Getting to know the types of chronic stress making the body feel unsafe and driving an overactive fight-or-flight response is the first step in lowering their impact on us. Keep in mind that “stress” is broadly defined as anything that impacts the body’s natural balance (called homeostasis), but it’s not a pie-in-the- sky, vague New Age concept, rather a real, measurable, predictable, physiological response to perceived threats causing a burden on the HPA axis.
There are four main categories of stress:
- Inflammation (chronic or acute)
- Circadian rhythm imbalances
- Nutritional imbalances
- Psychological stress (past and current)
Let’s take a closer look at the top four.
Top Stressor #1: Inflammation
Inflammation is the body’s response to injury. When cells are damaged for any reason, for example, due to a wound, infection, or toxin, the immune system responds by increasing blood flow to the area and releasing healing chemicals and hormones, such as cortisol, to help repair the injury. This process can cause redness, warmth, and swelling (a.k.a. inflammation). If you’ve ever twisted an ankle and watched it balloon up painfully, you’ll have a good idea of what inflammation looks and feels like. Not all inflammation is visible, though. Inflammation is considered chronic when it persists for a long time because the body is unable to fix the problem area.
The most common sources of chronic inflammation I see are due to pro-inflammatory foods, including foods we are sensitive to, as well as intestinal permeability from an imbalance of bacteria in the gut (gut dysbiosis), small intestinal bacterial overgrowth (SIBO), and gut pathogens including Helicobacter pylori (H. pylori), Blastocystis hominis, and yeast overgrowth/Candida.
Chronic inflammation may also occur from a variety of obvious and not so obvious sources, such as injury, obesity, sleep apnea, environmental toxins (radiation, chemical exposure, air pollution, mold, substance abuse, alcohol, certain medications, copper toxicity, iron overload), viral infections (such as Epstein-Barr virus), and lifestyle choices like overwork, overexercising, and not exercising enough.
The ongoing demand for anti-inflammatory cortisol to neutralize chronic inflammation can throw off the HPA axis and trigger adrenal dysfunction.
Top Stressor #2: Circadian Rhythm Imbalances
One of the fastest ways to induce adrenal dysfunction is through sleep deprivation. Sleep is the primary healing time for both our bodies and our minds; when we don’t get enough, our HPA axis suffers. Most adults require between seven and nine hours of sleep (those with chronic illness may need more), including enough body-restorative “deep” sleep as well as brain-restorative rapid eye movement (REM) sleep to function optimally.
Many of us don’t get enough high-quality sleep because our circadian rhythm, the body’s natural twenty-four-hour biological clock, is out of balance. When the circadian rhythm is in balance, cortisol floods the body in the morning to help us feel energetic when the sun is out and gradually declines throughout the day, reaching a low point at night to encourage sleep.
When that rhythm is thrown off and the optimal pattern of cortisol is disrupted, we may have trouble waking up, be fatigued during the day, and experience trouble falling and staying asleep. Additionally, we are more vulnerable to infection, increased sugar cravings, digestive issues, and night hunger. Furthermore, circadian rhythm imbalance has been tied to seasonal affective disorder (or, as I like to call it, sunshine and light deficiency).
Lights and screens that make nighttime seem as bright as daytime, too much time spent indoors, a lack of sunlight in the morning, jet lag, and shift work can all throw the rhythm off, negatively impact our sleep, and lead to adrenal dysfunction.
Top Stressor #3: Nutritional Imbalances
What we eat—or don’t eat!—can put stress on the body. Nutrient imbalances can be grouped into two main categories: nutrient deficiencies and blood sugar imbalance.
Certain macronutrients and micronutrients are required for proper adrenal function, and without a sufficient supply the adrenals will struggle to keep up with adequate hormone production. Nutrient deficiencies can occur as a result of:
- Eating nutrient-poor foods (including conventionally grown and raised foods, as they have been found to be lower in nutrients than organic options)
- Eating foods with less bioavailable (easily and readily absorbed and used) nutrients
- Following a calorie-restricted diet
- Having inflammation from infections or food sensitivities
- Taking certain medications
- Having an imbalance of gut bacteria
- Having low stomach acid or a lack of digestive enzymes
- Having a lack of sufficient thyroid hormones
These nutrient deficiencies add to the body’s stress load, and the stress response depletes these nutrients even more, burning through them at a high rate. If supplies aren’t replenished, the body enters a catabolic state, breaking itself down for nutrients to fuel the adrenals and, consequently, ratcheting up the stress level even higher. If we’re in this catabolic state for a prolonged period of time, we’re likely to experience severe nutrient deficiencies as well as perpetuate and exacerbate our adrenal dysfunction. It’s a cycle that can be difficult to break.
Blood Sugar Imbalance
Blood sugar, also called glucose, is an important energy source for the body, providing nutrients to the organs, muscles, and nervous system. It is primarily obtained from the carbohydrates found in the foods we eat.
When we eat foods containing carbohydrates, the carbohydrates are broken down into glucose that is then released into the bloodstream through the small intestine. Elevated blood sugar signals the pancreas to release insulin. Insulin is a hormone that helps restore balance by shuttling glucose from the bloodstream into cells where it can be used for energy and stimulates the liver to convert excess glucose into glycogen for storage.
Problems arise when we consume large amounts of sugar—and I’m not just talking about desserts— high‑carbohydrate foods such as grains and even starchy vegetables are an issue as well—and the pancreas has to release larger amounts of insulin to bring the levels of sugar in the blood back down. These surges in insulin can cause blood sugar levels to drop too low, leading to nervousness, light-headedness, anxiety, low energy levels, and cravings for more carbohydrate-rich foods. Hello, “hanger”! This starts the cycle all over again as blood sugar levels swing high and low.
The body prefers to keep blood sugar levels in a normal, steady range, so wild ups and downs put stress on the body, and especially the adrenals, as it tries to restore equilibrium. When the adrenals become stressed, they release an excess of cortisol and our liver gets the message to make more glucose by breaking down muscles for their amino acids (gluconeogenesis), which can lead to hyperglycemia and insulin resistance. In turn, when we don’t have enough cortisol, our liver doesn’t make enough glucose, and we end up with low blood sugar.
Excess cortisol release also leads to an increased production of inflammatory proteins that are associated with a heightened immune response and autoimmune conditions, such as Hashimoto’s, celiac disease, polycystic ovarian syndrome (PCOS), inflammatory bowel disease (IBD), rheumatoid arthritis, and lupus. Blood sugar imbalances have been described as adding “fuel to the fire” of autoimmune disease by many practitioners who focus on reversing these conditions.
Stabilizing blood sugar is an important part of protecting your adrenals from excess stress and healing from autoimmune conditions.
Top Stressor #4: Psychological Stress (Past and Current)
It is likely no surprise that psychological stress may be at the root of an impaired stress response. Feelings such as grief, guilt, fear, anxiety, excitement, and embarrassment can be classified as stress. This stress is based on our perception, not on the nature of the individual stress. Mundane, day‑to‑day things can cause stress, too—a text message from a demanding boss, a constantly cluttered house, an overdue bill, never-ending piles of laundry, or a computer meltdown can throw us into survival mode. And because these “threats” are near-constant most days, we can stay there much longer than we should.
An overactive fight‑or‑flight response is often present in people with a history of trauma. Traumatic events, such as an accident, abuse, or assault, can put us into a sustained fight‑or‑flight response that makes us keep going, even when our brain and body need to rest, digest, and heal. Childhood trauma has been especially relevant in setting the tone for altered hormone patterns in adulthood. We may not think an experience from our past (even one we don’t remember) has the power to influence us, but the body remembers and tries to protect us through the stress response. If the psychological trauma remains unresolved and our emotions suppressed, we may find it difficult to heal adrenal dysfunction despite our best efforts with physiological-driven lifestyle changes (replenishing nutrients, balancing blood sugar, curbing inflammation). When we are stuck in the fight‑or‑flight response, our bodies will continue to feel unsafe. Until we restore a sense of safety, both physically and psychologically, there is a high likelihood a chronic pattern of adrenal hormone dysfunction will persist.
I know from my own experience as well as my work with so many clients that addressing psychological stress may be the hardest part of transforming the adrenals. But it is absolutely the most important strategy and I want to assure you: We can shift our perceptions of stress and our mindsets to make stress easier to handle and resolve underlying emotional trauma to restore balance to our bodies.
This is an excerpt from Dr. Izabella Wentz’ new book “Adrenal Transformation Protocol.” Dr. Wentz is a passionate, innovative and solution focused clinical pharmacist.