“But I don’t feel stressed!” I hear this a lot from patients when their body is telling me otherwise either through lab work, radial pulse or other clinical factors.  Explaining that there are many physiological causes of stress often is helpful. Financial or relationship stress is just part of the picture when it comes to cortisol.

1. Gut Health

For example, a gut infection is a major stressor to the body and when we resolve this a lot of energy is freed up.  The next step is to rebalance the HPA Axis after a year of living with a parasite.

2. Nutrients

Dietary factors like consuming pro-inflammatory omega 6’s or restricting calories, nutrients and protein can raise cortisol.  Increasing certain nutrients like magnesium does the opposite.  Similarly, intake of the vitamin A in its bioavailable form regulates the HPA axis.

3. Lifestyle Factors

Commuting and posture are some of the factors that can raise your stress response.  Running too much is another common one along with caffeine. Frequent marijuana use affects both cortisol and prolactin.

4. Sleep, Sleep, Sleep

  • Reduced Sleep  – A loss of sleep for just one night leads to higher cortisol levels the next evening.
  • Poor quality sleep – Poor quality sleep activates the stress response.
  • Staying up late – Cortisol goes up when we are awake during normal sleep times.

5. Other Hormones

  • Thyroid:  “The effect of thyroid hormones on the adrenal axis was not secondary to changes in the level of circulating corticosteroids.”
  • Estrogen: Estradiol regulates the CRH (corticotropin releasing hormone) which is “best known for its role in activation of the mammalian stress response.”
  • Leptin: This study looks at CRH in relation to adiposity and leptin.  Furthermore, “the modulatory role of glucocorticoids could be altered in obesity.”

6. Noise

I was working with a patient the other day and a noise I didn’t notice outside was causing her to feel unsettled.  It reminded me of how we all respond differently to stressors.  Noise can be a significant one for many people.

7. Toxic exposure

This study looks specifically at heavy metals following an oil spill and the affect on the cortisol.  This links back to how there can be physiological stressors that affect our endocrine system and stress response past its limit without us knowing.

I have a couple questionnaires I use to help assess both the stress we know about and the stress we don’t know about.  Applying more than one method to figure out what is going on at the root is key to successful treatment.

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