Chronic stress and its effect on hormones
When considering changes that need to be made in order to have a healthy lifestyle, nutrition, physical exercise and sufficient sleep are usually the first things that come to mind. But stress management can also play a critical role. This is because of the many ways that chronic stress undermines good health.
While we may want to imagine our lives without trials and stress, this is impossible and perhaps not even desirable since our response to stress is actually adaptive. You have probably learned how in prehistoric times the fight-or-flight response protected us from the occasional attack by a saber tooth tiger. But fast-forward to modern times where we might experience relentless stress at work, at school, in relationships, raising our children, managing money, etc.. When the fight-or-flight response occurs frequently or becomes a chronic state, it’s no longer adaptive.
What is stress?
The World Health Organization defines stress as “any type of change that causes physical, emotional or psychological strain”[i]. “Any type of change” implies there are a broad range of factors that could potentially lead to a stress response. It also implies that there are probably individual differences in the types of triggers or circumstances that might cause stress: what is stressful for one person may not be for another.
“Physical, emotional or psychological strain” is broadly defined and includes many types of responses. Like stress triggers, there is wide variation in how stress affects different individuals, causing a multitude of emotional, cognitive and physical symptoms. For example, some might experience headaches, while for others it’s heart palpitations.
How stress affects hormones
One of the main pathways for these changes is the endocrine (or hormonal) system. During an episode of stress response, several hormones including cortisol are released that mobilize energy, increase heart capacity and blood flow, lower thyroid function and increase blood sugar[ii]. For women, stress can also disrupt the menstrual cycle. Repeated episodes of these symptoms can result in insomnia, anxiety, depression and fatigue. In some cases, they can lead to self-medication in the form of substance abuse.
Chronic stress can also exacerbate several pre-existing conditions such as diabetes and thyroid conditions.
A word needs to be said about a syndrome often associated with chronic stress: “adrenal fatigue”. The theory is that when people undergo chronic stress, the 2 small adrenal glands situated above the kidneys that produce cortisol and other hormones cannot keep up with the body’s increased need for these hormones, at which point symptoms start to develop.
There is a long list of symptoms associated with adrenal fatigue (one website lists 75!), including many that are characteristic of several other conditions, such as tiredness, trouble falling asleep at night or early waking in the morning, salt and sugar craving, and needing stimulants like caffeine to get through the day. These symptoms are numerous, common and non-specific enough that most of us could identify with them at least some of the time. As a result of this, there has been a dramatic increase of products in the supplement market that claim to address symptoms of adrenal fatigue.
Problem is the medical community asserts that adrenal fatigue is not a real condition[iii]. There are no reliable tests for determining adrenal fatigue so a diagnosis would typically be from symptoms alone. Many of these symptoms could be due to anxiety, depression, insomnia, Type 2 diabetes and host of other conditions with different causes; therefore, if you have been told or believe that you have adrenal fatigue, it is important to investigate alternative explanations for your symptoms.
A rare condition with a similar name that is recognized by the medical community is adrenal insufficiency, which typically requires prompt medical attention[iv]. Symptoms include nausea, vomiting, diarrhea, low blood pressure and joint pain. Very occasionally this presents as an adrenal crisis, which is considered to be a medical emergency. The most common cause of adrenal insufficiency is long-term steroid treatment for inflammatory or auto-immune diseases or cancer. It can also be caused by Addison’s disease (made famous by President Kennedy who suffered from it), which is an auto-immune condition. Those who promote adrenal fatigue as a condition sometimes claim that it is a mild form of adrenal insufficiency.
Can we get help for chronic stress?
Let’s begin with the symptoms themselves. Because these are numerous, individualized and broad-ranging, it’s not possible to discuss them all here. Some symptoms such as insomnia, depression, fatigue, thyroid underfunction and migraine headaches are addressed elsewhere in this blog. There are both medical and natural treatments such as homeopathy for all of these things.
If chronic stress has led to self-medication or substance abuse, this indicates deeper issues. It is important to recognize addiction as a problem and take steps to address it through counseling, therapy and medical help.
Dealing with the downstream effects of stress has value and can provide relief, but even more effective is getting at the cause(s): the factors or triggers that contribute to it.
It should be said that many people are not well situated to address every aspect of their lives that causes stress. For example, if stress is related primarily to work, we cannot always change jobs or switch careers. Or if we live in a neighborhood plagued by violence, we may not be able to afford to move out. Poverty can result in constantly having to choose between paying the rent or buying food—definitely stressful! Similarly, stress from discrimination perpetrated by others cannot easily be fixed by those who are the object of the discrimination. Such societal causes of stress are difficult to address at the individual level.
That said, some stress-causing factors can be assisted with counseling, such as dysfunctional intimate relationships, including with partners and children.
Ineffective time management is another very common cause of stress that most of us can identify with: committing to too many things in the calendar! A life or wellness coach can be very helpful in balancing out priorities.
What can we do about stress for ourselves?
There is much written about this, as seen in bookstores which have entire shelves in the self-help section on the topic of stress management. We have also touched on stress management as part of a healthy lifestyle in a separate blog.
Here is a very brief summary of some suggestions you can act on to reduce stress-related symptoms in your life:
1) Get regular exercise: This helps relieve muscle tension and other common physical symptoms of stress.
2) Spend time in nature: Even brief periods spent in green environments has been shown to have a beneficial effect on symptoms resulting from stress.
3) Try regular deep breathing: There are several approaches to this including yoga and Tai chi. Even a few minutes of regular deep breathing can help relieve stress. There are phone apps that can walk you through the steps for deep breathing.
4) Find time for activities you enjoy: If you don’t already have one, choose a hobby that stimulates your creative juices. All of the arts are therapeutic!
5) Eat properly: Food journalist Michael Pollen summed it up well: “Eat food, not too much, mostly plants”. You are what you eat.
6) Stay positive and don’t forget to laugh: Negative thinking and self-talk can be a major contributor to stress. Some advocate keeping a journal in order to help stay positive. Believe it or not, laughter therapy is considered to be a “non-pharmacological intervention”[v]. Try watching funny movies on a regular basis.
7) Stay connected with others: Alienation, loneliness and isolation is now understood to be a major driver of stress. (In 2021, the government of the United Kingdom established a “Ministry of Loneliness” to address this). Make sure you spend time with others on a regular basis. This could be volunteering, taking a class where you can meet people (i.e. not at home online), or joining a club where you can spend time others who have similar interests.
8) Regular meditation or reflection: Even a few minutes a day when you can shut the door and shut out the world helps to promote relaxation on a physiological level. There are many approaches to meditation and, like deep breathing, there are several phone apps that can assist you with this.
If you have taken some of these steps and you are interested in a natural approach to help you address stress-related symptoms, call me for a free 15-minute consultation or schedule one on the online scheduler to learn more about how homeopathy can help.
[i] https://www.who.int/news-room/questions-and-answers/item/stress
[ii] Ranabir, S, and K Reetu (2011) “Stress and hormones” Indian Journal of Endocrinology 15(1): 18-22 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3079864/pdf/IJEM-15-18.pdf
[iii] Categiani , F, and C Kater (2016) “Adrenal fatigue does not exist: a systematic review” BMC Endocrine Disorders 16(1): 48 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997656/
[iv] Pazderska, A, and S Pearce (2017) “Adrenal insufficiency: recognition and management” Clinical Medicine (London) 17(3) : 258-262 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6297573/
[v] Akimbekov, N, and M Razzaque (2021) “Laughter therapy: a humor-induced hormonal intervention to reduce stress and anxiety” Current Research in Physiology (4): 135-138 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8496883/pdf/main.pdf