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How you see, interact with, and navigate the world depends in large part on the balance of your hormones. These signaling molecules communicate with all major systems of your body and work to maintain homeostasis — your stable internal environment. Chief among these essential hormones is cortisol, a steroid released by the adrenal glands that plays a part in inflammation, metabolism, and your response to stress.
In this article we’ll look at the connection between stress, cortisol, and autoimmune health, and offer some tips for incorporating stress management practices into your daily life to help you better manage the challenges posed by autoimmune disease.
Cortisol, produced by the adrenal glands (located on top of the kidneys), is often referred to as the “stress hormone.” When a perceived threat stimulates a fight-or-flight response, large amounts of cortisol are released by the adrenal glands to prepare the body for physical activity and slow down nonessential processes, such as digestion. (Source)
Part of cortisol’s job is also to be anti-inflammatory when you face physical injury or a dangerous pathogen. Once the threat has passed, your cortisol level should drop back to its baseline. During chronic stress, though, cortisol stays high, and your cells stop responding to it in the normal way. It takes more cortisol to get the same anti-inflammatory effects, so your hypothalamus (an endocrine organ in the brain that helps maintain homeostasis) stimulates the adrenals to release even more cortisol.
Cortisol also plays a critical role in regulating various bodily functions, including metabolism, blood sugar levels, and immune response. When you’re subjected to chronic stress, the “off switch” for cortisol never gets flipped and the hormone becomes dysregulated, leading to potentially serious health consequences. This is especially concerning if you have an autoimmune disease or autoimmune-like symptoms. Unregulated cortisol running rampant in your body leads to additional inflammation, leaving you more susceptible to challenges with autoimmunity. (Source)
Cortisol's primary function is to help your body respond to stress, to kick into overdrive when you really need to. This response applies to both internal stressors, such as illness or injury, and external stressors, such as work and relationship stress.
When your body is under stress, cortisol levels rise to counteract the potential negative effects of inflammation. By suppressing certain aspects of the immune system, cortisol helps prevent it from overreacting and causing excessive inflammation — think of it as your body's own system of checks and balances. Unfortunately, this delicate balance can be disrupted when your body is under constant stress. This is when cortisol never gets turned off and you never return to a state of calm. (Source, Source)
Chronic stress can lead to a constant state of elevated cortisol, which can weaken your immune system over time. When your body is in this depleted state, it is more susceptible to infections and you are at increased risk of developing autoimmune disease. In some cases, this continuous exposure to high cortisol levels can cause the adrenal glands to become fatigued, leading to decreased cortisol production. Low cortisol levels can also have detrimental effects on the immune system, as your body loses its ability to effectively regulate inflammation. (Source, Source, Source)
Imagine each of us is carrying around a bucket of water. Some of us have just the right amount of water where we can manage the load and have very little spill out. Others are carrying buckets that are perpetually spilling out the sides. Cortisol dysregulation is like having your bucket overflow and spill out, potentially exacerbating autoimmune symptoms or even contributing to the development of an autoimmune condition.
If you think you might be struggling with chronically high cortisol, look out for symptoms such as:
If you feel your body is dealing with adrenal burnout, look out for these symptoms:
Studies have found that stress management techniques, such as cognitive behavioral therapy and mindfulness-based stress reduction, can help reduce cortisol levels and improve immune function in those with autoimmune diseases. This suggests that incorporating stress management strategies into care plans for autoimmune conditions could have significant benefits for overall health and well-being. (Source, Source, Source)
You can’t eliminate all the stressors you’re exposed to each and every day, but deep breathing exercises can help mitigate the effect of daily stress. This doesn’t have to be complicated — something as simple as taking a few moments to focus on your breathing can signal your body to slow down and relax. You can use the 2:1 breathing technique, in which you exhale for twice as long as you inhale, anywhere or anytime. With this method you would, for example, inhale for a count of 4, then exhale for a count of 8. For insight into why this works, check out this video with neuroscientist Andrew Huberman.
Meditation is another powerful tool to help calm the mind and body. In an 8-week study published in the journal Brain, Behavior, and Immunity, a meditation style called “mindfulness meditation” was shown to reduce the inflammatory response caused by stress. When you think of meditation you may imagine it means clearing your mind completely and holding that state for a certain length of time, but meditation doesn’t have to be that challenging. (Source)
To get started, it can be helpful to do guided meditations through apps like Headspace or Calm. And here’s a great video explaining how meditation is easier than you think.
You can also try other relaxation techniques, such as a mindful body scan, progressive muscle relaxation, or guided imagery. Restorative yoga is a slow-paced form of yoga that often uses props to support your body, allowing you to hold poses longer and achieve deeper rest and relaxation. Taking a few minutes at the end of the day to do a restorative yoga pose such as “legs up the wall” can be a powerful, yet simple tool to help your body decompress and regulate your nervous system. (Source)
You can also create an evening ritual with a soothing tea, such as chamomile, passionflower, or another favorite to nourish you. Add in a lighted candle, put on some relaxing music, and sit quietly for a few moments to be present and take some time for yourself.
Focusing on gratitude can help shift your perspective and reduce stress. In a study of participants with heart failure, those who did a daily gratitude journal showed reduced inflammatory biomarker scores and also increased their ability to slow their heart rate and be in a calmer, more relaxed state during the gratitude task. (Source)
Consider setting aside a few minutes each day to reflect on the things you're grateful for, or keeping a gratitude journal to document your thoughts. Look for opportunities to experience gratitude, whether it’s cuddle time with your dog, the birds chirping outside your window, a beautiful flower you spotted on your walk, or all the traffic lights going your way as you drive to work. Looking for these small moments in your day can have a profound impact on how you see your whole world.
During sleep your brain and body restore, repair, and rebuild, and quality sleep plays a crucial role in cortisol regulation and immune function. Seven to 9 hours of sleep each night is the ideal, but those with autoimmune conditions often struggle to get enough sleep. One key to improving your quality of sleep is establishing a consistent bedtime routine to help you wind down and support deeper, more restorative sleep. Journaling, meditating, or listening to soothing music before bed can all help you decompress and switch from the busy-ness of the day to a more restful state. (Source)
Exercise can decrease your cortisol levels. The increased circulation and endorphins experienced after movement generally leaves you feeling better than when you started. Aim for a combination of moderate aerobic exercise, like walking or swimming, and strength training. Yoga and qigong have been shown to help reduce stress and improve cortisol regulation as well. The goal is to find the right exercise balance that leaves you feeling strong and energized without overdoing it. (Source, Source)
There are a number of foods that have been shown to reduce cortisol in the body, ranging from bananas and dark chocolate to wild-caught salmon and mushrooms. Polyphenols, chemicals found in plants including spices, fruits, vegetables, seeds, and legumes, have antioxidant and anti-inflammatory properties. Polyphenols known as flavonoids give fruits and veggies their bright colors and are especially healthful, so eat the rainbow! As you focus on healthy, anti-inflammatory foods, be sure you also eat enough of them — research suggests making a habit of monitoring and limiting intake of calories can both raise cortisol levels and lower your sense of well-being. (Source)
Cortisol plays a significant role in the body's stress response and immune function. Chronically elevated cortisol levels can contribute to the development of autoimmune diseases and make symptoms worse. By focusing on effective stress management techniques, quality sleep, regular exercise and a balanced diet, you can better regulate cortisol levels and support your immune health.
Sometimes, getting outside support from a personalized Care Team can make all the difference in managing autoimmune disease. WellTheory offers trained Health Coaches who will help you determine which strategies and systems will work best for you to manage stress, energy levels, and overall autoimmune health.
Lycopene is the phytochemical that gives fruits and vegetables their red color. Lycopene is a potent antioxidant and has anti-inflammatory properties that protect the body from oxidative stress. Lycopene has also been found to decrease “bad” low density lipoprotein (LDL) and increase “good” high density lipoprotein (HDL) cholesterol.
Lycopene may also protect the skin against ultraviolet (UV) damage from the sun. One small study found that participants who added 16milligrams of lycopene to their diet every day had less severe skin reactions to UV light over 10 weeks than a control group without the added lycopene. (Of course, consumption of lycopene-rich foods doesn’t replace sunscreen!)
Carotenoids are responsible for yellow, orange, and red color in many fruits and vegetables. Research suggests that one carotenoid in particular, beta-carotene, may protect against decline in lung function. A study done in 2017 also suggested that eating fruits and vegetables rich in carotenoids such as beta-carotene, alpha-carotene ,and beta-cryptoxanth in had protective effects against lung cancer.
Like lycopene, dietary intake of beta-carotene has protective effects against diseases that are mediated by oxidative stress, such as diabetes, cancer, and autoimmune diseases. High levels of alpha carotene are associated with longevity — one large U.S. study found that high levels of alpha-carotene in the blood were linked with a reduced risk of death over a 14 year period. Aside from its antioxidant effects, the carotenoid beta-cryptoxanthin may prevent bone loss and may have anti-inflammatory and anticancer properties.
Lutein and zeaxanthin are also part of the carotenoid family, along with beta-carotene, alpha-carotene, and beta-cryptoxanthin. Lutein and zeaxanthin are the only dietary carotenoids that reach the retina, the thin layer of tissue that lines the inside on the back of the eye. They are known to support eye health and have preventative effects against age-related macular degeneration, an eye disease that can lead to the loss of vision as we age. However, lutein and zeaxanthin also have strong antioxidant and anti-inflammatory capabilities. Zeaxanthin can also help to recycle glutathione, another important antioxidant in the body. (9, 15)
Dark green, leafy cruciferous vegetables are a good source of sulfur (isocyanate, sulforaphane, glucosinolate). Our body needs sulfur in order to synthesize certain essential proteins. These sulfur compounds break down into isothiocyanates and indoles in the gut, which are known to have antibacterial, antiviral, antifungal, and anti-inflammatory effects. (36, 52, 33)
Research suggests that sulforaphane may support heart health by reducing inflammation and lowering blood pressure. It may also have antidiabetic effects. One study found that sulforaphane reduced fasting blood sugar in patients with type 2 diabetes. (55, 41, 47)
Glucoraphanin, a glucosinolate that’s found in some cruciferous vegetables, has been found to protect the blood–brain barrier in mice with induced experimental autoimmune encephalomyelitis (used to study MS, which can’t be induced in the same way), suggesting it may reduce the risk of developing MS. (16, 40)
Anthocyanins are phytochemicals that give red, blue, and purple plants their vibrant coloring. Anthocyanins have antioxidant properties that may boost heart health and reduce the risk of developing cardiovascular-related and other chronic diseases. (26)
Anthocyanin-rich foods have been linked to reductions in inflammation and reduced blood sugar concentrations, suggesting they may also have antidiabetic effects. Anthocyanins have also been found to protect eye health. One study found that daily supplementation with pharmaceutical anthocyanins improved the visual function of individuals with normal tension glaucoma (where the optic nerve is damaged despite pressure in the eye being normal). (30, 43)
Other phytochemicals called stilbenoids are typically found in grapes and blueberries. Like anthocyanins, stilbenoids have been shown to have a variety of benefits such as protective effects on the heart and brain, as well as antidiabetic, anticancer, and anti-inflammatory properties. (4)
Allicin, a phytochemical produced when garlic is chopped or crushed, has been associated with a lower risk of coronary events in older adults. Research suggests allicin may help reduce LDL and total cholesterol levels when consumed for more than 2 months. (8, 39)
Garlic is well known for its antimicrobial effects and has historically been used to combat infectious diseases. It is also known to be effective against a variety of bacteria, such as Salmonella, Escherichia coli, and Staphylococcus aureus. (8)
Another phytonutrient that is found in many white, tan, and brown foods is quercetin. Quercetin has anti-inflammatory properties and may be effective against obesity, cancer, viruses, allergies, and high blood pressure. (5)
Serum C-reactive protein (CRP) levels are a biomarker of inflammation in the body. High CRP levels are associated with heart disease, obesity, and lupus. One study done in 2008 found that the intake of foods rich in flavonoids, such as quercetin, is associated with lower serum CRP concentrations. (12)
The thousands of phytochemicals produced by plants for their own protection may also help prevent and treat many of our own medical conditions and diseases. Phytonutrients give fruits, vegetables, grains, nuts, and other plant foods their variety of colors, so “eat the rainbow” to maximize the health benefits offered by these plentiful chemical compounds.