Tag: stress

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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.

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Stress Awareness Week

Stress describes what we experience when we are physically, mentally or emotionally under pressure and feeling unable to cope. It activates our fight-or-flight response, with the outpouring of the stress hormones, adrenaline and cortisol. This response may have positive consequences in the short-term as it prompts us to take action, but prolonged stress and the feelings of helplessness that accompany it can have serious effects on our health.

We have compiled some key pieces of advice and top tips from a range of our books on the effects stress can have on our physical and mental wellbeing, as well as how to manage it:

 

‘Curing the Incurable’ – Dr Jerry Thompson

We already know that stress increases the incidence and severity of many diseases. A meta-analysis of nearly 300 studies found that stress lowered immunity. Stress increases inflammation, which in turn increases the risk of cancer. It activates the ‘fight or flight’ response, triggering the sympathetic nervous system, releasing hormones such as adrenaline, noradrenaline and cortisol, and reducing levels of growth hormone. Both adrenaline and noradrenaline block the body’s ability to destroy tumours. One study showed tumours grew 225% faster in stressed mice.

However, it isn’t just that we produce harmful chemicals when under stress. We also produce less of those anabolic hormones essential for healing and repair, as raw materials get diverted to produce more adrenaline and cortisol.

It is obvious that if we want to promote healing, then reducing stress becomes a priority. However, there is more to stress than meets the eye. In the study on rats subjected to electrical shocks mentioned in the Introduction, those that learned to avoid the shocks rejected their tumours three times as often as those that couldn’t. What’s more, 20% more of these rats rejected their tumours compared with those rats not subjected to any shocks. Here the stress proved beneficial and adapting to it had a positive survival effect. […] So reducing stress, or adapting to it in a positive way, can enhance our ability to fight a disease.

Many of the mental strategies that survivors have used are based on two simple ideas. Both are backed by a substantial amount of research:

  1. The body goes into healing mode once it becomes relaxed, and conversely healing of the body stops when we are under stress.
  2. Thoughts are creative and can modify health.

‘Eating Plant Based’ – Dr Shireen Kassam and Dr Zahra Kassam

Oxidative stress is an imbalance between the normal cellular processes of oxidation and reduction and is a result of the generation of metabolic products known as ‘reactive oxygen species’ (ROS). Certain ‘stressors’ can lead to increased levels of ROS, including cigarette smoking, medication, pesticides, radiation and also our diet choices. Oxidative stress then leads to the damage of proteins, DNA and cell membranes. The body requires antioxidants to counter the effects of these damaging ROS.

Plant foods contain hundreds of antioxidant compounds and have vastly higher antioxidant content than animal-derived foods. These antioxidants come in two broad categories: carotenoids and bioflavonoids. Both are large groups of structurally related compounds that help plants cope with radiation exposure from sunlight. Studies consistently show that those eating a predominantly plant-based diet have higher levels of antioxidants in the body compared with omnivores so, add more colourful fruit and vegetables into your daily diet as the intake of these anti-inflammatory foods reduces the very hormones that increase our stress levels.

‘Living PCOS Free’ – Rohini Bajekal and Dr Nitu Bajekal

Dr Nitu and Rohini Bajekal, writing in relation to PCOS but with aphttps://www.hammersmithbooks.co.uk/product/living-pcos-free/plication to all aspects of health, make these creative suggestions for managing our stress:

It helps to try and figure out if your stress is acute or chronic. It may be that it is a family member who needs your attention because they are sick, or it may be your relationship, work-related stress and deadlines, or even bullying and harassment. Chronic stress is a prolonged and constant feeling of stress that can negatively affect your health if it goes untreated. By identifying and acknowledging stress triggers, you may feel better equipped to deal with the situation.

[…] Regular exercise improves the feel-good factor and can help reduce anxiety levels. Walking or working out, especially in natural light, can help increase endorphins, also known as the happy hormones. Spending time outdoors in nature has been found to ease stress. […]

Gratitude practices and thinking of a few positive areas that are going well in your life can help relieve stress levels. Yoga, meditation or simple mindfulness and breathing techniques can calm the mind and reduce anxiety levels. Writing your fears or concerns in a diary or journal may help you to see the situation more clearly.

[…] Spending time in nature reduces stress. Studies have found that the Japanese practice of shinrin-yoku, translated as ‘forest bathing’, can lower blood pressure and improve immune function and mental health. Forest bathing involves immersing oneself in nature by mindfully using all five senses.

[…] Affirmations are powerful and positive simple statements that can help us challenge negative thought patterns. They can decrease stress, increase well-being, and make us more open to behaviour change.

‘Ecological Medicine’ – Dr Sarah Myhill and Craig Robinson (Second Edition available Jan 2023)

Life is inevitably stressful, and we all have skeletons in the cupboard. During sleep we relive the events of the day and remember the important things and rationalise the damaging memories. But if sleep is disturbed by adrenaline, then those memories are relived in a hormonally stressful environment, thereby reinforcing them. This is an obvious vicious cycle. The treatment is obvious too – stop adrenalin release at night with the Paleo-Ketogenic diet, thereby blocking any damaging memories that may be lurking.

 

 

 

‘The A-Z of Yoga for Cancer’ – Vicky Fox

 Breathing is key to helping to release anxiety by bringing us into the present moment. When we are conscious of our breathing we are fully in the moment because we can’t breathe in the past and we can’t take a breath in the future. This means we are in this moment with whatever this moment brings. […] There are many tools we can use to help bring us into the moment and it is about finding what works for you. I recommend beginning with a simple wave breathing exercise.

[…] Find a comfortable sitting position where your spine feels long. This maybe in a chair or seated on some cushions on the floor. […] shift from side to side until you feel there is equal weight on both sitting bones. Your spine should feel long, and you should not be shifting forwards or backwards. As you breathe in, sense the wave-like motion of your breathing.

Follow these steps:

                Inhale and sense or feel the wave rising.

                As you exhale, silently say to yourself ‘1’.

                Inhale and sense or feel the wave of breath rising.

                As you exhale, silently say to yourself ‘2’.

                Inhale and sense or feel the wave rising.

                As you exhale silently say ‘3’.

                Inhale and sense or feel the wave rising.

                As you exhale silently say ‘4’.

… and continue in the same way, Incrementally counting upwards to ‘10’ with each exhale and back down again to ‘1’ (this takes about 2 minutes).

This wave breathing is a form of meditation because meditation is giving your mind something to focus on; here the focus is movement of breath and counting.

 

National Stress Awareness Day (2nd November) is an annual initiative by Rethink Mental Illness which highlights the ways that stress can affect people and what you can do to manage your stress before it becomes a problem. The causes of stress and the best way to manage it can differ for every person and what works for some may not be as effective for others, so if you are struggling to cope with stress, make sure to consult your GP or look on the NHS website for more information.

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The Science of Stress Hormones

Stress Awareness Month

Exploring the role of hormones for Stress Awareness Month

There are two main hormones governing the stress reaction: cortisol and adrenaline. They work together to exert the ‘fear, fight or flight’ response that was first described in the scientific literature as long as 1936. This response gives a temporary increase in energy production, at the expense of processes that are not required for immediate survival. The resulting biochemical and hormonal imbalances should ideally resolve as soon as the danger is over, due to a hormonally driven negative feedback loop. The following is a typical example of how the stress response is supposed to operate as a survival mechanism:

* An individual is faced with a stressor

* A complex hormonal cascade ensures, and the adrenals secrete cortisol

* Cortisol prepares the body for a fight-or-flight response by flooding it with glucose, supplying an immediate energy source to large muscles

* Cortisol inhibits insulin production in an attempt to prevent glucose from being stored, favouring its immediate use

* Cortisol narrows the arteries whilst adrenaline increases heart rate, increasing the blood pressure and delivering more oxygen rich blood to the tissues

* The individual addresses and resolves the situation

* Hormone levels return to normal

Unfortunately, with our over-stressed, fast paced lifestyle, our bodies are pumping out cortisol almost constantly, which wreaks havoc on our health. In times of high stress the body will break down amino acids to form glucose through the process of gluconeogenesis (a physiological process via which proteins and amino acids are utilised, instead of glucose), to produce energy. Cortisol is the major stress hormone that promotes this process. Collagen, being a structural tissue made from protein, is one of the target areas for spare amino acids; the muscles are another. Chronically elevated stress levels increase collagen breakdown. Since collagen is the matrix upon which our bones are built, anything that is likely to break it down will have potentially serious consequences for the strength and integrity of the bones.

Cortisol primarily acts on the outer layer of the bone, known as the periosteum. Research has shown that elevated cortisol levels interfere with the formation of osteoblasts and cell proliferation. This dramatically decreases bone building and lowers bone density. Without adequate rest and repair, bone mineralisation and collagen formation will be reduced for the duration of the elevated stress.  The absorption of vitamin D is also adversely affected by high cortisol levels. This gives a double whammy in favour of bone loss.

Stress can rot your bones faster than a can of fizzy drink. Stress and the negative emotions that accompany it have been shown to have a chemical structure in our bodies. And guess what? That chemical structure is acidic! With all the emphasis I place on ensuring appropriate intake of alkaline minerals in earlier chapters, and the fact that increased acidity causes increased urinary calcium excretion, is it any wonder that for prevention and reversal of osteoporosis we absolutely have to take stress reduction seriously?

The power of exercise

My favourite way of combating the stress that often accompanies a bad day at work is to get out and go for a run, or go to a karate class. Both are also excellent ways of not only de-stressing the body but also improving bone strength. Exercise is a surefire way to de-fuse. It boosts the level of endorphins in the brain, morphine-like ‘happy hormones’ which are often depleted by our daily lives. Relaxation classes and guided meditation are well worth doing, as is a meditation based on love and compassion. Thoughts of love and compassion stimulate the production of a hormone called oxytocin, whose effects in the body work in the opposite way to those of cortisol. Oxytocin lowers the blood pressure and relaxes the walls of the arteries.

This blog is taken from Love Your Bones: The essential guide to ending osteoporosis and building a healthy skeleton by Max Tuck.