March is autoimmune disease awareness month.
More than 50 million Americans suffer from one or more of the 100+ named autoimmune diseases, with 75% of those afflicted being women. Since 1 in 5 Americans are afflicted, President Biden recently signed legislation that included the establishment of an Office of Autoimmune Disease Research as part of the National Institutes of Health (NIH), which will allow for more focused research into these conditions going forward.
Autoimmune diseases occur when a person’s immune system mistakenly attacks the very cells, tissues, or organs it is meant to protect. The cause is not yet known, and may be due to a combination of underlying factors. There seems to be a genetic predisposition, with factors such as bacteria, viruses, hormones, chronic stress, and some medications acting as triggers.
Today we are going to talk about stress as an exacerbating factor in autoimmune disease, as well as the resulting inflammation, some surprising effects from chronic inflammation, and what you can do to break this cycle.
What exactly is stress? We know it when we feel it, but what is actually happening on a biological level?
You may have heard of the “fight-or-flight” response to danger that is subconsciously and biologically programmed into our brains. When faced with a threat, either real (e.g., grizzly bear, oncoming train) or imagined (e.g., upcoming deadline), information is sent to the amygdala, the emotional processing area of the brain. If it senses “danger,” an immediate distress signal is sent to the hypothalamus, the command center of the brain, which sends signals to the adrenal glands to activate the “fight-or-flight” response through the release of epinephrine (adrenaline). All of this happens so quickly that your body is already reacting before your conscious brain can fully process the danger. The result of this fight-or-flight response is an increase in blood pressure, heart rate, alertness, and energy to prepare the body for action.
After the immediate epinephrine surge, the adrenal gland releases the hormone cortisol into the bloodstream. Cortisol has many effects throughout the body, including the regulation of metabolism, blood sugar, the sleep-wake cycle, blood pressure, and inflammation.
In acutely stressful situations, cortisol can be extremely helpful, allowing more sugar to be released into the bloodstream to be used for energy, enhancing the brain’s use of glucose for maximal alertness, increasing tissue repair, and suppressing all non-essential functions. When the danger or perceived threat disappears, cortisol levels fall, and the parasympathetic nervous system takes over and restores equilibrium.
In cases of chronic stress, such as family problems, work challenges, or chronic illness, the stress response never resets, and cortisol levels remain high. Long-term elevated cortisol levels can cause:
- Increased blood sugar,
- Weight gain,
- Cardiovascular disease,
- Digestive problems, and
- Suppression of the immune system.
You can measure your cortisol levels using the Adrenal Function Panel. This simple saliva test evaluates cortisol and the other important adrenal hormone DHEA levels at four timepoints throughout the day. Results will indicate whether your adrenal function is normal, acutely stressed, or chronically stressed.
STRESS AND AUTOIMMUNE DISEASE
Chronic stress can lead to high circulating cortisol levels, as noted above. This leads to a decrease in the ability of cortisol to regulate the inflammatory and immune responses. As many as 80% of patients with autoimmune conditions reported “uncommon emotional stress” prior to disease onset. The presumed mechanism is through altered cytokine production. (The American Cancer Society defines cytokines as “small proteins that are crucial in controlling the growth and activity of other immune system cells and blood cells. When released, they signal the immune system to do its job. Cytokines affect the growth of all blood cells and other cells that help the body’s immune and inflammation responses.”)
A 2018 study in Sweden showed that individuals diagnosed with a stress-related disorder such as Post-Traumatic Stress Disorder (PTSD) were more likely to be subsequently diagnosed with one or more autoimmune diseases, and those autoimmune conditions were likely to emerge at younger ages than seen in non-stressed populations.
EFFECTS OF CHRONIC INFLAMMATION
As mentioned above, autoimmune diseases are characterized by a person’s immune system attacking healthy cells and tissues, resulting in either localized or generalized inflammation. The symptoms depend upon the part of the body under attack but can consist of the four hallmark signs of inflammation: redness, swelling, heat, and pain. Symptoms may come and go over time.
Chronic inflammation, in addition to any autoimmune disease-specific symptoms, can also cause fatigue, muscle and joint pain, sleep disorders, cardiovascular diseases, and an overall feeling of “blah.” An interesting recent article also implicated chronic inflammation as the cause of depression in roughly 30% of depressed patients. A number of other studies have shown that depressed patients have increased inflammation. And a recent study showed that chronic inflammation can lead to a “leakier” blood-brain barrier, whereby inflammatory molecules can cause neuroinflammation in the brain itself.
HOW TO DECREASE STRESS AND INFLAMMATION
No matter what the cause of your stress, there are lifestyle changes you can make that will help decrease the stress itself, resulting inflammation, and even positively affect many autoimmune conditions.
Similarly, coping with stress in unhealthy ways such as overeating, drinking alcohol, and smoking can increase the burden on the immune system, and negatively impact health and healing.
LRA Testing. Delayed allergy testing can help you identify hidden causes of inflammation. Identifying common foods and chemicals that are stressing your immune system can be the first step on your path to wellness. Hidden allergies can contribute to chronic and autoimmune conditions.
Follow our Top Ten Tips to Support your Immune System
Elicit the Relaxation Response. The relaxation response is the opposite of the stress response and can be cultivated and practiced to help reduce stress. There are many relaxation techniques that can help elicit this response such as:
- Abdominal breathing
- Mindfulness meditation
- Tai chi chuan
Get plenty of restorative sleep. Watch our short video on “Classic Wisdom for Restful Sleep” for some helpful tips.