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만성피로 및 에너지 항상성에 대한 부신 호르몬 관점에서의 접근

Other Titles
 Functional approach to chronic fatigue and energy homeostasis in perspective of adrenal hormones 
Authors
 박병진 
Citation
 Journal of Korean Institute for Functional Medicine, Vol.1 : 32-38, 2018 
Journal Title
Journal of Korean Institute for Functional Medicine
Issue Date
2018
Keywords
Fatigue ; Homeostasis ; Cortisol ; Dehydroepiandrosterone
Abstract
The health paradigm has been ruling things out except diseases and taken a passive, wait and see approach. However, the
future paradigm of medicine should use the concepts of rule in and disease prevention. The adrenal glands produce many
hormones including cortisol and dehydroepiandrosterone (DHEA) which is play an important role in energy and immune modulation,
ultimately stress adaptation. Adrenocorticotropic hormone, an important component of the hypothalamic-pituitary-adrenal axis,
is the last hormone to stop working in pituitary gland. The biological reserve for adrenal glands needs minimum 10 percent
to rule out histopathological diseases. Therefore, the disease category in adrenal glands is limited, albeit their crucial role
for daily life, such as Addison’s disease and secondary adrenal insufficiency, especially in perspective of stress adaptation.
After exclusion of adrenal diseases, we can perform some laboratory tests to evaluate functional and dynamic status for adrenal
hormones, and do a three-dimensional examination: 1) One day evaluation for diurnal variation of cortisol in context of individual
lifestyle, 2) Serial evaluation for cortisol, pregnenolone, DHEA and adrenal status, 3) Cross-sectional staging for adrenal status
according to cortisol and DHEA levels. Based on the functional estimations for adrenal status, individualized management
should be done: Lifestyle modification, therapeutic diet education, supplementation, and medication if necessary. Bridging
the gap between conventional approach and functional approach for chronic fatigue may be helpful for enhancing health and
quality of life. In upcoming super-aging society, the importance of functional fatigue status would be more noticed and multidisplinary
approach should be actively performed.
Full Text
http://scholar.dkyobobook.co.kr/searchDetail.laf?barcode=4010026730605#
DOI
10.32581/jkifm.2018.1.32
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Family Medicine (가정의학교실) > 1. Journal Papers
Yonsei Authors
Park, Byoungjin(박병진) ORCID logo https://orcid.org/0000-0003-1733-5301
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165456
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