Chronic Stress, Burn-out and Adrenal Dysfunction

If we don’t have the tools to adequately deal with stressors whilst we are facing them, they can have long-term effects on our physiology.

Back to all articles

Posted

March 15, 2022

It’s a term we use often and generously, but what does ‘stress’ really mean? A stressor is any change (internally or externally) that challenges your system. Stress is the experience of or reaction to that change.

 

What is Stress? 

It’s a term we use often and generously, but what does ‘stress’ really mean? A stressor is any change (internally or externally) that challenges your system. Stress is the experience of or reaction to that change. 

Our bodies and nervous systems were designed to respond to short-term stressors like coming to halt at a traffic light or short bursts of high-intensity exercise. However, the insidious and problematic stressors are long-term like environmental burden, inflammation or health, work and financial stressors. 

If we don’t have the tools to adequately deal with those stressors whilst we are facing them, they can have long-term effects on our physiology; so, while we might be out of the situation causing us stress, our body is still responding as though there is an imminent threat. If this goes on for long enough, the adrenal glands will alter the production of our stress hormone, cortisol and the autonomic nervous system will stay in the sympathetic (fight or flight) state despite being in a ‘safe’ environment. 

 

Systems that Stress Impact

 

The physical and emotional experiences of stress can and do have very real consequences on our physiology. It can impact most systems in the body including, but not limited to the:

  • Immune system: Chronic stress has been shown to suppress both cellular and humoral immune function; this affects your ability to defend against viruses and mount an immune response. In a large Swedish study, it was also found that stress-related disorders were correlated with a 30% increased likelihood of developing an autoimmune condition.
  • Endocrine system: Excess cortisol, our primary stress hormone, interrupts the brain’s communication with the thyroid (TSH → T4 and T3) and the conversion to the more active thyroid hormone (T4→T3 and instead increases reverse T3), downregulating the thyroid’s function. Cortisol can also impact sex hormone levels, particularly progesterone which is an important protective hormone for fertility, sleep and anxiety. 
  • Digestive system: There is a highway between the gut and brain called the vagus nerve which primarily regulates the parasympathetic, or rest and digest, nervous function. The state of our nervous system can dictate aspects of digestive function like stomach acid and gastric motility.  

Most of these effects are bidirectional, meaning that these systems also affect the stress response. This is why it is so important to approach health from a multi-system, holistic approach as the clinicians at LCON do. We are the first clinic in the UK to offer a full holistic experience – combining industry-leading nutrition and functional medicine expertise, alongside the latest in-house testing, so we can attend to all your health needs.

 

gut brain axis

Burn-out

The World Health Organization (WHO) pathologized burn-out in 2019 as a diagnosable condition which features: 

  • feelings of energy depletion or exhaustion
  • increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job
  • reduced professional efficacy.

Note that the WHO specifically classifies it as an occupational phenomenon, however in clinical practice, I’ve seen burn-out in many facets of life (parenting, care-giving, pandemic-related etc.). 

 

There are phases of adrenal dysfunction that lead up to burn-out. This typically begins with what I call an ‘Alarm’ state where cortisol tends to be overproduced which leads to feeling ‘tired and wired’ (think anxiety +fatigue). The second phase, ‘Resistance’ occurs as the adrenal cortisol production begins to wane, swinging between over and under production; fatigue becomes more pronounced and physical changes begin to occur (sleep, digestion, hormones). Finally, with enough time, ‘Exhaustion’ is the final phase which is where people identify as burnt-out. The fatigue is overwhelming and it can look and feel similar to depression from a psychosocial perspective.  

 

If we aren’t able to determine what your adrenal glands are doing through symptoms, we can test cortisol. The most helpful tests to understand cortisol are 4-point urinary or salivary tests that track the cortisol curve. This can give more specific direction for treatment. Contact us to inquire about further testing.

 

Key Nutrition and Lifestyle Principles to Support The Stress Response

  1. Balance blood sugar: When blood sugar drops, typically after a carbohydrate heavy meal or snack, cortisol is released to help liberate blood sugar. Consuming protein, fat and fiber at each meal helps to stabilize blood sugar. Foods like eggs, lean meats and fish, high quality protein powders, nuts/seeds, avocados, olive oil,  fibrous fruit and vegetables can all help to keep blood sugar from dropping, curbing the stress response.
  2. Adequate calories: If inadequate calories are consistently consumed (especially for women), it can exacerbate the stress response and signal to the body, ‘my survival is being challenged’ which is unfavorable in the recovery from chronic stress.
  3. Micronutrient rich: Micronutrients such as B vitamins, Magnesium and Vitamin C are crucial for adrenal function. Foods such as eggs, citrus fruits (oranges, kiwis), pumpkin seeds, leafy greens and lean meats are adrenal supportive foods. 
  4. Reduce inflammation: Cortisol is highly anti-inflammatory; reducing inflammation can help to reduce the demand of cortisol. Foods high in antioxidants such as berries, cocoa, green leafy veg, green tea and oily fish can mitigate inflammation. Reducing processed and refined foods decrease inflammatory burden.  
  5. Move your body for your stage of burnout: Being sedentary can promote a state of stress, however over-exercising can also. Moving your body gently each day through activities like walking and low intensity yoga are safe for most people. Depending on your stage of adrenal dysfunction, movement capacity changes.
  6. Mindfulness: Practicing mindfulness can entail traditional meditation, though it doesn’t have to. Mindful walks, eating, and conversations can all help to regulate the nervous system.

 

Chronic Stress, Burn-out and Adrenal Dysfunction

 

Herbs are an amazing tool to expedite results when treating hormonal imbalances and nervous system dysregulation. I will almost always use herbal medicine in conjunction with nutrition and lifestyle to restore the system to a parasympathetic state and help the body adapt to stress. 

To be clear, stress and cortisol are not all bad. We require cortisol, and enough cortisol, to feel our best. It’s about balance. The environmental burden both physically and mentally has become more potent over the years and it has never been more important to have the tools to manage it than it is now. The pandemic has accentuated that we, as a society, need to be better equipped with resources to truly manage stress. Whether you’re focusing on your digestive health, autoimmune conditions, chronic infections, or hormone health, holistically addressing your stress response will always be an ameliorating factor. If you’re looking for more support and direction in your journey with stress, I created a self-study course available online (lifetime access!) that gives you the tools, module-by-module to be equipped to truly change your relationship with and response to stress. You can find out more here

 

Dr Heather Robinson

Author Dr Heather Robinson

Heather’s areas of focus include women’s health and hormones (PCOS, endometriosis, supporting fertility, acne thyroid etc.), adrenal dysfunction, chronic stress and burnout, mental health (anxiety, depression and panic), chronic digestive conditions including SIBO, parasites, candida, IBD and ‘IBS’, as well as complex conditions such as chronic fatigue, fibromyalgia and mould toxicity. She’s run a general practice, seeing hundreds of complex health conditions without diagnosis; she is confident in working with you to get to the root of your concern.

 

The holistic stress solution course

 

Related articles:

 

 

 

References: 

https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases

Margaret E. Kemeny, Health Psychology Program, Department of Psychiatry, Laurel Heights Campus, University of California, 3333 California St., Suite 465, San Francisco, CA 94143.

Segerstrom, S. C., & Miller, G. E. (2004). Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry. Psychological Bulletin, 130(4), 601–630. https://doi.org/10.1037/0033-2909.130.4.601

Chang, Lin. “The role of stress on physiologic responses and clinical symptoms in irritable bowel syndrome.” Gastroenterology vol. 140,3 (2011): 761-5. doi:10.1053/j.gastro.2011.01.032

Song H, Fang F, Tomasson G, et al. Association of Stress-Related Disorders With Subsequent Autoimmune Disease. JAMA. 2018;319(23):2388–2400. doi:10.1001/jama.2018.7028

Goppelt-Struebe M, Wolter D, Resch K. Glucocorticoids inhibit prostaglandin synthesis not only at the level of phospholipase A2 but also at the level of cyclo-oxygenase/PGE isomerase. Br J Pharmacol. 1989;98(4):1287-1295. doi:10.1111/j.1476-5381.1989.tb12676.x