Chronic stress and cortisol release
We often hear the phrase "stress is not good for the heart". Not very surprising as it has been proven that chronic stress could lead to cardiovascular disease, but also other health issues. Often we do not have any control over our stress response as we are constantly exposed to challenges in life such as tight deadlines at work, studying to get a degree or family problems. There is, of course, a physical cause triggering a series of events within our body leading to undesirable outcomes impacting quality of life in the long run.
When the body experiences chronic stress, it perceives it as a threat and a distress signal is sent to the brain activating the stress response system called the HPA axis; this consists of the hypothalamus, the pituitary gland and the adrenal gland. The HPA axis normally helps the body to protect itself from a dangerous situation with a 'fight-or-flight' response.
The hypothalamus releases corticotropin-releasing hormone (CRH), which travels to the pituitary gland, stimulating the release of adrenocorticotropic hormone (ACTH). This hormone then travels to the adrenal gland where it triggers the release of cortisol, 'the stress-hormone'. The body is now tense and on high alert, ready to face 'the threat'.
What are the health issues caused by high levels of cortisol in the body?
Under normal circumstances, cortisol helps regulate various processes in the body:
Blood pressure regulation thereby influencing the cardiovascular system
Metabolic regulation thereby influencing the use of fats, proteins and carbohydrates
Suppression of inflammation thereby influencing the immune system
Blood sugar level regulation
Influencing the sleep-wake cycle
Chronic stress can keep the HPA axis continuously activated, leading to elevated levels of cortisol in the body for a long period of time. This can cause physiological changes ending in several consequences:
High blood pressure, increasing the risk of cardiovascular disease
High sugar levels, increasing the risk of developing Type 2 diabetes
Excess inflammation causing chronic pain; this occurs when prolonged cortisol exposure renders the body resistant to its anti-inflammatory effect
Weight gain
Muscle weakness
Autoimmune thyroid disease
And many more..
Taking back control of our physical wellbeing
Many of us experience a few or several of the consequences of high cortisol levels and as a result become dependent on medication, perhaps for the rest of their life. But, what if we prevent this from happening in the first place? It requires a level of investment and dedication, but that is a small sacrifice compared to a lifetime risk of side effects from medication and dependency. We are competent enough to help ourselves and take control of our own health. It is a game of ebb and flow, but there are several ways to keep cortisol levels under control even if we suffer from chronic stress. It requires some lifestyle changes:
Make sure to get plenty of sleep. This can be difficult when you are under stress, but there are some ways to make sure that you become relaxed. Having a nice bedtime routine can unwind you and bring you into relaxation mode. For example, taking a shower, drinking chamomile tea while reading a book or listening to an audiobook before bed. White noise machines that can help calm the mind to make it easier to fall asleep. Meditation before going to bed may help calm your breathing and relief some of the pressure of the day. Try to avoid drinking caffeine around 6 hours before bed and avoid nicotine and alcohol
Regular exercise can boost 'happy hormones' called endorphins, serotonin and dopamine
Take care of your diet. There are several foods that have a cortisol-lowering effect such as dark chocolate, whole grains, fruits and vegetables, fatty fish, legumes and lentils and probiotics and prebiotics. Also make sure to drink plenty of water as dehydration can temporarily increase cortisol. If water is too boring, then drinking green tea can have benefit as well as it contains a calming compound called L-theanine
Control your breathing. Deep breathing activates the parasympathetic nervous system, known as the 'rest and digest' system, thereby lowering cortisol levels. Exercises such as yoga can help, but if you do not have the time, simply find 10 minutes during the day for yourself and just breath. Perhaps listen to your favorite music while you do so
Laugh. They say that "laughter is the best medicine" and this could not be more true as even forced laughter can lead to reduced levels of stress. Plan a fun day with a friend or practice laughing yoga
Observe yourself and recognize stressful thinking. Becoming more self-aware helps you to recognize stress signals and allows you to process them. By implementing mindfulness-based exercises, you can manage your stress better and avoid becoming overwhelmed
Interact with a pet. Whether you get a pet for yourself or babysit your friend's dog, interaction with animals has shown beneficial effects for the mind and reduction in cortisol levels
It may seem daunting at first, but start with baby steps and try one of the above mentioned techniques and build up from there.
References
Whitworth J.A., et al. Vasc Health Risk Manag. 2005;1(4):291-9.
Mohd Azmi N.A.S., et al. International Journal of Environmental Research and Public Health. 2021; 18(2):676.
Knezevic E., et al. Cells. 2023;12(23):2726.
https://www.healthline.com/health/happy-hormone#exercise Assessed and Endorsed by the MedReport Medical Review Board