Stress and Adrenal Fatigue

This week I want to talk a little about the stress response. My goal is to give people a little information about how to recognize and hopefully reduce what is a largely unavoidable consequence of living.
Ever since the beginning, humans have been exposed to stress. Through the Milena humans have adapted in a manner that gives them an advantage for survival. The stress response and all the physiological events that take place can give us superhuman strength, increased stamina, improved sensory ability and enhanced problem solving abilities. These increased abilities come at a price however and if exposed to the stressful stimulus for too long the body begins to degrade and all advantages are lost to beyond the point that was previously considered normal.
Let us first differentiate between two types of stress. First there is "good" stress, called Eustress. This type of stress is when the body is pushed outside of its normal comfort zone for positive results. Examples of this are weightlifting or exercising. The stress placed on the body causes it to build and become stronger. Eustress may also be mentally challenging work that results in accomplishment and contributes to a sense of well being. The second type of stress is Distress, or "bad stress". This type of stress is when the person is unable to adapt to the challenges places upon them. While eustress is generally considered good and distress bad, both of these in excess are damaging to the body. Lets talk about how the body responds to stress.

The Stress Response

The body uses two major systems to communicate with itself. One is the nervous system (electrical) and the other is the endocrine system (chemical).  Each of these systems can influence and regulate the other.
The nervous system is divided into two major systems; the sympathetic also known as the "fight-or-flight" and parasympathetic known as the "rest-and-digest".
     
     Fight or Flight     This response system, and those that it affects, is designed to do exactly what the name implies; either stay and fight whatever is threatening us or turn and run like the wind. Both of these responses will require largely the same things of the body. When this system is triggered, usually by something we see or hear or perceive to be a threat, the body will respond with the following.

• Increased heart rate
• Increased respiration rate
• Reduced blood flow to non-essential functions such as digestion
• Increased blood flow to muscles, brain and lungs
• Reliance on intuitive behavior
• Freeing glucose from storage in fat and liver for muscles
• Dilation of pupils
• Erectile inhibition
• Inhibition of immune function

A response to this may be rapid heart rate and breathing combined with a sudden rush of energy and a sudden hyper-focusing on one particular stimulus. The cost is reduced awareness of what else may be going on around you, sudden dry mouth and a subsequent feeling of a "crash" after the stressful event. This "crash" is very similar to what is experienced a short time following the consumption something very sweet


     Rest and Digest     This nervous system is generally engaged when we are calm and in a safe place. Characteristics of the system include the following.

• Increased salivation
• Reduced heart rate
• Increased digestion
• Reduced blood to extremities (arms and legs)
• Increased elimination of urine and feces

A response of this system may look like your relative sitting in the recliner chair after a large Thanksgiving meal. Belly full (making noise), slow breathing (snoring) and a blanket over the legs (shunted blood from extremities).
 

The problem with stress is when we encounter too much of it and the body does not have the time or tools to recover. Stressful events in a typical day include:

• Too little rest
• Driving
• Finances
• Interpersonal relationships
• Arguements
• Traffic
• Poor diet
• Drugs (Caffeine, alcohol, etc..)
• Illness
• Pain
• Fear (crime, traffic, children)

In addition to the Fight-or-Flight response mentioned above, the body responds in another way to stress, and that is through the release of cortisol (endocrine system). This chemical hormone is released as a necessary component of this response. Cortisol is a normal part of the body. It is crucial in the establishment of our daily rhythm. Generally cortisol is highest in the morning and acts as a stimulus for waking. Then, throughout the day, the level of this chemical gradually diminishes. As the level of cortisol declines, so does our energy, to what is finally a low point in the evening, and hopefully, we go to bed. Now, anytime we encounter a stressful event the body releases a little cortisol from the adrenal glands to help compensate. This release gives us a little boost and we have the extra to deal with whatever stressed us. The problem arises when the body is constantly asked to release this cortisol. Several things occur when we are placed in a state of elevated and chronic stress . The increased levels of cortisol inhibit the immune system from functioning. A reduced immune function will increase the chances of illness and can dramatically affect the long term risk of things like cancer. This constant demand for cortisol drains the adrenal glands to the point of fatigue and possible exhaustion.
Adrenal fatigue will have symptoms such as:

• Difficulty waking in the morning (from reduced morning cortisol)
• Unrestful sleep
• Difficulty getting to or staying asleep
• Craving for salt or sugar
• Mid-day fatigue (esp. 2-4pm)
• Increased evening energy (second wind)
• Not sick for a long time or sick all the time
• Increased seasonal allergies
• PMS (mood swings, cramps)

The adrenal glands are fairly robust glands and take a while to drain. Most will not notice the first symptoms until sometime in their late 20's and thereafter. By that same regard however it means that they also take some time to restore. The good news is that there are many things that you can do to help. Reducing stress or at the very least ones perception of stress. Providing the adrenals with all the necessary nutrients to rebuild and restore themselves. Additional supplements and nutrients can accelerate the process and diminish symptoms of the fatigue. Among the basics are adequate sleep, healthy food and adequate vitamins and minerals. Make sure to keep you sugar and caffeine to a minimum and when you are tired  , especially in the evening, don't go to the freezer for that bowl of ice cream, go to bed. If you absolutely must have a desert then do so at least two hours before going to sleep. Sugar (also alcohol) before bed is a fantastic recipe for a very un-rested slumber.
The complexity of this system provides us with many ways to treat. Adrenal support is a part of almost every patients treatment protocol, the specifics are, of course, tailored to the individual and their own personal health goals.
As always, your comments and stories are welcome. Be well, be happy and be good to one another.

Good Fat Bad Fat

There are a few things that can go a long way to helping one have the best chance possible at living a long healthy life. One would be, to get plenty of rest. Second would be, stay well hydrated. Third would be eat healthy and this includes getting all the essential minerals, vitamins and fats necessary. In general I believe that our medicine is food and food should be our medicine. Whenever possible I try to incorporate a varied and seasonal diet to provide for all the necessary nutrients the body needs throughout life. When this is not possible, or a particular condition arises where there needs to be a therapeutic level of a nutrient introduced, I will recommend supplementation.This brings me to essential fats. There are many nutrients that are essential, meaning, humans cannot produce them and they must be ingested. Among the fats there are two, ALA (alpha-linolenic acid) and LA (linoleic acid). ALA is what is called an omega-3 fatty acid and LA is an omega-6 fatty acid. The human body lacks the necessary enzyme to make these two fats but it can make several other different fats from them.

• ALA (α-linolenic acid) omega-3 → EPA and DHA 
• LA (linoleic acid) omega-6 → DGLA (Dihomo-gamma-linolenic acid) and AA (Arachadonic acid)

 As a society here in the west we generally have no shortage of the omega-6 fats. Sources of LA include:

• corn oil
• safflower oil
• cottonseed oil 
• soybean oil
• sunflower oil

Generally, we do not find the same prevalence of ALA. Sources of this fat include:

• Cod liver oil
• Salmon
• Mackerel
• Herring
• Sardines
• Krill
• most oily cold water fish
• Flax seed oil
• Walnut oil
• Hemp seed oil

Now, why is this important? One of the most important thing that research has revealed to date is that the concentrations of each, omega-6 to omega-3, matters a great deal. Research shows that here in the west, people consume what amounts to around 20x more omega-6 than the omega-3. Historically this ratio was around 1:1, for tens of thousands of years, not 20:1 as is the case today. The shortage is in the omega-3's.  With the prevalence of processed foods, many of which use the above omega-6 acids, it is easy to see why this imbalance is present. Lets not take a look at how the presence or absence of these two fats effects the body.

Omega-3's
ALA, is converted in the body to EPA and DHA

EPA (Eicosapentaenoic acid) for the heart:

• Lovers blood pressure
• Prevents platelets from sticking together
• Reduces depression
• Lowers cholesterol
• Reduced heart disease risk

DHA (Docosahexaenoic acid) for the brain:

• Deficiency likely causes decreased adult mental function
• Cancer inhibtion
• Development of brain cells and vision in infants.

Omega 6's
  LA is converted to DGLA and AA in the body.

DGLA (Dihomo-gamma-linolenic acid) from borage seed:

• anti-inflammatory
• tumor inhibition 

AA (arachadonic acid) from fatty red meat:

• Pro-inflammatory
• muscle regeneration 

Now that we know what each of the above do, generally, lets talk about how the ratios affect our health outcomes.

If we move this ratio closer towards 1:1 there is a whole host of health benefits. In general we do not need to attain a 1:1 ratio, of omega-6 to omega-3, as ideal as that may be. Most of the health benefits can be attained with a 2:1 or even 4:1 omega-6 to omega-3 ratio. When we do reach 2:1, through supplementation for example, the following health benefits have been shown:

• Dramatic reduction in cardiovascular mortality ( around 70%)
• Reduced chances of cancer (lung, breast, and colorectal)
• Reduction in asthma symptoms
• Reduction in incidence of diabetes
• Reduction is arthritis symptoms (rheumatoid)
• Reduction in overall bodily inflammation

Depending on your diet and health picture it may be necessary to modify your diet and even supplement omega-3's. Most people fall somewhere within the 2 gram range but may go as high as 10 grams or higher of needed supplementation of ALA (EPA & DHA). It is important to note that these fats affect how the body undergoes blood clotting and any individuals who are on anti-platelet or anti-clotting medication for any reason need to exercise extreme caution and seek close supervision by your physician. As with all supplements and medications please consult with your doctor before making any changes.
All comments are welcome and as always, be healthy and happy.

Allergies - Food, Chemical and Hay Fever

Where to begin. The topic of allergies is a massive one and it includes many different aspects. What I will try to do here is discuss some of the differences beginning with what an allergy is and how is it different from a sensitivity.
Allergies in their true sense are characterized by a response of the bodies immune system. This is different from a sensitivity which does not elicit a response from the immune system but the term is frequently interchanged.

Allergies are classified in to the following categories of hypersensitivity:

• Type 1 hypersensitivity: This is an immediate reaction and is frequently referred to as anaphylactic. Symptoms can be mild to fatal and frequently occur within 15min to 10hrs.
• Type 2 hypersensitivity: Also known as cytotoxic (cell death) hypersensitivity, this is a reaction that is usually from something inside the body rather than an external source and can cause damage to whole types of tisssue. It should be noted that there is published literature suggesting that a very small molecule called a hapten (poison ivy and others) can trigger this process resulting in autoimmunity (multiple sclerosis, lupus erythematosus, etc.)
• Type 3 hypersensitivity: Frequently referred to as immune complex hypersensitivity. This reaction occurs in 3-10hr or more and includes things like rheumatoid arthritis. The reaction is a result of foreign particle (bacteria, virus, parasite or other) combining with a part of the immune system and causing a reaction. 
• Type 4 hypersensitivity: This is a delayed onset hypersensitivity and may not take effect for days after exposure. Some vaccines respond by this mechanism. Additionally, it is thought that ingested foods can also elicit this type of response.

In order to know how to treat an allergy it helps to understand what is going on. As is the case with many symptoms of the body, what is frequently thought of as a result of the infecting organism, is really symptoms from the response of the immune system. What I mean is, when you get sick what you are really feeling is your body's response to fighting the invader (virus, bacteria, etc). When the body is infected with something foreign it generally knows right away (even if you don't). Local immune cells found everywhere in our body are constantly asking every cell they run into 2 questions: "Are you me?" and, "Are you dangerous? If that foreign cell can't give the right answer it is slated for destruction. The cell asking the question will explode and release its contents after getting the wrong answer. These contents will hopefully take the first step in killing whatever it encountered but that frequently is not enough. The exploded cell guts have wide-reaching effects. They effect all the cells locally causing them to spread apart and get leaky, (this causes swelling of tissue) but will also allow cells to leave the bloodstream and enter the tissue. Additionally, these cell guts, most of which is histamine, also send out a signal to bring in reinforcements. These reinforcements will travel from all reaches of the body following the chemical signal left behind by that first cell explosion (degranulation). The result is many more immune cells rushing to the area of infection and now the degranulation is greatly increased. All this release of histamine is now coursing though the body and it affects everything. There is swelling of the eyes and respiratory tract. Joints may be affected as well and swell. The effect will reach muscles and generally cause the entire immune system to switch into a high gear. The body now is asked to make many new immune cells to replace the ones degranulating (exploding) and fatigue sets in frequently to the point of feeling sick, like getting a cold.
So really what is causing the telltale symptoms of allergies is your body responding normally, albeit in excess, to something, that it thinks, is not supposed to be there. The problem is when that something is ubiquitous, say for example pollen. There is no need for the body to respond with a full immune response to pollen as it poses us no real threat, yet may of us do, why?
The body is a complex organism and it relies on multiple systems working together. In addition to the immune system as I have already discussed we must consider the endocrine system as well. This system is huge and all encompassing. Metabolism, energy, mood, sleep, reproduction and others all rely on endocrine products. These products are produced by organs all throughout the body and they all rely on one another. If the output of any one, say the pancreas or adrenal gland, is reduced it causes changes to all the other glands relying on it.

Most treatment for allergies is focused on two aspects of the immune response.

1. Either prevent the histamine released by immune cells (a normal process) from attaching to their receptor. Imagine putting a key into a lock that is not the right key. While the wrong key is in the lock it is impossible to open the lock using the right key, as the hole is already filled.   
2. Prevent the immune cells from releasing their contents (histamine) at all.

If this one aspect was the only consideration it would be an open and shut case but it is not. With something as complex as allergies a multi-system approach needs to be employed to achieve any substantial and long-lasting effect.

A naturopathic approach to allergies includes more than just this one part and encompasses the entire body picture.  Treatment includes stabilizing the immune cells to prevent them from being too sensitive to normal environmental things like pollen. This treatment will be most effective with type 1 hypersensitivities but can be modified to include other types. The most frequent intervention is bioflavenoid therapy (the good stuff from brightly colored foods) combined with nettle and a compliment of vitamins and homeopathy. To really exert a lasting effect on the allergy it is necessary to support healthy function of the adrenal system as well. This treatment can include herbs, lifestyle modification, dietary changes and glandulars. Close attention should be payed to the dietary picture as well. With type 4 sensitivities it is possible to be regularly introducing something to the body that is putting the immune system on alert. Being that the digestive system has a tremendous amount of immune tissue this can be a very pronounced alert.

Ignoring the allergy symptoms or in worse cases suppressing them can cause the body to manifest these symptoms in another system, such as the skin. Eczema, and psoriasis have been suggested as being, at least in part, manifestations of either food or environmental allergies. Suppression of symptoms here will frequently cause the body to look for another avenue of expression that may result in adult onset asthma. Exacerbation of the original allergy or a completely new allergy that is more extreme, even to the point of being anaphylactic, may also result from long term allergies.

With so many considerations it is important to be involved in a dialogue with someone who can take all these systems into consideration. Be pro-active, stay informed and ask questions.

Starting your day off right.

   As a tribute to the start of my new space for all things Naturpathic, I thought it fitting to begin with some healthy guidelines about starting your day off right. The time of waking is a special time. This time, usually the morning for most of us, represents the beginning of a new day and new opportunities. The machinery of the body sees this time a little differently. For the last eight hours or more (time from your last meal) you have been  fasting. What this means for the body, is that, all the sugar requirements needed to keep us alive have been coming from storage. The conversion of this stored sugar into usable sugar is called glycogenolysis and it happens mostly in the liver and muscles. When we wake and eat our first meal, breaking the fast, we are changing the method by which we acquire and utilize sugar. Now we are getting our sugar from digested food and storing the rest for when food is not available. This is called glycogenesis. The name of the game for the body is stability. We prefer a slow steady supply of sugar (like we get at night) rather than peaks and surges such as after sweet meals (high glycemic index).
     This first meal after our nightly fast will set the stage for how hungry we feel throughout the day. According to a study published by the  British Journal of Nutrition , eating a breakfast high in protein increases the feeling of satiety throughout the day. What this means is that we will feel fuller from eating less if we start out with a breakfast that is high in protein. For the start of my day I choose a hard boiled egg (17gm protein) as my protein of choice and I eat it within 1 hour of waking. Alternatives to this can include a lean, antibiotic-free, nitrate/nitrite-free meat such as turkey or pork. For you meataphobes out there 4oz (110gm) of tempeh will give you about 15gm of protein. While generally I remove soy from the diet for a whole host of reasons (later post) I do make an exception for fermented soy products.
    So there you have it. In Summary:

1. Eat Breakfast (within 1 hr of waking)
2. Choose a protein rich source for the first meal such as a hard boiled egg, lean preservative-free meat, or fermented soy product.
3. Ask your doctor before making any medically significant changes to your lifestyle.