).
  3. Magnesium.
  4. CoQ10.
  5. B vitamins.
  6. EFA’s (lipid membrane of mitochondria, inadequate intake = impaired activity of mitochondrial membrane).
  7. Antioxidants (reduce damage by ROS).
29
Q

Why should you consider iron deficiency and anaemia when working with a client with CFS?

A

Iron deficiency and anaemia are extremely common causes of fatigue. Iron is essential for energy production.

30
Q

State 3 things you should consider if a client is complaining of fatigue.

A
  1. Thyroid function.
  2. Adrenal function.
  3. Inflammation.
  4. Iron deficiency/anaemia.
  5. Sex hormone balance.
31
Q

What does SHIN stand for in relation to the treatment CFS?

A

Sleep.
Hormonal support (thyroid, adrenal DHEA, sex hormones).
Infections/Immune dysfunction.
Nutritional support.

CNM Nutrition 2 S1 (10 decks)

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