A note for practitioners.

Previously published 2/06/2019. Updated 11/02/2023.

As practitioners, we know the definition of stress and the impact of stress on our health, acting as a trigger and mediator to many health conditions, which can range from headaches/migraines, digestive discomfort, constipation and/or diarrhoea, to more serious conditions like poor memory, peptic ulcers, ulcerative colitis, or life-altering disorders like dementia, Alzheimer's, autoimmunity, cardiovascular disease, type-2 diabetes and obesity.[1]

We often consider stress to be related to anxiety, overwhelming work demands, and social and economic instability, but the biggest growing concern today is social isolation.[2,3]

Traumatic experiences, which may have occurred during childhood, can play a decisive role in the progression of a disease. Early (adverse) life events and chronic stress (at any stage of life) are shown to bring structural remodelling to the amygdala (involved in emotional reactivity, the fear centre of the brain based on previous experiences), prefrontal cortex (regulates thoughts, actions and emotions; the brain region most sensitive to stress), and the hippocampus (involved in learning and memory), which in turn alters behavioural and physiological responses.

Physiological changes in brain structure and function can impair the HPA axis and make a person even more susceptible to stress.[4,5,6]

Negative inner conversations and rumination are key perpetrators of stress and disease.

Digital dementia, brought by overstimulation of technology and a sedentary lifestyle, is increasing in the younger population (spending long hours in front of screens every day), thus leading to social inadequacy and profoundly making a young person hypersensitive to stressors, over-reactive and easily irritable.

It is undeniable — and we see it in practice daily —, the relationship between stress and ill health is extremely complex and often multilayered. All of our clients/patients complain about stress or stress-related issues in one way or another. What is really puzzling is how ongoing stress affects clients/patients in their everyday life. While some are able to cope with a huge amount of stress, strive and achieve greatness, others break at the tiniest inconvenience to their routine.

What is most striking too, is that burnout brings the strongest person to a standill, making them rethink their life and priorities entirely. Some, may end up being that much more sensitive to stressors, anxiety disorders and depressive disorders.

Histamine

There is a growing body of evidence that brings light on stress susceptibility and genetics seems to play a strong part, making a person more sensitive and susceptible to stress.

Chronic stress raises the risk of infections because it exerts an immunosuppressive effect — disturbing the natural capability of the immune system to react efficiently.[7,8] It also increases the release of histamine, and disturbs the gut microflora and the metabolites they release, which include histamine (and other pro-inflammatory secretions); a great concern for people with asthma.[9]

Acting as an excitatory neurotransmitter, histamine can affect emotions and behaviour and disrupt the circadian rhythm. High histamine can cause headaches (may appear after ingesting fermented foods, a sign of histamine “overload”). Excessive histamine can become neurotoxic and provoke changes to the blood-brain barrier and immune function, thus participating in the development of Alzheimer’s.[10] And so is excess ammonia[11,12] another byproduct of some gut bacteria[13], which, also results from the breakdown of protein (think paleo diet, carnivore diet, protein-based replacement meals, malnourishment/starvation, and over-exercising).

Alcohol and NAFLD

Other metabolites include alcohol, the second cause of non-alcoholic fatty liver disease (NAFLD), after actual alcohol consumption.[14,15] You can develop NAFLD even if you do not drink any alcohol. It is believed that gut bacteria production of alcohol can reach up to 1 litre daily. Alcohol is diverted to the liver for detoxification. This much alcohol chronically inflames the liver and causes lesions and cirrhosis.

Diabetes

The effect of stress on the gut microbiome can also lead to diabetes.
This is accentuated by poor-sugar management and insulin dysfunction. The energy rollercoaster a stressed person jumps on daily inevitably leads to disease in the long term. Together with a sedentary lifestyle and a nutrient-poor, sugar-based diet, void of fibre, the predictability of disease increases exponentially.

Sugar and high levels of stress hormones may also intensify the severity and the duration of pain by raising inflammation markers, a combination worth bearing in mind for clients/patients with rheumatoid arthritis.

Inflammation

Inflammation is a huge stressor for the body and is often the main culprit in disease progression and stress is a key player in inflammatory processes.[16]

Enzymatic function and hormones

Digestion and enzyme production (to digest our food and detoxify toxins) are greatly reduced under chronic stress, while the demand increases. Reduced motility often leads to gut discomfort, pain, and toxin accumulation, negatively impacting the detoxification of hormones, especially oestrogen, which may re-enter circulation from the colon.

Hormone balance is a key issue because of the “pregnenolone steal”, which is shunting a huge amount of cholesterol towards the production of stress hormones and less may be available for the production of sex hormones.

Thyroid hormone disruption also results from higher levels of stress hormones in the bloodstream. Hypercortisolemia interferes with the conversion of T4 to T3 (the active form) and cellular uptake of thyroid hormone, contributing to metabolic dysfunction and eventually, Hypothyroidism.
Hypothyroidism increases cortisol levels creating a vicious circle.

Diet

Malnourishment (deficiencies) can increase our susceptibility to stress, contribute to anxiety and depression, and prevent natural healing and repair.

During heightened periods of stress, the body requires ample amounts of vitamin C, B vitamins, zinc, and magnesium. Stores may quickly become depleted, which may be exacerbated by a nutrient-poor diet.

Stress hormones affect insulin sensitivity since their main role is to increase blood sugar and blood pressure so that muscle fibres can receive an immediate rush of nutrients and oxygen, so you can run away from danger or fight.

The “flight-or-fight” mode is thus activated. If activated chronically, this eventually leads to imbalances in blood sugar, increasing the risk of atherosclerosis and heart disease.

Sleep is also deeply affected and clients/patients may find waking up in the morning rather difficult, as well as falling asleep and reaching the deep stages of sleep. Drinking coffee as a fight-back mechanism only activates the sympathetic nervous system further, keeping that person locked in a state of “fight-or-flight” (by keeping cortisol levels extremely high).

Radiation and electric magnetic fields

We are constantly bombarded by external stressors and these may not be felt in the same way than other stressors, but the symptoms are real and very often debilitating.

EMFs are the biggest stressors affecting our health today and with the growing spread of 5G (and soon 6G), there is little the body is equipped with to deal with the extreme level of radiation it is exposed to. It is, therefore, crucial to consider EMF exposure in your clients’/patients’ unresolved health issues and to help them take preventative action.

Sport and over-exercising

It is often missed out but professional athletes and people exercising intensively are also more prone to stress-related conditions due to the impact of stress on gut function, the microbiome, and motility, very often in combination with a protein overload.

Tips

To help clients/patients become more resilient to stress, we must look deep into their eating habits and lifestyle factors and help them identify and address problematic areas. If trauma is at the root of dysfunction, it is essential to support our clients/patients and refer them to the appropriate forms of therapy.

Improving digestive capabilities and absorption, restoring a symbiotic intestinal milieu and reducing the secretion of toxic metabolites by pathogenic and opportunistic bacteria (released in the gut and in the bloodstream) should be the first recommendations.

Recent research shows that prebiotics are more efficient than probiotics alone to improve the “terrain”. Linseeds and other widely available prebiotic-rich foods may help restore bacterial populations and promote the release of short-chains fatty acids; reduce the production of alcohol and risk of NAFLD and bring inflammatory responses into balance.[17]

Recommending prebiotic fibres (GOS, FOS, and XOS), as part of diet recommendations, can help clients/patients shift their gut microflora; however, symptoms may worsen first (e.g. gastrointestinal distention and pain), because prebiotic fibres also feed gas- producing pathogenic bacteria. When balance is re-established, gas production will be greatly reduced (usually within 2 weeks).

Daily physical activity, hydration and regular bowel movements are crucial, which help prevent stagnation, let it be of waste or of thoughts.
​
We need to move to make things move. 

References:

1. Salleh, MR. (2008). Life event, stress and illness. The Malaysian Journal of Medical Sciences. 15(4), pp. 9–18.

2. Snyder-Mackler, N. et al. (2019). Social status alters chromatin accessibility and the gene regulatory response to glucocorticoid stimulation in rhesus macaques. PNAS. 116, pp. 1219–1228.

3. Lea, AJ. et al. (2018) Dominance rank-associated gene expression is widespread, sex-specific, and a precursor to high social status in wild male baboons. Proceedings of the National Academy of Sciences of the United States of America. doi:10.1073/pnas.1811967115

4 McEwen, BS. (2009). The brain is the central organ of stress and adaptation. Neuroimage. 47 (3), pp. 911–913.

5 Arnsten, AF. (2009). Stress signalling pathways that impair prefrontal cortex structure and function. Nature reviews. Neuroscience. 10(6), pp. 410–422. doi:10.1038/nrn2648

6 Pagliaccio, D. et al. (2015). Amygdala functional connectivity, HPA axis genetic variation, and life stress in children and relations to anxiety and emotion regulation. Journal of Abnormal Psychology. 124(4), pp. 817–833. doi:10.1037/abn0000094

7 Williams, C. Katirai, M. (2018) The relationship between sense of coherence and rumination. Journal of Public Health Issues and Practices. 2(110). doi:jphip/2018/110

8 Segerstrom, SC. Miller, GE. (2004). Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry. Psychological Bulletin. 130(4), pp. 601–630. doi:10.1037/0033-2909.130.4.601

9 Cohen, S. et al. (2002). Reactivity and vulnerability to stress-associated risk for upper respiratory illness. Psychosomatic Medicine. 64(2), pp. 302-10. 

10 Hough, LB. (1999). Histamine actions in the central nervous system. In: Siegel, GJ. Agranoff, BW. Albers, RW. et al. Basic Neurochemistry: Molecular, Cellular and Medical Aspects. 6th ed. Philadelphia: Lippincott-Raven. Available at: www.ncbi.nlm.nih.gov/ books/NBK28245/

11 Walker, V. (2014). Ammonia metabolism and hyperammonemic disorders. Advances in Clinical Chemistry. 67, pp. 73–150.

12 Adlimoghaddam, A. Sabbir, MG. Albensi, BC. (2016). Ammonia as a potential neurotoxic factor in Alzheimer's disease. Frontiers in Molecular Neuroscience. doi:10.3389/fnmol.2016.00057

13 Vince, AJ. Burridge, SM. (1980). Ammonia production by intestinal bacteria: the effects of lactose, lactulose and glucose. Journal of Medical Microbiology. 13 (2), pp. 177–191.

14 Cassard, AM. Ciocan, D. (2018). Microbiota, a key player in alcoholic liver disease. Clinical and Molecular Hepatology. 24(2), pp. 100–107. doi:10.3350/cmh.2017.0067

15 Szabo, G. (2015). Gut–Liver Axis in Alcoholic Liver Disease. Gastroenterology. 148(1), pp.30-36.

16 Friesen, CN. Hofmann, HA. (2019). Molecular origins and outcomes of status and stress in primates. Proceedings of the National Academy of Sciences. 116(4), pp, 1081–1083. doi:10.1073/pnas.1819472116

17 Zhang, X. et al. (2017). Flaxseed oil ameliorates alcoholic liver disease via anti-inflammation and modulating gut microbiota in mice. Lipids in Health and Disease. 16(1), 44. doi:10.1186/s12944-017-0431-8.