「中英」人人都在讨论皮质醇,它究竟有多重要

Leon Edler

Maybe you can’t sleep. Or you sleep too much. Maybe you keep breaking out, or getting sick. Perhaps your stomach bloats, your skin sags, you feel shaky. Maybe you can’t focus, eat or get rid of the tension in your spine.
也许你睡不着。也许你睡得太多。也许你的皮肤一直爆痘,或者总是生病。也许你有胃胀气,皮肤松弛,感觉身体虚弱。也许你无法集中注意力,吃不下东西,或者总觉得脊背发紧。
If you’ve scrolled through TikTok lately, you might be inclined to blame one or all of these things on your cortisol levels. Over the last year or so, users have flooded the app with stories about how their supposed cortisol imbalances have led to a range of health concerns — and have recommended that viewers look into their own cortisol levels.
如果你最近刷过TikTok,你可能会倾向于将某个问题或所有这些问题归咎于皮质醇水平。在过去一年左右的时间里,用户纷纷涌上TikTok诉说他们的故事,他们认为是皮质醇失衡导致了一系列健康问题——并建议看到视频的人去检查一下自己的皮质醇水平。
Cortisol, sometimes known as the stress hormone, is a chemical that helps regulate the way our bodies react to stress. “It’s a hormone that connects the mind and the body together,” said Martin Picard, an associate professor of behavioral medicine at Columbia University. Nearly every organ has a receptor that responds to cortisol. It is crucial in helping us function throughout the day, whether by regulating blood pressure or combating inflammation.
皮质醇,有时被称为压力荷尔蒙,这种化学物质有助于调节我们的身体对压力的反应方式。“这是一种将身心联系在一起的激素,”哥伦比亚大学行为医学副教授马丁·皮卡德说。几乎每个器官都有一个响应皮质醇的受体。无论是通过调节血压还是对抗炎症,它对于我们日常维持身体功能起到至关重要的作用。
That doesn’t necessarily mean that cortisol imbalances are responsible for the various ailments that people are sharing on TikTok, said Nia Fogelman, an associate research scientist at the Yale Stress Center. “I think it’s completely natural and understandable why people want to A, figure out what’s going on with their bodies, and B, to want some one thing that we can fix,” she said. But it’s not that simple.
耶鲁大学压力中心的助理研究员尼亚·福格曼说,这并不一定意味人们发在TikTok上的各种疾病都是因为皮质醇失衡。“人们想要:一、弄清楚他们的身体发生了什么;二、想要通过做一件事来解决。我想这是很自然而且可以理解的,”她说。但事情没有那么简单。
What does cortisol do?
皮质醇有什么作用?
When we experience stress, the pea-size pituitary gland in the brain — sometimes called the master gland — signals to the adrenal glands perched atop the kidneys, prompting them to secrete and deliver cortisol into our bloodstream.
当我们承受压力时,大脑中豌豆大小的垂体腺——有时被称为主腺体——会向位于肾脏上方的肾上腺发出信号,促使它们分泌皮质醇并将其输送到我们的血液中。
Our bodies release the chemical when we are faced with a challenge, whether psychological or physical, real or imagined, said Jeanette M. Bennett, a health psychologist who studies the effects of stress on health at the University of North Carolina, Charlotte. We release cortisol when we encounter a tangible threat, like coming across a bear on a hike, but also when we receive an ominous work email. The more threatening we perceive an event to be, the more cortisol we typically produce. Researchers frequently use public speaking as a tool for studying cortisol levels, she added, since any situation in which we’re being socially evaluated tends to produce a quick spike of cortisol.
北卡罗来纳大学夏洛特分校的健康心理学家珍妮特·M·贝内特研究压力对健康影响,她说,当我们面临挑战时,无论是心理上的还是身体上的,现实的还是想象中的,我们的身体都会释放这种化学物质。当我们遇到明显威胁时,比如在徒步时遇到熊,我们会释放皮质醇,但当我们收到不想看到的工作邮件时也会释放皮质醇。当我们感知到一件事越具有威胁性,通常就会产生更多的皮质醇。她还说,研究人员在研究皮质醇水平时,经常将人们的公开演讲作为研究工具,因为任何让我们面临社会评估的情况都会导致皮质醇快速上升。
“The mind and the body will respond as if we were in danger of dying, when actually what’s happening is that our sense of self is being threatened,” Dr. Picard said.
“身心会做出反应,就好像我们处于死亡的危险之中,而实际上受到威胁的是我们的自我意识,”皮卡德说。
This is a gift from evolution: Cortisol helps us mobilize the energy we need to confront, or flee from, danger, partly by raising the amount of glucose in our blood. It also regulates our metabolism. Our levels fluctuate throughout the day, rising when we first wake up and falling as we drift off to sleep, said Dr. Gregory Fricchione, the associate chief of psychiatry at Massachusetts General Hospital and a professor of psychiatry at Harvard Medical School.
这是进化带来的礼物:在对抗或逃离危险时,皮质醇通过提高我们血液中的葡萄糖含量,在一定程度上帮助我们调动所需的能量。它还调节我们的新陈代谢。马萨诸塞州综合医院精神病学副主任、哈佛医学院精神病学教授格雷戈里·弗里乔内博士说,我们的皮质醇水平全天都在波动,当我们第一次醒来时会上升,而当我们逐渐入睡时会下降。
“Cortisol is your friend,” Dr. Fricchione said, “until there’s too much of it.”
“皮质醇是你的朋友,”弗里乔内说,“但太多了就不好了。”
What happens when you have high cortisol?
当你的皮质醇水平高时会发生什么?
We function best when we have the right balance of cortisol. “Our bodies are this harmonic unit,” Dr. Fogelman said. But chronic stress can elevate our baseline cortisol levels over time, leading to a cascade of consequences. Persistently high cortisol levels may weaken the immune system, Dr. Fricchione said, as well as raise blood sugar levels and blood pressure. There’s also an integral link between cortisol and sleep: We need the hormone level to decrease so that we can fully rest. People with high cortisol often struggle to fall and stay asleep, Dr. Fricchione said.
当我们拥有适当的皮质醇平衡时,我们能够发挥得最好。“我们的身体就是这样的和谐单元,”福格曼说。但慢性压力会随着时间的推移提高我们的皮质醇水平基线,导致一系列后果。弗里乔内说,皮质醇水平持续偏高可能会削弱免疫系统,还会升高血糖水平和血压。皮质醇和睡眠之间也存在不可或缺的联系:我们需要降低激素水平才能充分休息。弗里乔内说,皮质醇含量高的人常常难以入睡且睡得不安稳。
Imbalances can also cause fatigue and irritability, Dr. Bennett said. “This is what’s hard with cortisol,” she said. “Because it’s such an inherently important hormone to just daily function, outside of stress, any time that daily rhythm is thrown off, that’s going to create behavioral problems.”
贝内特说,失衡也会导致疲劳和易怒。“这就是皮质醇的难点,”她说。“因为它是一种对日常功能非常重要的荷尔蒙,即使没有压力,任何时候日常节奏被打乱,都会造成行为问题。”
Some mental health conditions, including depression and post-traumatic stress disorder, are associated with cortisol imbalances, said Dr. Raza Sagarwala, a resident physician in the department of psychiatry at Vanderbilt University Medical Center who has studied the effects of non-pharmacological treatments on cortisol levels.
一些精神健康疾病——包括抑郁症和创伤后应激障碍——都与皮质醇失衡有关,范德比尔特大学医学中心精神病学系的住院医师拉扎·萨加尔瓦拉博士说。他做过非药物疗法对皮质醇水平影响的研究
In rare cases, people who develop excessive amounts of cortisol can exhibit a cluster of symptoms known as Cushing’s syndrome. Those with Cushing’s syndrome may develop a hump of fat on the back of their necks; some people gain weight, feel fatigue and have trouble sleeping. Some bruise easily, and their blood sugar and blood pressure levels may also rise. People with the condition may require medication or surgery, but they first need to be diagnosed by a doctor, said Dr. Pratibha P.R. Rao, the medical director of the Adrenal Center at the Cleveland Clinic.
在极少数情况下,皮质醇过多的人会出现一系列症状,被称为库欣综合征。患者可能会在脖子后部长出一团脂肪;有些人体重增加、感到疲劳并且难以入睡。有些人容易瘀伤,他们的血糖和血压水平也可能升高。克利夫兰诊所肾上腺中心医学主任普拉蒂巴·P·R·拉奥博士说,患有这种疾病的人可能需要药物治疗或手术,但首先需要由医生进行诊断。
Without testing cortisol levels and consulting a physician, it’s almost impossible to determine whether something like acne or poor sleep is definitively linked to hormone imbalances — and cortisol may just be a convenient culprit that people can point to when they don’t have any other clear explanations for their health concerns. “When people say they have elevated cortisol — I would tell you, you cannot feel that,” Dr. Bennett said. But if people are truly worried about their cortisol levels, experts said, they can talk to their primary care doctors about getting tested.
如果不测试皮质醇水平并咨询医生,几乎不可能确定痤疮或睡眠不佳等问题是否与荷尔蒙失衡有明确的联系——当人们对他们的健康问题找不到任何其他明确的解释时,皮质醇可能只是一个容易指认的罪魁祸首。“人们会说他们的皮质醇升高了——我会告诉你,你是感觉不到的,”贝内特说。但专家表示,如果人们真的担心他们的皮质醇水平,他们可以与他们的全科医生讨论是否需要做检测。
Can you measure your cortisol?
你能测量你的皮质醇吗?
You can use blood or saliva to test your cortisol levels at a particular moment, but a one-time snapshot isn’t likely to be particularly useful, Dr. Picard said, because cortisol levels change throughout the day. Urine or hair samples can reveal cortisol levels over a longer period of time, although hair samples are primarily used in research settings.
皮卡德说,你可以测试血液或唾液在某个特定时刻的皮质醇水平,但一次的检测不太可能特别有用,因为皮质醇水平在一天中都在变化。尿液或头发样本可显示较长时间内的皮质醇水平,尽管头发样本主要是在研究环境下使用。
Some companies offer at-home cortisol tests, which typically involve finger pricks or saliva swabs. But experts instead recommend talking to a primary care doctor, who may refer you to an endocrinologist. “I’m not one for all this home kit testing,” Dr. Rao said. “My advice is, don’t test in that way.”
一些公司提供了居家皮质醇检测服务,通常需要采指血或唾液拭子。不过专家的建议是去看初级照护医生,他们可能会推荐你去看内分泌科。“我不太支持这些居家检测,”拉奥说。“我的建议是不要这样做检测。”
One reason for the caution is that physicians try to obtain a comprehensive picture of how your cortisol levels ebb and flow before determining whether there may be any issues, said Dr. Mihail Zilbermint, an associate professor of clinical medicine specializing in endocrinology at Johns Hopkins Medicine.
其中一个原因是医生会尽量对你的皮质醇水平涨落做全面的了解,然后才判断是否存在问题,从事内分泌专业的约翰斯·霍普金斯医学院临床医学助理教授米哈伊尔·泽尔伯明特说。
“It’s not hard to test cortisol levels, but it’s not easy to interpret,” he added.
“检测皮质醇水平不难,但解读其含义就难了,”他还说。
Can you lower your cortisol levels?
可以把皮质醇水平降下来吗?
Some small studies have suggested that yoga and mindfulness interventions like meditation may help lower cortisol levels, Dr. Sagarwala said, adding that even setting aside five minutes a day to relax and reset the mind might be beneficial. He recommended the “five senses” exercise, which can ground you in a moment of stress: List five things you can see, four things you can touch, three things you can hear, two things you can smell and one thing you can taste.
有一些小型研究表明,瑜珈和冥想这样的正念干预可能有助于降低皮质醇水平,萨加尔瓦拉说,并且即使每天只拿出五分钟来放松自己,让心神复位,都是有好处的。他建议进行“五感”练习,让你在承受压力时沉下心来:列出五种你能看到的东西,四种能触碰的东西,三种能听到的东西,两种能闻到的东西,一种能尝到的东西。
Exercise can also be helpful for regulating cortisol, Dr. Bennett said, especially moderate physical activity like jogging or cycling. Those movements prompt your body to mirror your stress response, raising your heart rate and then lowering it once you stop working out. That cycle effectively trains our bodies to activate and shut down our stress response appropriately.
锻炼也有助于调节皮质醇,贝内特说,尤其是慢跑或骑自行车这样强度适中的身体活动。这样的运动会让你的身体去映射应激反应,提高心率,停止锻炼后再把心率降下来。这个循环有效地训练我们的身体去妥善地启动和关闭我们的应激反应。
People should identify the stress reduction methods that work best for them, Dr. Fogelman said. A few minutes of box breathing, for example, might soothe one person but not another. Once you find a strategy for alleviating stress, your cortisol levels can potentially become more stable, she added; this is true even for people who have been exposed to intense, long-term stress.
每个人都应该找到最适合自己的减压方法,福格曼说。例如有些人用几分钟的方格呼吸法可以平静下来,有的人则不能。一旦找到缓解压力的方法,你的皮质醇水平就有希望变得更稳定,她还说;这对那些要长时间面对巨大压力的人也是适用的。
“Stress is not a bad word,” Dr. Fricchione said. “Just being a living organism means that there’s going to be stress.”
“压力不是什么毛病,”弗里乔内说。“只要是个生命体就会有压力。”

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翻译:明斋、Duran

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