Q and A: about health and research

The human body's response to stress is one of its most sophisticated survival mechanisms. Whether the threat is physical, emotional, or psychological, the body rapidly activates a coordinated network of hormones and neural signals designed to help us respond effectively. Central to this process are corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), adrenaline, cortisol, and other glucocorticoids. Together, these substances form an integrated stress-response system that prepares the body for action, sustains performance during a challenge, and regulates recovery afterward. The Two Arms of the Stress Response The stress response operates through two interconnected systems. The first is the sympathetic nervous system, which produces the immediate "fight-or-flight" response through the release of adrenaline. The second is the hypothalamic-pituitary-adrenal (HPA) axis, which produces a slower but longer-lasting hormonal response involving CRH, ACTH, and...

Addisonian crisis remains a significantly underestimated and underrecognized medical emergency, frequently leading to misdiagnosis.   Addison’s disease is a form of primary adrenal insufficiency, most commonly of autoimmune etiology. Typical clinical features include fatigue, generalized weakness, reduced physical performance, and cutaneous hyperpigmentation. Adrenal insufficiency (AI) can cause severe, life-threatening encephalopathy , often presenting as acute altered mental status, confusion, seizures, coma, or psychosis due to severe cortisol deficiency. It mimics infectious or autoimmune encephalitis, characterized by hypotension, profound hyponatremia (low sodium), and hypoglycemia. ICD-10 Code Description E27.1 Primary adrenal insufficiency E27.2 Addisonian crisis An Addisonian crisis represents a life-threatening endocrine emergency resulting from acute cortisol deficiency. Immediate treatment is...

Why Has Progress in Psoriasis Treatment Been Slow? There is a concerning trend among some medical professionals who adopt a somewhat superficial attitude toward the dangers of excessive salt intake, often citing its harms without fully grasping the complex clinical implications or delving deeply into the underlying science. This lack of nuanced understanding can be particularly frustrating for patients dealing with chronic conditions. As someone who has lived with genetically inherited psoriasis and Adrenal insufficiency for 64 years, I am deeply frustrated by the slow pace of scientific progress in treating these conditions. It's disheartening to see how little has changed since psoriasis was first formally described. In 1809, English physician Robert Willan (1757–1812) provided one of the earliest diagnostic descriptions of psoriasis, categorizing its various forms, including guttate, scalp, and palmar psoriasis. At that time, he referred to it as "lepra vulgaris," a te...