“The number one root of all illness, as we know, is stress.” – Marianne Williamson
Stress is part of life, our body’s reaction to acute stress is very important for our survival and health, the problem arises when we are under chronic stress which causes a dysregulation of our HPA axis.
The hypothalamic-pituitary-adrenal (HPA) axis is a crucial neuroendocrine system for maintaining the homeostasis (self-regulating process by which an organism tends to maintain stability while adjusting to conditions that are best for its survival) and managing allostasis (ability to achieve stability though change) during stressful conditions (mental and physical stress). It’s our key system of surveillance, protection, adaptation, and resilience.
The journey of stress response starts at amygdala in our brain, its function is like an inner and outer surveillance system, by detecting and getting triggered by danger/change from both inside and outside of body or even emotional memories (which is stored in hippocampus) and report it back to the brain. For example an outer danger such as a truck coming towards you or inner danger such as stomach pain.
Once amygdala is triggered, it will send a message to hypothalamus to release Corticotropin-releasing hormone (CRH), which triggers pituitary gland to release Adrenocorticotropic hormone (ACTH), this hormone triggers immediate release of Adrenaline and Nor-Adrenaline from the brain in addition ACTH triggers Adrenal gland to release more Adrenaline and nor-adrenaline from medulla and Cortisol from adrenal cortex.
Adrenaline helps with “fight and flight” response by increasing heart rate, increasing blood pressure ( via release of Aldosterone) , increasing breathing rate and blood sugar level.
Cortisol acts on the liver, muscles, adipose tissue and pancreas, it will trigger liver to increase gluconeogenesis ( production of glucose from glycogen) in order to increase glucose (sugar) level in blood for energy production.
Under normal circumstances, once the stressful situation is over, our body will recover from an acute spike of Adrenaline and cortisol and will get back to homeostasis, but if our body is under long term stress and does not get the opportunity to recover, it causes a cascade of biological changes which will have a negative impact in our body.
Symptoms of HPA dysregulations include:
- Trouble falling asleep; waking in the night, not feeling rested when you wake
- Cravings for caffeine, sugar, carbs, or fat
- Fatigue around 3-4 most afternoons, cravings at this time
- Slow metabolism; weight gain, especially stomach area, difficulty losing weight
- Chronic colds, respiratory, or sinus infections; recurrence of old infections, i.e. Epstein Barr Virus or herpes
- Irregular or poor digestion
- Hormonal imbalances of any kind Autoimmune disease, i.e. Hashimoto’s
- Anxiety; depression; depression when you wake in the morning; low motivation during the day
- Decreased memory or concentration, making mistakes at work
- Blood sugar problems including low or high blood sugar; metabolic syndrome; insulin resistance or diabetes
The mechanism of Chronic HPA activation and long term cortisol release and its effect on the body include:
- Chronic release of cortisol will increase fibrinogen which causes blood clotting.
- It will increase systematic inflammation by producing inflammatory cytokines
- Production of inflammatory cytokines will reduce immunity and ability to fight off infections.
- It will increase blood glucose level and as the result of this, it will decrease cells insulin sensitivity causing insulin resistance in our cells.
- Due to insulin resistance, the cells are starving for glucose, as the result it will increase carbohydrate craving and weight gain.
- An increase intake of salt/fat/carbohydrate causes gut dysbosis (imbalance of gut microbes) which causes intestinal inflammation, problems with absorption and elimination
- Chronic high level of cortisol will reduce blood circulation to the gut, causing ischemic damage to the gut and reducing mucosal lining IgA and reducing gut microbiota.
- Long term elevated level of cortisol cause and increase in abdominal fat, this fat will reduce leptin ( satiety hormone) level and increase Ghrelin (hunger hormone) which causes more fat/sugar/salt cravings.
- It will negatively impact our thyroid by reducing Thyroid stimulating hormone (TSH) and reducing the conversion of inactive thyroid (T4) to the active hormone (T3).
- Long term high Cortisol also suppress GnRH (Gonadotropin releasing hormone) and LH (Luteinizing Hormone) as the result it will cause anovulation and lowers sex hormones, Premature ovarian failure, corpus luteal dysfunction, ovarian failure, implantation failure, repeated pregnancy loss, premature labor and delayed labor.
- Cortisol uses DHEA and DHEA-S( produced by adrenal gland which is converted to androgen and estrogen) as a buffer during stress response, long term cortisol production will lower DHEA and DHEA-S levels causing lower levels of androgen and estrogen.
- Due to the negative impact on androgen, it will reduce libido
- Lower dopamine production as the result causing anxiety and depression
- It will decrease bone density by stimulating adrenal cortex to release aldosterone which causes mineral release into the blood stream
- It will elevate blood pressure due to high mineral content in the blood
- Basal cortisol elevation causes damage to the hippocampus and impairs hippocampus-dependent learning and memory. Chronic high cortisol causes functional atrophy of the hypothalamic-pituitary-adrenal axis (HPA), the hippocampus, the amygdala, and the frontal lobe in the brain
- High serum cortisol level will reduce melatonin causing insomnia and circadian rhythm dysregulation
The effect of long term stress on the body is measured via testing for allostatic load. Allostatic load is the burden of chronic stress on the body. The effects can be measured by the followings (please consult with your medical doctor regarding these tests):
- Urine/salivary cortisol level
- DHEA-S
- Waist/Hip ratio
- Albumin
- Hemoglobin
- Fibrinogen
- CRP/ESR
- Systolic/Diastolic blood pressure ration
- Thyroid panel
- CBC with differential
- Metabolic panel
- ANA
Treatments:
- Stress management: Exercise, yoga, medication, setting boundaries and prioritizing
- Resetting circadian rhythm and improving sleep hygiene and herbal supplements to improve sleep quality.
- Improve gut health by taking high quality probiotics
- Psychotherapy to deal with trauma
- Better eating habits and nutritional support to reduce fat/sugar/salt intake
- Taking appropriate supplements/herbs to regulate HPA axis
- Acupuncture
How does Acupuncture help with Stress and HPA axis dysregulation:
In TCM ( traditional Chinese Medicine), acupuncture is used to restore the balance yin and yang, in wester terms this can be explained that acupuncture modulates the balance between sympathetic nervous system and para-sympathetic nervous system. Studies have shown that Acupuncture can stimulate the production of neurotransmitter Enkephalin ( which reduces substance P release from spinal cord and inhibit afferent pain fibers). Another study has shown Acupuncture and electro acupuncture can release other endogenous opioid peptides such as Beta endorphins, acupuncture seems to have a modulating effect on Beta endorphin levels, another study has shown that in turn Beta endorphin will inhibit the ACTH release and lower cortisol level. The direct relationship between acupuncture and cortisol have been tested and in one study it was shown after four weeks of acupuncture treatments there was a decrease in salivatory cortisol levels. One study showed and increase level of cortisol 15 min and 45 min after acupuncture, while another study showed there was a decrease in morning salivary cortisol level after 10th acupuncture session. It seems acupuncture at first causes a spike in cortisol level but with more sessions it will reduce cortisol levels. Another study measure the patient reported measurement of acupuncture and stress and it showed patients who received acupuncture reported lower level of stress.
Herbal medicine for Stress and Anxiety
Herbs have been used in different traditional medicine to treat stress and HPA axis dysregulation. Adaptogens are commonly used to treat HPA axis dysregulation ( adaptogens should not be used during pregnancy).
- Ashwagandha: has anxiolytic effect via GABA mimic agent.
- Reishi mushroom: contains phenols and flavonoids which help with anxiety
- Rhodiola: reduces monoamine oxidase (MOA), and as result increase serotonin and Beta endorphin levels
- Ginseng: Improve stress response, energy level, stamina, memory and mental performance
- Holy basil: improve energy, reduce fatigue and elevates mood, study showed 8 weeks of supplementation of Holy basil may reduce objective and subjective measures of stress, and improve subjective measures of sleep quality.
- Maca: it reduces psychological symptoms, including anxiety and depression, and lowers measures of sexual dysfunction in postmenopausal women independent of estrogenic and androgenic activity.
- Study shown a traditional Chinese herbal formula SNSF ( Chai hu, Shan yao, Zhi shi, Gan cao), exert anti-depressant and antianxiety effect by regulating the signaling pathway of 5-hydroxytrptamine, Dopamine, GABA, and neuroactive ligand receptor interaction.
- A review of 45 common herbal antidepressant formulas showed the antidepressant effects of herbal medicine might involve multiple signaling pathways including Monoamine neurotransmitter system, GABAergic system, L-glutamate signaling pathway, HPA axis regulation, regulation of BDNF (brain derived neurotrophic pathway) which is important for learning and memory, anti-inflammatory, anti-oxidant, affecting microbiota which is important in serotonin production in the gut.
At Yarrow Holistic Center in West Lafayette, Indiana, we specialize in natural, integrative therapies to help you manage stress, anxiety, and overall emotional well-being. Our expert practitioner offers a range of holistic services for stress management, including:
- Acupuncture
- Herbal medicine and nutraceuticals
- Functional nutrition counseling
- Mind-body exercises and therapeutic movement
Whether you’re experiencing acute stress or struggling with the long-term effects of chronic anxiety, our personalized treatments are designed to support both your physical health and emotional balance. We help you reduce stress naturally and restore harmony in your life.
Discover how Yarrow Holistic Center can help you feel calmer, healthier, and more resilient—schedule your consultation today.
