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Prolonged psychological stress suppresses cortisol secretion
Milos Zarković1, Elka Stefanova, Jasmina Cirić
1Institute of Endocrinology, Belgrade, Serbia. mzarkov@eunet.yu
Clinical Endocrinology
|February 21, 2004
Summary
Prolonged psychological stress can temporarily suppress the hypothalamic-pituitary-adrenal (HPA) axis, leading to low cortisol levels. This HPA axis suppression during stress may be misdiagnosed as HPA insufficiency.
Area of Science:
- Endocrinology
- Psychoneuroimmunology
- Stress Physiology
Background:
- Acute psychological stress activates the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system.
- The physiological response to prolonged psychological stress remains less understood.
Purpose of the Study:
- To prospectively assess cortisol secretion during prolonged psychological stress.
- To evaluate the HPA axis function after the stressor's elimination.
Main Methods:
- Prospective study of five healthy adults (34-39 years) experiencing prolonged psychological stress from air raids.
- Endocrine testing (morning cortisol, ACTH stimulation test) and psychiatric assessments were conducted during and after the stress period.
Main Results:
- No endocrine or psychiatric disorders were observed after 2.5 years of follow-up.
- Significant reductions in depression and anxiety scores were noted post-stress.
- Transient suppression of the HPA axis was evident during the stress period.
Conclusions:
- Prolonged psychological stress is linked to transient HPA axis suppression, indicated by low morning cortisol and blunted cortisol response to ACTH.
- Reduced cortisol response during stress can lead to misdiagnosis of HPA insufficiency.