Lifestyle: Stress and Resilience

No matter your diet, how much your exercise or supplement, if you are not managing stress, you will be at risk for many health conditions such as heart disease, diabetes, thyroid disorders, autoimmunity, depression, fibromyalgia, or hormone imbalances.

Not all stress is considered bad. Without it we would not survive. Stress helps us adapt to our environment and meet and overcome life’s challenges. It’s our “fight or flight” response. Heart and respiration rate increase, certain nutrients are mobilized in the body, immune system is activated, and overall awareness is heightened. At the same time, body functions are diverted from those that are not needed for immediate survival such as digestion and reproduction.

Most popular discussions of how stress affects our health revolve around the adrenal gland. You may hear terms such as “adrenal fatigue” or “adrenal exhaustion” because cortisol is the most common metabolite measured in clinical and experimental models of stress. Cortisol is produced by the adrenal glands. It is assumed that if you are measuring cortisol you are measuring adrenal function. This is only partly true because the signally mechanisms of the stress response is mediated by the Hypothalamic-Pituitary-Adrenal Axis or HPA-Axis for short. This is a better understood problem in the brain and central nervous system than the adrenal glands themselves

A more accurate term for “adrenal fatigue” is HPA-Axis Dysregulation. It refers to a constellation of sings and symptoms including fatigue, disturbed sleep, poor exercise tolerance and recovery, low libido, brain fog, weakened immune function, and reduced stress tolerance.

HPA-Axis Dysregulation is attributed to many aspects of the modern lifestyle including lack of sleep, poor diet, chronic stress, lack of or excessive exercise, and inflammation. It affects nearly every cell and body tissue. Because of this, it must be addressed in every case of chronic health conditions in order for healing to occur.

If you are going to be able to take control of your stress response, it is vitally important to first know the most frequent sources of stress. There are four primary causes of HPA-Axis Dysregulation, listed below.

Triggers of HPA Axis Dysregulation:

1) Perceived Stress. There are four key determinants that determine the magnitude of the HPA response. NUTS is the often used mnemonic for this.

Novelty of an event. The first time we do something, we anticipate how we might feel during the event (pleasure or pain), which triggers a stress response of anticipation.
Unpredictable nature of the event. This combined with something new heightens our stress response. An example would be taking driving lessons for the first time and merging onto a busily freeway.
Received Threat. This could be a threat to your physical well-being, but usually it is a threat to your ego. If you are in a situation and think, “If I mess up, what will they think of me?”, then your brain will consider this a threatening and stressful situation.
Sense of loss of control over some situation. Internal stress perception causes neuronal imbalances from situation like finances, relationships, work, and public speaking. Mental / emotional stress is more harmful since there is less sense of control and lasts longer.

2) Circadian Disruption. HPA-Axis and circadian rhythm are intertwined and have a prolific effect on one another. Without proper sleep, repair of the stress response is limited. Sleep heals and rests itself metabolically and psychologically. Our bodies are designed to function optimally on a twenty-four hour circadian rhythm. Sleep is disrupted by artificial light exposure, nighttime light exposure, not enough exposure to natural sunlight, jet lag, shift work, and caffeine.

3) Glycemic Dysregulation. There is a bi-directional relationship between the HPA-Axis and metabolic functions. Disruption of one harms the other. Eating foods high in refined carbohydrates, our blood sugar rises quickly causing a quick insulin production from our pancreas to the spiked response. Over production of insulin pushes down glucose levels rapidly causing you to feel tired and irritable. Cortisol levels kick in due to the hypoglycemic stress to counter the effects of the insulin. You often can’t wait for your cortisol to kick in so you reach for something sweet or caffeinated or both. This constant up and down places a burden on your stress response system.

4) Inflammation. Cortisol is a powerful anti-inflammatory agent, so acute and chronic inflammation triggers the HPA-Axis and increases cortisol. Often, these inflammatory trigger are hidden and not so obvious.

Trigger/Effect

Exercise
Overtraining initially increases cortisol but may then cause chronically low cortisol. Being sedentary can lead to sleep disorders and contribute to metabolic dysfunction.

Social Isolation
Social support mitigates the impact of stress. Lack of social support is a major stressor and decreases lifespan.

Gut Issues
Multiple Gut-HPA interactions: Intestinal permeability, often caused by stress, can lead to HPA activation. Beneficial bacteria play a role in regulating the HPA-axis.

Food Intolerances
Induce intestinal permeability and cause inflammation.

Chronic Infection
Increases inflammation.

Environmental Toxins
Diverse range of effects, including endocrine disruption and oxidative stress.

Thyroid Function
Hypothyroidism increases cortisol levels.

Drugs (caffeine, antidepressants, steroids, etc…)
Dysregulate the axis in multiple ways.

8 Steps To Recover From HPA-Axis Dysregulation

1) Dietary Recommendations

Eat a moderate-carbohydrate diet to avoid any dips in your blood sugars. Eat adequate protein and avoid excess dietary potassium. Eat frequently throughout the day and ensure adequate sodium intake. Avoid caffeine and alcohol.

2) Get enough sleep

Goto bed early and sleep deeply 8 plus hours nightly. Minimize electronic media and distractions that could could hinder sleep. Many people get a second cortisol surge after 11pm, which further disrupts a good night sleep.

3) Exercise wisely

Avoid overtraining since this can worsen recovery time. Favor low-intensity activities such as walking in nature, swimming, yoga, or tai chi.

4) Cultivate pleasure and connection

Being around others, connecting and laughing activates the parasympathetic nervous system (rest and digest) which down regulates the stress response.

5) Replace important nutrients

Vitamins C & D, B vitamins, selenium, magnesium, and zinc are all important for HPA-Axis response to stress along with the thyroid.

6) Use adaptogenic herbs

Specific adaptogens such as Eleuthero, Schizandra, Aswaganda, Rhodiola , Siberian ginseng, and Licorice root extract have demonstrates positive effects with regard to the stress response.

7) Prioritize rest during the day

Scheduling a nap when possible can truly be restorative.

8) Hydration is key

Dehydration can be a hallmark of HPA-Axis dysregulation. Add fresh lemon juice or Himalayan sea salt into your water several times during the day.