Basic Stress Physiology
Your body responds to its environment like a triage unit. Whether it is responding to physical, chemical, or emotional stress, the body requires the release of cortisol from the adrenal glands above many other functions. Tip: You can feel calm on the outside, but be stressed on the inside.
Your body wants to produce cortisol at the expense of other hormones such as estrogen. High amounts of cortisol then communicate back to the brain to tell the pituitary gland “enough cortisol”, and it stops producing hormones that release it. Over time, when you’re body is so concerned with turning “off” the pituitary so that it does not release more cortisol, the pituitary gland may limit the production of other hormones, notably thyroid and sex hormones. This is all controlled by an area of the brain known as the hypothalamus.
If you have chronically high levels of cortisol over time, this wreaks havoc on your body – affecting your immune system, sex hormones, blood sugar control, sleep and energy, your detoxification capacity, as well as even bone density. Even slightly elevated levels over time can contribute to the progression certain diseases and may even include neurodegenerative diseases like Parkinson’s or Alzheimer’s disease.
The H-P-A-T Axis
The hypothalamus tells the pituitary what to do. When you’re body has high amounts of cortisol, it turns “off” the pituitary. Which also turns off other hormones…over time the hypothalamus region of the brain begins to deteriorate as the body sees it as “less important”. When the hypothalamus begins losing function, the fear and anxiety center of the brain known as the amygdala tends to take over. This process happens over a spectrum of function and therefore, can linger underneath the surface for years before major symptoms develop.
Because of these interactions, long-standing stress can lead to chronic insomnia, frequent waking, thyroid problems, immune problems, hair loss, and even depression.
This pathway is known commonly in textbooks as the: “Hypothalamus-Pituitary-Adrenal-Thyroid (HPAT) Axis” and it regulates how well you respond to stress. Most textbooks refer to it as just the HPA axis, but research now shows a clear relationship with thyroid health – even when blood test seem to be in the “normal” range. I’ve explored the impact of stress on the thyroid previously.
Here are some lifestyle techniques that help to keep this system in balance.
Formula for Stress
1. Balance Your Blood Sugar: There’s a reason that I categorize adrenal & blood sugar disorders together. Cortisol should be naturally high in the morning, then taper down during the day, and then rise again overnight as you sleep. When you sleep you are fasting and the body depends on cortisol to release sugar reserves it needs to maintain body functions overnight. If you have drastic peaks and valleys in your blood sugar control over the course of a day, this puts unnecessary stress on your adrenals.
It also creates a vicious, self-feeding cycle: High cortisol leads to insulin resistance and insulin resistance leads to high cortisol!
Key Point: You do not have to be overweight or insulin resistant for your blood sugar to be out of balance. It can be independently driven by stress.
a. Eat every 2-3 hours. Even if it’s just a small snack like a handful of nuts. It’s important to “graze” throughout the day rather than eating major meals spaced apart from one another. Because of stressful work & family schedules, it can be common to miss meals -especially breakfast. Never skip breakfast and forgo your typical breakfast foods. Assuming you do not have an allergy, nothing is wrong with grilled chicken, eggs, or nuts with breakfast. A good source of high quality protein is best.
Key Point: You need to eat to keep your stress under control and to defend against stress cravings that lead you to unhealthy foods.
b. Identify Your Carbohydrate Tolerance: If you’re tired after a meal or hungry for sweets shortly after eating a meal, it’s likely you have exceeded your body’s ability to handle carbohydrates. You’re tired because the body is unable to allow sugar to enter your cells and is frantically turning them into triglycerides instead! Stay away from fruit juices and other sweetened beverages. Watch your intake of starchy fruits, vegetables, & refined grains. Find the balance that’s right for your unique health profile.
Key Point: Some people are at a point where every meal makes them tired. These individuals need added support, or may just need a longer time period for their systems to balance. Be patient or seek help from a qualified health professional trained in functional nutrition, since there are many resources for this, for example Rootine wrote an article on cellular nutrition which could be really interesting for this.
2. Consider Using Balancing, “Adaptogenic Herbs like Ashwagandha. These herbs help to stimulate your adrenal glands and maintain an appropriate balance of cortisol. The interesting thing is that these herbs help whether you have too much or too little cortisol. Some of these herbs have been used for 1000’s of years. It’s interesting how some of the major advances in medicine today were the treatments of choice centuries or even millennia ago!
Many individuals are exploring bio-identical hormone treatment or medical hormone replacement therapy for the symptoms. Many hormonal imbalances may have their root in chronic stress & adrenal fatigue. These patients often feel better while undergoing treatment, but can experience unintended side effects after treatment & still rarely focus on the root cause of their condition.
There are reasons why Doctors will not use hormone replacement for more than two years, and afterwards, will not revisit it again. For instance, your body may not be producing estrogen like it used to, when you take synthetic estrogen it can turn off the release of other hormones such as the thyroid, potentially leading to polypharmacy and increased risk of adverse reactions to your medication. Talk to your prescribing medical doctor about possible side effects and alternative options to hormone management.
Key Point: After menopause, your main source of hormone production turns to the adrenals. If you had fatigued adrenals coming into menopause, you may not transition as well and experience a hormone rollercoaster such as the hot flashes, mood swings, disturbed sleep, weight gain, thinning hair, loss of bone density, and other signs and symptoms that women commonly report.
3. Identify Hidden Allergies, Sensitivities, and/or Intolerances: Hidden allergies to commonly consumed foods such as corn, wheat, dairy, soy, & eggs, account for some 90% or more of allergies in the United States. Some ethnic backgrounds can tolerate certain foods better than others, but as a general rule, these are the main culprits you need to worry about. Consider the gold standard of an elimination diet followed by the reintroduction of each food individually. Or, consider both IgE (what it’s typically tested), and IgG testing (delayed allergies not usually screened). Sometimes you feel better by eating foods that you are reactive simply because you’re immune system is unable to respond anymore. This is why “withdrawal” reactions can take place upon removing certain foods.
More importantly, these hidden reactions to food can act like a slow, smoldering fire going on underneath the surface. You can often get through life with minor annoyances and discomforts, but sooner or later the right spark can set more serious problems ablaze.
In the case of Celiac disease (the autoimmune reaction to wheat/gluten intake), only one out of eight people with the disease actually know they have the disease! For biopsies to come back positive, you need at least 50% damage inflicted on your stomach lining. Many patients have been scoped and biopsied and still suffer problems while their doctors tell them nothing is wrong & that no lifestyle change is necessary.
Key Point: Give a full elimination diet a trial and see how you feel…what do you have to lose? Small, low-level stresses over time can and do contribute to chronic disease over periods of 5-20+ years.
4. Watch out for Hidden Gut Infections: When the gut is inflamed, it is often accompanied by an imbalance of the healthy bacteria normally found in the gut. These healthy bacteria host a myriad of functions including important roles in the immune system, digestion, thyroid function & general cell health. Ever know a “Type A” personality who gave themselves an ulcer with stress? Ever have diarrhea when preparing to give a speech, or the moments before an important sporting event begins?
Cortisol dampens the ability of the immune system to defend against pathogens. Pathogenic yeasts and other bacteria such as H. pylori that are naturally found in low amounts in the GI tract, can now claim substantial real estate in your gut lining.
Additionally, if you’ve been camping or traveling and drinking untreated water, there’s a possibility of parasites and other infections such as Giardia. Even a past history of frequent antibiotic issues can lead to a loss of healthy bacteria and an overgrowth of harmful bacteria.
5. Eliminate Sources of Caffeine, Even Decaffeinated Varieties: Caffeine triggers a stress response and the release of catecholamines called epinephrine and norepinephrine. If you’re a person who wakes up in the middle of the night frequently, it’s because when your body is unable to produce enough cortisol, it will produce catecholamines in their place – making you wired and awake.
Decaffeinated coffee and tea can still contain up to 60% of the caffeine. The only exception I will make with patients is to drink green tea. Green tea has some caffeine but it also has healthy compounds such as EGCG & L-theanine – which help with detoxification & relaxation. Some still need to be extremely strict and also eliminate green tea from their diet – at least until their stress improves.
6. Consider Mainstream Stress-Reduction Techniques: Meditation, biofeedback, deep breathing, reading affirmations, visualization, yoga, stretching and even self-hypnosis have been proven to significantly reduce stress. These stress-reduction tips are listed last because you and I both know that it can be extremely difficult and impractical to sit and meditate for even five to ten minutes when we feel wired & stressed.
Many clinicians will recognize the important role of stress in health & disease, but will respond by telling us to sleep more, breathe more, slow down, and maybe try meditation if it works for you. Although these tips would surely improve anyone’s stress…having trouble sleeping and finding mental clarity are some of the main reasons patients like you visit the doctor in the first place! Many still just prescribe medications which may work in the short-term, but still may leave you asking questions over the long-term.
It’s frustrating to visit a doctor because you are “sick and tired of being sick and tired”, and being told that to fix it you need to sleep more, to quit worrying about it, or worse, being told it’s “all in your head”.
Change IS Possible
If you are fearful of practicing some of these lifestyle techniques because of withdrawal reactions such as a caffeine headache, feeling ill, or suffering from mood swings – it’s a sign that your body is already in a chronic state of compensation.
Sooner or later, instead of depending on caffeine & sweets, you may be depending on pharmaceutical drugs to keep your system in balance – and have little choice about it. I share these tips because I want you to take control while you still have it, and if you feel you need further help & guidance, I’d love the privilege of being a resource for you.
What’s your Stress Formula? Any tips to add? How do you cope with the inevitable stress in your life?
