STRESS-THE SLOW POISON

“Anyone can become angry - that is easy, but to be angry with the right person at the right time, and for the right purpose and in the right way - that is not within everyone's power and that is not easy.” -- Aristotle

Stress is a term that is commonly used today but has become increasingly difficult to define. It shares, to some extent, common meanings in both the biological and psychological sciences. Stress typically describes a negative concept that can have an impact on one’s mental and physical well-being, but it is unclear what exactly defines stress and whether or not stress is a cause, an effect, or the process connecting the two. With organisms as complex as humans, stress can take on entirely concrete or abstract meanings with highly subjective qualities, satisfying definitions of both cause and effect in ways that can be both tangible and intangible.

Background

Biology primarily attempts to explain major concepts of stress in a stimulus-response manner, much like how a psychobiological sensory system operates. The central nervous system (brain and spinal cord) plays a crucial role in the body’s stress-related mechanisms. Whether these mechanisms ought to be interpreted as the body’s response to a stressor or embody the act of stress itself is part of the ambiguity in defining what exactly stress is. Nevertheless, the central nervous system works closely with the body’s endocrine system to regulate these mechanisms. One branch of the central nervous system, the sympathetic nervous system, becomes primarily active during a stress response, regulating many of the body’s physiological functions in ways that ought to make an organism more adaptive to its environment. Below is a brief biological background of the neuroanatomy and neurochemistry and how they relate to stress.

WHAT HAPPENS??

The Pathophysiology of Chronic Physical and Mental Stress

Physical or mental stress causes increased activity in the limbic system, especially in the region of the amygdale and hippocampus, in turn transmitting signals to the hypothalamus.  These signals cause greatly enhanced secretion of CRF (corticotropin releasing factor) into the hypophosial portal system which in turn stimulates the release of ACTH (adrenocorticotropic hormone).

ACTH activates, adrenocortical cells to produce steroids, especially cortisol. 

The effects of cortisol on metabolism during physical or mental stress can be life-saving, from mobilizing glucose, protein and fat in time of need following trauma, infection or debilitating disease.  This may include the rapid provision of energy sources, replacement of depleted proteins in damaged tissues and the re-synthesis of essential intracellular substances such as creatine phosphate, necessary for the maintenance of cellular life and reproduction of new cells.

During inflammation (the consequence of almost any damage by trauma or infection to tissue), the chief ability of cortisol is to stabilize damaged intracellular lysosomes, preventing their excess release of proteolytic enzymes such as prostaglandins and thus, in turn, helping to minimize the resultant inflammation.

However, long term exposure to cortisol greatly diminishes the body’s immune response, resistance to stress and inflammation:-

Migration of white blood cells into the inflamed area and phagocytosis of damaged cells is reduced

The immune system is suppressed, particularly that of T lymphocytes and antibodies in the inflamed area

Fever is lowered by reducing the release of interleukin-1 by white cells and diminishing their effect on the hypothalamic temperature control system, which in turn reduces the ability of the body to neutralize and destroy bacteria and viruses, otherwise unable to survive high body temperatures

Chronic gluconeogenesis and mobilization of lipids impairs insulin function and carbohydrate metabolism in turn, which may lead to diseases such as insulin resistance diabetes, hypertension, atheromatous changes in the intima of arteries, congestive heart failure and auto-immune disease

An appreciation of the patho-physiological mechanisms involved in the ‘allostatic loaded’ state (the undue physiological wear and tear on the body that results from the ongoing adaptive efforts to maintain stability (homeostasis) in response to stressors) will help one understand both the rationale behind many of the pharmaceutical and psycho-social interventions as well as that of osteopathic manipulative treatment.

The sick and suffering patient is someone in whom the body’s homeostatic, adaptive mechanisms have, for some reason, been unable to dampen the allostatic drives adequately, with consequent injury to body and mind.  Allopathic or osteopathic intervention is an attempt to de-facilitate these drives.

What takes the toll??

THE BODY:

Following are some of the physical effects of stress on our body

Palpitation : increased heart beat

Increased, shallow breathing

Tremors

Cold, clammy extremities

Moist eyebrows

Tightening of muscles, showing tightening of abdominal muscles, tense arms and legs, clenched jaw causing gritting of teeth.

Sweating

Constipation

Diarrhea

Dyspepsia

Increased frequency of urine

Irritability

Hyperacidity

Weakness

Hair loss

Loss of appetite

THE MIND:

 common mental effects of stress are:

Inability to concentrate

Difficulty with coming to decisions

Loss of self-confidence

Irritability or frequent anger

Insatiable cravings

Irrational fear

Panic attacks

Compelling emotions and mood swings

Uncontrolled mental stress can also induce people to become alcoholic addicts, show signs of bulimia or anorexia, lead to drug and nicotine dependency etc.

                   BEAT THE STRESS

The way of the body (exercise):

There are many proven health benefits to exercise, one of which is the bodies release of endorphins. Setting aside time for fitness is easy, when you get creative.

 Make it mandatory to ride a stationary bike or do crunches and leg lifts every time you are watching television. While working on the computer use an exercise ball to engage your core muscles which in turn, improves posture.

Chances are, nobody has to tell you that exercise is a great stress reliever. But here's the thing: You can reduce stress even more—and make that reduction last longer—if you tailor your workout specifically to your personality type.

You are what you eat:

People overlook the mind-body connections of stress. If your mind is stressed, you will probably feel physical symptoms; if your body is stressed, your mind will likely suffer. 

 Calcium promotes strong bone-growth, and it is also important for muscle relaxation. Because the mind and body are connected, relaxed muscles may help relax your mind. If you're often tense and tight due to high stress levels, consuming calcium may help relax your muscles.

That mid-day cup of coffee is an important part of your day. That dose of caffeine helps you feel energized, gain some mental clarity and improves your concentration. But, as soon as caffeine wears off, you may find yourself foggy and groggy.

 Instead of coffee, consider sipping a cup of chamomile tea. For centuries, chamomile tea has been used to help support a state of relaxation. Most people consume it in the evening, but don't be afraid to try it whenever stress arises.

To relieve stress, some people grab a fishing pole and head down to the river. If you're not into putting on rubber waders and casting into freezing water, you can instead choose to eat fish to help manage stress. Fatty fish such as salmon and mackerel help bring down cortisol levels, which elevate when stress levels are high.

When your body is under stress, magnesium levels tend to be lower. In one study published in the Cardiovascular Drugs And Therapy journal, researchers noted that competitive tri-athletes who supplemented with magnesium during a 4-week trial experienced lower overall levels of cortisol in their system than those who didn't.  Magnesium-rich foods to include in your diet plan are beans, broccoli, halibut, nuts, scallops, spinach and tofu.

Foods from the earth will keep your body and mind running in peak conditions. Try eating more natural fruits and vegetables for a month and you will notice the difference.

Laugh till your tummy hurts:

Laughing releases in endorphins, your bodies chemical that reduces pain and calms stress. Rent or go see a funny movie, or a comedy act. Laughter is contagious, so invite a couple friends to join you.

Play mind with mind:

"Don't let your mind play tricks on you," so the saying goes. The Buddhist monks teach that we must realize that all of our thoughts and stresses, stem from our own mind. People and situations aren't stressful, it's how we choose to feel about people and situations.

 Your feelings come from within you and your mind. It's time for you to choose to relax and let your stressful thoughts go, the moment you feel stress coming on, take a deep breath, slow your breathing and let your stresses go.

Easier said then done, I know. Try using 5 to 10 minutes of complete silence in the morning and at night. Within a week your meditation time will leave you feeling more in control of your thoughts and feelings. Life will become easier to live. Remember, it's all in your mind.

Your ears can help you:

Music soothes the soul, and in stressful situations (work deadlines, exams, breakups, moving, weddings, babies), playing classical music can act as a cause to slow down your breathing and heart rate.

Many scientific studies have shown that the brain exhibits different behavior when listening to classical music and one of those behaviors is that it causes the release of chemicals that make you feel better. These are the same ones that get released when you exercise.

Conclusion:

Bodybuilding is the best thing for making your overall life rock-solid. We are all individual of each other and may find unique ways to relieve stress. Take time to listen and learn about yourself as you develop a better sense of which path to relaxation is right for you.

Always remember, you are in control of your own mind and as a result you ultimately choose how to react to situations.

THE FAST AND THE FURIOUS

Considering a title THE FAST AND THE FURIOUS reveals my interest towards movies but this one is not about movies but this one is about the first line of defense mechanism of our body THE NEUTROPHILS.
 They are fast enough in response to defend from initial infections and furious enough to be effective and hence my title.

WHAT IS THE ORIGIN OF THE TERM, NEUTROPHIL?

Neutrophil comes from the Latin word "neuter" meaning "neither," and the Greek word "philein" meaning "to love." Put the two words together and you have "love neither." This is a reference to the fact that neutrophils stain easy with neutral dyes. Dyes are colored stains that are used in laboratories, often to tell cells apart from one another. Neutral dyes are made up of salts that do not have an electric charge. This lack of an electric charge is why these dyes are called neutral.

WHAT ARE THESE CELLS:Neutrophil granulocytes are the most abundant type of white blood cells in mammals and form an essential part of the innate immune system. In general, they are referred to as either neutrophils or polymorphonuclear neutrophils (or PMNs), and are subdivided into segmented neutrophils (or segs) and banded neutrophils (or bands). They form part of the polymorphonuclear cell family (PMNs) together with basophils and eosinophils.The name neutrophil derives from staining characteristics on hematoxylin and eosin (H&E) histological or cytological preparations.

STRUCTURE:A main characteristic of neutrophils is that they have three to five round sections within them called lobes that are connected by thin threads known as chromatin.Another characteristic of neutrophils is that their cytoplasm (a gel-like substance that fills up a cell) is light pink and mostly made of thin, difficult to see, pink or purplish-pink grain-like particles. The light pink cytoplasm provides a strong contrast with the dark colored nucleus.

WHERE ARE NEUTROPHILS MADE?

Neutrophils are made by the bone marrow (a tissue that fills the openings inside of bones). Neutrophils are sometimes made outside of the marrow as well. After the neutrophils are formed, they are released into the circulating blood.

WHAT PERCENT OF WHITE BLOOD CELLS ARE NEUTROPHILS?

Approximately 50% to 70% of white blood cells are neutrophils. Neutrophils are the most common type of white blood cell. The amount of neutrophils on blood work tests is known as the ANC (absolute neutrophil count). On most blood work tests, the ANC will be presented in terms of the amount of neutrophils per mm3 (cubic millimeters) of blood. See the next section for a description of cubic millimeters. The normal range for the neutrophil count is 1500 to 8000. It is important to keep in mind that the ranges mentioned above will be different depending on the machine used to do the blood test. Always use the normal range printed on the lab report to decide what range is normal.

Anti-microbial function

Being highly motile, neutrophils quickly congregate at a focus of infection, attracted by cytokines expressed by activated endothelium, mast cells, and macrophages. Neutrophils express  and release cytokines, which in turn amplify inflammatory reactions by several other cell types.

In addition to recruiting and activating other cells of the immune system, neutrophils play a key role in the front-line defence against invading pathogens. Neutrophils have three strategies for directly attacking micro-organisms: phagocytosis (ingestion), release of soluble anti-microbials (including granule proteins), and generation of neutrophil extracellular traps (NETs)

Phagocytosis

Neutrophils are phagocytes, capable of ingesting microorganisms or particles. For targets to be recognised, they must be coated in opsonins—a process known as antibody opsonization. They can internalize and kill many microbes, each phagocytic event resulting in the formation of a phagosome into which reactive oxygen species and hydrolytic enzymes are secreted. The consumption of oxygen during the generation of reactive oxygen species has been termed the "respiratory burst", although unrelated to respiration or energy production.

The respiratory burst involves the activation of the enzyme NADPH oxidase, which produces large quantities of superoxide, a reactive oxygen species. Superoxide dismutates, spontaneously or through catalysis via enzymes known as superoxide dismutases (Cu/ZnSOD and MnSOD), to hydrogen peroxide, which is then converted to hypochlorous acid HClO, by the green heme enzyme myeloperoxidase. It is thought that the bactericidal properties of HClO are enough to kill bacteria phagocytosed by the neutrophil, but this may instead be a step necessary for the activation of proteases.

DEGRANULATION: Four kinds of granules exist in neutrophils that display differences in content and regulation. Secretory vesicles are the most likely to release their contents by degranulation, followed by gelatinase granules, specific granules, and azurophil granules.

WHAT CAN CAUSE THE LEVEL OF NEUTROPHILS TO BE TOO HIGH?

There are many possible causes for an abnormally high neutrophil count. A neutrophil level that is more than 8000 is considered to be abnormally high. One basic cause of a high neutrophil count is when a high level of stress is placed on the body. The stress can due to many factors such as nervousness, exercise, or seizures (involuntary muscle movements due to overexcitement of nerve cells in the brain). Another cause is a sudden infection from bacteria. Damage or inflammation of tissues can also lead to a high neutrophil count. Examples would be burn injuries and a heart attack.

Sudden kidney failure can cause a high neutrophil count. The kidneys are two organs located on each side of the spine, behind the stomach. The kidneys filter (remove) wastes from the blood. A condition known as ketoacidosis can also cause a high neutrophil count. Ketoacidosis is a condition in which acids and poisonous chemical substances known as ketones are produced by the body. Ketones are produced when the body has a difficult time breaking down fats.

Another cause of a high neutrophil count is eclampsia. Eclampsia is a rare, but serious complication of pregnancy characterized by an attack of convulsions (abnormal, severe, involuntary muscle movements) . 

A high neutrophil count can be caused by cancer spreading in the body. Cancer is a group of diseases in which symptoms are due to an abnormal and excessive growth of cells in one of the body organs or tissues.

Hemolytic anemia can cause a high neutrophil count. Hemolytic anemia is a condition in which the red blood cells are destroyed earlier than they should be. Red blood cells help carry oxygen to the blood. Another cause of a high neutrophil count is polycythemia vera. Polycythemia vera is a condition of unknown cause in which there is a long-term increase in red blood cells and other types of cells. Myeloid metaplasia can cause a high neutrophil count. Myeloid metaplasia is a condition in which bone marrow (a tissue that fills the openings of bones) grows in abnormal places in the body.

Certain medications can also lead to a high neutrophil count. One such medication is corticosteroids. Corticosteroids are a group of drugs that act similarly to a natural chemical in the body known as corticosteroid hormone. Corticosteroid hormones control the body's use of nutrients and the amount of water and salts in the urine (pee). Another such medication that can raise the neutrophil count is lithium carbonate. Lithium carbonate is a type of salt that is used as a drug to reduces mania (an abnormal, overly excited state).

WHAT CAN CAUSE THE LEVEL OF NEUTROPHILS TO BE TOO LOW?

There are many possible causes for an abnormally low neutrophil count. When the number of neutrophils are abnormally low (less than 1500), this condition is known as neutropenia. Neutropenia can be caused by a decreased production of neutrophils. A decreased production of neutrophils can be caused by leukemia. Leukemia is a type of cancer in the blood in which bone marrow (a tissue that fills the openings of bones) is replaced by early forms of white blood cells. See the previous section for a description of cancer.

In leukemia, the level of neutrophil production decreases because they are crowded out of the bone marrow by the early forms of white blood cells. A condition that occurs before leukemia, known as preleukemia, can also cause an abnormal decrease in neutrophils. Another cause of a decreased neutrophil count is myelofibrosis, in which the normal bone marrow is replaced by fibrous tissue (the connective tissue of the body).

Another cause of decreased neutrophil production is damage to the bone marrow. Such damage can be caused by infections, medications, and radiation (a type of energy often used to treat cancer). Bone marrow destruction occurs in aplastic anemia. Aplastic anemia is a condition in which the there is an abnormal decrease in the cells that make up blood (such as white blood cells) because the bone marrow is not working properly to make these cells.

Besides decreased neutrophil production, another cause of a decreased neutrophil count is an increase in the destruction of neutrophils. Such destruction can be caused by a severe bacterial infection that causes the formation of pus or leads to bacteria increasing in the blood. Pus is a yellow or green creamy substance sometimes found at the site of infections.

The body can actually produce proteins known as antineutrophil antibodies that destroy neutrophils. These proteins are produced in autoimmune diseases in which the body mistakenly attacks itself. An example of an autoimmune disorder that can cause an abnormal decrease in neutrophils is systemic lupus erythematosus (abbreviated SLE). SLE is a long-term disease in which the connective tissues throughout the body are inflamed because the body's defense system attacks these tissues as if they were foreign substances.

Another condition that can cause a decrease in neutrophils is hypersplenism. Hypersplenism is a condition in which there is an abnormal enlargement of the spleen and an abnormal decrease in white blood cells. The spleen is an organ near the stomach that helps fight infection and removes and destroys worn-out red blood cells. In a condition known as Felty's syndrome, an abnormal decrease in neutrophils is found. Felty's syndrome is a group of abnormal changes (such as an enlarged spleen, frequent infections, and a decreased white blood cell count) that accompanies rheumatoid arthritis. Rheumatoid arthritis is another example of an immune disorder (see last paragraph) in which the body's defense system attacks its own tissues, causing inflammation of bone joints.

Certain medications can cause an abnormal decrease in the neutrophil account. One such type of medication are phenothiazines drugs, which are used to treat psychosis, allergies, and vomiting. Psychosis is a mental disorder characterize by an impairment in the ability to understand reality. Another type of drug that can cause an abnormally low neutrophil count is phenylbutazone, which is a drug used to reduce inflammation in conditions such as arthritis (inflammation of bone joints).

Another cause of a low neutrophil count is too little vitamin B12 or folic acid (a type of vitamin) in the body. A vitamin is one of a group of substances made up partly of carbon (an element) that are essential in small amounts for normal bodily functioning and chemical processes in the body to take place.

Cardipolumonary bypass can lead to low neutrophil count. Cardiopulmonary bypass is a procedure used during heart surgery in which the flow of blood is moved away from the heart and the lungs with a pump and returned to the aorta. The aorta is the largest artery of the body. An artery is a blood vessel that carries blood away from the heart.

Dialysis can cause a low neutrophil count as well. Dialysis is a technique in which one is hooked up to a machine that performs the functions of the kidneys, removing wastes and extra water from the blood. The kidneys are two organs located on each side of the spine, behind the stomach. The kidneys filter (remove) wastes from the blood.

A rare cause of a decreased neutrophil count is Chediak-Higashi syndrome. This is a disorder found at birth characterized by a massive decrease in white blood cells, movement abnormalities, pale skin, a pale appearance in the back of the eye, an abnormal sensitivity to light, reoccurring infections, and early death.