Hi, guys! I hope you are having a wonderful Memorial Day Weekend!
As you might remember, I am super into the gut-brain connection stuff lately. I have listened to a bunch of podcasts on the subject, read a ton online, and I am almost finished with 10% Happier, which has already helped me chill out quite a bit with regard to my stress level and constant worrying. And, as a result (*knock on wood*), things are looking good on the UC front going into week 9 (!!!) between Remicade infusions. (I usually go every 8 weeks.) I know some of you are interested in this subject too, so when Dr. Jim LaValle contacted me about writing a post about stress and its connection between the gut, brain, and immune system, I immediately took him up on his offer. I found what he said helpful, and I hope you guys do too!
James LaValle, is a nationally recognized clinical pharmacist, author, board certified clinical nutritionist, founder of Metabolic Code Enterprises, Inc., a web platform and practice solution enterprise, launching AIR Support and the Metabolic Code Assessment. In addition, he founded an Practices at Progressive Medical Center in Orange County, CA. In 2001 he founded and operated LaValle Metabolic Institute, an interdisciplinary medicine facility in Cincinnati for the past 15 years (sold in 2014) where he served thousands of patients using his metabolic model for health. He also founded Integrative Health Resources 15 years ago, which is focused as a natural products industry consulting company. James has 27 years’ experience integrating natural therapies into various medical and business models. James is probably best known for his expertise in natural therapeutics application and drug/nutrient depletion issues and uncovering the underlying metabolic issues that keep people from feeling healthy and vital. As such he has written hundreds of articles for a variety of industry journals and publications, and has lectured for thousands of healthcare professionals and consumer audiences globally on these topics. He was a founding author of the NHI on Demand database and spearheaded the Lexi Comp databases relating to natural therapeutics.
Stress and the Gut-Immune-Brain Connection
By Jim LaValle, R.Ph, CCN, DHM,DHPh.
Almost everyone has had a time when they were upset about something and could not eat very much or were very stressed and wanted to eat a lot, i.e. comfort foods like cookies or a bag of chips or ice cream. So, it’s easy to believe that there is a link between stress and our digestive system, our gut health. But most people probably don’t fully understand just how profoundly stress, especially chronic stress, can impact gut health. The known connection between early life stressors and the development of Irritable Bowel Syndrome stands as just one example of the impact stress can have on gut health. But remember the intestinal tract also houses 70% of our immune system. Research is revealing much about the communication between the brain, the GI tract and the immune system, and it has opened a whole new level of understanding to how stress can affect gut health. The shift in immune function under stress can be significant and over time can lead to conditions such as autoimmune disorders, inflammation, mood changes and chronic pain. How does stress end up impacting our GI tract, and what can we do to manage the stress and it’s impact? Read on to find out.
How Stress Affects the Gut
When a person is under stress, the perceived stress causes the brain to send signals to the rest of the body via the HPA axis, the hypothalamic pituitary adrenal axis. You can think of the brain as the master circuit breaker. Your brain perceives stress and sends out signals from the hypothalamus (a small section at the base of the brain that directs hormone production) to the pituitary gland to the adrenal glands (HPA axis), which produce the stress hormone cortisol and the catecholamines known as adrenaline and noradrenaline. There is another way that the brain sends a message to the intestines and to the rest of the body. The hypothalamus sends a signal to the spinal cord and stimulates the sympathetic nervous system (excitatory) and those excitatory signals travel along the enteric nervous system, the nerves in the gastrointestinal tract. The enteric nervous system connects the GI tract to the brain. Chronic stress signals cause two things to happen in the intestine that really change your quality of life. First you release more corticotropin-releasing hormone (CRH) that causes another surge of cortisol. The other major issue is that mast cells (a type of immune cell in the gut) begin to secrete histamine into the GI tract. This causes the mucosal barrier of the GI tract to get more “leaky” or permeable.
This process activates the immune system and begins to make you more prone to intolerances and allergies. So basically your immune system starts to behave more “allergic” over time, making you react to proteins that get through the mucosal barrier. As your histamine level goes up in the intestine, you use up the enzyme diamine oxidase (DAO), which is responsible for breaking down histamine. There are tight junctions between the cells that line the intestine, which allow for nutrients to pass through but then protect against chemicals passing through that should not. When DAO is lowered the tight junctions do not function correctly. So you start to get proteins from foods, or other compounds into the blood stream resulting in an inflammatory response. Then when you eat gluten, dairy, soy, peanuts or other foods that are known to be more allergenic you begin to develop sensitivity to them. So many times people were able to tolerate a food like peanuts when they were kids but as adults develop a significant allergy or sensitivity. One of the reasons for this is the disruption of the mucosal barrier of the gut, which can happen for many reasons; stress can be one of them.
What You Can Do to Manage Stress
It is easy to get stuck in the routine of using modern medicine rather than selecting natural products. However, if you are feeling the effects of stress in your digestive health, a good baseline strategy is to at least take some intestinal supporting ingredients, especially probiotics. Aloe extract, probiotics, turmeric, cat’s claw and others can be of tremendous value in GI tract health. However, you can’t ignore the fact that some of the problem could be coming from the brain’s inappropriate response to stress. From years of clinical practice it was very common to see people with anxiety and nervousness also have irritable bowel. With IBS there can be constipation, diarrhea or both. This becomes very disruptive to a person’s life and it feeds into the anxiety cycle. If you find yourself always relying on intestinal health natural products with no sustained relief in sight, look to chronic elevations in the stress hormone cortisol and take steps to manage it. This is often easier said than done.
Stress today can pervade all aspects of our mobilized life. Financial pressures, not enough sleep, working long hours all can overload our brain circuitry. First, it is obviously important to realize that some stresses in life cannot be avoided, in which case it becomes even more important that mind-body techniques and other strategies are deployed to help keep metabolism in balance in the face of chronic stress, and the potential gut and immune issues that can result.
Here are the most important steps you can incorporate into your life:
1. Sleep: If you are not getting a restful 7 to 9 hours of sleep per night, your body and your brain cannot prepare properly for the demands of the following day. Over time this can lead to short term memory loss, weight gain and increases in blood sugar levels, and it can compound stress and all the effects from it. Prepare your bedroom, make sure it is plenty dark, take an Epsom salts bath if you want to calm down and add lavender. If you don’t have time to do these things then simply try melatonin to help signal to your brain it is time for sleep.
2. Deep breathing: Under chronic stress, we lose vagal tone, which dictates the depth and expansion of the lungs. So you guessed it, deep breathing techniques help reset the stress response and vagal tone. You can get various apps that will walk you through deep breathing just a few minutes twice a day. Also meditation practices, yoga and Tai Chi can have a big impact on resetting the nervous system circuit board. It is all about establishing calm borders.
3. Managing daily stress: If you feel overcommitted, like you are always pushing, anxious and just a little overwhelmed, you are probably not alone. We see it frequently in clinical practice. In many cases mind-body techniques are difficult to do because you can’t ever get to a tranquil state. Sometimes your body needs help to reset the stress responses. There are ways to do this such as using adaptogens. Since the beginning of recorded botanical medicine, the herbs for stress (adaptogens) have been the most valued in all cultures. Plant Adaptogens make you more resilient to the physiologic and psychological impact of stress. For example, ashwaganda, rhodiola, American and Korean Ginseng will commonly be found in adrenal stress support products, typically along with B vitamins. It is interesting to note that even though these nutrients are associated with adrenal gland health, they all act at the brain in the region of the hypothalamus to change the impact of stress signally from the brain.
4. If the stress has now lead you to changes in behavior like anxiety, food cravings and mood changes during the course of the day, leaving you feeling even a little agitated, then you have to consider a few other natural compounds that could benefit you:
- Theanine is an extract from green tea. If you are a worrier, someone that makes lots of mental lists and can’t stop the wheels from churning then consider taking 200mg of Theanine 3-4 times a day.
- If you are anxious and nervous and are having trouble with controlling cravings for carbohydrates then consider an herbal extraction known as Relora®. The typical dose is 250mg 2-3 times a day.
- Aged Garlic ExtractTM, known as Kyolic®, has been the subject of more than 750 published scientific studies. Kyolic Aged Garlic Extract has been shown to reduce oxidative stress and support healthy relaxation.
- Other options to consider include Kava Kava and Holy Basil. Kava Kava has long been know for it’s calming properties and has been used for years. A few years ago there were reports of liver damage from kava supplement however research into the issue found that it was most likely from a very rare immune response and very high amounts of the herb were taken. Holy Basil is an adaptogenic herb that helps calm stress while also having a benefit of support for blood glucose regulation.
And finally if you are under stress, it can suppress some parts of the immune system (while upregulating others), so it’s important to support the body’s immunity. Addressing one’s gut health with probiotics like Kyo-Dophilus, and the other ingredients mentioned above, can help regulate some of the overactivity in the immune system, other ingredients can help strengthen the parts of the immune system that get suppressed. Ingredients like vitamin C, Kyolic Aged Garlic Extract, mushroom extracts and astragalus are excellent immune support ingredients that I’ve used successfully in clinical practice.