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Aldosterone in insulin resistance

Posted by Dr Sandy on in IR | 671 Views | Leave a response

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Transcript of “Aldosterone in insulin resistance”

When you’re insulin resistant, that is, you’ve got  metabolic syndrome, pretty much every chemical in the body is NOT QUITE RIGHT.  Some are up.  Some are down.  Few are actually at physiologically NORMAL levels.

Traditionally the focus is on the big guns.

  • Sugar
  • Insulin
  • And cholesterol

In this series, we  take a look at some of the other players.  Who they are, what they’re up to and how they’re part of the state of insulin resistance.

This week, we feature ALDOSTERONE.


aldosterone front page

Click here to view the Aldosterone in insulin resistance presentation as a prezi

Now, aldosterone is an UPPER.  It’s levels are typically HIGHER, than normal,  in someone who is insulin resistant and  it often goes,  hand in hand, with high blood pressure.

So what exactly is aldosterone ?

Well, aldosterone is classed as a mineralocoticoid hormone. It’s  derived from cholesterol and  produced by the adrenal glands, these are the little glands, perched on top of the kidney.

It’s BIG job – is to regulate the body’s salt levels.

This is quite important, because sodium is a mover and shaker.   Quite literally hundreds of transporters, dotted all over the body,  use the movement of sodium ions, as the vehicle to move things across cell membranes.

In by gone times………..before the advent of processed foods, sodium was a rather scarce resource.

So aldosterone had to work hard.  The way aldosterone helps the body, hold onto sodium, is by acting on the  mineralocorticoid receptors……….. specifically the ones, stuck in the tubules of the kidney.

Now, this encourages the kidney to hold onto sodium and to pee out potassium.

Which in by gone days, was rather pervasive. And potentially toxic.

In the process, of holding onto sodium and eliminating potassium,  water ends up being is reabsorbed…………….and this, is what impacts blood pressure.

The effect of aldosterone on blood pressure

You see, the water fills up the pipes and these have a fixed capacity.

So when blood pressure is low, the filling of the pipes is most helpful.

aldosterone restores blood pressure

Of course,  if the pipes become TOO FULL, the extra liquid, has “nowhere” to go, so the blood pressure rises.

aldosterone raises blood pressure

So aldosterone levels are carefully controlled.

Regulating aldosterone levels

By several systems,  most notably…..

The renin-angiotensin-aldosterone system or RAAS for short.   This system is triggered when there is a  drop in blood flow to the kidney.

The other important regulator of aldosterone levels, is the HPA axis – this is a hormonal system which connects the hypothalamus and pituitary, which are in the brain and the adrenal glands.  This system,  fires up every day, as part of your circadian rhythm, but it can also be triggered, when you face a particularly stressful situation.

So in a nutshell………

Aldosterone is a “stress” hormone.  Now, the stresses that trigger it’s release, are quite variable, they include  severe blood loss, severe anxiety.

aldosterone raises blood pressure

Mmmm not sure if you’ve ever thought about the fact that insulin resistance is to all intents and purposes…………… a stress response.

This explains why stress hormones, like aldosterone are elevated.

So what ?

Things to do, to “regulate” aldosterone levels

Well most of the stresses I listed are beyond your ability to control.  But having said that, you can nudge your aldosterone levels lower.

Now one of the ways to do this, is through meds that interfere with the RAAS pathway.  They will lower your blood pressure, but won’t do much to alleviate the “stress” response.   In actual fact, they’ll keep it firing.

To actually lower the stress response, you need to target, the actual stressors.

There are two levers, you can pull.

The first one,  would be to manage your sodium levels.   Remember TOO LITTLE sodium, not too much,  is the stressor.    Click here to learn more

The second, is to manage your insulin levels.  Studies have shown, insulin acts directly on the adrenal gland, bumping up the production of the adrenal steroids.

Here are a few of the journal articles I’ve used to tell the aldosterone story.

 Emerging Role of Aldosterone in Mediating the Vicious Cycle of Obesity, Insulin Resistance and Metabolic Syndrome. Korean Circ J. 2018 Mar;48(3):227-229.  Sungha Park

Insulin Regulates Adrenal Steroidogenesis by Stabilizing SF-1 activity.  Scientific Reports (2018) 8:5025.  Ann W. Kinyua, Khanh V. Doan, Dong Joo Yang, My Khanh Q. Huynh, Yun-Hee Choi, Dong Min Shin & Ki Woo Kim.

Effect of Low Salt Diet on Insulin Resistance in Salt Sensitive versus Salt Resistant Hypertension. Hypertension (2014) 64(6): 1384–1387. Rajesh Garg, Bei Sun, and Jonathan Williams 

Know someone who is  pre-diabetic or has  type 2 diabetes.  Share this post with them – so they  begin to look at their condition from a systems perspective.

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And if this is your first time here, be sure to subscribe, so you catch future episodes of the UPS & DOWNS of insulin resistance.

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Posted in IR | Tagged aldosterone, blood pressure, insulin resistance, salt, ups and downs

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Located in Johannesburg, South Africa

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