How Does Stress Impact Your Health?
What is it about stress that impacts our health in such a silent yet detrimental way?
Knowing our bodies better can help in putting the pieces together, so let’s dive into some biology and science.
Anatomy:
You have 2 glands that sit on top of your kidneys like little pyramids. These are your Adrenal Glands.
Your adrenals make: Cortisol Epinephrine Norepinephrine Aldosterone Sex hormones: Testosterone, Progesterone, and Estrogen.
For now, let’s focus on the hormones directly related to stress.
Cortisol
Cortisol is a hormone that impacts every organ in the body. It helps to regulate stress, blood sugar, and blood pressure. It plays an important role in metabolism and your sleep-wake cycles. Cortisol also suppresses inflammation and pain.
When the sun begins to rise, our eyes sense the increase in light and this triggers cortisol production. Because of this, cortisol is highest in the morning and tells us to wake up. When we are frightened or under a lot of stress, our adrenals will make more cortisol along with epinephrine and norepinephrine to help us survive.
The body responds the same way if you are running from a bear, lost in the woods with a broken ankle, or burning the midnight oil trying to meet that do-or-die deadline. I think I just gave new meaning to the term “deadline.”
Healthy Cortisol | Unhealthy Cortisol from long-term stress or use of cortico-steriod drugs. |
Helps us wake up in the morning | Insomnia, Can't fall aseep |
Helps our body digest and utilize carbohydrates, fats, and proteins | Can't lose weight |
Decreases stomach acid and digestive enzymes and causes GI distress. | |
It suppresses pain and inflammation immediately. | Long term stress can causes chronic pain, chronic inflammation, and auto-immune disease. |
Regulates blood pressure | If left unchecked, can cause blood pressure. |
Regulates Blood Sugar | Dumps more blood sugar into the system and can contribute to diabetes. |
Regulates electrolytes | Can contribute to osteoporosis. |
Epinephrine
Epinephrine, also known as “adrenaline”, plays a role in focus, panic, metabolism, and excitement. It’s made in the adrenal glands when our body is in “fight or flight” response or when we are doing activities that scare and excite us. Have you heard of an Epi-pen or “adrenaline junkies”? Epi-pens are a high dose of epinephrine. It quickly opens the lungs so you can breathe, increases your heart rate, and strengthens the heart muscle contraction. Blood vessels to your important organs, like the brain, heart, and muscles, dilate to improve performance, focus, and energy. Short term this can save someone’s life and can give someone an “adrenaline” high. Overtime, however, this is damaging to the body.
Healthy actions of Epinephrine
In the moment, Epinephrine can save someone's life when they are in anaphylaxis. It can also increase blood flow the brain, heart, and muscles but long term levels of epinephrine
Long term, negative Impacts
Long term effects of Epinephrine may contribute to conditions like dysautonomia: poor regulation of the nervous system and can cause damage to the blood vessels. It increases the risk of heart attacks and strokes from high blood pressure.
Further explanation is beyond the scope of this article.
Wong DL, Tai TC, Wong-Faull DC, Claycomb R, Meloni EG, Myers KM, Carlezon WA Jr, Kvetnansky R. Epinephrine: a short- and long-term regulator of stress and development of illness : a potential new role for epinephrine in stress. Cell Mol Neurobiol. 2012 Jul;32(5):737-48. doi: 10.1007/s10571-011-9768-0. Epub 2011 Nov 17. PMID: 22090159.
Norepinephrine
A hormone that plays closely with epinephrine as it gets secreted during a fight or flight response. This hormone is mainly stored at the end of your nerves and get released when you need to act fast. Norepinephrine will constrict blood vessels to increase blood pressure, will also increase your heart rate, and it dumps more glucose into the blood to fuel the brain, muscles, and the heart.
Let’s paint a picture:
You wake up rushed in the morning to get ready, get the kids fed, and out the door in time. You rush to your computer or your work. The morning is busy with tasks, and you may have skipped breakfast. You rush through lunch, sometimes even working and eating at your desk. Time is ticking and you can’t believe it’s already 2:00! You find yourself asking, “where did the day go?!” You rush to pick up the kids, feed them a snack, and take them to whatever practice they’ve got. Meanwhile, your phone is buzzing with alerts and texts. Then your family needs dinner. Heck, you need dinner! You get everyone fed and it’s time to do homework, manage the kids’ needs, AND somewhere in there you need to exercise and take care of you! WHOA!!
Add in work pressure, spouse stress, societal expectations, and whatever you are dealing with personally.
My cortisol is spiking just thinking and writing about all that!
If this describes your life, what do you think the body is doing to keep you going? It’s producing all those fight or flight hormones mentioned above.
When cortisol spikes to keep up with the lifestyle I just described, epinephrine and norepinephrine get produced as well. If you stay in that state constantly, it’s no wonder your blood pressure is rising, you’re chronically exhausted, and still can’t sleep. That stubborn weight won’t come off and all you want is either salty snacks or sugar.
Nearly 70 million American’s struggle with Insomnia
37.3 million Americans, 1 in 10, have diabetes and of those, over 90% are diagnosed with the lifestyle preventable Type 2.
68 million Americans, 1 in 3, have high blood pressure.
More than 795,000 Americans have a stroke every year.
There are about 805,000 heart attacks in the United States every year.
Work related stress causes 120,000 deaths and results in $190 billion in healthcare costs annually.
https://www.stress.org/42-worrying-workplace-stress-statistics. The American Institute of Stress. September 23, 2019. Author Milja Milenkovic.
https://www.smallbizgenius.net/by-the-numbers/workplace-stress-statistics/. 42 Worrying Workplace Stress Statistics. Author Damjan Jugovic Spajic/ March 17, 2022.
Stress is not the only reason for poor health, but its certainly a part of the equation.
To further explore this, I would like to break down various complaints in the primary care setting and how stress can be a contributing factor. Please note that there are many other factors that can play into the following conditions.
Stress and Insomnia:
When sunlight hits the back of your eyes, there is a domino effect of signals that tells the brain to wake up. When this happens, cortisol will rise to help you get going. Healthy levels of cortisol will help you wake up like a spring chicken ready to go. When you go through your day as described above, the stress of the day will demand cortisol to stay elevated. Cortisol naturally falls as the day progresses but with the demands of the modern “go-go, get ‘em, get ‘em”, the cortisol is never allowed to fall. Cortisol will inhibit melatonin, our sleepy hormone, to be produced. So, a common cause for the kind of insomnia when someone is struggling to fall asleep initially will be high cortisol at night. Your body may be making plenty of melatonin, but your mind is very much awake and stressed. That fight or flight is a survival mechanism. If you are in this state, do you think your body will feel “safe” enough to relax and sleep. No! The body will behave in a rest with one eye always opened.
The other picture of cortisol and insomnia is the person that pings up quickly and startled in the middle of the night and can’t fall back to sleep. Their mind is on and can’t shut off. This excitatory state means your body is in a “stress” state.
Top Tips:
1. Shut it down. Stop work related activities 1-2 hours BEFORE bedtime. Your body needs time to wind down.
2. Magnesium helps to relax the nerves and the muscles. Magnesium glycinate is great for the racing mind and for those who have looser stools. Magnesium citrate is great with restless legs and slower bowels.
3. Cortisol reducing herbs taking at night can be beneficial in calming the stress response.
4. Try a calming, reflective activity like coloring, puzzling, a gratitude journal, reading scripture, or meditating.
Stress and Diabetes
The body will always choose survival over reproduction, sleeping, digestion, and healing. We can heal later but first we need to get out of this life-threatening situation. Remember, the body doesn’t know the difference between running from a bear and living a modern-work-family-life balance.
During your state of “survival”, the body is designed to pull more sugar (glucose) into the blood stream and take it to the important survival organs like our muscles, heart, and brain for fuel. This extra boost in sugar helps us to think fast on our feet, run, and perform at top shape. The heart needs to keep up as well. But what if we are sitting at our desks or in our cars? Where is all this extra glucose going? What about when we are craving those sugary snacks while sitting in our stressed-out state? Why are you craving those sugary snacks in the first place??
The stress in your body is dumping more glucose into the blood and because you’ve skipped breakfast and had a standard American, highly processed, carbohydrate lunch, your blood sugar is super high.
GLUCOSE goes UP and stays UP because we aren’t using it like we would if we were literally running from danger. THIS PICTURE WILL LEAD TO DIABETES.
Diabetes is too much sugar in the blood.
Top Tips: 1. You must add movement/Exercise into your day 2. Choose protein snacks and not sugary snacks 3. Watch your afternoon caffeine 4. Whole Grains are your friend because they contain FIBER which keeps you full longer and stabilizes your blood sugar.
Stress and Blood Pressure
In times of stress, when you’re pushing the limits between excitement mixed in with a little fear, or when you are pushing your body to the limits in endurance sports, epinephrine (adrenaline) and norepinephrine gets secreted in response to the increase in cortisol. This increases the heart rate and triggers stronger contractions of the heart to pump blood and glucose to the survival organs like we discussed: brain, muscle, and heart. As discussed above, epinephrine and norepinephrine will contract blood vessels to less important organs for survival like your digestive tract and reproductive organs. When we are running from the bear, we don’t have time to go to the bathroom or reproduce. We’re busy surviving but this comes at a cost.
The constriction of blood vessels combined with an increased heart rate will increase blood pressure. Living in a perpetual state of stress will put stress on your heart and blood vessels. This can lead to what we are seeing: deadly heart attacks and stroke. Stress combined with a poor diet and the desk-job lifestyle is a recipe for cardiovascular disaster.
Cortisol is also playing into this trifecta. It works with the kidneys to control sodium-potassium levels in the body as well as fluid control. This help with keeping blood pressure regulated in that fight or flight response but is another layer to increasing blood pressure with day-to-day stress.
Top Tips:
1. Many will crave salt when they are stressed and their adrenal glands are running on empty. Having a pinch of salt is fine. In fact, your body may need it along with other minerals. The problem is the obscene amounts of salt in processed foods.
2. Take breaks from your desk and go for a walk outside.
3. Breathe in the fresh air.
Time Efficient Inspiratory Muscle Strength Training Lowers Blood Pressure and Improve Endothelial Function, NO Bioavaliblilty, and Oxidative Stress in Midlife/Older Adults with Above Normal Blood Pressure. Daniel H. Craighead , Thomas C. Heinbockel , Kaitlin A. Freeberg , Matthew J. Rossman , Rachel A. Jackman , Lindsey R. Jankowski , Makinzie N. Hamilton , Brian P. Ziemba , Julie A. Reisz , Angelo D’Alessandro , L. Madden Brewster , Christopher A. DeSouza , Zhiying You , Michel Chonchol , E. Fiona Bailey and Douglas R. Seals. Originally published29 Jun 2021https://doi.org/10.1161/JAHA.121.020980Journal of the American Heart Association. 2021;10:e020980 https://doi.org/10.1161/JAHA.121.020980 PMID: 34184544 Manuscript received January 22, 2021. Manuscript accepted April 22, 2021
https://www.modernheartandvascular.com/breathing-techniques-that-lower-blood-pressure/ Breathing Techniques that Lower Blood Pressure. Modern Heart and Vascular.
Stress and Digestion:
Have you heard of stress causing a stomach ulcer? What about having an upset stomach before an important presentation or butterflies in your stomach before a performance? The overly excited or scared thoughts in your mind can trigger a physical response in your stomach and your intestines. This is a great example of how our thoughts can lead to a physical response in the body. This is also another great example on how the brain and digestive tract interact with one another. When the brain senses danger, fear, or a high level of excitement, it sends signals to the adrenals to make cortisol. When your cortisol is elevated, this slows stomach emptying and causes stomach acid to pool; irritating the stomach lining and potentially causing an ulcer. This increase in stomach acid can cause nausea, acid reflux, vomiting, and pain. Elevated cortisol can initially cause spasms along the large intestines leading to lose stool or diarrhea in some people. These uncomfortable symptoms can add fuel to your stress and create a viscous cycle.
Cortisol has also been shown to inflame the gut lining, decrease digestive enzyme activity, and cause an imbalance in your gut flora. Remember, your digestive tract isn’t a “survival” organ system. During moments of stress, blood flow to this area slows down.
Stress = decrease in optimal digestion
Top Tips:
1. If you’re under a ton of stress and your stomach is a mess, consider eating cooked foods instead of raw foods. Steamed and cooked vegetables are far easier to digest.
2. Slippery Elm Bark or Marshmallow root are two herbs we call, demulcents. Like aloe vera to burnt skin, these herbs can soothe an irritated stomach.
3. L-glutamine is the most prominent amino acid in strengthening the gut lining. This may be a useful supplement to take to protect the digestive tract from the damage stress can cause.
4. Chamomile tea can soothe not only your digestive tract but also your nerves. It’s a calming, safe herb to take anytime.
Stress and the Brain
Did you know they are studying the impacts of cortisol on the brain and other parts of the body in veterans? Veterans have been under extremely stressful situations and have very high cortisol that’s measurable in their hair. The findings are striking. Studies are showing a decrease in not only the hippocampus, the part of the brain responsible for memory and learning, but also the prefrontal cortex, another part of the brain related to memory. Alzheimer’s anyone? 6.5 million Americans are living with Alzheimer’s and this number is expected to grow. Conversion Disorder is another decline in neurological function that gets aggravated by stress. Bottom line, stress is hurting the brain. Brain fog, difficulty in concentrating, memory loss, headaches, anxiety, PTSD, and depression are all signs of an inflamed brain.
If I haven’t made it clear why stress can be a silent killer, let me ask you this:
Have you ever been so stressed you can’t complete a sentence, you start stuttering, or you can’t solve a problem? It isn’t until you stop, breathe, and go for a walk outside that logic returns and solutions become clear. Your brain is calming down and being allowed to process optimally.
Cortisol shuts down the higher reasoning and logical thinking centers in our brain so that we can do crazy things like punch a shark in the face or run from danger on a broken ankle. A more modern example is the toilet paper shortage during the pandemic. People were stressed to the max and SARS-CoV-2 (COVID 19) is a respiratory and vascular virus, not a “stomach” virus. When people are in a panic, they can do irrational and silly things. They are in survival mode and not logical, higher problem-solving mode. Don’t we need to be in the higher problem-solving mode in our careers or our lives? YES! Therefore, taking brain breaks and going for walks outside is so important. It literally keeps your brain healthy and functioning optimally.
Top Tips:
1. Take brain breaks throughout the day. Get up, go for a short walk outside, and come back to your work.
2. Try a 5-minute guided meditation at your desk. Search for a guided meditation on YouTube, turn off your lights, close your eyes, and rest. I promise you will feel refreshed.
3. Consider scheduling a workout in the middle of your day. This not only breaks up your day, but you will become healthier, stronger, and more confident from the exercise. The exercise also improves circulation to the brain which it desperately needs. When you get back to the office, I promise you’ll be refreshed and able to tolerate stressors better.
Stress and Inflammation
You have 2 kinds of inflammation: acute and chronic. The acute, or good kind, of inflammation is how the body responds to infections, injuries, or foreign substances. It works to fight infection and heal injuries. Chronic inflammation is the bad kind and is associated with chronic diseases. Its an ongoing form of inflammation that is considered the cause of all ailments
The 5 classic signs of good inflammation are:
1. Pain
2. Heat
a. Fever
b. Hover your hand over an area that looks “inflamed.” Is it warm/hot?
3. Redness
4. Swelling
5. Loss of function
When the body is injured or infected, it releases chemical messengers that will cause the blood vessels in that area to dilate, allowing important nutrients for healing to pass through. This is what causes swelling and puts more pressure on the already irritated nerves, creating more pain. The increased blood flow is what creates the heat and redness. The loss of function is due to the disruption of the tissue or structure itself.
Think about when you have a sinus infection. The congestion and the fever are symptoms that your immune system is doing its job but its uncomfortable and often-times creates a sinus/pressure headache.
This is the healing processing in all its glory. Let’s face it. Physical and even emotional healing hurts.
Culturally we don’t want to deal with the pain, so we medicate. *But this may not be the fault of the consumer but the fault of modern medicine. We need to get better at teaching our patients HOW to deal with emotional pain in a healthy way or HOW to help the body heal on its own. Naturopathic doctors take it a step further by looking at the causes and working to eliminate those. Medications are there when we are really suffering but not as the first line of therapy when someone can work through something.
What’s important to understand is that early inflammation, whether it’s physical or emotional, is GOOD because it’s our bodies natural way of healing. It can be uncomfortable but it’s part of the process. Medicate when a fever is too high or when the pain is too great because there will be times when that is necessary.
Overall, however, its good to thing about the following:
What’s the opposite of healing?
NOT HEALING!
What happens if we don’t heal?
WE GET WORSE!
What does worse look like?
CHRONIC, ONGOING PAIN and SUFFERING THAT WILL CONTINUE TO GET WORSE!
Before you know it, you are taking 4 or more medications for the rest of your life.
Did you know the average older American takes 4 medications? 40% of older Americans take 5 or more medications and 20% takes more than 10!
Modern medicine commonly prescribes a class of drugs called “corticosteroids” for those in chronic or acute states of pain, inflammation, or infection. You might recognize names like, Prednisone, Hydrocortisone, or Cortisone shots. These are very high dosages of “cortisol” because we know that cortisol puts an immediate stop to pain and inflammation. Over-the-counter anti-inflammatories like Advil or Motrin act similarly but are not as strong. Whatever pharmaceutical you take, the benefits of anti-inflammatories are the same. IMMEDIATE RELIEF! It’s amazing until the pain comes back. Anything lasting longer than 6 months is a chronic, ongoing issue.
We have just established that inflammation in its early stages are good and necessary for healing. When you take an anti-inflammatory that means you are slowing healing down. The stronger the anti-inflammatory, such as Cortisone or Prednisone, the stronger the suppression of inflammation. Remember, inflammation hurts. Most people who take a pharmaceutical grade corticosteroid will observe immediate relief. Well guess what?!
A common prescription would be a 10-day dosage of Prednisone only and only 3 cortisone injections in one spot. Why? Because there are severe consequences to long term use of these medications. The side effects to these medications will look like people who are in CHRONIC, ONGOING STRESS!
Stress = an increase in cortisol, epinephrine, and norepinephrine.
In this article, I have described the negative impacts of long-term stress or high cortisol.
I’m basically describing potential side effects of Prednisone because its “cortisol” on steroids…literally. That’s why we call them “cortico-steriod” drugs.
When cortisol is elevated for long periods of time, it eventually will turn into a pro-inflammatory substance, adding fuel to an inflamed fire. Stress will increase pain, it will suppress your immune system, slow down healing, flare up autoimmune disorders, among many other consequences.
Long term, chronic inflammation caused by poor lifestyle choices, our environment, STRESS, and chronic illnesses need to be addressed either through suppression, modulation, or eliminating the cause.
Therefore, it is so important to explore what is causing the stress and work towards solutions to decrease or minimize it. Looking into behaviors that are inflaming your body and working to address those are also moving in the direction of healing.
Disclaimer: This article is NOT recommending you stop your medications. This article is also NOT telling you or advising you on how to treat any health condition. The intention of this section is to educate the reader on the concepts of inflammation, healing, and how stress or cortisol impacts that process. To bring home this message, I’m using the example of corticosteroids.
Resource:
Chronic Stress, Cortisol Dysfunction, and Pain: A psychoneuroendocrine rationale for stress management in pain rehabilitation. Kara e. Hannibal, Mark D. Bishop. Physical Therapy, Journal of American Physical Therapy Association. Phys Ther. 2014 Dec; 94(12): 1816-1825. Published online 2014 Jul 12. Doi: 10.2522/ptj.20130597
Stress and Your Immune System
There are layers to healing. I can give a patient the most beautiful supplement plan and it wont work. I’ve sat through the continuing education courses, learned top of the line protocols, and then when you get into the trenches of implementing the protocol… the patients don’t behave like text book. They flare up. They don’t like something.
What I am finding is that there is something greater than a supplement or medication treatment plan with fancy labs. It comes down to our attitude and approach to life. Do you submerge yourself in gratitude and a desire to enjoy life no matter what or do you get so lost in your ailments that you get stuck? What do you focus on?
I have a dear friend, Gigi, who has stage 4 cancer and chooses to liver her life to the fullest. After my car accident I started to swim. There was Gigi in the cold pool a day after her chemo treatment, my buddy with a twisted ankle, me post car accident, and the coach with a broken toe. Yet- we were all there. Showing up. Doing what we love but also choosing health and wellbeing.
Then I hear a friend share a story about her boss who has a treacherous history,, miserable, and stuck in suffering. If it isn’t an abusive spouse, it’s overtraining and pushing the body to the limits. When that’s all gone then its sickness and burning oneself out.
I’m coming to believe that healing goes beyond the treatments. Mind over matter. The decision that you. Will. Get. Better. You are ok. This thing that ails you is just a blip.
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