Homeostasis of the body and development of the diseased state

All living organisms have systems which work in concert to maintain functions in the setting of external or internal perturbations.  This process is known as homeostasis.  Whether it is the acquisition of energy through food or the ability of the body to adjust to threat of physical harm, or “fight or flight”, the body is able to accomplish and optimize its function to allow for maximal effect.  From a single-celled organism to advanced animals, the ability of an organism to adjust becomes a multi-systemic process.

While a single-celled organism could die (“lyse”) if it came across too much alcohol, sodium or sucrose (table sugar) in its environment, an advanced organism has a multi-cellular system to buffer the direct effects of these substances up to a point.  What might be poisonous on a cellular level, in an advanced organism, multiple cells lining its digestive tract can begin to manage these substances and reduce the direct harm.  After the substance is absorbed from the intestines and filters into the liver cells, toxins can be metabolized to less harmful products.  For example, alcohol is broken down in two steps by alcohol dehydrogenase and its product aldehyde by aldehyde dehydrogenase in liver cells to form acetate, which is then converted to carbon dioxide (exhaled) and water (urinated).    For alcohol, the lethal dose 50 (LD50 = a calculation of a dose in which a level is expected to kill half of the population) is a blood alcohol between 0.35 and 0.40 percent, which constitutes about 17 beers in 1 hour for a man weighing 180 pounds.  For sugar, a potentially LD-50 for the same adult would approach 5 lbs  – or more than 250 pieces of “fun size” Halloween candy (20,000 calories).  That’s a lot of candy corn!  For salt poisoning, a more common event with drowning survivors or drinking sea water if stranded at sea, it is estimated that as little as 25 grams of sodium (around 4 tablespoons) at one time for an adult and 7-13 grams for a child could be lethal.  It is definitely not a wise decision to conduct a salt-eating challenge to boost your social media followers.

The greater the perturbation in the system, the less compensated the adjustment and more harmful or life-threatening the consequence.  The body’s shift from “compensated” to an “uncompensated” or “diseased state” can occur rapidly, such as from a poison or drug ingestion or insidiously, such as the long-term effects of high glucose levels on the tissue of the kidneys, eyes and nerves.     It is at this crossroads where a patient may present with symptoms or have signs of a developing dysfunction. 

I am always amazed when I see a patient with severe anemia from a slow-bleeding colonic tumor presenting with no more than a gradual fatigue and weakness to the point.  If a patient were to develop an acute, significant gastrointestinal bleed from a stomach ulcer, s/he may suddenly become weak and dizzy – and probably pass dark, tarry stools or even blood in the stool.  At a much higher blood count than the patient with a slow-bleeding tumor, their systems decompensate.

Our body makes similar functional adjustments as one gains weight through time.  The adjustment process can become more severe as weight gain occurs, leading to a breaking point, when the health effects of weight impact the quality of life.  Many people may have noticed early signs and symptoms of these changes, including fatigue, body aches or fibromyalgia symptoms and sleep disorders.  They may have already sought out providers or tried different medications or used substances to treat the problems with a temporary effect.  A person may take ibuprofen for back pain or body aches.   He or she may drink caffeinated beverages for an energy boost.  They may take sleeping pills for sleep apnea.  They may take herbal or homeopathic medications and potentially delay the recognition of the underlying problem.