Dr. Sugunakarraju Pagidipati

The adrenal glands are present above the kidneys (hence the name) and produces an important hormone known as cortisol. Cortisol is responsible for regulating multiple body functions, including controlling the blood pressure, protein and carbohydrate metabolism, and anti-inflammatory response, and stress management.

Under natural circumstances, the body produces excessive cortisol in the following situations:
Physically stressing situations like illness, surgery, injury, pregnancy, etc.

1. Emotionally stressed situations
2. Alcoholism
3. Athletic training
4. Malnutrition
5. Depression
6. Panic disorders

Causes: Cushing’s syndrome is a group of symptoms that manifest when there is too much cortisol in the body. It is more common in women than men, in the age group of 25 to 40. Some of the common causes for Cushing’s syndrome are listed below:

1. Consuming too much of prednisone (and other steroids) or for prolonged periods can cause Cushing’s syndrome. These are strong anti-inflammatory medications and are used in asthma, arthritis, lupus, transplants, etc., to control the body’s inflammation reaction. It is therefore advisable to use topical steroids than oral steroids or injections as their effects are more noticeable and severe.
2. Adrenal gland tumours can cause excessive production of cortisol.
3. Pituitary gland tumours or adenomas also can also cause excessive production of cortisol, leading to Cushing’s syndrome.

The first type is known as exogenous Cushing’s disease and the others are known as endogenous Cushing’s disease.
Signs and symptoms: Cushing’s disease produces characteristic features which are referred to as the Cushingoid appearance. These features include the following:

1. A rounded, plump face with a pinkish hue
2. A moon face, with fat deposits on the face
3. A buffalo hump with fat deposits between the shoulders
4. Stretch marks on the abdomen, thighs, and arms
5. Weak muscles, especially in the hips and shoulder
6. Significant weight gain
7. Skin that gets thin and bruises easily
8. Extreme tiredness
9. High blood pressure
10. High blood sugar
11. Thin arms and legs
12. Delayed healing of cuts and injuries
13. Increased facial hair in women
14. Menstrual disorders
15. Reduced libido, infertility, and erectile dysfunction in men
16. Emotional issues like depression, anxiety, irritability
17. Increased thirst and urination
18. Bone loss, and eventually fractures
19. Affected bone growth in the developing years
20. Increased susceptibility to infections

Complications: Untreated Cushing’s disease can lead to bone fractures, hypertension, full-blown infections, kidney stones, etc.

Treatment: This would depend on the cause. If you are on long-term steroids, the dose would need to be adjusted. This should always be done under medical supervision, as it requires constant adjustment. Underlying tumours (pituitary or adrenal) need to be diagnosed and treated. There are other hormones too which come into the picture and need to be monitored. If you wish to discuss about any specific problem, you can consult an endocrinologist..

Every person is familiar with the remark “Stop fidgeting” but does anybody ever wonder why do humans fidget? Is there any scientific reason for such an action? This article will throw light on the underlying causes for what is known as fidgeting.

Fidgeting and its underlying causes

• Scientific research has revealed that fidgeting has many benefits still most people get annoyed when they see another person twitching and tapping. Most people do this seemingly without any control over their movement when they are ordered to be still. Research shows that there is at least one biological reason to back this action.
• Since the same brain area is used for movement and speech, it is only natural that gestures are interlinked with thorough preparation for a speech. People tend to move their hands more when they are looking for a word to say, but are not being able to find it. In a recent study, it was found that school children between the age of 6-8 years who use their hands a lot can come up with the right answers during lessons.
• While this is one theory, another neurological theory suggests that a portion of the mental load is off-loaded through the process of fidgeting when people have to tackle complex problems or thoughts. The theory is called cognitive load hypothesis. The offloading mechanism frees up the mental faculties thus, devoting them to the mental process. While this may not be a definitive explanation for fidgeting, it does go to show that there is a link between a person’s hand movements and their thought and speech process.

Other reasons for fidgeting

• Other than the cognitive advantages, some evidence has also been found linking fidgeting with metabolism. People who fidget are found to have a higher metabolism and lower BMI. This difference can be seen between thin and overweight people. Fidgeting amidst lollygagging during the day helps burn up to 350 calories a day. Also, fidgeting among other incidental physical activity helps keep an individual fit.
• Among other reasons, fidgeting also serves as a coping mechanism for people with ADD. If a person is engaged in something that he/she is not interested in then the additional sensory-motor input that is even slightly stimulating or entertaining helps the brain to get completely engaged. This helps to maintain focus on the actual activity being performed by the individual.
• So, fidgeting helps distract that part of the brain that is getting bored. This helps the other parts of the brain focus better on the actual activity. This is known as floating attention which perhaps is an evolutionary trait that dates back to prehistoric times. In those times, the ability to focus entirely on a task with undivided attention was not favorable to the human since doing so could make them unaware of the enormous ravenous beast hiding behind the bushes.

Thus, though there is some degree of understanding is there when it comes to fidgeting, more research studies are required to gain further insight. Consult an expert & get answers to your questions!