Articles- Nutri Focus - Stress

Nutri Focus - Stress

Stress is at an all time high in the UK, with stress-related disorders and ailments accountings for approximately 75-95% of all doctor's visits, according to some estimates. Stress can severely affect health and has been linked to such diverse conditions as cancer, diabetes, immune system breakdown, alcohol and substance abuse, cardiovascular disease, gastrointestinal disease, lung ailments, accidents, cirrhosis, anxiety, depression and suicide to name but a few.

The most recently published statistics from the UK's Health and Safety executive (www.hse.gov.uk/statistics/causdis/stress/), provide us with a very worrying picture of the stress situation in the UK, a situation that experts believe is likely to get steadily worse rather than better:

• Estimates from the Labour Force Survey indicate that self-reported, work-related stress, depression or anxiety accounted for an estimated 13.5 million lost working days in Britain in 2007/08.
• Around 1 in 6 considers their work to be very, or extremely stressful.
• Stress is the second most commonly reported reason for work-related ill health, following closely behind musculo-skeletal problems.

The Chronic Effects of Chronic Stress

Stress is one of the most commonly used words in relation to ill health and yet few people really understand just how far-reaching the effects of stress can be. Stress can be physical, mental or emotional & can be short-term or ongoing. Stress is everywhere, and as humans we seem to have a very turbulent relationship with our stress response - it seems we can't live with it and yet it is essential for life - we simply couldn't live without it.

Stress & Evolution - Going Back to Our Roots

As a species, our stress response has evolved in exactly same way as all other vertebrates. Dr Robert Sapolsky, Professor of Biological Sciences and of Neurology and Neurological Sciences, is an expert on stress and has spent more than thirty years studying the physiological effects of stress on health. He commented, "the stress response is incredibly ancient evolutionarily; fish, birds and reptiles secrete the same stress hormones that we do, yet their metabolism doesn’t get messed up the way it does in people and other primates".
So why, when we all secrete the same stress hormones, is stress causing so many problems for us when in most other animals it doesn't? The simple answer is that our bodies have not yet evolved to deal with the different types of stressors face in the 21st century as compared to those we faced when living in caves.
Dr Robert Sapolsky explains, ''Stress hormones are brilliantly adapted.
You mobilize energy in your thigh muscles. You increase your blood pressure and you turn off everything that’s not essential to surviving, such as digestion, growth and reproduction. You think more clearly, and certain aspects of learning and memory are enhanced. All of that is spectacularly
adapted if you're dealing with an acute physical stressor - a real one!''

But What Happens When the Stress is Psychological and Chronic?

When stress is non-life threatening, and is more of a constant psychological stress such as in a high-pressure work environment or through constantly worrying about financial pressures, the stress response starts to work against us. It seems we have not yet evolved fully to deal with classic 21st century stress.
Dr Sapolsky explains, ''if you turn on the stress response chronically for purely psychological reasons, you increase your risk of adult onset diabetes and high brood pressure. If you're chronically shutting down the digestive system, you're more at risk for gastrointestinal disorders.''
In situations of chronic stress, all aspects of brain function can also be affected, including the neurons associated with Learning, memory and judgment, which don't function as weft under stress. Long-term stress also suppresses the immune system, making you more susceptible to infectious diseases, and can even shut down reproduction by causing erectile dysfunction and disrupting menstrual cycles.

The Science Behind the Stress Response

1. Alarm - This is the classic stress response, which we all experience in a short-term stressful situation. Stress stimulates the pituitary gland in the brain to release the hormone ACTH, which stimulates the adrenal cortex. As a result, DHEA and cortisol levels increase; when these are high enough, the brain stops producing ACTH. Once the stress is over, cortical and DHEA Levels return to normal.
2. Resistance - With repeated stress, the body becomes tired and less responsive to the effects of cortical. This means that more cortical must be produced. The body can make cortisol from DHEA, so the extra cortisol is made at the expense of DHEA and DHEA levels fall. As it takes more time for these adrenal hormones to raise blood sugar levels to normal, symptoms of fatigue and unstable energy Levels can occur.
3. Exhaustion - The body can no longer produce enough cortical, so both this and DHEA are low. Irritability, an inability to cope with the slightest stress, low concentration, low energy, depression and headaches are common at this stage. Low tolerance to alcohol and high incidence of inflammatory and degenerative diseases are also typical of this stage.

The health effects of chronic stress are so far-reaching it would be impossible to detail them all, but here are some of the most common and possibly most debilitating problems that have been linked to long-term stress:

Depression
Stress is a major risk factor for depression. Studies have shown that depressed people are much more Likely to have elevated tenets of the stress hormone cortical than people who are not depressed'.

Breast Cancer
Studies have demonstrated tine between chronic stress and breast cancer risk. One study published in the American Journal of Epidemiology in March 20032 found a link between stressful life events and the occurrence of breast cancer, whilst another found that patients with breast cancer were less likely to survive if they had alterations in their cortisol levels.

Cardiovascular Health
It is now well established that stress is a major cardiovascular risk factor. One study published in the British Medical Journal Looked at the cardiovascular effects of work-related stress in 2002. Conclusions of the prospective cohort study were rather alarming; researchers found that those people who reported persistent stress due to work demands had the same level of risk for fatal heart attacks as people who smoke and don't exercise. They also found that employees with high job stress had a 2.2-fold Cardiovascular mortality risk compared with their colleagues with low job stress.

Homocysteine
Homocysteine is a natural substance made by the body; however, many people tack the enzyme to break it down completely. Excess levels of the protein Homocysteine can seriously damage the Lining of the arteries and are a significant risk factor for cardiovascular disease. Excess levels have also been linked to Alzheimer's Diseases. Research has shown that stress increases Homocysteine levels in the blood.

Brain Function
The hippocampal in the brain has high levels of cortisol receptors. Studies have shown that chronic stress impairs hippocampal funding, leading to neuronal atrophy and destruction, decreased short-term memory, decreased contextual memory and poor regulation of endocrine response to stress.

Irritable Bowel Syndrome
Links have been identified between stress and the symptoms of irritable bowel syndrome (IBS). Researchers have found that patients with IBS have significant disruptions in capitol levels compared with matched controls.

Sleep Problems
Normally, when you are asleep, cortical levels are low. But at times of chronic stress, cortisol levels may not drop sufficiently while you sleep. Thus, disruption of the sleep-wake cycle is a common symptom of chronic stress. If it continues, this initial degree of sleep disruption and insomnia can eventually lead to a vicious cycle of chronic insomnia.

Thyroid Function
Thyroid stimulating hormone (TSH) is produced by the pituitary gland in the brain and stimulates the thyroid gland to produce more thyroid hormone.
The thyroid grand produces T4, a kind of pre-hormone that is converted into T3, the active hormone. When cortisol levels are raised under stress, TSH levels fall, which means there is less stimulation of the thyroid gland. Cortisol also inhibits the conversion of the inactive 1-4 to the active 7-3 hormone, meaning there is less active T3 in the blood. Chronic stress can therefore have a dramatic effect on the function of the thyroid gland.

Immune Function
Chronic and prolonged stress has a significant depressant effect on the immune system. This is why people undergoing periods of chronic stress often suffer from more frequent infections. In an interesting study at Ohio State University College, women who were happily married had significantly better immune function and T cell status than those in difficult marriages.

Nutritional Solutions for Balanced Adrenal Health
Optimum nutrition is incredibly important in helping the body to cope with prolonged exposure to stress. Primary aims of an adrenal balancing diet should focus on balancing the blood sugar levels, energy production support and calming down the nervous system. Eliminating stimulants such as tea, coffee, alcohol and sweet, fizzy drinks is also recommended. In addition, nutritional supplementation can be highly effective in heaping to support a healthy adrenal response.

Key Nutrients for Adrenal Support
When recommending appropriate nutritious supplementation for the adrenal glands it can be very helpful to consider specifically the symptoms your patient is predominantly displaying, as not all stress pictures are the same. Certain herbs and nutrients can be helpful at different stages of the stress response, ranging from gentle adrenal support through to adrenal exhaustion.

Stressed & Tired Formula
Symptom picture: tired, apathetic, depressed; lack of motivation and energy; physical complaints such as indigestion, chronic fatigue, impaired memory/learning.

Asian Ginseng
Asian ginseng is the world's most renowned plant adaptogen. It has long held the reputation of being the most valued and widely used herb in China and Asia and has traditionally been used to stimulate mental and physical activity, enhance stamina, prevent fatigue and increase resistance to stress and disease. More recently, it has proved very useful for individuals who have exhausted adrenal reserves. Animal and human research studies suggest that ginseng may influence the activity of the HPA (Hypothalamic- Pituitary-Adrenal) axis through a variety of mechanisms; overate, it seems to have an incredibly balancing effect on the HPA axises.

Cordyceps mycelium extract
Cordyceps mycelium is one of the most valued medicinal fungi in Chinese medicine. It has traditionally been used to strengthen and rebuild the body after exhaustion or long-term illness. Preliminary animal studies support its traditional uses. Researchers have proposed that the polysaccharide fraction may help to increase corticosterone production, stimulate immune function by increasing the number of T-helper and natural kicker cells, improve energy metabolism and reduce elevated blood glucose levels without reducing plasma insulin levels.

Rhodiola Root Extract
Since 1960, more than 180 clinical, pharmacological and photochemical studies have been published to support the use of Rhodiola rosea for adaptogenic, anti-stress and neuroendocrine effects. Other health benefits associated with this herbal extract include improved cognitive function, increased physical work capacity and athletic performance, immune enhancing, antioxidant and anti-carcinogenic effects. The most recently published study on this amazing photochemical demonstrated some remarkable effects, researchers concluded that ''repeated administration of Rhodiola rosea exerts an anti-fatigue effect that increases mental performance, particularly the ability to concentrate, and decreases cortical response to awakening stress in burnout patients with fatigue syndrome''.

Stressed & wired Formula.
Symptom picture: nervous, anxious, easily distracted, fidgety, irritable, agitated, feeling out of control, altered blood fats and high blood pressure, hot flushes and food cravings.

Rehmannia
Rehmannia has been used in traditional Chinese medicine for centuries as a nourishing 'yin' tonic - to replenish exhausted reserves and provide support for the kidneys and circulatory system. Alterations in blood glucose Metabolism are a common finding in individuals under conditions of chronic stress and lead to many of the associated health challenges. Rehmannia has tong been renowned for supporting a healthy blood sugar balance; it is believed to enhance the activity of hepatic enzymes involved in the metabolism of glucose and affects liver glycogen content. Studies show that Rehmannia and its active principles possess wide pharmacological anions on the brood, immune system, endocrine system, cardiovascular system and the nervous system.

Biota Seed & Polygala Root -
Support the central nervous system and function as naturally calming sedatives.

Asparagus Root, Ophiopogon Root & Scrophularia Root -
Help to prevent the exhaustion of bodily reserves and additionally support healthy detoxification.

Schizandra Fruit & Jujube Fruit -
Maintain the integrity of heart tissue and function.

Platycodon Root –
Has pulmonary affinity, ‘ventilates’ the lungs and supports oxygen transport.

Stressed & hot Formula.
Symptom picture: Hot conditions of the joints, lungs and GI tract; sore, achy, tired, stiff; joint pain, limited range of motion, tenderness, inflammation

Liquorice Root
Liquorice root is renowned for its systemic health effects for the HPA axis, liver and digestion. Liquorice root provides direct support for the adrenal glands and can act as a cortisone mimic without the typical side effects commonly associated with steroid drugs. In this respect liquorice root is an excellent support in situations where prolonged adrenal fatigue is indicated.
Liquorice root also improves digestion and assimilation to reduce the potential introduction of food based antigens that can trigger inflammatory events. lt is also a useful support for immunological function.

Ashwagandha Root
Ashwagandha is widely considered as the Indian Ginseng. ln Ayurveda, it is classified as a rasayana (rejuvenation) and expected to promote physical and mental health, rejuvenate the body in debilitated conditions and increase longevity. It is renowned as a useful botanical for supposing normal functioning of the HPA axis. lt has a natural sedative and tranquilizing effect. The immune system is often compromised in times of chronic stress; ashwagandha also provides useful immune support and antioxidant protection of the mucous membranes against free radical injury.

Muscle Relaxation Formula
Symptom picture: muscle tension, inability to relax, poor sleep quality, difficulty dropping off to sleep

Magnesium & Calcium
Often nicknamed nature's tranquilliser, magnesium works as a co-factor for the profusion of adrenal hormones and helps to maintain optimal functioning of the adrenal glands. Magnesium is a pivotal nutrient in the maintenance of a healthy stress response. A study published in the Journal of the American College of nutrition's found that a deficiency of magnesium intensified adverse reactions to stress, mediated by excess release of catecholamines and corticosteroids. In this study, researchers found that low magnesium and high calcium levels increased the release of stress hormones, which further reduced levels of tissue magnesium. Muscle cramps are an obvious sign of a magnesium deficiency and a lack of either calcium or magnesium can make you more nervous, irritable and aggressive. Calcium and magnesium can be very useful for helping to relax nerve and muscle cells and ease symptoms of irritability.

Valerian
Valerian has been used for centuries as an excellent anti-anxiety herb.
Derived from the dried rhizomes and roots of an attractive perennial with pretty pink flowers, it grows throughout Europe in wet soils. As a natural relaxant, it is useful for several disorders such as restlessness, nervousness, insomnia and hysteria. Valerian acts on the brain's calming neurotransmitter (GABA - gamma-amino-butyric-acid) receptors, enhancing their activity and promoting a calming, sedative effect.

Passion Flower
Passion Flower was a favourite of the Aztecs, who regularly used it to make relaxing drinks. It has a mild sedative effect and promotes steep, with no known side effects at normal dousing. Passion Flower is particularly effective for relieving anxiety and can be particularly effective at helping to break the pattern of reading stressfully to life's challenges.

Sleep Formula
Symptom picture: Difficulty getting to sleep or staying asleep due to worry and anxiety.

5-HTP
5-Hydroxytryptophan (5-HTP) is the immediate precursor to the 'feel-good' neurotransmitter serotonin. It has proven to be an effective nutrient for balancing mood, appetite, steep, sexual behaviour and gain sensations. In 1991, a double-blind mufti-centre Swiss study compared 5-HTP to Fluvoxamine (a potent SSRI used for depression and obsessive compulsive disorder). Both groups showed significant and nearby equal reductions in depression. By week six, both groups had about an equal number of patients showing 50% improvement in the Hamilton Rating Scale for Depression.
In other words, 5-HTP at levels of 100mg tid resulted in a 50% improvement in depression - as effective as Fluvoxamine. Studies have also shown that 5-HTP improves quality of sleep.

Theanine
L-theanine is a relaxing, health-promoting amino acid found in tea. Studies have shown that when theanine is absorbed by the body, it can help to bring about an alert, yet totally relaxed state of mind. When Japanese tea-drinkers refer to the 'tea-mind', it is this particular state of tranquillity brought about by thiamine to which they are referring. L-theanine is clinically proven to reduce stress and improve the quality of steep. It is also renowned for improving Learning performance, promoting concentration, lowering blood pressured and supporting the immune system. The preferred form of L-theanine for supplementation is Suntheanine; a pharmaceutical grade and extensively researched form of L-theanine.

Zinc
Found in rich supply in oysters and many wholegrain foods, nuts and seeds, zinc is often tacking in many diets today. Zinc is an essential nutrient for balanced adrenal function as it works as a cc-factor in the production of adrenal hormones. A recent study in the journal Amino Acids Looked at the effects of zinc deficiency on depression and anxiety-related behaviour in mice. Results showed that low zinc levels were strongly associated with depression-like behaviour. Zinc is also an essential nutrient for the conversion of pre-thyroid hormone T4 - active T3.

Glandular Support

Adrenal & Pituitary Glandular Extracts
The adrenal glands become severely depleted fatigue. Glandular tissue concentrates taken as a supplement act in an adaptogenic way and can support situations of either 'hyper' or 'hypo' adrenal function.

In any stress supporting program it is also important to address lifestyle issues to target the root causes of stress.

Practical lifestyle solutions for stress management

• Identify areas of stress and take steps to reduce or eliminate them.
• Effective time management, allowing more space for relaxation is key for stress reduction
• Yoga, meditation, T'ai chi or breathing chasses can alt be helpful to encourage more effective relaxation
• Regular exercise is beneficial; running, brisk walking, swimming, cycling - choose something you realty enjoy and go for it!

'Without stress there would be no life'

It would be impossible to completely eliminate stress from our lives and neither would we want to. Remember, it is not always the stressor that is the problem; often it is our imbalances response that creates the problem. Taking measures to balance adrenal function and restore a healthy stress response through improving nutritional and practical Lifestyle factors has the potential to have a significant impact on overall health. In his book, The Stress of life, Hans Selye M.D. wrote, ''without stress there would be no life”. Perhaps it would do us all good to remember this.

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Other Resources:

• Stanford University, Stanford News service. ‘Robert Sapolsky discusses physiological effects of stress’Selye H MD The Stress of life
• Sapolsky R Why Zebras Don’t get Ulcers
• Meek J & Holford P Boost your immune system
• Holford P Beat Stress and Fatigue
• Holford P Optimum Nutrition for the Mind