June 2005

Stress is a specific diagnosis

by Dr. Howard Loomis

Albert Einstein said "Imagination is more powerful than knowledge." I wish he had added that when imagination is used in concert with specific knowledge, the combination can lead to spectacular breakthroughs in practical application.

Imagine...

... yourself successfully specializing in the treatment of only one condition, a condition of pandemic proportions, that will expand your scope of practice and provide an area of expertise with a greater patient base than musculoskeletal or personal injury can ever provide.

... that no other profession and very few of your colleagues specialize in this area.

... entering your office every day brimming with confidence, rather than filled with fear or uncertainty.

... the information you need to become expert in this specialty is already available and requires only a small investment of time, and no investment in new equipment or changes in your present office procedures.

... the improved clinical results you and your patients will experience, leading to an increase in referrals to your office without advertising or "hard sell" strategies.

... the increased personal satisfaction and professional fulfillment you will enjoy, and the increased respect you will experience in your community.

All of this is possible and easily achieved. No fads, no gimmicks, no get‑rich‑quick schemes. It's all available and yours for the taking. Just specialize in diagnosing and treating the effect of stress on the body.

Let me be quite clear. I am not talking about the emergency response involved in anaphylactic shock, but rather the slow, insidious effect of prolonged stress.

Last month I wrote about stress and how this common word seems to have lost significance as a specific diagnostic term. Yet, we should use stress as a definite diagnostic entity, with its own ICDA code, and I don't mean some non‑descript psychological supposition. Stress is specific and you can learn specific diagnostic tools to pinpoint its effects on the body. There is a specific cascade of physiological steps that occur whenever our bodies are confronted with a structural, functional, or emotional stress that is too strong or continues for too long for us to manage. The secret to understanding the deleterious effect stress is having on your patient's body is as simple as knowing when and why normal level of blood glucose cannot be maintained.

The body's specific physiological response to stress

Step One: When under stress, each cell, tissue, organ, and organ system requires more nutrition, in particular glucose, to produce the energy needed to meet its demands.

Step Two: If the stress continues for too long or is too strong, the blood glucose level will begin to drop.

Step Three: Fortunately, the hypothalamus recognizes the blood glucose level is dropping and takes definite steps to protect the glucose needed for the brain and central nervous system. How does the hypothalamus respond? By stimulating the release of the chemicals cortisone, growth hormone, and, to a lesser extent, thyroxine which shift the cells from using glucose to using fat for energy production. This shift is necessary to conserve glucose for the brain and central nervous system, neither of which could ever convert enough fat to maintain their energy levels. The retina of the eye and germinal epithelium of the gonadal tissues also must remain on glucose for energy.

The sympathetic system is also strongly activated, mainly by signals transmitted from the hypothalamus downward through the reticular formation and spinal cord to cause massive sympathetic discharge. Sympathetic stimulation causes the pancreas to secrete glucagon and the adrenal medulla to secrete epinephrine. Both of these hormones are rushed to the liver where they induce increased breakdown to stored glycogen, increased synthesis of glucose, and increased fat mobilization. Direct stimulation to the liver itself results in increased protein metabolism and decreased secretion of cholesterol for bile formation.

A simple, yet specific, screening for stress can be done by palpating the major "stress points" in the body. First, palpate across the top of the shoulder, the so‑called "shawl area" over the upper trapezius muscle. Next, palpate for Pottenger's Saucer. Its existence is evidence of muscle contraction in the spinal area from which innervation to the digestive organs as well as the adrenal glands and liver arises. Evidence of these two areas of stress indicates that the body is unable to physiologically respond to its demands and maintain a normal blood glucose area.

Learn how to diagnose stress and its specific effects on the body and imagine the possibilities for you and your practice.

(Dr. Loomis welcomes input on the subjects covered in this column. To make a comment or ask a question, write to him at 6421 Enterprise Lane, Madison, WI 53719. Visit www.loomisenzymes.com online or call 800‑662‑2630 for information on upcoming Loomis Institute seminars.)