Dr. Laura: Long Term Effects of Cortisol and Stress

Cortisol is released in a daily rhythm, but also in response to stress. Ever wonder what are the long term effects of cortisol (stress) in the body?

picture from  philosophytalk.org

Long term danger can be perceived in the form of anything that takes away our freedom, feeling unloved, feelings of insecurity, projecting into the future something that is not true, as if it were and  fear-based memories for future survival so as to avoid any repeat of traumatic events.

Cortisol is not all bad, it has some daily and life-saving functions. The problems lies when the body gets stuck in fear gear, cannot return to its natural state of homeostasis and subsequently has difficult with rest and digestion.

Normal Cortisol Function

Cortisol hormone produced by the adrenal glands. It is released twice a day with blood levels peaking in the morning, and rising slightly again in mid afternoon.

Throughout the day, cortisol:

  • Helps provide energy; maintains blood glucose
  • Suppresses nonvital organ systems to provide energy to the brain, nerves and muscles
  • Is a potent anti-inflammatory hormone
  • Prevents widespread tissue and nerve damage associated with inflammation

Short Term Stress Response

In response to a moment of physical or emotional shock or trauma, the body releases three main chemicals: epinephrine, norepinephrine and cortisol. In the short term, these chemicals trigger a series of events in the body to promote survival including anti-inflammatory actions and activation of energy to flee from the danger. Short term response has a clear purpose to better outcome (safety, life).

Once the epinephrine, norepinephrine and cortisol are released into the blood flow,

  • heart rate increases
  • blood pressure increases
  • respiration rate increases
  • arteries vasoconstrictor & release sweat.
  • pupils dilate
  • Pro inflammatory response so as to destroy antigens, pathogens, or foreign invaders; adrenoreceptor antagonists have been shown to inhibit stress-induced inflammation and cytokine production by blocking the proinflammatory effects of norepinephrine.

Long Term Cortisol Danger

Body’s release

When the brain feels you are in danger on an ongoing basis, cortisol release goes into overdrive. This can be things that threaten our survival like financial concerns, relationship problems, too many commitments, feelings of bitterness towards others, anger, resentment, being unhappy with yourself, lack of faith, hope, love, fear of loosing something you treasure… the list can go on.

Basically the body gets stuck in some type of survival mode. It is then difficult to re-establish to its natural balance.

Medications

Long term medications that end on “-sone” are often producing similar effects to cortisol in the body. These are drugs that suppress the immune system like prednisone, hydrocortisone.

Cortisone type drugs are used to treat pain, allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis, or breathing disorders.

Be sure to also be aware of information on cortisone drug side effects. 

  • Osteoporosis
  • Muscle wasting
  • Hypertension
  • Hyperglycemia
  • Hyper irritability
  • Depression
  • Weakness
  • Vascular fragility including easy bruising
  • Striae or redish stripes over the lower abdomen (thinning of the skin structures)
  • Suppressed immune system, make it easier to get infections
  • Central obesity

If you feel like you are “always on” , have difficulty digesting food or feel “tired and wired”, chances are you are running the meter up on cortisol. As you can see the long term effects are not favourable for good health.

Have Hope

Don’t give up hope, however. The first step is to recognize what is stressing you out. This is more than relationships, it can be pain, inflammation, poor diet, lack of sleep, poor coping mechanisms or genetic wrinkles.

Resolution doesn’t happen overnight but can be improved on a steady course of treatment over time.  Treatment will look at things like sleep hygiene, a healthy diet, the right amount and type of exercise,  and new perspectives on managing yourself in relationships with yourself and others.

The Last “Peace”

Need more peace in your life?  Join me at Goodness Me! on Sept 19th in a presentation on Anxiety Antidotes.

 

References:

Constanzo LS. 2011. BRS Physiology Fifth Edition. Walters Kluwer|Lippincott Williams & Wilkins. Philadelphia.

Hannibal KE, Bishop MD. Chronic Stress, Cortisol Dysfunction, and Pain: A Psychoneuroendocrine Rationale for Stress Management in Pain Rehabilitation. Physical Therapy. 2014;94(12):1816-1825. doi:10.2522/ptj.20130597.

Wright H. 2009. A More Excellent Way. Whitaker House. Pennsylvania.

Dr. Laura – The Sunshine Vitamin

What you don’t know about vitamin D

If you live in Canada and don’t supplement, you are likely deficient in vitamin D.  How much to supplement and for how long is very individual. It is based on things like the  natural colour of the skin, immune status, food intake and time spent outdoors in the summer.

The body makes vitamin D when the skin is exposed to sunshine or ultraviolet light. About 20 min of unprotected exposure mid day in the summer months in Ontario will produce about 1000IU of vitamin D.

Small amounts of vitamin D may be found in food sources such as fish, egg yolk, beef liver, however, when sunlight is inadequate (no exposure or seasonal variance), supplementation is essential.

Vitamin D helps:

  • the body absorb calcium and phosphorous
  • build bone mineral matrix
  • the nerves and muscles function
  • boost the immune system
  • modulate autoimmune diseases

Vitamin D deficiency can be suspect in multiple sclerosis, cancer, pancreatic deficiency, Crohn’s, Colitis, fibromyalgia, chronic fatigue, chronic low back pain, or severe muscle weakness.

Check your Vitamin D Status

Vitamin D levels have an optimum range, with increased risks for health disease when deficient or in excess.

OHIP no longer pays for vitamin D testing mostly because they found everyone to be deficient and suggest we all should supplement, at least through October to March. How much to supplement depends on the individual.

Recent research shows that people supplementing may have overdone it and now there are risks showing up for people who are taking vitamin D in excess. Protect from overdose by getting enough vitamin A (liver, organ meats, cod liver oil) and K2 (brie cheese!) in the diet.  Sometimes if levels are high enough, it means lowering the dose or stopping supplementation for a while.

Levels are best monitored by a blood test, then with the advice of your doctor you can be sure you are taking the amount that is right for you.

You may pay (about $45) for a basic vitamin D blood test with your Naturopathic Doctor. You may book your appointment (fees in addition to the blood test) today to investigate further.

Dr. Laura M. Brown, ND

Do you need more vitamins?

What drug should you avoid taking with vitamin C? Why could your feet be tingling? Long term use of Metamucil make you deficient in a what B vitamin? Easy bruising and bleeding could be a sign of what vitamin deficiency?  What vitamin is made by bacteria?

This is Part 2 of 2 on vitamin deficiency. It covers information on vitamins B5, B6, B12, C, D,E, & K.

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Vitamin B5: Pantothenic acid (B5) is used in metabolic cycles is key to the body’s production of energy, cholesterol, heme and acetylcholine. Cholesterol is used as the back bone of many hormones. Heme is used to carry oxygen in your blood. Acetylcholine is controls involuntary functions mediated by the activity of smooth muscle fibers, cardiac muscle fibers, and glands.

Some body signals that you are low in B5: burning, numbness or tingling in the feet, muscle weakness, swollen tongue (glossitis), cracks at the corner of your mouth (chilosis), recurrent upper respiratory tract infections (colds), fatigue, postural hypotension, hypochlohydria, GERD/heartburn, and depression.

Sources of B5:  whole grains, broccoli, kale, cabbage family of vegetables, mushrooms, legumes & lentils, avocado, eggs, milk, poultry and organ meats.

Vitamin B6 (Pyridoxine/pyridoxyl/pyridoxamine) is involved in over 50 enzymatic reactions and potentially effects the function of cardiovascular, skin health, blood production, nerve function, healthy pregnancy, blood sugar regulation and cognitive function. Signs of deficiency include anxiety, depression, insomnia, irritability, confusion, abdominal pain, weakness, seizures, anemia, and poor immune function. There is even a rare form of B6 deficient epilepsy.

B6 requirements increase with diseases that affect absorption such as Celiac disease. The increased prevalence of hydrazine and hydrazide compounds as found in aerospace fuels, anti-toxicants in the petroleum industry, plating materials in metal manufacturing and ripening agents used on plants. B6-zapping hydrazine is also found in tobacco smoke, tartrazine (FD &C yellow food dyes). There are numerous drugs that deplete B6 and lead to common sides effects such as neuralgias, depression and anxiety.  Those with Parkinson’s disease should consult a medical expert before supplementing with B6 as it can interfere with L-dopa when taken without carbidopa.

Food sources of B6 include potatoes, bananas, meat, poultry, fish and whole grains.

Vitamin B12: Methyl or Hydroxyl cobalamin. Measured via B12 serum levels. Falsely elevated B12 levels may exist in those with renal failure or hepatitis. Those with vegan diets are at increased risk of deficiency as major food sources are animal based.

Pernicious anemia is the result of loss of intrinsic factor, a protein that is excreted by the stomach and helps B12 absorption in the small intestine. If the stomach has low acidity as in long term use of proton pump inhibitors (a lot of medications ending in “-prazole”, presence of H.pylori, aging or damaged parietal cells as in autoimmune disease, or the small intestine mucosa is damaged as in Celiac or Crohn’s disease, B12 absorption will be reduced. Additionally those on long term use of psyllium (Metamucil) will be at increased risk of B12 deficiency. Large amounts of orally dosed B12 may help compensate by allowing for absorption by diffusion. Intramuscular injection (IM) of B12 (available with Dr. Laura) by passing the need for intrinsic factor. IM or intravenous B12 is also more helpful than oral supplementation for those with a defect in the transportation system of B12 to the brain or a an accelerated breakdown of B12 in the brain tissue. Signs of B12 dependency are dementia, depression, headaches, insomnia or chronic fatigue.

Vitamin C (ascorbic acid) is important in immune function, collagen formation (for skin and connective tissue), neurotransmitter formation, plays a role in fighting viruses and bacteria and is a key anti-oxidant. Scurvy is the severe form of vitamin C deficiency. Fatigue, depression and anxiety of health are acute signs preceding the diagnosis of scurvy. Signs are bleeding abnormalities due to poor connective tissue formation and possible vitamin C deficiency include bleeding nose, easy bruising, bleeding gums, bone pain, osteoporosis, arthralgias (pain stiffness and joint swelling), myalgias (muscle aches and pains), edema (swelling), and symptoms of suggestive of cardiovascular disease or mimicking peripheral vasculitis, or venus thrombosis.

Dose limiting symptoms of vitamin C are diarrhea and cramping.  Vitamin C increases the absorption of non-heme iron this is good for those with low levels of iron/anemia. Vitamin C also seems to help the absorption of aluminum, which isn’t so good as it builds up in the bone, brain and liver and may contribute to the development of osteoporosis and Alzheimer’s disease. Avoid taking vitamin C at the same time as antacids, or aluminum hydroxide compounds. Chewable vitamin C may erode your dental enamel (it is an acid). Vitamin C supplementation can help or hinder the function of various medications; check with your medical practitioner for details.

Good sources of vitamin C include bell peppers, citrus fruits, cantaloupe, broccoli, Brussels sprouts, cauliflower, potatoes. Vitamin C is lost in high temperature and prolonged cooking.

 Vitamin D (cholecalciferol) The body makes vitamin D when the skin is exposed to sunshine or ultraviolet light. About 20 min of unprotected exposure mid day in the summer months in Ontario will produce about 1000IU of vitamin D. Small amounts may be found in food sources such as fish, egg yolk, beef liver, however, when sunlight is inadequate (no exposure or seasonal variance), supplementation is essential.

Vitamin D helps the body absorb calcium and phosphorous, builds bone mineral matrix, helps the nerves and muscles function, boosts the immune system, and modulates autoimmune diseases. When the supplemental D3 taken with K2, vitamin D helps get calcium out of the blood stream and into the bones. Vitamin D deficiency can be suspect in multiple sclerosis, cancer, pancreatic deficiency, Crohn’s, Colitis, fibromyalgia, chronic fatigue, chronic low back pain, or severe muscle weakness. You may purchase D3+K2 drops at Forward Health.

Vitamin E: There are 8 different kinds of vitamin E – each a different type of tocopherol. Vitamin E is known as an antioxidant and the most potent, bioavailable form is alpha-tocopherol. When supplementing it is best to have a mixed or blend of tocopherols. Vitamin E is also involved in anticoagulation (inhibits platelet aggregation), is anti-inflammatory and stabilizes the cell membrane. Those with fat malabsorption issues at risk for deficiency. Vitamin E is also depleted in those with a high consumption of fatty foods, as thermally oxidized vegetable oil depletes vitamin E status. Good food sources of vitamin E include almond oil, wheat germ oil, nuts and seeds, whole grains, egg yolks and leafy green vegetables.

Vitamin K: There are actually four different kinds of Vitamin K. Vitamin K1 is what is often tracked so closely for those on warfarin because warfarin is an anticoagulant and affects the INR – the measurement we use to factor coagulation, or thickening of blood. Vitamin K1 is found in lots of leafy greens. K1 is also given to newborns to help prevent hemorrhage; a newborns’ intestinal tract is not yet making its own Vitamin K. K2 is made by some bacteria in our gastrointestinal tract, and by bacteria in some foods, like brie cheese. K2 helps Vitamin D3 get Calcium into the bones, so is useful in those suffering with osteoporosis or steroid induced bone loss and also can help lower total cholesterol in people on kidney dialysis. K3 and K4 still have much research pending. Those with Celiac disease not on a gluten free diet, chemotherapy, anticonvulsants or antibiotics may be at risk of vitamin K depletion, most likely due to the disruption in the bacteria of the gastrointestinal tract.

Good food sources of Vitamin K include dark leafy greens and to maximize absorption are best eaten with a source of fat (butter, olive oil, coconut oil, avocados). Olive oil actually is a source of vitamin K1 so it’s on double duty! Cheese, especially brie, egg yolks and fermented soy beans (natto) are also sources of Vitamin K.

Again, emphasize a diet with a full variety of  fresh wholesome foods, rather than supplementation. There are cases however where supplementation for the short term, and sometimes even the long term, is necessary for optimum health status. A naturopathic doctor has the training and resources to help you decide what is best for your individual requirements.

Dr. Laura M. Brown, ND

Source:

Gaby, A. (2011) Nutritional Medicine. Fritz Perlberg Publishing. Concord, NH.