We generally use the term Stress to describe the complex neurological, hormonal and biophysical response of our whole body to a survival threat. In today’s society the stress response is highly triggered by the need to achieve and deliver in the work place. When you consider the statistics, high stress is an epidemic of large proportions. About 27% of those employed between ages 20 and 64 report a high stress level. For this highly stressed population, 60% report work as the main source of stress (Statistics Canada, General Social Survey, 2010). What most people don’t realize is that a feeling of personal stress is predictive of chronic health conditions for the next four years (National Population Health Survey, 1994/95). This is important because health conditions arising from stress can take up to four years to develop. The most prevalent chronic health conditions in Canada include: Hypertension, Diabetes, Cardiovascular Disease and Chronic Respiratory Diseases (Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, using POHEM Model, Statistics Canada, June 2010).
The prevalent model used to describe the body’s response to stress is called The General Adaptation Syndrome (GAS) and it was first described by Hans Seyle in 1947. In this model, continuous triggering of a high stress response (such as what happens in the work place) leads to an increase in metabolic function which in turn uses more body resources such as Vitamins, Minerals, Glucose, Proteins, Enzymes, Hormones and Neurotransmitters. A prolonged stress response is detrimental to the health of the body and can only be sustained until availability of resources declines and depletion or exhaustion sets in. The utilization of the body’s resources is also affected by the presence of environmental toxins (such as heavy metals, GMO’s, pesticides and chemicals, etc), which dampen, alter and disrupt the body’s metabolism. The adequacy of body resources is also affected by the quantity and quality of nutrition. When the caloric content (quantity) is met at the expense of nutrient quality, the stage is set for an earlier depletion of the body’s resources. These depletions are further aggravated because the neurological stress response attenuates the “Rest and Digest” activity and amplifies the “Fight or Flight” response. This means that the stress response will save some energy by disengaging digestion and nutrients absorption may be slower and less efficient. Thus the process of replenishing the body’s stress-depleted resources is compromised by stress itself.
Modern times bring an additional complication to the stress response because for survival most of us are no longer required to “fight” or “flight” in a physical way, but mentally behind a desk at work. The neurological and hormonal response has now prepared the body for heavy energy consumption geared towards utilization of all of our voluntary muscles. But since “fighting” or “fleeing” rarely happen, resources are now being used ineffectively. The high level of fight-or-flight hormones causes the dysfunction of hormonal regulatory mechanisms that bring the stress response back to the pre-challenged point. As mentioned earlier it takes around 4 years to move from stress induced dysfunction to recognized health conditions.
The Conventional Medical System (CMS) does not interviene until a recognized health condition can be diagnosed or a main offending symptom identified. Afterward the focus is mainly on alleviating symptoms while the root cause often remains unaddressed. At this point, after diagnosable symptoms have emerged, the changes in function have affected the structures of the body sometimes in an irreversible way. At this stage the body self-healing ability will take a lot more time to re-establish balance. This is why prevention is an essential part of Naturopathic Care. Given that more than 1 in 4 people will experience high levels of stress that increase the risk of chronic conditions, a patient’s stress levels should be part of any treatment when presenting with general symptoms such as fatigue, abdominal discomfort, digestion issues, aches, headaches, insomnia. etc.
Stress levels are assessed by measuring the levels of salivary Cortisol. Increased Cortisol production levels by the adrenal glands is regarded as the main stress hormonal response that activates the whole body metabolism. Cortisol levels follow a diurnal variation, peaking in the morning upon wake-up and gradually declining to a minimum at night. By taking four (4) measurements during the day, the diurnal variation and its fluctuation can be established. The experience of stress will bring cortisol to higher levels either during certain periods of the day or during the whole day. As deficiency of body resources starts to set in, cortisol levels may not be as high or low in the morning because the body does not have enough resources to maintain necessary levels. At this point feeling tired on waking up may set in. One way to measure how the body resources are being utilized is to look at the morning DHEA to Cortisol ratio. The production of Cortisol and DHEA in the adrenals share the same resources, but these hormones exert opposite effects on the body. In a healthy stress response, the levels of DHEA and Cortisol will rise to a stress challenge keeping the ratio within normal range. This means that the body has enough resources to produce both hormones in adequate quantities. A high ratio implies that the body is sacrificing the production of DHEA to satisfy the stress response with Cortisol. Therefore, it is very important to test both Cortisol and DHEA when assessing how the body is dealing with its stress load because it gives us a more complete picture of the patient.
Aside from Cortisol and DHEA, an individual’s stress response might affect other body functions. Perhaps a pre-hypothyroidism state might be detectable in thyroid laboratory work. Perhaps a pre-diabetic state might be ensuing. Perhaps the immune function is altered or deficient and colds might now be more common, or wound healing is slower; sex hormones might decline and infertility issues might be encountered.
As we can see, Stress produces dysfunction at a general level in the body. The order in which body functions are affected depends on a person’s biochemical individuality dictated by the individual’s gene expression. At the physical level Stress requires a multi-layered approach that addresses the different hormonal, metabolic and neurological imbalances. Naturopathic medical treatments are consistent with this required multilayered approach. Naturopathic Physicians incorporate Lifestyle and Dietary changes, Clinical Nutrition interventions, Botanical and Mind-Body Medicine amongst others as key tools to help the body heal itself by addressing the root cause and prevent chronic disease.
