Stress is defined as “a physical or emotional strain or tension, or an event that is perceived as being threatening to our physical or mental health”. Levels of “stress” are difficult to quantify because each individual will react to stress differently. Perception of stress is another factor. An event that one person may perceive as a huge stress may only be considered slightly challenging for another.
Stress can be both psychological and physical. Physical stressors include chronic illness, traumas and even exercise.
We all suffer from stress to some degree. In most cases, we can deal effectively with stress and move on. We adapt.
Excess stress causes a variety of physiological effects:
- Difficulty shedding body fat, particularly fat around the middle
- High blood pressure
- Musculoskeletal aches
- Insomnia
- Poor immune function
- Low sex drive
- Gastrointestinal disturbance
- Inability to concentrate
- Low energy/fatigue
When we are exposed to stress (whether that stress is emotional or physical), the body increases the output of hormones from the adrenal glands. These glands are located on top of the kidneys. The hormones secreted from the adrenal glands help us respond to stress.
The adrenal medulla secretes adrenaline and noradrenaline, which
- Regulate blood sugars (as we saw in Maximize Your Energy: Part 3),
- Increase heart rate and breathing rate,
- Diverts blood away from the internal organs to the muscles and brain
- Breaks down glycogen to release glucose (sugar) into the blood.
All of these effects allow us to cope with an acute stress, for example if we are sprinting 500m to catch a bus. This is the “fight or flight” response.
However, if we are sitting on the bus, which is stuck in traffic and making us late for an important meeting, these reactions are not as appropriate.
As we learned in Maximize Your Energy Part 3, when adrenaline is released, our blood sugar rises and so it is easy now to see how excess stress (particularly emotional stress such as being late for a meeting, being stuck in a traffic jam, having an important deadline, exams approaching) can easily affect our ability to regulate blood sugars.
The adrenal cortex secreted glucocorticoids, the most well known of which is cortisol. This hormone is integral to the body’s stress response. Cortisol also regulates blood sugar, immune function and blood pressure.
DHEA is another important hormone manufactured in the adrenal cortex. It is made from cholesterol and helps to modify the damaging effects of long-term cortisol exposure.
Aldosterone (the water balancing hormone) is also secreted from the adrenal gland. This hormone balances electrolytes such as sodium and potassium, thus regulating blood pressure. If aldosterone is too high, potassium decreases and blood pressure increases. This results in:
- Muscle cramps
- Muscle weakness
- Numbness/pins and needles in the hands and feet.
If aldosterone levels drop, too much sodium is excreted from the kidneys along with water, which results in a reduction in blood volume and thus, blood pressure. Other symptoms of low aldosterone include:
- A fast heart rate,
- Dizziness/light-headedness when suddenly standing upright from lying/sitting down,
- Fatigue
- Craving for salt
When blood sugars are always on a rollercoaster, glucocorticoids (cortisol), as well as adrenaline, are constantly being pumped out into the blood. Over time, this leads to exhaustion of the adrenal gland itself.
Now we can see how stress affects blood sugar control, our blood pressure and, of course, the immune system.
In 1936, scientist Hans Selye introduced the General Adaptation model showing three phases in our response to stress. He developed the theory that “stress is a major cause of disease because chronic stress causes long-term chemical changes”.
Stage One: Alarm Stage
This is the fight or flight stage. The stressor may be physical (infection, trauma, lack of sleep, toxin exposure) or psychological (excessive workload, relationship strife, financial strain). The body responds to this acute stress by pumping out adrenaline and noradrenaline from the adrenal medulla, and cortisol from the adrenal cortex. This results in:
- Increased heart rate and breathing rate
- Diversion of blood flow to muscle and brain,
- Increased perspiration,
- Increased blood sugar
- Blood pressure
Anyone who has ever experienced this will know that this phase only lasts a few seconds to a few minutes, after which the body starts to calm down and the levels of stress hormones in the blood reduce.
Some people feel then experience extreme exhaustion.
In today’s society, however, with multiple everyday stressors, this set of events can be experienced a number of times per day.
Stage Two: Resistance
When we experience multiple stressors over a long period of time, the body enters the resistance stage.
The adrenal glands continue to release cortisol, which cause fats, proteins and carbohydrates to be converted into glucose to increase the blood sugar level. Excessive long-term cortisol output results in suppression of the immune system, leading to increased susceptibility to infections and chronic disease, reduced bone density and increased blood pressure.
This stage can last from days to years depending on the stressor and the individual’s coping mechanisms.
Stage 3: Exhaustion
Eventually, if the stressor is persistent and the resistance stage persists for too long, the adrenal glands lose the ability to cope with further demands. In this case, they no longer react properly to stress by releasing their hormones and the body enters the exhaustion phase, or what is termed adrenal fatigue.
When the adrenal glands reach this stage, production of cortisol and aldosterone decreases. This results in low blood sugar and low blood pressure. Other cells of the body start to suffer because they can’t function well without a constant blood sugar level and imbalanced electrolytes.
Individuals in the Resistance Stage become less resistant to infections but also more prone to developing physiological imbalances such as allergies and autoimmune conditions (Lupus, Rheumatoid Arthritis).
The “adrenal fatigue” patients I see at Invigorate Clinic tend to be those who have been high achievers, always on the go and appear to have been full of energy all throughout their life. As I spend more time exploring the individual’s history, it often becomes apparent that they have been reliant on stimulants such as coffee to keep them going. (Excessive coffee consumption is in itself a stressor because it causes the adrenal gland to increase output of adrenal hormones). These individuals also tend to under sleep, stay up late at night even when tired and are always driven to be “No. 1” or “the best”.
GPs only test blood levels of cortisol. At Invigorate Clinic however, we like to use saliva testing to identify the stage of stress response that the patient has reached. We look at cortisol AND DHEA. Blood testing can be misleading, as it does not distinguish between active and non-active hormones. Similarly blood testing is usually just done as a once-off sample in the morning time and so does not reflect output over a 24-hour period.
If you, or someone you know, might be suffering from chronic stress or low energy/fatigue, contact us today to arrange a consultation and testing.