Mind-body connection with Cortisol, inflammation

[rhollander]

I have some questions about the mind-body connection with inflammation and cortisol that keep nagging me. we treat so many unidentified mind-body conditions with prednisone, a synthetic version of our natural adrenal stress hormone cortisol, and immune modulators. for instance migraines, vertigo, tinnitus, back pain. When doctors prescribe these medications, we presume they are reducing inflammation at the level of the symptoms in the body. However, if we consider the mind-body perspective, could it be that the medications are really working at the level of the brain? why would giving cortisol reduce inflammation, when it is in itself a stress hormone? Could it be that Cortisol, as an exogenous hormone, down regulates the corticotrophin-releasing hormone from the brain, thereby effectively decreasing endogenous cortisol production from the adrenal gland and thus decreasing danger signals from the brain into the body? And if this is so, when we treat other conditions not currently solely classified as Mind-Body, like asthma and autoimmune conditions such as lupus, inflammatory bowel disease, and thyroid disease, with anti-inflammatories like prednisone and other immune modulators, could this give credence to a Mind-Body component in these conditions? In that danger signals from the brain initiate downstream dysregulation to the point of creating dangerous pathology in the body, for example Life-threatening bronchoconstriction in asthma and bleeding intestine in inflammatory bowel disease. Stress precedes so many of these conditions. we usually explain them away with a genetic cause and stress influencing the body peripherally, while ignoring how we process stressful danger signals in the brain first. appreciate your thoughts. Rachel

[abatson]

Hi Rachel,
I am definitely no expert in this area, so I will just share with you my understanding. First, I’m not familiar with using prednisone for the treatment of some of the conditions you mentioned as a standard of care, so I can’t speak to that. However, when prednisone is used for conditions such as asthma or auto-immune conditions, there is good bench research showing its affects on the immune system. I would think of endogenous prednisone as more of an immune system “regulator” than a “suppressant”. When the body gets injured, prednisone is released to regulate the immune response and healing mechanisms. You would not want the body to overactive the immune system because you would end up dieting of the strong immune response. This situation can happen in asthma attacks, sepsis and even those who died of acute Covid infection. It was the immune system which created the physiologic environment that lead to the person’s death. So, cortisol is there to tamp it down so it doesn’t over-react. In auto-immune conditions, the body is now attacking its own tissue, so suppressing the response with cortisol is helpful so the tissues have a chance to heal. Here is a paper explaining in detail what research shows about how cortisol regulates the immune response, but even this article is a little outdated.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1751559/
Hope something here addressed your thoughts.
Alicia

[aolden]

“The enteric nervous system relays psychological stress to intestinal inflammation.” Here is an recent article that talks about stress, steroids, and gut inflammation – I found it very interesting. https://doi.org/10.1016/j.cell.2023.05.001

[rhollander]

Thanks for the replies.

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