I think we are all ready for this year to be in the rear view mirror. If I had a dollar for every time I said 'WTH is happening?', I would be a rich woman!
So today I am taking a break from the Heavy Metals series to talk about stress, particularly how stress impacts your immune health and might even increase your risk for certain cancers.
No doubt many of you know about the death of Chadwick Boseman of colon cancer at age 43. Many of us are collectively grieving (which is another stressor in a year chock full of stressors). The shock for many is that he was so young and colon cancer is thought of as a disease in older individuals.
Reuters / Sunday, March 04, 2018
Chadwick Boseman arrives at the Oscars in 2018. Boseman, an actor whose work celebrated African-American pioneers and culture, has died at age 43 after a four-year battle with colon cancer, according to an announcement posted on Friday to his social media accounts. REUTERS/Mario Anzuoni
Most likely he had a genetic predisposition, which many cancers with early onset do, but there are so many confounding variables to consider in why cancer occurs and what makes it difficult to treat. Perhaps there were multiple factors that led to his getting cancer.
I say this because we know that even if you have a gene associated with cancer, you may not get it, and most cancers are not genetically linked.
Other potential lifestyle factors that could increase your chances of getting cancer are whether you smoke, whether you drink alcohol, whether you are obese or sedentary, whether you eat a lot of inflammatory foods like fried foods or blackened or grilled foods, whether you have chronic diseases and possibly whether you have had chronic or acute stress.
This illustration is from a research paper about stress and cancer. Basically, the hypothesis is that chronic stress creates problems in the HPA (hypothalamic-pituitary-adrenal) axis which impairs the immune system. The immune system is responsible for watching out for potential cancer cells and killing them before they get out of control and become cancerous.
So a way to approach cancer prevention is to modify all of the lifestyle factors that may increase your risk and promote your body's ability to heal itself. That is the Functional medicine approach.
In Functional medicine, we have a '4 pillars' approach but I added a 5th pillar.
My pneumonic is S-E-E-D-S.
The first 'S' is for stress. I'll outline some ways to reduce the burden of stress on your system so you can hopefully prevent the immune impairment and potential for cancer. Some signs that stress may be throwing your HPA axis off kilter include difficulty falling asleep or staying asleep, unusual weight gain, especially in the abdomen, hair loss, indigestion or heartburn, difficulty concentrating, mood swings or anxiety, frequent hypoglycemia (blood sugar too low), fatigue or 'crashing' energy and frequent infections and/or inflammation (sign of immune suppression).
The other lifestyle factors to modify to promote your best health include:
E - environment - people who live near a freeway live on average 10 years less than people who don't! Find out more here. Also, check out EWG.org to find out if your personal care products or household cleaners are toxic. Filter your air and water.
E - exercise - I think of movement as an essential way to improve the health of our mind, body and soul. We know exercise will promote the release of endorphins that improve our moods (depression may increase your risk for cancer) and that it also can increase lymphatic flow (essential to immune activity and elimination of toxins) and increase sweat production (also a pathway to eliminate toxins that can damage cellular DNA and promote cancer).
D - diet - In Functional medicine nutrition is at the top of the hierarchy of modifiable lifestyle factors, as nutrition - what you put in your mouth - will either promote health or disease. Watch 'Fat Fiction' now and learn how certain foods we commonly consume can promote cancer, diabetes, inflammation and heart disease. Look here for examples of how to eat to prevent cancer.
S - sleep - The society we live in does not value or promote sleep. Our bodies need deep sleep. During sleep that occurs from around 10-12pm, our bodies do the work of cellular repair, clean up and restoration. If you have adrenal dysfunction from chronic stress, an essential part of restoring normal adrenal function is getting 8-10 hours of sleep nightly. If this seems impossible to you, work with a Functional medicine provider to get help. You can't heal if you don't sleep.
So how to lower your stress levels?
Stressors include physical stress (too much intense exercise, for example) or emotional stress (from a difficult relationship at home or work) or psychological stress (from perceived threats to our safety - like pressures at work or an ongoing pandemic(!) - or a mood disorder or chronic illness, isolation, divorce or loss of a loved one).
Sometimes the stressor can't be eliminated but we can lower the impact on our HPA axis by having a regular stress management plan as part of our self care regimen.
We all need time for self care and sometimes we let the pressures of life limit us to the basics of brushing our teeth and grooming ourselves (or neither if you are a 19 yo college male - ahem). Beyond the basics we need to care for our bodies by choosing nutrient dense foods and care for our minds and spirits by setting aside time to manage stress.
I usually prescribe a mindfulness practice (or several) as a start on the road to lowering the demand for the primary stress hormone, cortisol. Bringing cortisol back into balance and rebalancing the adrenal gland can help bring the immune system back online.
Your stress management strategy can include daily breathing exercises, regular meditation, participating in mindful movement like mindful walking or yoga or tai chi. I had one patient who decided to set aside time daily for a session of coloring in an adult coloring book - when she did this small act of self care her hormones came back into balance quickly! Spend time enjoying the company of a loved one or just take a nap when you need one. Listen to music or read a book or magazine just for pleasure (not for work).
Additional ways to lower cortisol include adaptogenic herbs and supplements as well as using CBD regularly. A great all-purpose herbal is ashwagandha.
CBD derived from hemp plants, along with other associated chemicals from hemp (cannabinoids and terpenes), acts on our built-in pathways that reduce stress chemicals and neurotransmitters (messenger molecules in the nervous system that can turn up or turn down your level of stress). This supports your natural (endogenous) endocannabinoid system.
For those of you who live where medical marijuana is legal, a small amount of THC along with the cannabinoids is indicated for PTSD, which is a heightened state of chronic stress. Too much THC can cause more emotional distress so work with a knowledgeable practitioner to achieve the best results.
An easy daily practice to reduce stress is deep belly breathing. Lie on your back and place a hand over your abdomen. Take a slow deep breath while you count to 5. Hold for a couple of seconds and exhale slowly for a count of 5. Pause a couple of seconds and repeat. Do this 5 times (at least) to help lower your baseline sympathetic tone (elevated in times of stress). You can do this exercise sitting up as well (like when you are sitting at a red light or in between Zoom meetings) but to get started, try doing it first thing when you wake up and do the practice again when you lay down at night to go to sleep.
I leave you with a brief compassion meditation.
Karen Miller, MD is an OB/GYN and Certified Functional Medicine provider who specializes in integrative women's health and complex medical illness. She is medical director and co-owner of Elevate Functional Medicine.