Tag: stress management

Posted on by

The Damaging Effects of Chronic Stress

chronic stress

The following is an extract from ‘The Plant-Based Dietitian’s Guide to Fertility’ by Lisa Simon RD and looks at the effects stress can have on fertility. The book will be available for purchase on Hammersmith Health Books and other online vendors this month. 

I cannot emphasise enough how significant an effect chronic stress can have on your health. I would go so far as to say that it is at a level playing field with nutrition and, if it isn’t addressed, quite simply you will not improve your health.

Your body’s response to stress is instant and starts in your brain. It begins a series of interactions between the hypothalamus, pituitary and adrenal glands. This results in the release of adrenaline and cortisol, two of the ‘stress hormones’, from the adrenal glands. Once the stress has passed, your cortisol and adrenaline levels reduce back down. This step is really important as the communication between the glands in your brain and the adrenal glands above your kidneys also influences the production of sex hormones. If the stress doesn’t pass, the stress response doesn’t stop and this results in disruptions to your reproductive hormones. It is because of this that chronic stress may lead to poorer sperm quality and infertility in both men and women.

The effects of chronic stress on fertility

So, the effects of chronic stress on general health but also on fertility can be significant, and sometimes it feels like a bit of a vicious circle. Struggling to conceive is stressful, going through fertility treatment is stressful, and worrying about the effects of stress is stressful! Add that to general life stressors like work, relationships, social pressures, financial strains etc, and you can see how present stress is daily, even if you are not always aware of it. This is when the effects of such stress can start to become apparent in your state of health and affect your fertility, and this is why it is so important for both your mental and physical wellbeing to have in place some great stress management techniques. In terms of fertility treatment, data show that men report feeling stressed providing sperm samples on the day of egg retrieval, and this may negatively affect overall semen quality, with effects on sperm concentration and motility. However, it is difficult to say whether stress results in reduced semen quality, or whether it is a consequence of decreased semen quality.

Being diagnosed with infertility, frequent medical appointment, and failed IVF treatment are all very stressful events. It isn’t just the stress itself though that can affect sperm quality; how you respond to stress may also play a part. Responding by being assertive or confrontational may negatively affect fertility by increasing adrenaline production which then results in the blood vessels in the testicles tightening. This reduces testosterone production and the making of new sperm, so for men, stress management techniques are just as important as for women.

As stress causes an increase in cortisol and subsequent suppression of sex hormones, this can lead to a decreased sex drive and can also lead to undesired weight gain. Whereas acute stress is more likely to result in a reduced appetite, chronic stress is more likely to decrease behavioural control and increases impulsive behaviour. An estimated 35-40% of those experiencing stress increase their food intake. The types of food likely to be chosen are foods high in sugar and/or fat, with low-energy, high-nutrient foods, particularly fruit and vegetables, decreasing. This may then lead to overeating, which in turn can lead to weight gain and potentially increase feelings of anxiety and depression. Conversely, some experiencing chronic stress may decrease their food intake, leading to weight loss, with potential adverse effects on their mood, energy, concen­tration and, for women, their menstrual cycle.

Managing Chronic Stress

Managing stress is the third pillar of lifestyle medicine and essential to improving your chances of conceiving a healthy baby. In terms of techniques for doing so, everyone is different, and what might work for one person may not necessarily work for the next. For example, I’ve had patients telling me that meditation is their idea of ‘hell’, but then when I explore further, I find their concept of meditation is sitting on a yoga mat, cross legged, with both hands raised, fingers touching, while gently humming. This stereotypical image does not reflect the broad spectrum of meditation and is very different to most people’s practice.

Note from the author: In my new book, The Plant-Based Dietitian’s Guide to Fertility, I recommend the following from which you can pick and mix what is right for YOU. Please do see the book for the full information:

  • Guided meditation
  • Controlled breathing
  • Positive visualisation
  • Laughter therapy (yes! You heard right)

My experience of managing stress after embryo transfer

I can’t say that I didn’t worry at all during the two week wait after embryo transfer as I think some degree of anxiety is inevitable when you are pinning so much on something working, but every time I felt as though my anxiety was starting to get too high, I would apply some or all of the stress management techniques I describe in the book to bring it down.

Another thing I would highly recommend, if it is possible for you after embryo transfer, is to book those two weeks off work, or at least the first week. You want to remain as calm and stress-free as possible during that time, not having to deal with the commute if you are not working from home; work stress is something that you just don’t need. Also, finding something to occupy your mind is crucial so you don’t spend long periods trying to second-guess whether you are pregnant. That can be really counterproductive, and please, STEP AWAY FROM GOOGLE! It can be so tempting to search the internet for ‘signs I am pregnant’ or ‘what does implantation feel like?’ but this can raise stress levels and mean that you are obsessing over the slightest little sensation. Try and spend those two weeks doing lovely things with either your friends or your partner. Go out for relaxing meals, watch a film in the cinema, organise a pamper evening, do some crafting – anything that helps you to relax and distracts you from negative thoughts.

And remember, if none of these techniques are for you, there are many other forms of stress management that can be equally as effective. These can be going for a lovely walk, or a gentle run outdoors in nature, curling up with a cuppa and your favourite book, or having a lovely warm (not hot) bubble bath. As long as you take some time out, away from your phone and other screens, and just focus on being present, you will feel much better for it.

Posted on by

5 Ways to Prevent or Reverse Hypertension

Blog post written by Dr Eugene Kongnyuy, author of No Pills, No Needles, launching 25th May.

 

10 years ago, I was diagnosed with high blood pressure (hypertension). As a physician and researcher, I decided to self-experiment. My aim was to find out what could successfully reverse my hypertension so that I could stop taking blood pressure (BP) medicine. I tried over 70 different things including salt restriction, meditation, stress management, different dietary regimens, weight loss, walking, etc. After 5 years of self-experimenting, none of the things worked for me and I felt disappointed.

In order to keep fit, I decided to run or jog for 1 hour every morning. Six months after I started this programme of 1 hour per day of regular exercise, I took my BP and it was very low. I stopped the BP medicine and the hypertension was gone.

One hour of regular moderate to high intensity exercise per day may be what you need to reverse your high blood pressure. Over the years, I have kept with 1 hour of exercise per day while tracking my BP and I have learned a lot more. Here are some of things that I have learned that can help you either prevent or reverse hypertension.

 

  1. Exercise regularly

Exercise is the centrepiece for the prevention or reversal of high blood pressure. Experts recommend 150 to 300 of moderate exercise (or 75 to 150 minutes of vigorous intensity exercise) per week. This is what you need to prevent hypertension. In order to reverse hypertension, you would probably need a lot more. To reverse hypertension, I had to do 1 hour of moderate to vigorous exercise per day (or 420 minutes per week).

First, aerobic or ‘cardio’ exercises cause repetitive contraction of large muscle groups which in turn forces the heart to work hard and pump blood to the muscles. Regular ‘cardio’ workouts, such as jogging, brisk walking, running, cycling, swimming, yoga, dancing, football, golf, hiking and basketball, increase the heart rate and train the heart muscles[1]. You need to train your heart muscles to pump blood more efficiently and this takes time. The longer the duration of each exercise, the better the results. Cardio training over several months causes a significant fall in blood pressure.

Second, exercise causes the endothelium (inner wall of blood vessels) in exercising muscles to produce nitric oxide and prostacyclin, both of which promote enhanced vasodilatation by relaxing the smooth muscle cells in the blood vessel walls[2].

Third, exercise blocks the renin-angiotensin-aldosterone system (RAAS), a hormone system that, when stimulated, raises blood pressure by increasing vascular resistance and causing sodium retention by the kidneys. This causes the blood vessels to widen and the kidneys to flush out sodium.

Fourth, exercise blocks the sympathetic nervous system (SNS). This causes the blood vessels to relax and widen, which in turn reduces the blood pressure. The SNS is one of the two main divisions of the autonomic nervous system (the other being the parasympathetic nervous system – PNS) that is responsible for our ‘fight or flight’ response among other things. The autonomic nervous system is a control system that acts largely unconsciously and regulates bodily functions, such as heart rate, digestion, respiratory rate, pupillary response in the eyes, urination, and sexual arousal. The SNS activation causes BP to rise. Once activated, the system fires electrical signals that lead to the release of the hormone adrenaline by the adrenal gland. Exercise blocks the SNS and therefore lowers the BP.

 

  1. Get active

Exercising plus being physically active throughout the day is more effective than exercise alone. I realised that each day when I came back from work, I did between 1000 to 2000 steps. I spent most of the day sitting. I decided to change my desk to a standing workstation. I remained standing while working, reading emails, writing, and I held standing meetings. The number of steps I did per day increased from 1000-2000 to 4000-5000 steps. I observed that my systolic BP was about 10 mm Hg lower during the day than it would otherwise be when I wasn’t physically active. I also find gardening, cooking and cleaning very helpful in keeping me physically active. There are many other ways to be physically active and each person can figure out what he or she can do to avoid a sedentary lifestyle.

 

  1. Get sweaty

Sweating lowers blood pressure by causing the dilation of blood vessels under the skin as well as loss of water and salt. I found that exercise that caused me to sweat was more effective in lowering my BP than exercise that didn’t. With sweat-inducing exercise, my systolic BP was about 10 to 20 mm Hg lower than exercise that didn’t cause me to sweat. Sweating is a natural method the body uses to control body temperature. When your body starts to heat up, whether because of exercise or outside temperature, it releases sweat from the more than 2-4 million eccrine glands spread out across your skin, pouring liquid through pores to lower body temperature. Sweating induces a ‘diuretic’ effect by causing increased loss of salt, including sodium, and this lowers blood pressure[1]. For those who can afford it, having a sauna at home could be an easy way to get sweaty.

 

  1. Keep warm

I found that my BP was generally lower in warm weather (such as summer or being in a hot country) than in cold weather (such as winter or a cold country) independent of sweating. Numerous studies have found a correlation between temperature and blood pressure, and have also generally shown higher blood pressure during winter. The explanation is that cold weather activates both the sympathetic nervous system and the renin–angiotensin-aldosterone system. Warm weather does the reverse as well as inducing sweating[1]. Therefore, following the sun when booking holidays can therefore be a good way to manage your hypertension.

 

  1. Lose weight

Weight is important if you want to say ‘goodbye’ to your antihypertensive pills. Studies have shown that by losing 5 kg (8.8 pounds), your systolic and diastolic blood pressure can drop by 4.5-3.2 mm Hg respectively[3]. If you have mild high blood pressure, weight loss alone can be sufficient to control it. Weight loss improves blood pressure, although exercise has a greater impact. This is the reverse of what I found for type 2 diabetes. Diabetes is affected more by weight loss than by exercise. In my case, I estimate that my BP was treated 80% by exercise and 20% by weight loss and my diabetes 80% by weight loss and 20% by exercise.

 

In conclusion, by combining regular exercise with being physically active throughout the day, doing something what makes you sweat, keeping warm and losing some weight, you can prevent or reverse hypertension. In this article, I decided to focus on my experience. But it’s important to note that there are other ways which, although they didn’t work for me, could work for other people. These include salt restriction, healthy diet, quitting smoking, moderating alcohol intake and managing stress.

One of my self-experiments was to find out the effect of altitude on my BP. It’s well known that the higher you climb, the higher the BP. However, I found that the effect of exercise and sweating was so strong that it completely overrode any effect of altitude on my BP.

These are just a few of the lessons I have learnt self-experimenting which helped me reverse both hypertension and type 2 diabetes. After hesitating for several years, I finally decided to put my experience in writing because I felt it could help many people, or at least the methods I used could be applied by anyone to find out what works for them. I have written down all my lessons in a book No Pills, No Needles which is coming out in May 2021.

 

[1] Rosenthal T. Seasonal variations in blood pressure. American Journal of Geriatric Cardiology 2004; 13(5): 267–272.

[2] Nystoriak MA, Bhatnagar A. Cardiovascular effects and benefits of exercise. Frontiers in Cardiovascular Medicine 2018; 5: 135.

[3] Fortenberry K, Ricks J, Kovach FE. How much does weight loss affect hypertension? Journal of Family Practice 2013; 62(5): 258–259.