Allostatic Load In order to understand what is meant by ‘allostatic load’, one must first

understand what is meant by the main term ‘allostasis’. Allostasis, a concept first developed by
Peter Sterling and Joseph Eyer in 1988, literally means “stability through change”. It has been
used to describe how the physiological parameters of the human body co-vary when there is a
change in the behavioral or psychological state of the organism ( Sterling, P., Eyer 1998). In order
to maintain healthy functioning, allostasis “requires the ongoing adjustments of one’s internal
physiologic milieu and the result is the physiologic systems exhibiting fluctuating levels of
activity as they respond to and adapt to meet their environmental Activity (Seeman 1997). This
contrasts with the earlier concept of homeostasis, which emphasizes the “importance of
maintaining constancy of ones "milieu intérieur" as the hallmark of healthy functioning”
(Seeman 1997). Whereas the latter focuses on optimal set points, the former highlights optimal
operating ranges as the benchmark for normalcy and stability.

Protective and Damaging Effects of Stress Mediators’, Dr. Bruce McEwen provided the
following illustration that demonstrated how the idea of ‘stressors’ and ‘perceived stress’ relate
to the concepts of ‘allostasis’ and ‘allostatic load’ ( McEwen 1998). In the illustration, the
concepts of allostasis and allostatic load are described as ‘a cascade of cause and effect that
begins with the primary stress mediators leading to primary effects and then to secondary and
tertiary outcomes’. The primary stress mediators of allostasis, or the chemical messengers that
are released as a part of allostasis, include the ‘adrenal steroids and catecholamine.

As depicted over time, allostatic load, proposed by Dr. McEwen and Dr. Eliot Stellar as ‘the cost
of chronic exposure to fluctuating or heightened neural or neuroendocrine response resulting
from repeated or chronic environmental challenge that an individual reacts to as being
particularly stressful’ (McEwen and Stellar 1993) ‘can accumulate and the overexposure to
mediators of neural, endocrine and immune system stress can have adverse effects on various
organ systems leading an individual to disease’.

Studies that examine the effects of high allostatic load have found instances of both cognitive
and physical impairment among those with high allostatic load scores (Landforms 2006) .

Reference
Sterling, P., Eyer, J., Allostasis: A New Paradigm to Explain Arousal Pathology, in Handbook of
Life Stress, Cognition and Health, S. Fisher, Reason, J., Editor. 1988, John Wiley & Sons:
Oxford, England. p. 750

McEwen, B.S., Protective and damaging effects of stress mediators. N Engl J Med, 1998. 338(3):
p. 171-9.

McEwen, B.S. and E. Stellar, Stress and the individual. Mechanisms leading to disease. Arch
Intern Med, 1993. 153(18): p. 2093-101.

Seeman, T.E., et al., Price of adaptation--allostatic load and its health consequences. MacArthur
studies of successful aging. Arch Intern Med, 1997. 157(19): p. 2259-68.

Lindfors, P., O. Lundberg, and U. Lundberg, Allostatic load and clinical risk as related to sense of
coherence in middle-aged women. Psychosom Med, 2006. 68(5): p. 801-7.