Life in today’s world is a bit like being stuck on a treadmill (while someone leans on the accelerate button). Most of us feel overwhelmed, overworked, and far too stressed out. Even if you don’t perceive stress as wearing away at your emotional and physical wellbeing, consider this: we did not evolve with mobile phones pinging us multiple times an hour. We did not evolve with cans of carbonated, caffeinated, liquid sugar within arms’ reach, nor did we evolve with long-haul flights, spin classes, or political podcasts. And while we tend to think of stress as a mental burden, it can be a critical and often overlooked detriment to physical health.
The Fight or Flight Response
A stress response – known as the “fight-or-flight” response – is an important part of our survival mechanism when we come into contact with a dangerous situation. At the first sign of danger, hypothalamic-pituitary-adrenal axis, or HPA axis, is activated. The brain’s hypothalamus releases what’s called corticotrophin-releasing hormone (CRH). CRH stimulates the pituitary gland (also in the brain) to release adrenocorticotropic hormone (ACTH), which ultimately stimulates the adrenal glands to release the hormone you’re probably most familiar with, called cortisol. In addition to putting our systems on high alert and preparing us to fight or flee, cortisol is also an anti-inflammatory agent, modulating how inflamed we become in response to a wound or virus.
What Happens When Stress Becomes Chronic?
In one of the most overused (but accurate!) analogies of health writing, you may have heard how the human stress response originally developed to help us flee a chasing tiger, but isn’t meant to be turned on all the time. It is meant to be a powerful, but temporary survival mechanism. However, when the body is under constant, chronic stress, cortisol gets stuck at alarmingly high levels. We can become desensitized to that cortisol, and despite high levels of this hormone, inflammation and immune responses can flare out of control – potentially triggering or contributing to a number of chronic diseases. This is commonly referred to as HPA Axis Dysregulation, or Adrenal Fatigue.
Stress Can Make You Fat, Flabby, and Diabetic
You might recognize a frustrating pattern, where you’re eating well and exercising frequently (perhaps exercising harder than usual!) but the number on the scale just won’t budge, and you seem to be holding on to a little more fluff around your mid-section. Have you stopped to evaluate your stress level and the impact it may be having on your fitness goals?
A consistently high level of cortisol is correlated with abdominal weight gain, which is that stubborn belly fat that you just can’t get rid of, also known as visceral fat. Visceral fat is also particularly dangerous; it’s associated with an increased risk for heart disease and type II diabetes.
As part of the stress response, cortisol prompts the liver to release sugar into the bloodstream for extra energy to outrun the proverbial tiger that might be in hot pursuit. With elevated blood sugar, the body will secrete insulin, the hormone that manages our blood glucose levels by transferring sugar into cells. However, chronic stress leads to chronically high blood sugar, and constant output of insulin. As a result, our cells can become resistant to insulin over time, which can lead to Type II Diabetes. Unstable blood sugar levels can also increase sugar cravings, tempting you to reach for junk food as a coping mechanism for stress, further hindering your health and weight goals.
Chronic Stress is a Hormone Thief
The adrenal glands are responsible for producing numerous hormones in addition to cortisol, including the building blocks for key sex hormones like estrogen, progesterone, and testosterone. However, in a high-stress state, the adrenals perform what is called the “pregnenolone steal,” and allocate important materials to producing only cortisol, at the expense of our sex hormones. It’s important to note that this can occur in both men and women!
Additionally, our bodies operate other key communication systems, such as the HPG inhibits functioning at every level of these systems – which is biologically intentional. In a time of famine, for example, the body would want to deprioritize reproduction (by slowing down the HPG axis and communication to the gonads (testicles or ovaries)) and would want to slow down metabolism, by slowing thyroid function via the HPT. Our bodies are incredibly smart and finely tuned instruments – they just can’t tell the difference between a stressful job and a hungry lion, tiger, or bear.
Stress Can Take Root in Early Childhood
The negative consequences of stress on physical health can start from early childhood. The Adverse Childhood Experiences (ACE) Study examined the relationship between several different negative childhood experiences, ranging from neglect, parental divorce, to domestic violence, and the occurrence of diseases that these children experienced in adulthood.
Of the ~8000 respondents, more than half reported having at least one negative childhood experience. As the number of negative childhood experiences increased, so did the prevalence of depression, cancer, autoimmune disease, and risk of early death, to name a few. Research in this field is still relatively new, and quite often a practitioner won’t think to look for a disease trigger decades in the past. However, addressing deep-rooted trauma has been shown to have a powerful impact on physical symptoms.
For further reading on this topic, we recommend the work of science writer Donna Jackson Nakazawa.
The Path Forward
Key signs of a dysregulated stress response include sleep disturbances (inability to fall asleep, or waking up too early), changes in mood, stubborn weight gain, fatigue, anxiety, low libido, and immune system problems, such as constantly getting sick, or exaggerated reactions to wounds or bug bites. If you suspect HPA Axis dysregulation, take stock of what in your life may be creating systemic stress. You may be able to find some relief through lifestyle modifications, mindfulness exercises, sleep hygiene and blood sugar regulation. However, if your symptoms do not resolve in a short period of time, we suggest working with your holistic health care practitioner to do thorough, multi-point cortisol testing, and implement a personalized treatment program.