Allostase und allostatische Last – Grenzgänge zwischen Gesundheit und Krankheit

Authors

Johannes W. Dietrich, Julia Altenberend

Published in

Leibniz Online. Volume 61. Sep 01, 2026.

Abstract

Outside distinctive ecological niches, the evolution of species is marked by an increasing independence of the organism from external physical and chemical boundary conditions. This form of freedom, characteristic of living systems, requires means of “autopoiesis”, i.e., ways for the organism to produce and maintain itself through information processing, self-regulation, and self-organisation. The discovery of these principles hallmarked the transition to modern life sciences over the past 200 years. Key elements of this advance were Claude Bernard's concept of the “milieu intérieur” and Walter B. Cannon’s closely related principle of homeostasis. The theory of homeostasis plays a key role in modern physiology, but leaves important gaps regarding the pathophysiology of disease. This shortcoming has been addressed by the supplemental concept of allostasis, extending the homeostatic theory by introducing adaptive and predictive modes of control. Allostatic responses ensure “stability through change” in situations of strain and stress. In allostatic mode, a feedback control system can adjust its set point and parameters to approach a state vector that is better suited for survival. Although allostasis is generally beneficial for survival, it also exposes the organism to some new kind of strain, referred to as allostatic load. If ongoing or excessive, allostatic load may be life-threatening on its own terms, which is referred to as allostatic overload. The theory of allostasis helps to elevate our understanding of a wide range of diseases and biopsychosocial situations. Examples include fever, starvation, type 2 diabetes, hypertension, thyroid disorders, psychosomatic diseases and chronic sequelae of social disparity. The recent development of clinically applicable panels for the quantitative assessment of allostatic load facilitates differential diagnosis at the narrow frontier between health and disease.

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• 06_Allostase_Dietrich_Altenberend_FR_GH.pdf

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