We all need some level of stress to protect us with a fight or flight response when we are in challenging situations. However, excess stress may lead to improper functioning of the adrenal glands resulting in damage to your body.

Chronic psychosocial demands and medical conditions like diabetes and hypertension may cause your body’s system to experience undue stress leading to activation of your sympathetic nervous system. This causes excess release of hormones like cortisol and catecholamines from your adrenal glands, which are adjacent to the kidneys in your body. These excess hormones then result in adverse changes in your body leading to:

• decreased immunity

• increased heart rate and risk of heart disease & hypertension

• gastrointestinal problems

• insomnia/sleep disturbances

• tension headaches

• anxiety or depression

• weight gain

• fatigue and difficulty concentrating

If stress is not appropriately managed, it may lead to increases in hormones such as cortisol, catecholamines, glucagon, and growth hormones. This may result in “stress hyperglycemia”(excess circulating blood glucose) and increased insulin resistance. These factors promote excess weight gain.

Cortisol is a steroid hormone (glucocorticoid) that is regulated by the pituitary and hypothalamus glands in the brain exerting an influence on the adrenal glands. Its production follows your circadian rhythm (internal biological clock) in a diurnal pattern (spiking within 30 minutes of awakening and gradually decreasing throughout the day with a second evening spike).

Increases in cortisol are necessary for mobilizing the energy needed during the response to stressful conditions by increasing blood glucose. Other beneficial effects of cortisol include decreasing inflammation, suppressing the immune system and regulating nutrient metabolism when needed.

However, if the levels remain chronically elevated, then increases in appetite promote weight gain and increase in fat accumulation (usually in the abdomen) leading to worsening of other medical conditions.

It is also important to note that the symptoms of low cortisol include:

• low appetite and weight loss

• abdominal pain, nausea, or vomiting

• low blood glucose and salt craving

• muscle/bone pain

• fatigue,dizziness

We may not be able to remove all forms of stress in your life but there are ways to support your body’s adaptive response. The relaxation response is necessary to treat and reverse the adverse effects of chronic stress.

• Our structured Stress Management Evaluation will include:
  Comprehensive history and targeted physical exam as necessary to identify pathology associated with chronic stress.

• Specialized testing for inflammatory biomarkers such as high sensitivity C-reactive protein.

• Assessing hormonal levels including cortisol, IGF-1 (growth factor), and DHEAS.

• Evaluating for metabolic dysfunction with targeted lab testing (fasting insulin, glucose, hemoglobin A1c, leptin, uric acid).

• Nutritional and physical exercise recommendations.

• Psychoeducational focus on engaging the relaxation response and building resiliency to counter the heightened stress response.

Resources:

• Progressive muscle relaxation (PMR) training: coordinated tightening and releasing of several muscle groups to induce relaxation with therapeutic breathing.

• Guided imagery uses recall of pleasant memories and sensations to create a positive cognitive and emotional state.

  “Mental state” guided imagery is a journey used to relieve anxiety and pain associated with a heightened emotional response.

  “End stage” guided imagery targets a specific physiologic change such as sympathetic nervous system hyperarousal as experienced with chronic stress.

• Autogenic training involves focusing on physical sensations such as warmth, heaviness, and relaxation in different parts of the body.

• Biofeedback-assisted relaxation using electronic devices to monitor and teach control of breathing or heart rate to induce relaxation.

• Therapeutic breathing, which is a foundational technique for many stress relieving practices