Cortisol has been used during COVID-19 pneumonia because it can slow down the efforts of the immune system through a cascade of pro-inflammatory cytokines.
The main function of cortisol is to block inflammation caused by any kind of damage. Inflammation is inhibited by cortisol in the early stages, during which a large number of substances are released that activate the inflammatory process and increase blood flow and plasma outflow in the damaged area (oedema) leading to the defensive work of lymphocytes and the 18 substances that, like darts, cannons and traps, the immune system possesses.
Confinement is a strong source of stress.The main reasons for this are: an insufficient nutritional value of the diet; the imbalance caused by oxidants, smoking and sedentary lifestyles; and social and environmental influences.
Any sustained stress can lead to increased secretion of ACTH (a hormone produced in the pituitary gland that stimulates the adrenal glands) from the functional brain-hypothalamus unit, which acts on the pituitary gland, and from there to the adrenal glands, which produce adrenaline (corticosteroids), also cortisol.
All life events go to the limbic system (the set of brain structures that manage our emotions and instincts outside of consciousness, if you like, the unconscious), which increases its activity as a consequence of mental stress, especially in the amygdalae which are a primary processor of threats: We jump at the sight of a snake, or flee at a sudden noise - and hippocampus where we have memories tied to contexts; and from the hippocampus, from where signals are sent to the hypothalamus (central regulator of the whole endocrine system and its connection with the emotional system) where the hormonal cascade of stress will start.
Another effect of stress is a reduction in leukocyte mobilisation and phagocytosis in the affected area. Phagocytosis by which some families of white blood cells - lymphocytes - engulf and digest viruses, bacteria and tumour cells.
"This virus is not going to kill as many people as tobacco and obesity kill".
Many stressors are perceived and interpreted by the brain in different ways, so stress does not affect everyone in the same way. In a situation such as the one we are dealing with, it must produce reactions of flight, attack and fight, as in all situations of danger.. Inside a flat you can't do any of it, so we are flooded with stress hormones that will decrease the activity of the natural killer lymphocytes, the attacking force of the immune system.
So being stressed, confined, sedentary, smoking or drinking, or discouraged, sleeping little, produces stress. Let's take a look at the consequences of stress in this short summary.
Effects of cortisol produced by sustained stress:
It is stressful to see how badly the pandemic has been managed or foreseen by these rulers, and even more so to think that they are the ones who are going to manage something more complicated: the way out of the crisis. In business, managers like these are dismissed. We are stressed by the fact that in this swamp of dead people they still want to win votes to secure their seats and impose their dogmatic conception of collective life, treating us as if we were idiotic children. They do not care about the suffering of thousands of families and citizens who are also affected by these dead and their families. They continue their election campaign every time they open their mouths: lies or half-truths, propaganda... Phew, a lot of exogenous stress.
They have isolated themselves by not going to the Cortes and the Senate and protecting themselves from contagion because of the "extreme courage" they claim to have. But they throw health workers and law enforcement officers out of protection. The Minister of Social Welfare lets those who "no longer have any social value" die in his old people's homes and cause a lot of expenditure on pensions. But he is so charitable that he wants us to stop working and the state to send us our income home.
Tobacco and tobacco shops are open, but the doors are closed to books.. It is stressful to see what they are valuing: certainly not the health workers, not the elderly. I walk my dog, but not my child. The dead are hidden from us like fools.
The stress of reduced mobility and confinement induces a decrease in cellular proteins, blocking growth hormone, which is responsible for the production of millions of new cells every day. We have one trillion immune cells. We get tired easily because the cellular power plants, the mitochondria that increase with exercise, are diminishing.
Cortisol produces these effects in all cells except liver cells. It causes a decrease in protein synthesis because cortisol depresses the formation of RNA (which is a package of instructions, orders to make proteins and a decrease in the transport of amino acids to the muscle). If there is too much cortisol, muscle mass can be lost.
"Only the overall care of our being in the mental, physical and nutritional aspects is what contributes to homeostasis: to the quasi vital balance of all its components".
We can put on weight during this "house arrest", due to a decrease in glucose utilisation: cortisol produces this effect in the cells of the whole organism. Glucose from food is not used properly and our blood glucose levels rise. Because cortisol inhibits glucose utilisation by cells. We know that people who take cortisone put on weight, because we also make it worse with sweets and cakes. Hence the need for us to consume meat, fish, dairy products, eggs, nuts, fruit, pulses, vegetables and olive oil. We need 50 nutritional elements. These foods provide us with: vitamins, minerals, proteins and fats, all of which are necessary for the proper functioning of all the body's organs (one of which is the immune system).
Many mistakes are being made with restriction diets, such as detox shakes or inappropriately named plant milks. Lack of fat in the diet causes stress. We have the best: olive juice.
The immune system is an organ of the body, and cannot be augmented separately by any supplement or diet, because it forms a functional unit with the nervous system, the glandular system, the nutritional status, the liver, the neuroendocrine system, the muscular system and the skeletal system. They cannot be separated or enhanced separately.
As I said, the cerebral nervous system forms a unit with the immune system. Lymphocytes receive, receive and themselves produce hormones and neuromediators. The brain has gateways - receptors - in its cells for cytokines produced by lymphocytes. Killer lymphocytes receive opioids from the nervous system and produce the thyroid hormone TSH as well as ACTH. They have inputs, receptors, for corticosteroids, insulin, testosterone, growth hormone, oestrogens..., for all these substances.
The sympathetic system - which makes us alert - influences the actions of the medullary system in the manufacture and production of cytotoxic T-cells and antibody synthesis. All this shows us that the mind, the emotions, the brain and the neuroendocrine system form a single unit..
If we say that stress acts on the brain and the brain acts on the adrenal glands that release cortisol and adrenaline, then the cells of the immune system also secrete ACTH, the master hormone that acts on the pituitary gland. The nervous, endocrine and immune systems therefore form a unit.
Excess cortisol, which many confined people will have, can also lead to hypertension, due to sodium retention and potassium excretion, so that hypertensives will see their symptoms aggravated if they do not exercise, as well as increasing "bad" cholesterol, which is deposited in the arteries, prior to inflammation.
"If we had governors who knew economics, they would put up sports centres in bulk without VAT".
This can be counteracted by daily physical exercise, at least 40 minutes, which will increase anti-inflammatory cytokines, lower the chance of cholesterol turning into an attack on the circulatory system, because it increases HDL which carries it to the liver and becomes part of the bile that ends up in the faeces.
Increased cortisol levels have an adverse effect on testosterone levels. Also due to its effects on the thyroid it will increase fat accumulation preferably in the abdominal area.
In short, stress can lead to a marked atrophy of the immune system; consequently, the individual who suffers from it will be more likely to acquire infectious diseases and to defend himself badly if he already has them. There are also alterations in sleep, appetite and mood, which improve with exercise: the best medicine against stress, because it improves memory, increases cerebral irrigation, raises HDL and lowers DLH, lengthens life, prevents cardiovascular diseases.. It is the best pill for overall health.
José Antonio Rodríguez Piedrabuena
Specialist in psychiatry and psychoanalysis. Specialist in management training, group and couple therapies.