What habits form the foundation of health? Depending on who answers the question, the answer will vary. Most people at least will answer with nutrition and exercise, but these are really only part of the story.
It’s not uncommon for me to see a patient that eats a healthy nutrient-dense diet, exercises regularly and still feels terrible all the time. When they go to the doctor their physical and basic blood work are “normal". They come to me not sure what they are doing wrong - how can they get any more strict with their diet or work out any more than they do? As we get further into their history, I usually learn they work sixty plus hours a week, haven’t taken a vacation in 3 years, eat 50% of their meals at their desk, get an average of 6 hours of sleep per night, and don’t have any time for self care. So what’s going on here?
The problem is diet and exercise are only part of the health equation. Equally important are sleep, stress management and a healthy gut. These are what I call the five pillars of health:
I’ve spent some time already touching on digestive health, and we’ll talk about it and the other pillars again in the future. But with the days getting shorter and the holidays rapidly approaching, I wanted to dedicate some time to stress and stress management over the next few weeks.
Even if you don’t perceive yourself as a stressed out person, you should still understand the effects that stress has on your body and know what symptoms are caused by it. You might be surprised.
You’ve probably heard that stress is bad for you but if you’re like many Americans, you don’t do anything to lower your stress levels. According to the Stress In America survey conducted by the American Psychological Association, 42% of adults say that are not doing enough to manage there stress and 20% of Americans say they never engage in an activity to help relieve or manage stress (1). I consistently see stress management undervalued and it’s one of the hardest things for my patients to change in their lives. The problem is, without lowering stress it can be very difficult to overcome a chronic illness, especially because so many illnesses are caused or at the very least exacerbated by stress to begin with.
To fully understand the effects of stress on your body and health, let’s look at your body's stress response system. When we perceive a stressor, the HPA (hypothalamic-pituitary adrenal) axis is activated. The hypothalamus and pituitary gland are located in the brain. They send a signal down to two small glands that sit on top of your kidneys called the adrenal glands. They are part of the endocrine (aka hormonal) system. Their job is to make cortisol and adrenaline in response to stressful situations. However, cortisol isn’t only released when under acute stress. Even on a normal day without acute stress, your body makes a healthy level of cortisol in the morning which helps you feel awake and ready for the day. As the day goes on, cortisol slowly decreases and at night reaches an all time low as melatonin increases and we fall asleep. Cortisol and melatonin are responsible for our circadian rhythm.
When under acute stress, your adrenals respond by releasing a burst of cortisol and adrenaline. This triggers the sympathetic nervous system and allows our body to go into “fight or flight” mode. Physically, there is increased blood flow to the muscles - diverting it from other areas of the body, increased blood pressure and heart rate, and increased blood sugar for energy production. This allows us to respond to threatening stimuli quickly and was an essential part of survival to our great ancestors. In the event they were attacked by a saber tooth tiger, this response would have come in very handy!
The problem is that modern day humans don’t have occasional acute stress. Instead, we experience the constant every day stress of modern life: working long hours, deadlines, loud noises, bright lights, traffic, nutrient poor diets, sleep deprivation, this list goes on. We face emotional stress, environmental stress, and physiological stress, all of which trigger the stress response. So even if you don’t feel emotionally stressed, your environment or physiological imbalances may still be causing you to experience a chronic stress response.
Chronic stress is related to: an increase in inflammation (2), poor memory and concentration (3), depressed immune system, elevated blood sugar (3), intestinal permeability, abdominal weight gain, sex hormone disruption and low libido, disturbed sleep and anxiety/depression. As you can see, stress can be associated with just about all modern chronic disease.
Chronic stress results in what is commonly known as adrenal fatigue, but more accurately called HPA axis dysregulation.(4). This syndrome is characterized as dysregulated cortisol levels (either high or low) and depending on how long the stress has been present, changes in other hormones such as DHEA (5) and the parent hormone, Pregnenolone. Pregnenolone is the parent or precursor to all the adrenal and sex hormones your body makes. When there is an increased demand for cortisol, the body uses up the majority of pregnenolone to fill this demand which in turn can effect sex hormones (estrogen, progesterone, testosterone). This is called the pregnenolone steal and is why stress can affect the menstrual cycle, libido, skin, and cause other hormonal issues.
In my practice, I’ve seen HPA axis regulation and stress management improve acne, aide weight loss, improve digestion, regulate the menstrual cycle, resolve headaches, improve mood and insomnia, lower blood pressure and balance blood sugar - just to name a few.
What to do about it?
Stay tuned next week for stress management tips, as well as herbs and nutrients that support the stress response. Or feel free to give me a call, I’m always here to help.