It’s all about tigers. Tigers? Yes tigers.
Written by Dr. Anna Cabeca, OB/GYN
You’ve all likely read many articles on stress. It’s something we constantly hear about – and intuitively understand – as being bad for our health, longevity, relationships, and happiness.
And most of you know from personal experience that ongoing, chronic stress doesn’t feel very good, either. Right?
Instead, constant stress feels like,
Exhaustion (but you still can’t sleep at night!)
Sluggishness (where did your waistline and metabolism go?)
You’re a germ magnet (did your immune system leave the building with your metabolism? How can you have yet another cold?)
Cravings (does sitting at home eating sugary sweets sound familiar?)
Abruptness and isolation (you certainly don’t feel like cuddling with your partner!)
Your brain being shrouded in fog (why are you feeling so wishy-washy?)
Your body turning on you (where is all of your beautiful hair and what’s the deal with your skin?)
And like you’re about to blow!
Some of you may understand why chronic stress takes this kind of unrelenting toll on your health, others may not. So let’s talk briefly about what stress does to you and how it creates havoc with your hormones, leaving you – and your thyroid – in a state of imbalance and inflammation.
Then we’ll talk about actions that you can take, starting today, to counter that stress, balance your hormones and start feeling better. I will also share with you about the most powerful and beautiful hormone in our body that does a great job counteracting stress.
What does stress have to do with hormone imbalances?
It’s all about tigers.
Well, maybe the absence of tigers.
Our bodies were wired to respond to threats – such as a lurking tiger (or outside stress) – back in our cavewoman days. It’s called our “flight or fight” response. The cavewoman would see the tiger, and that short-term stressor would immediately cause nerve chemicals and hormones to respond to prepare her body and mind to deal with that threat and survive.
Increased adrenaline would stimulate the cavewoman’s autonomic nervous system, increasing breathing, nerve sensitivity, and heart rate, to help her body deal with the stressor.
Cortisol (our primary stress hormone which is produced by our adrenal glands) would provide a quick energy fix, heighten mental alertness, and temporarily raise her pain threshold.
Other hormones would be shut on and off depending on their importance in dealing with the tiger at that moment.
Functions such as the cavewoman’s digestive system would shut down in this mode. The surge in cortisol also means her immune system would become deprioritized, as would many other important functions in her body such as sexual function (no need to have a libido when you are about to be eaten by the tiger).
For a short-term (tiger!) emergency, this is protective! But longer-term (with no tiger anywhere to be seen), not so much.
Cortisol in control = adrenal dysfunction = hormone imbalances
When a stress is constant or unmitigated for too long a period of time, the body remains in a state of hypervigilance, causing cortisol to accumulate to unhealthy levels in the body. The adrenal glands eventually become dysfunctional. And with this we see all of those symptoms – and how you will feel – as listed above!
Consistently raised cortisol levels also causes high blood sugar, high blood pressure, insomnia, immune system suppression, protein catabolism (the body breaks down protein from its own muscles for energy), and even hypothyroidism. If nothing is done about this cortisol imbalance you may eventually become insulin resistant and even pre-diabetic.
I used to see this so often with my patients, and now routinely see it in the participants of my women’s restorative health programs. Women join a program really suffering with fatigue, brain fog, and weight gain. They may feel lost in their relationships, with a diminished libido or a feeling of being disconnected. They likely blame it on menopause, or a suspect thyroid, but no-one usually pins it on the effects of chronic stress!
And no-one ever says, “Dr. Cabeca, can you address my adrenal dysfunction?”
But we need to address it. Because chronic stress and adrenal dysfunction are about so much more than belly fat, fatigue and not feeling frisky.
When your adrenals are over-worked they break down and are eventually not able to secrete many beneficial and protective hormones like progesterone, DHEA, and pregnenolone.
Your body won’t even be able to produce enough cortisol at some point…it will actually start stealing away precious protective hormone resources such as progesterone in order to make even more cortisol! This is known as “progesterone steal.”
The body stays in “survival mode (where is that tiger!)” versus “thrive” mode. Sexual hormones and thyroid hormones are neglected.
In women, if adrenal dysfunction happens after menopause, it can greatly worsen menopausal symptoms because of this progesterone steal phenomena and because many of the hormones secreted by the adrenals are inter-related with the production and metabolism of other vital hormones such as estrogen, progesterone, and pregnenolone.
Dysfunctional adrenals can cause hypothyroid symptoms
Since the adrenals communicate chemically with the thyroid an adrenal imbalance can adversely affect hormones secreted by the thyroid gland as well.(1)
We know from the research that stress is a trigger for autoimmune diseases, including autoimmune thyroid disease(2); and that chronic stress can result in reduced TSH levels.(3)
Prolonged cortisol elevation also causes the digestive system to slow down. When intestinal motility slows down it decreases the liver’s ability to clear toxins, including excess estrogens. This excess estrogen results in increasing the levels of thyroid binding globulin (TBG), which in turn binds more thyroid hormone to TBG, making it unavailable to the body.
This issue of digestive system slowdown is really important. It impacts our having a healthy gut as well as supporting detoxification. We know that a weakened gut barrier can lead to leaky gut and that leaky gut is highly associated with autoimmune diseases.
Heal your adrenals and get your hormones in harmony again!
When I had patients coming to see me with the symptoms noted above, it was sometimes difficult – without testing – to know if they were suffering from natural age-related hormone decline, a thyroid condition – or both! But there was often one commonality: chronic stress in their lives. Many were parents, often also with either part-time or full-time caregiving responsibilities to aging parents as well.
One of the first things that I did to help my patients then, and that I still do now, was to initiate protocols to:
The second thing I did was to help patients get their cortisol under control!
And finally, some testing was usually important, as well.
Eat alkalizing foods!
The best way to support your adrenals is to eat alkaline foods and to take in the right nutrients, including adrenal adaptogens.
I recommend that you adhere to a diet of mostly unprocessed foods with the right proportions of carbohydrates, protein, and healthy fats, and a wealth of alkalizing fresh vegetables and fruits. 80% alkaline and 20% acid foods make for the healthiest diet. Remove dietary stressors such as gluten and dairy as these types of food sensitivities are highly acidic and known to trigger thyroid symptoms and gut imbalances.
The right supportive nutrients
I also recommend adrenal adaptogens that help control your body’s stress level. A few I like are Maca, Ashwagandha, Siberian ginseng and Rhodiola rosea. Maca in particular supports alkalinity, the adrenals and detoxification.
Vitamins B, C and D are all important. Many women are particularly deficient in Vitamin D, especially in winter months. It is worth noting that the adrenals contain more vitamin C than any organ in the body! And the adrenals can burn through a year’s supply of B vitamins in a few weeks of extreme stress! I suggest high quality supplements for Vitamin D, Vitamin C, and B Vitamins.
A good probiotic is important to nourish a healthy gut. Note that an alkaline diet is also supportive of a healthier bowel movement, so important for healthy detoxification!
Other recommendations to support adrenal health and decrease inflammation include:
DHEA (5-15 mg for women, 25-50 mg for men, in most cases)
Carnitine to improve energy production
Alpha Lipoic Acid 300 mg per day to help with blood sugar control
Zinc supports adrenal function
Progesterone: Progesterone is one of the first hormones I’ll replace in women.
Of course you always want to consult with your own medical professional about what is the best course of action for you; only they know your unique medical history and what prescriptions and other treatments you might be undergoing.
Counter cortisol! Stress management and a lot of “O”
Stress management is key and you all are constantly bombarded with ways to DO THAT. Isn’t it terrible that we need to be TOLD how to relax, manage stress and appreciate the joy that is all around us!
I believe in two simple activities that help me with my stress management (and my outlook on each day). One is journaling. Every morning or evening…a few minutes to reflect on the day, to look for the positives. To ask myself if I stayed true to the things most important to me, was I loving…did I care and connect or was I not present, abrupt or “witchy”!
Try it, and you may find it helps you as well. In the am, think about the true “must do’s” for the day…stay clear of the clutter that always comes up. For me, I find that too many priorities is a stressor, so I need to sit back for a few minutes each day and think about what really needs my attention (and many times, the answer isn’t cleaning or errands…it is connecting with a friend I haven’t talked to in a while, or getting out to the garden, or walking my dog at the park).
The second stress management activity I rely upon is focusing on increasing the amount of another key hormone, one that counters cortisol: oxytocin (I call it the big “O”).
Oxytocin (our hormone of love and bonding) will help counterbalance cortisol’s negative effects
Oxytocin is the powerful hormone of love, bonding and connection. It’s the hormone we release in abundance during childbirth that overflows as we look into the eyes of our newborn. It is also released in abundance with orgasm, laughter, play, hugging and giving. It’s the twinkle in your eyes and the smile on your face hormone! Yes! I call it the anti-aging hormone! And it is one of the best counters to stress!
To create more oxytocin in your life:
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- Laugh, play, hug, look into someone’s eyes and smile, give gratitude and thanks, play with a pet, and stay in the present (so difficult for many of us).
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- Learn to control the stress you can (and learn to manage your thoughts around the stress you simply can’t control). Remember, stress is a normal and actually a healthy part of life when we have perceived control around it and internal peace within it.
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- Make a proactive effort to carve out time in each day to connect with others (an easy one? Don’t eat watching the TV!).
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- Remember the “O” in oxytocin also is the “O” in orgasm! Making love is a great way to counter cortisol’s negative effects.
Test, don’t guess!
I always say, “test don’t guess”. So many of us make diet and other changes, but have little way to measure if anything we are doing is helping. This is especially true when it comes to hormone imbalances.
In all of my women’s restorative health programs I promote testing as a way to know what is going on as well as to measure whether what you are doing is helping! For example, participants measure their urine alkalinity (using simple to use pH test strips to self-test) and are encouraged to get a handle on their blood sugar (another easy self-test!) as well.
I also suggest additional labs so that women know what is going on in their bodies. This includes knowing their thyroid numbers, including antibodies. The list also includes tests for cortisol, DHEA, estradiol, estrogen, hemoglobin A1C, homocysteine, testosterone, and more… really addressing some key serum markers and hormone testing.
Knowing whether you are suffering from adrenal dysfunction can be very helpful, and your cortisol levels can be tested using a panel of saliva tests. With patients and clients I recommend they measure cortisol levels at several points in the day to track the adrenals day-night pattern (called the “diurnal rhythm”). We hope to see cortisol elevated in the morning to help you get going, lower but steady throughout the day to sustain energy then fall in the evening to support restful sleep.
Final thoughts
Finally, keep in mind that your health is about a lot of things…most (I feel about 75%) are lifestyle decisions that you can make…so we can’t only blame our genes nor our circumstances! Start today by eliminating common food sensitivities (gluten and dairy are probably the worst suspects) and focusing on an alkaline diet. Take in more adrenal adaptogens and key nutrients (along with that daily probiotic!). Move (that helps in so many ways, including supporting a healthier digestion)! Incorporate more “O”, oxytocin, the good stuff, into your life and focus on gratitude. Like I always say to my clients and my children: “It takes gratitude, not attitude.”
And talk with your doctor about measuring and understanding your own unique hormone levels. There are many things a doctor can do to improve your overall hormone balance should you need help.
About Dr. Anna Cabeca
Dr. Anna Cabeca is an Emory University trained gynecologist and obstetrician, a menopause and sexual health expert, international speaker and educator.
References:
[1] Abdullatif, H.D., Ashraf, A.P. Reversibly subclinical hypothyroidism in the presence of adrenal insufficiency. Endocr Pract. 2006 Sep-Oct;12(5):572.
[2] Mizokami, T., et al. Stress and thyroid autoimmunity. Thyroid. 2004 Dec;14(12):1047-55.
[3] Wellwood, C., Rardin, S. Adrenal and Thyroid Supplementation Outperforms Nutritional Supplementation and Medications for Autoimmune Thyroiditis. Integr Med (Encinitas). 2014 Jun;13(3):41-47.
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Thank you for this. I swear the stress of teaching is what made me hypothyroid. I teach disadvantaged middle schoolers, and it’s very stressful. I have finally, I think, found some balance despite the pressure of test scores and demands of parents. Love your website. It was my inspiration for starting mine: TeachingwithAnxiety.com.