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paraventricular nucleus

heapsreal

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A recent thread/link i posted on adrenal fatigue mentions that issues occur in the paraventricular nucleus(PVN) that is in the hypothalamus. WHAT THE !! mm i have to read more??

The PVN is said to have multiple sub populations that are activated by a variety of stressful and physiological events. It send s messages to the pituitary where oxytocin and vassopressin are released as well as regulating appetite and autonomic functions in the brain stem and spinal cord.

Other info i found say that in chronic stress that PVN has 3 functions-
1)directly controls HPA axis, cortisol/adrenaline response etc
2)neurohypophysial peptides structurally and functionally related to peptide hormones that includes oxytocin and vassopressin
3)projects neurons that regulate autonomic function.

So this is only a little research so far but those 3 functions or dysfunctions can explain some symptoms in cfs/me like poor sleep or too much sleep, neuro peptides and autonomic function explain orthostatic intolerance/POTS, hyperadrenergic responses. Also chronically elevated cortisol/adrenaline can cause insulin resistance as well as cause hormonal imbalances.

I think when we look at these dysfunctions i think this is how dr jay goldstein was looking into treating cfs/me. The infection/immune side of cfs/me i think keeps the chronic stress going which causes these neurological problems. Also i suppose the hit and run theory is also relevant here to ie in some the infectious cause is gone but its left one with the neurological dysfunction maybe. We can have so many different things out of whack like neurotransmitters, cytokines, hormones, immune defiencies, infections etc which is why i dont think there will ever be one cure but treatments need to go after several things.

If anyone has any other interesting info or links to PVN, hypothalamus or HPA dysfunction etc and even better how to treat the dam thing, please post.

cheers!!!
 

heapsreal

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The HPA axis
Corticotropin-releasing hormone (CRH) is secreted by a hypothalamic
region called the paraventricular nucleus (PVN) and
acts on CRH receptors in the anterior pituitary to cause the
release of adrenocorticotropic hormone (ACTH) into the
blood. ACTH acts on the adrenal cortex, which produces
and releases cortisol into the blood and participates in maintaining
homeostasis throughout the body. CRH also activates
the locus ceruleus (LC) which utilizes norepinephrine (NE) and
causes further stimulation of the PVN and subsequent release
of CRH. It also stimulates the amygdala, which is part of the
limbic system.

1,2 Elevated brain NE levels and CRH have been
implicated in sleep disturbances, including primary insomnia.

3,4
NE levels have also been shown to directly correlate to CRH
levels, whereby elevated NE results in elevated CRH and low
NE results in low CRH

Rest of the article here:- http://naturalmedicinejournal.net/pdf/NMJ_JUNE10_TC.pdf
 

Enid

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Can't send any links heapsreal but think your thinking/research ties up - hypothalamus/brain stem "injury" - possibly "hit and run" or persisting pathogen(s) - though very ill and bedbound at one stage I noticed the higher faculties of the brain eg reason were intact even between passings out. Won't use the word "stress" it's the open invitation to the mumbo jumboists we've long known codswallop and probably too stupid too.

Just hope more understanding will point a way to easing your sleeping difficulties.
 

justy

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Hi Heaps - bit over my head at the moment, but i think there is certainly something going on in the HPA axis. My own doctor - Dr Myhill suggested that for me i could have an issue with my pituitary gland due to damage to it after 2 post partum haemorrhages (sp?) it is very susceptible to this type of damage - causing sheehans syndrome, which can be mild or take years to be noticed, she believes i have an element of this, but as i COULD breastfeed, it rpobably isnt the whole story (the pituitary affects the production of milk and is also concerned with the production of oxytocin, which is very important in milk ejection etc. Sorry to get so bogged down in breastfeeding, but the interesting thing for me is that i am one of those who feels much better when pregnant (so much so that i did it 4 times) and that improved well being continues during breastfeeding - but twice i have become very ill again straight after stopping breastfeeding. Hmmm...

All the best, Justy
 

heapsreal

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Can't send any links heapsreal but think your thinking/research ties up - hypothalamus/brain stem "injury" - possibly "hit and run" by a pathogen(s) - though very ill and bedbound at one stage I noticed the higher faculties of the brain eg reason were intact even between passings out. Won't use the word "stress" it's the open invitation to the mumbo jumboists we've long known codswallop and probably too stupid too.
I understand what u mean by 'stress' but for the record i refer stress to being from infections, sleep dysfunction and all those symptoms we suffer that keep us in a viscious cycle of cfs/me.

cheers!!
 

heapsreal

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Hi Heaps - bit over my head at the moment, but i think there is certainly something going on in the HPA axis. My own doctor - Dr Myhill suggested that for me i could have an issue with my pituitary gland due to damage to it after 2 post partum haemorrhages (sp?) it is very susceptible to this type of damage - causing sheehans syndrome, which can be mild or take years to be noticed, she believes i have an element of this, but as i COULD breastfeed, it rpobably isnt the whole story (the pituitary affects the production of milk and is also concerned with the production of oxytocin, which is very important in milk ejection etc. Sorry to get so bogged down in breastfeeding, but the interesting thing for me is that i am one of those who feels much better when pregnant (so much so that i did it 4 times) and that improved well being continues during breastfeeding - but twice i have become very ill again straight after stopping breastfeeding. Hmmm...

All the best, Justy

All over my head too Justy. Im trying to understand it though, mainly to fix my sleep. I think if i can sort sleep out at this stage then its my best bet of recovering. Sleep meds have definately helped me to function but they dont really fix the problem which is why im digging so deep into researching it. An inverted cortisol rhythm is within my ability of understanding and seems to be an issue for me.

I wonder if u being ill after stopping breast finding is related to PVN. There has been a few women say they have had remissions during pregnancy.

ME definition of inflammation of the brain and spinal cord, could be inflammation of the hypothalamus/PVN maybe?

Its interesting subject.

cheers!!
 

heapsreal

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A copy and paste which might help us to understand abit more, hopefully. Not sure if hypothalamus transplant exists though.



An Overview of the Hypothalamus

The Endocrine System’s Link to the Nervous System

Written by Kelly M. Rehan
The Hypothalamus Essentials
  • The portion of the brain that maintains the body’s internal balance (homeostasis).
  • The hypothalamus is the link between the endocrine and nervous systems.
  • The hypothalamus produces releasing and inhibiting hormones, which stop and start the production of other hormones throughout the body.
The hypothalamus plays a significant role in the endocrine system. It is responsible for maintaining your body’s internal balance, which is known as homeostasis. To do this, the hypothalamus helps stimulate or inhibit many of your body’s key processes, including:
  • Heart rate and blood pressure
  • Body temperature
  • Fluid and electrolyte balance, including thirst
  • Appetite and body weight
  • Glandular secretions of the stomach and intestines
  • Production of substances that influence the pituitary gland to release hormones
  • Sleep cycles
The hypothalamus is involved in many functions of the autonomic nervous system, as it receives information from nearly all parts of the nervous system. As such, it is considered the link between the nervous system and the endocrine system. You can learn more by reading a SpineUniverse article about the nervous system.

Anatomy of the Hypothalamus
The hypothalamus is located below the thalamus (a part of the brain that relays sensory information) and above the pituitary gland and brain stem. It is about the size of an almond.

Hormones of the Hypothalamus
The hypothalamus is highly involved in pituitary gland function. When it receives a signal from the nervous system, the hypothalamus secretes substances known as neurohormones that start and stop the secretion of pituitary hormones.

Primary hormones secreted by the hypothalamus include:
  • Anti-diuretic hormone (ADH): This hormone increases water absorption into the blood by the kidneys.
  • Corticotropin-releasing hormone (CRH): CRH sends a message to the anterior pituitary gland to stimulate the adrenal glands to release corticosteroids, which help regulate metabolism and immune response.
  • Gonadotropin-releasing hormone (GnRH): GnRH stimulates the anterior pituitary to release follicle stimulating hormone (FSH) and luteinizing hormone (LH), which work together to ensure normal functioning of the ovaries and testes.
  • Growth hormone-releasing hormone (GHRH) or growth hormone-inhibiting hormone (GHIH) (also known as somatostain): GHRH prompts the anterior pituitary to release growth hormone (GH); GHIH has the opposite effect. In children, GH is essential to maintaining a healthy body composition. In adults, it aids healthy bone and muscle mass and affects fat distribution.
  • Oxytocin: Oxytocin is involved in a variety of processes, such as orgasm, the ability to trust, body temperature, sleep cycles, and the release of breast milk.
  • Prolactin-releasing hormone (PRH) or prolactin-inhibiting hormone (PIH) (also known as dopamine): PRH prompts the anterior pituitary to stimulate breast milk production through the production of prolactin. Conversely, PIH inhibits prolactin, and thereby, milk production.Thyrotropin releasing hormone (TRH): TRH triggers the release of thyroid stimulating hormone (TSH), which stimulates release of thyroid hormones, which regulate metabolism, energy, and growth and development.
Hypothalamic Disease
A disease or disorder of the hypothalamus is known as a hypothalamic disease. A physical injury to the head that impacts the hypothalamus is one of the most common causes of hypothalamic disease.
Hypothalamic diseases can include appetite and sleep disorders, but because the hypothalamus affects so many different parts of the endocrine system, it can be hard to pinpoint whether the root cause of the disorder is actually related to another gland.
In particular, the hypothalamus and pituitary gland are so tightly connected that it’s often difficult for doctors to determine whether the condition is associated with the hypothalamus or pituitary gland. These are known as hypothalamic-pituitary disorders. However, there are hormone tests that help shed light on which part of the body is the root cause.
The hypothalamus is arguably the most essential of the endocrine system. By alerting the pituitary gland to release certain hormones to the rest of the endocrine system, the hypothalamus ensures that the internal processes of your body are balanced and working as they should.
 

Shell

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heapsreal this over my foggy head too, but I've suspected something Hypothalamus for a while - just not sure what.

justy Your story is fascinating to me. I became ill during my 4th preg but started to improve as I breastfed him. As a side thing I have wondered about his health. He has a catarract making him blind in that eye. He also has very high tone in his legs making him a tiptoe walker, but has no other signs of ASD so I don't think he has it. However when he was 18 months I spent 10 days in hospital with him with suspected Meningitis. He had IV antibios and fluids but the Paed told me had viral meningitis in the end.
He's been ok since.
I went into a fairly good remission with the next one. My daughter however was extrememly unwell from birth and for three years I felt like I live in the Children's hospital. She was dx with Failure to Thrive and multiple UTIs. A lot happened - don't want to go into it here. She's more or less fine now and gluten free. I relapsed about three months after her birth but I breastdf her for just over 2years.
I miscarried the next baby and haemorraged rather badly. Blue lights situation.
Miscarried again but they admitted me straight away so no haem that time.
I had luteul phase defect - thank God I was charting to spot it. I fixed the problem myself and my next pregnancy resulted in my youngest daughter who is very healthy. I went into a semi-remission with her and for the first few months of Breastfeeding her. Then I relapsed again. The thing with her was I was supposed to have another elective C section but she went into terrible distress pulse off the chart literally. I was shipped downstairs and she was born by emergency c section. I wanted to go home but wasn't allowed on the grounds I had heam again. Being ever mistrustful of all medics I demanded to know by what amount and was told 800mls. Now I thought 1000mls was classed as a haem but apparently over 500 or 600 is.

I don't know if anything I've written has any baring on my health or anyone elses, but the fact that Dr Myhill mentioned haemorraghe just raised a flag for me.
Sorry if what I've written isn't any use ---ignore at will. :)
 

heapsreal

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Shell, it sounds like birth was a very stressful event/s for you more so then what is expected, and then the chronic stress of looking after your sick children, wow, that could easily trigger some type of dysfunction in the PVN. I wonder with your first 2 kids being sick if its cfs/me being passed on?? Meningitis could easily be from cfs/me. Did u have any sibling, parents or grandparents that could have had cfs/ME?
CFS/ME i think is best described as neuro/immuno/endocrinology its all interconnected i guess.
Thanks for sharing.
 

heapsreal

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I think alot of us had other ongoing stresses at the time prior to get cfs/me. I had been doing shift work for 13 yrs at that stage as well as being oncall for work, so i could be asleep at 3am and then get woken up for a job that i would do immediately leave to do(i work as a paramedic). I think the disrupted sleep the going from nothing to 100mph in 3 secs etc. When i think about it i would have more adrenal rushes in a week then the average person would have in 3 months, coupled with the crap sleep and strange sleep cycles. Before i got all these infections i was starting to feel worn out or burnt out but still functioning ok and made changes to a quieter place to work but i think was too late as this was when all my infections started, cmv mono, chickenpox, ebv mono all within 6-9months which is what i never really recovered from. not long after this was an emotional time , first my father died and 12 months later my mother died. There was alot of stress around my family which was hard enough but also having cmv/ebv still belting me over the head, bang i was gone. So many different stresses from different angles.

When u look at the function of the hypothalamus its easy to see that it can just freeze up and get out of sync. With cfs/me we still have the ongoing stress on infections that are hard to overcome because of our immune suppression and the accumulation of all the things going dysfunctional make it hard to treat.

Shell your storie made me realise that we are all dealing with many different stresses, thats everyone but when u through cfs/me ontop, the camels back is broken.
 

Enid

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I've just turned up an old document - "Engaging with Myalgic Encephalomyelitis - Towards understanding, diagnosis and treatment." by Prof Malcolm Hooper 2003. It brings together the large body of research at that time (all the well known "faces") and all the systems and interactions you mention are there. It's brilliant (though the science difficult for me) but I don't find it on the web,( though I do see some Prof Hooper talks on You Tube.)

Certainly on the right track heaps.
 

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heapsreal

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Hi heaps.

You may find something useful in this discussion on how benzos affect HPA function (the PVN is rich in GABA receptors) :

http://www.benzobuddies.org/forum/index.php?topic=44373.0
Thanks marco, i have read a few things about that. Its the main drug docs reach for to overcome issues with PVN. If the PVN is broken then really the only way docs know how to treat this is mainly with benzo's. I think the withdrawal issues cfsers 'might' have with benzo's might not be withdrawal but maybe the unmasking of this PVN dysfunction, although i think maybe those that keep increasing benzo doses to overcome this issue will then have an exaggerated PVN response and benzo withdrawals??
My recent experience with phospahtidylserine and cutting my benzo dose in half has shown me that i am not having issues with cutting back benzo dosages and having withdrawals. But then my doses have never been that high.
I think many of us with cfs/me might have the same dysfunction as chronic benzo uses but ours are caused by infections or whatever it is that causes cfs/me, i say this as there are many cfs/me people who have this issue with sleep etc which is possibly PVN dysfunction but these people havent used benzo's. Im sitting on the fence with my legs dangling over the benzo side as i think they have helped more then harmed cfs/me'rs. Maybe this shows that PVN dysfunction is a common cause of insomnia but can occur due to different mechanisms?? Its interesting to see how they are treating these issues on benzobuddies, very similar to adrenal fatigue. Maybe people who have been given benzo's in the first place have underlying adrenal fatigue, horse or the cart??

thanks for the link,
cheers!!!
 

Little Bluestem

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I think benzos, Xanax in particular, has helped me more than harmed me; although I am now wondering if it is causing some of my HPA axis problems.

In the early years of my ME/CFS, when I had no idea what was wrong, MDs wanted nothing to do with me and referred me to psychiatrist/psychologists. They wanted me to play with their shiny new toy, the SSRIs. After bad experiences with several of those, I said that if I had any kind of psychological problem it was more along the lines of anxiety than depression. I had this low level, background edginess about everything in general and nothing in particular. Although I did not fit the diagnostic criteria for any defined anxiety disorder, they gave xanax a try and it has helped me as much as anything. Dr. Cheney's upregulated autonomic nervous system theory really resonates with me, despite the fact that I think the initial cause was some sort of pathogen.

P.S. I was amused that to have general anxiety disorder, you had to have all of one set of symptoms and a certain number of a second set of symptoms. That did not seem very general to me.
 

Marco

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Thanks marco, i have read a few things about that. Its the main drug docs reach for to overcome issues with PVN. If the PVN is broken then really the only way docs know how to treat this is mainly with benzo's. I think the withdrawal issues cfsers 'might' have with benzo's might not be withdrawal but maybe the unmasking of this PVN dysfunction, although i think maybe those that keep increasing benzo doses to overcome this issue will then have an exaggerated PVN response and benzo withdrawals??
My recent experience with phospahtidylserine and cutting my benzo dose in half has shown me that i am not having issues with cutting back benzo dosages and having withdrawals. But then my doses have never been that high.
I think many of us with cfs/me might have the same dysfunction as chronic benzo uses but ours are caused by infections or whatever it is that causes cfs/me, i say this as there are many cfs/me people who have this issue with sleep etc which is possibly PVN dysfunction but these people havent used benzo's. Im sitting on the fence with my legs dangling over the benzo side as i think they have helped more then harmed cfs/me'rs. Maybe this shows that PVN dysfunction is a common cause of insomnia but can occur due to different mechanisms?? Its interesting to see how they are treating these issues on benzobuddies, very similar to adrenal fatigue. Maybe people who have been given benzo's in the first place have underlying adrenal fatigue, horse or the cart??

thanks for the link,
cheers!!!

No problem.

I'm particularly interested in GABA-B and glutamate receptors in the PVN and how they might impact on HPA function.
 

heapsreal

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No problem.

I'm particularly interested in GABA-B and glutamate receptors in the PVN and how they might impact on HPA function.
The drug xyrem that is said to increase deep sleep is a gaba B drug as well as baclofen. I have found baclofen improves sleep quality and when i have used it lately with phos serine, its been really good sleep, but i dont use baclofen all the time as i wont to avoid tolereance.
Blocking glutamate sounds like a good idea, there seems to be alot of off switches and blocking glutamate is one. What ideas do u have for glutamate??
 

GreyOwl

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A old thread @heapsreal, but I found this:
http://moscow.sci-hub.io/ebbbfdfc7a38c456b049f8639bbbdc05/engelmann2004.pdf
The hypothalamic–neurohypophysial system regulates the hypothalamic–pituitary–adrenal axis under stress: An old concept revisited
Mario Engelmanna, Rainer Landgrafb, Carsten T. Wotjakb
Which seems to describe two responses: one to perceived (ie. psychological) threat and one to real (ie. physical) stress. They are quite different HPA responses. It has been cited over 300 times, so must be robust? I'd be interested in your thoughts.
Also tagging @Mohawk1995.
 

heapsreal

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A old thread @heapsreal, but I found this:
http://moscow.sci-hub.io/ebbbfdfc7a38c456b049f8639bbbdc05/engelmann2004.pdf
The hypothalamic–neurohypophysial system regulates the hypothalamic–pituitary–adrenal axis under stress: An old concept revisited
Mario Engelmanna, Rainer Landgrafb, Carsten T. Wotjakb
Which seems to describe two responses: one to perceived (ie. psychological) threat and one to real (ie. physical) stress. They are quite different HPA responses. It has been cited over 300 times, so must be robust? I'd be interested in your thoughts.
Also tagging @Mohawk1995.


Link didnt open for me. It looked like a russian search engine.

The whole hpa axis stuff seems to get more complicated the deeper one looks into it.

Theres alot of trial and error but i think we have to start with optimizing our adrenal and sex hormones to healthy ranges and balanced within the correct 24hr rhythms. Easier said then done. Then look at things that can throw it off like inflammation and cytokines from infections etc. Hpa and sleep, horse or the cart there. Medically i guess its a cluster _____. Lol.

If you can copy and paste that article would be good.