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Is Stress to Blame for Autoimmune Disease?

Is Stress to Blame for Autoimmune Disease?

Stress … a physical and emotional response to change. When money is tight or a relationship gets shaky, stress can wreak havoc on your health and wellbeing. You may notice symptoms that affect your body, mood, and behavior, such as:

  • Headache
  • Anxiety
  • Muscle tension
  • Anger
  • Chest pain
  • Lack of motivation
  • Upset stomach
  • Drug misuse
  • Sleep problems

But the impact of long-term or chronic stress may actually turn your body against itself, leading to autoimmune disease.

Autoimmune Disease: Why is My Body Attacking Itself?

Autoimmune disease happens when the body’s immune system creates antibodies that attack its own cells, tissues, and organs. There are more than 100 autoimmune conditions. Some of the most common include:

  • Hashimoto’s thyroiditis
  • Multiple sclerosis
  • Rheumatoid arthritis
  • Lupus
  • Celiac disease
  • Pernicious anemia
  • Autoimmune vasculitis
  • Myasthenia gravis
  • Graves’ disease
  • Type 1 Diabetes
  • Ulcerative colitis
  • Guillain-Barre syndrome
  • Psoriasis

While the exact cause of the autoimmune disease is unknown, what we do know is your body begins to attack something that doesn’t belong. It could be toxins, allergens, food, or infection. And then something goes wrong. Suddenly, it turns around and aims its strike at your skin, brain, gut, thyroid, or joints. In extreme cases, it ambushes your entire body.

A combination of genetic, hormonal, immunological, and environmental influences are believed to trigger onset. These may include sex hormones, cigarette smoking, bacteria, viruses, or diet. Where it gets puzzling is that at least 50% of autoimmune disorders are activated by unknown factors.1

But recent research is pointing a finger at stress.

The Stress Connection to Inflammation

The immune system is made up of billions of cells that make their way through the bloodstream and tissue ever ready to destroy foreign invaders. When antigens ( harmful foreign substances) contact and begin to damage a cell, an inflammatory response is activated that attracts white blood cells responsible for healing.2 It’s a complex and highly-coordinated process that can mend a broken bone or prevent you from getting the chickenpox twice.

Research has shown us, however, stress can mess with the immune system.3 When we’re stressed, our bodies produce more of the steroid hormone cortisol, which initially suppresses inflammation, enhancing the immune response. The problem is…when levels are elevated long-term by chronic stress, we turn on cortisol for months on end, which may be producing a type of cortisol resistance.

Cortisol then switches to suppressing rather than enhancing the immune response by decreasing lymphocyte count and altering the balance between type 1 and type 2 cytokines (molecules that coordinate cell communication during an immune response, signaling the movement of cells toward inflammation)4.  When this occurs, the immune system can no longer regulate the inflammatory response, and we become chronically inflamed.

Chronic, systemic inflammation points to dysregulation of the immune system, which is ultimately thought to result in autoimmune disease.5 Consider a 2018 study that looked at more than 106,000 people diagnosed with a stress-related disorder. When compared to more than 1 million others without a diagnosis, stress was found to contribute to a 36 percent higher risk of developing autoimmune disease. The stress-related patients were more likely to develop multiple autoimmune conditions as well as had a higher rate of autoimmune disease if younger.6

Reduce Stress to Prevent or Reverse Autoimmune Disease

The degree to which stress is to blame for autoimmune disorders is still uncertain. In my office, we address the whole person, which includes assessing and treating the complex combination of genetic, environmental, immunological, and hormonal factors that all contribute to the root cause of the disease. Using an integrative medicine approach that requires diet and lifestyle changes, supplements, and naturopathic therapies, autoimmune disease is often totally reversible.

With that said, a major focus of an autoimmune treatment plan is to introduce or accelerate stress-reduction practices that draw on evidence-based mind-body medicine techniques. These practices are intended to reduce inflammation by taking your body out of a constant fight-or-flight response where cortisol is continuously released. Many of the symptoms of autoimmune diseases are actually a result of chronic inflammation such as:

  • Chronic fatigue
  • Fever
  • Rashes
  • Mouth sores
  • Chest pain
  • Abdominal pain

These symptoms may be mild or severe, lasting weeks, months, or years, robbing you of your health, wellbeing, and sense of joyful living.

Breaking the Stress Cycle

So, what can be done to reduce the release of cortisol? It takes self-awareness to manage your stress levels. It’s important you understand what areas of your life — people, places, conditions — trigger your flight-or-fight response, as there is a predetermined threshold of stress unique to each individual.

Once the intensity of stress passes this threshold, it creates issues with not only immunity but also cognition. Memory and judgment are usually impacted first.7 That’s why we often see unhealthy behaviors accompany stress:

  • Smoking
  • Drug or alcohol misuse
  • Turning to high-fat, high-sugar foods for comfort
  • Sex, technology, or other addictions
  • Poor sleep habits

These behaviors, in turn, contribute to the progression of inflammation and autoimmunity, perpetuating a cycle that’s difficult to break without the awareness that you’re caught in an actual psychological AND physiological response fueled by stress.

Stress-Reduction Practices

There will always be some level of stress in life. In fact, stress is one of the driving forces behind the survival of the human race. When faced with life-or-death situations, the release of cortisol during fight-or-flight has preserved life and limb. Unfortunately, mortgages, taxes, discrimination, and family pressures are just some of the modern-day stressors that leave us in a constant state of fight-or-flight for months, even years, leading to long-term health consequences and the presentation of new, mysterious illnesses.

So, it’s up to you to find ways to minimize stress that work for you. There are a number of mind-body medicine techniques backed by research that are shown to help manage stress and lower cortisol. I want to share a few of those with you as well as add some stress-reducing practices I use myself when I feel increased levels of stress in my mind or body.

  1. Emotional Freedom Technique: An evidence-based technique that uses a combination of tapping on acupoints together with speaking a specific, meaningful phrase out loud. EFT is proven to reduce the emotional impact of incidents and memories that trigger emotional distress. The body works to rebalance itself and accelerate healing once the emotional stress is decreased or eliminated.8 Find a practitioner in your area. =
  2. Mindfulness-Based Stress Reduction (MBSR): A group program that combines mindfulness meditation and yoga to reduce stress and help people struggling with physical and mental illness. MBSR has been shown to reduce perceived stress during ulcerative colitis flare-ups. Ulcerative colitis is an autoimmune disease with no cure characterized by inflammatory flare-ups in the digestive tract, which may be induced by stress.9
  3. Diaphragmatic Breathing: Also known as belly, abdominal, or deep breathing, diaphragmatic breathing is a manipulation of breath where air is drawn deep into the belly rather than the chest. The physiological results include lower oxygen consumption, lower heart rate, lower blood pressure, higher theta wave amplitude, and the experience of alertness and being invigorated.10 These biomarkers, as well as studying recipient self-assessments suggest diaphragmatic breathing may be an effective tool for reducing stress.
  4. Biofeedback: Biofeedback is a process using instruments to measure brainwaves, breathing, muscle activity, heart rate, and temperature to quickly provide feedback to an individual so they can learn how to intentionally change the physiological response to triggers. Biofeedback is intended to improve both health and performance but has also been shown to significantly lower perceived stress.11

In addition to these well-known evidence-based stress-reduction techniques, there are several others recommended by integrative health practitioners for patients with autoimmune disease. Ask your healthcare provider for suggestions or referrals. You can also try one of these simple methods to begin to manage stress right away:

  • Self-care: Try a bath, a massage, journaling time, whatever it is that brings you peace and clarity of mind.
  • Disconnect from technology: Set and follow rules for screen time in your home such as no devices after 8 pm.
  • Exercise: Take a morning or evening walk, hit the gym for a group exercise class, or take your family on outdoor adventures on the weekend.
  • Release the need for control or perfection: This is the one women often struggle with. Let go of expectations of how your life or career is supposed to look. Follow your joy and ask for help when you need it.

Conclusion

While the evidence is currently inconclusive, more research is pointing to the critical role stress plays in the onset and progression of autoimmune disease. Whether you are being proactive and looking to prevent autoimmunity or you’ve been diagnosed and want to reverse your condition, adding stress-reduction practices to your toolbox is a great strategy to take your health into your own hands and improve your wellness.

References:

  1. https://www.ncbi.nlm.nih.gov/pubmed/18190880
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5805548/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/
  4. https://www.ncbi.nlm.nih.gov/pubmed/24798553/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465119/
  6. https://jamanetwork.com/journals/jama/fullarticle/2685155
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579396/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381429/
  9. https://nccih.nih.gov/research/results/spotlight/041114
  10. https://www.ncbi.nlm.nih.gov/pubmed/31436595
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411437/

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