Welcome to the Gut Honest Truth blog where a Certified Functional Medicine Practitioner gives you digestible information to tackle your chronic health concerns.
That’s me, Katie Morra;
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On to the post...
What is stress?
The topic no one wants to hear but alas every practitioner will throw it at you like a brick being tossed at a glass window. We have this very strong mechanism of action in our bodies that goes all the way back in time, when our ancestors were being chased by lions on the Serengeti, called the flight or fight response.
The main hormone involved in the fight or flight response is a hormone called cortisol. In times of immediate and acute danger, our ancestors’ bodies would prep to fight the danger or run from the danger aka our bodies pumped out cortisol like it was the last thing it would ever do. The blood and energy would rush from the organ systems that did not need to be optimally functioning in that moment of impending doom to their extremities to save their lives. This means shunting energy away from the organ systems involved in digestion, immune system, reproduction, urination and bowel movements.
Over the many years since, our development has not come far enough to differentiate life or death situations from minor, everyday stressful situations. We can’t differentiate a lion ready to maul your face off on the Serengeti and your husband frustrating you or your boss yelling at you regularly. So, every time your husband frustrated you and you’re about to have dinner, your energy and blood flow flees to your extremities like he’s a big bad lioness. The daily stressors of sitting in traffic, fear of being late, confrontations with your family, having marital troubles can all trigger this primal fight or flight response and cortisol imbalances. You can learn more about what impacts cortisol levels here.
How does stress impact the thyroid?
If you are newly diagnosed or a bit unfamiliar with the intricacies of the thyroid, head to this blog and learn a bit more or download my eBook How to Put the Fire Out on Your Thyroid before you continue reading.
Below is a snapshot photo of thyroid hormone synthesis and everything written in red are places where dysfunction can occur, contributing to hypothyroidism and Hashimoto's thyroiditis. As you can see many of these are considered stressors on the body. However, the stress concept has two negative effects on your thyroid that I want to focus on going forward.
1. Stress can increase systemic inflammation and impact the way that the body processes thyroid hormone by communicating to the thyroid to slow down to reserve its energy in case there is an immediate danger or threat to the body. In addition, stressors such as over exercising and restrictive eating, can also impact this. The thyroid will slow its conversion of T4 (inactive thyroid hormone) to T3 (active thyroid hormone), and ultimately increase levels of reverse T3 (we don't like this), which can swing someone into a state of hypothyroidism.
2. Stress can contribute to low stomach acid production which may impair your digestion in the immediate moment. Without enough stomach acid, you can’t properly digest and absorb protein. Similarly, you may poorly digest carbohydrates and fats due to the downstream effect that acid production has on stimulating your digestive enzymes and bile production. Without these digestive processes working like a well-oiled machine, I often find a patient has nutrient malabsorption and gut overgrowths due to large chunks of food sitting in the intestines.
Nutrient malabsorption can lead to a thyroid hormone conversion issue, as well as gut overgrowth. Both of which are a major trigger for the development of hypothyroidism and autoimmune thyroiditis.
Stress is tough and not many people want to admit it or confront it in their lives. The goal isn’t to remove stress, that is impossible. The goal is to identify what in your life are big contributors to your stress level, how do you manage it and how could you improve in your stress response.
Exercises for managing stress
Start doing this as a part of your daily routine: before you get out of bed in the morning, before you eat lunch, and as you retire to bed at night. For calming down in the moment: 4-7-8 breathing; 4 sec in, 7 sec hold, 8 sec out. Repeat x 3-4 breaths. For mindful maintenance: 5-5-5 breathing; 5 sec in, 5 sec hold, 5 sec out. Repeat throughout the day.
Legs on the Wall Yoga
Start by aligning your yoga mat so that the short side touches the wall you'll be using. You will assume position by laying down flat on your back and as the name implies, bringing your legs up the wall in front of you. Keep your legs together and straight while keeping your arms placed at the side of your body. Close your eyes, allow your full body to relax. Focus on your breath and feel your tummy raise and lower. I recommend that you stay in this pose for 5-15 minutes, start where you are comfortable.
5 Senses Approach
This is so simple and you can do this anywhere, anytime and no one has to know. You notice five things you can see, four you can hear, three you can feel, two you can taste and one you can smell. I encourage you to deepen your breath while doing this exercise.
Adaptogens & stress
Adaptogens are a category of herbal supplements that help us adapt and rebalance in times of stress. They help us to cope more easily while also establishing a new stress threshold. The great thing about adaptogens is that they help to bring us back into center balance. So if we are too high in cortisol (stress hormone) it will lower it and if we are in the final stages of pure exhaustion (no cortisol production) they will bring us back up into a normal and appropriate level over time. They help our brains perception that we are in constant survival mode by increasing our ability to resist and manage stress. This will impact your ability to reset your hormones, immune system, mental clarity and much more.
When starting an adaptogen supplement, I recommend to my patients that they start at the lowest dosage, as well as the frequency, and to increase slowly over a few weeks span until optimal feeling or hitting the upper limit of the dose. Many patients notice changes begin within a few days to a few weeks of starting adaptogen support.
In addition to using adaptogens and minimizing stressors, we often use the DUTCH Complete test by Precision Analytical plus a full thyroid panel in our practice to really monitor how the adrenals, thyroid and sex hormones are playing into each other in the body and make more individualized recommendations based off lab work and the patient's clinical history.
The thyroid and stress response can get complicated and many providers and patients want to jump right into the sexy stuff aka testing and treatment. But the truth is if we don't work on the unsexy stuff aka our stress management, we will be fighting an uphill healing battle long term. Please remember, no stress is not the idea but rather minimizing and managing.
Practical considerations for stress management:
Seeking a therapist
Developing systems that make daily activities more seamless
Creating a routine that allows for intentional habits that bring you joy (baths, reading, coloring, etc.)
Exploring breath work techniques such as box breathing
Spending time with loved ones without your phone
If you need a team in your corner to get to the next level, Gut Honest Truth is accepting new patients. You can request an intake session with one of our Institute for Functional Medicine trained providers here.