20Nov

The Steps to Digestion: A Quick Guide

Do you often experience abdominal pain, bloating, or acid reflux after eating? Do you reach for symptom soothers like Tums or Pepto bismol more often than you’d like to admit? Maybe you pop probiotics because you’ve heard from a friend that they help with bloating, but that isn’t working? Digestive symptoms typically signal that something has gone wrong during one of the steps to digestion.

Digestion is a very complicated process that most people don’t fully understand. There is much more going on than just food going through your mouth, reaching your stomach, and eventually coming out the other end. Each meal travels 26 feet before it ends up in the toilet! That’s 26 feet where potential problems could arise.

digestive system with neon pink blue green and turquoise

The digestive organs usually work in perfect coordination like a well-oiled machine. But like any machine, sometimes things can go wrong. Reaching for over-the-counter (OTC) symptom soothers is not always the best choice to address your digestive issues, especially if you are experiencing these symptoms regularly.

This blog is a quick guide to digestion and a basic explanation of all the steps to digestion. Reading this blog should help you realize that digestive issues are not usually an easy fix!

Digestion Starts in the Mouth

woman smiling and eating a yellow popsicle on white background

Digestion begins when you take a bite of your food and start to chew. The salivary glands in your mouth kick into action, infusing each bite with saliva that is filled with enzymes that kickstart the process of breaking down starches and fat. This fat digesting enzyme is only available in trace amounts for adults. In babies, it’s present in much larger amounts and helps the infant digest the fats in milk.

Chewing is imperative for multiple reasons. The first is because it breaks down your food into smooth bits that can be swallowed without choking. Chewing also helps you burst open foods like seeds that cannot be digested without being physically broken open. Many people eat way too quickly, so be mindful when you eat, and chew your food thoroughly before swallowing!

peristalsis graphic showing how it moves

Once you swallow your food, it travels down your esophagus where wave-like movements direct it towards your stomach. These waves are referred to as peristalsis.  A sphincter muscle allows entry to the stomach, and helps to prevent food from coming back up in the wrong direction. The next steps to digestion are outlined below.

The Stomach breaks down and liquefies your food

black and white xray image of torso organs with red highlight of stomach and esophagus

Once food exits the esophagus, it enters the stomach where it is added to stomach acid, enzymes, and fluids. Your stomach has 3 layers of thick muscles that tighten and relax, churning this mixture thoroughly until your food turns into a liquid called chyme.

There are actually a couple compartments within the stomach. When food enters the stomach, it gets stored in the top compartment shortly and then moves into the lower compartment where the churning begins.

Eventually after a lot of churning, the food becomes chyme: an acidic, mushy food paste that consists of partially digested food and gastric juices. The gastric juices contain concentrated hydrochloric acid, (HCl) water, and enzymes. Stomach acid is extremely acidic (~1.5 pH), but doesn’t damage your stomach due to the mucus produced by the walls of the stomach that protect the digestive lining. This acid will kill most bacteria that sneak their way into the stomach with your food.

At this point in digestion, the starches are partially split and proteins are uncoiled. Fats separate from the rest of the mixture and float on top of the watery, protein and carb-rich chyme. As the chyme leaves the stomach, the fat layer is the last to exit. The more fat in a meal, the slower digestion proceeds, which explains why you feel fuller longer after a fatty meal.

Food exits the stomach a little bit at a time through a valve at the bottom of the stomach called the pyloric valve. Your stomach spits out chyme into the small intestine for a few hours after your meal until it is empty.

The small intestine is responsible for nutrient absorption

The small intestine is an incredibly long and winding organ where the majority of nutrient absorption occurs. There is so much surface area on the walls of the small intestine that if it were laid out flat, it would cover 1/3 of a football field!

This hugely important organ receives and secretes enzymes in response to food to help break down carbohydrates, proteins, and fats in preparation for absorption. You may be able to guess that the role the small intestine plays is actually one of the most important steps to digestion, and you would be correct. Each step is extremely important, but nutrient absorption is essential to life.

The cells along the walls lining the small intestine have finger-like projections called villi that pick up vitamins, minerals, and broken down nutrients once they’re small enough to absorb. Each villus then directs these nutrients into your bloodstream or into your lymph.

villi of the small intestine

The liver and gallbladder are in charge of bile production and storage

Your liver has many functions, but did you know it plays a role in digestion? The liver produces bile, which helps digest fats. The liver sends bile over to the gallbladder for storage, where it remains until needed in the small intestine. Once the small intestine is in need of bile, hormone messengers signal the gallbladder to contract and squirt bile through the bile duct into the small intestine.

Bile is an emulsifier. What this means is that it causes the separated fat layer to become suspended within the watery chyme.  This leads to more fat being exposed to fat-digesting enzymes for optimal absorption. Most bile gets reabsorbed and reused, but some may exit the body with the feces at the end of all the steps to digestion.

diagram of the liver and gallbladder and their parts

It is indeed possible to live without a gallbladder, because the liver will continue to produce bile. But instead of the bile getting stored somewhere, it is delivered directly into the small intestine through a different duct. If you have had gallbladder removal surgery (and even if you haven’t), you may need some supplemental bile and enzyme support.

Your pancreas secretes digestive enzymes

black and white xray image of torso organs with pancreas highlighted in red

Your pancreas is in charge of making digestive enzymes that help break down macronutrients (carbohydrates, proteins, and fats) into smaller and smaller pieces until the nutrients are small enough to be absorbed.

The job of the pancreas is to release pancreatic juices containing these digestive enzymes into the small intestine. Pancreatic juices also include alkaline bicarbonate, which neutralizes the stomach acid that enters the small intestine with chyme. The pancreas plays an essential role in digestion because the small intestine cannot play its role in nutrient absorption without these digestive enzymes.

One type of nutrient that doesn’t get absorbed in the small intestine is fiber. So, fiber will move along into the large intestine for the next steps to digestion. 

Stool is formed in the large intestine

diagram of the intestines and all of its regions

Once the remnants of your food enter the large intestine (colon), digestion and absorption are mostly complete. Essentially all of the carbs, fat, and protein have been digested and absorbed at this point.

The colon absorbs any leftover minerals and reabsorbs water that was donated by other digestive organs earlier in the digestive process. What is left behind is a paste containing water, indigestible fiber, dead bacteria, and any other undigested materials: this is what makes up your feces. The longer stool sits in the colon, the more water is extracted and the harder your feces become, leading to constipation.

A lesser-known organ: the gut microbiota

Our colon contains about 100 trillion beneficial microbes. They outnumber human cells by about 10 times! In a way, the gut microbiota can be considered its own organ. For example, humans don’t create enzymes that allow us to digest fibers, so this is where the gut bacteria come in handy.

Gut bacteria are able to ferment and break down fibers for us. They salvage nutrients for us that we wouldn’t necessarily have access to otherwise. They turn fibers into short chain fatty acids (SCFAs) such as butyrate, propionate, and acetate that benefit us in many ways. For example, SCFAs can give energy to colon cells, can protect against inflammation, and can even promote brain health. 

Our gut microbiota also break down and help recycle the components of bile. They can even produce some vitamins for us, but not in amounts large enough to meet our body’s needs. So it is still very important to make sure you have a balanced diet based on a variety of foods to ensure you are consuming enough micronutrients.

gastrointestinal bacteria friendly vs unfriendly

Our gut microbiota can also be thrown out of balance, in a state called dysbiosis. Dysbiosis occurs when you have a higher proportion of unfriendly bacteria compared to friendly bacteria. This can lead to many other health complications. A comprehensive stool test can be used to determine whether or not you are experiencing dysbiosis or have a balanced microbiome.

Research about the gut microbiota is booming. There is still so much that we don’t understand, but we are just now realizing the impact these bacteria have on our lives.

Potential root causes of digestive dysfunction

hand holding marker and words that say root cause on black background

So now you should understand a little bit about the complex interrelation between the digestive organs. There are many points along the way where problems could arise.

Here are some examples of potential root causes that can lead to various digestive and absorption issues:

  • Not fully chewing your food
  • Sphincter muscle dysfunction between stomach and esophagus
  • Small intestine bacterial overgrowth (SIBO) due to bacteria leaking from the mouth or relocating from the large intestine
  • Low stomach acid production
  • Insufficient bile flow
  • Low production of pancreatic enzymes
  • Motility dysfunction of the small or large intestine
  • Dysbiosis of gut microbiota
  • Chronic stress
diagram showing stress causing brain gut dysregulation and altered motility of intestine

OTC medications simply mask your symptoms but they don’t address the root cause. This is like putting a band-aid on your symptoms, only providing temporary relief. Diving deep into the steps to digestion to really understand your digestive function, and finding the issue your symptoms stem from is often the only way to get rid of uncomfortable symptoms for good! 

Do you need some help figuring out the root cause that your digestive issues are stemming from?

Schedule your appointment today to get your digestive system back in check!

Interested in learning more about digestive health? Read our other blog, “Heal Your Gut with 5 Simple Lifestyle Changes” to learn more about what you can get started on doing today!

19Nov

Heal Your Gut with 5 Simple Lifestyle Changes

There is so much information on the Internet about how to improve gut health and relieve uncomfortable symptoms. It can be confusing to know where to begin if you’re doing the research on your own. Do I need to take any supplements? How about probiotics? Should I avoid certain foods? Should I get tested for – insert any of the multitude of gut conditions here? How do you really find out what is best for you to heal your gut?

Unfortunately, there is not a “one size fits all” answer when it comes to gut health. The types of things listed above should always be done in coordination with a dietitian, who has the knowledge to guide you in the right direction according to your personal needs.

The good news is that there are some easy gut health lifestyle changes that you can start doing today that can help lay the foundation for a healthy gut! 

Here are 5 simple lifestyle changes you can make that will help you to heal your gut!

1. Slow down while eating

Are you the type of person who rushes through their lunch break? Or maybe you’re finished with your meals within a mere 10 minutes. Please stop eating food too quickly! It is important to chew your food sufficiently in order to heal your gut.

Chewing is an essential part of digestion. Chemicals in our saliva, such as digestive enzymes, help us break down certain nutrients. The antimicrobial properties of our saliva also help to kill some potentially pathogenic bacteria that may be present in the things we consume.

Chewing until food is soft and smooth makes digestion easier further down the digestive tract. Not chewing food enough may lead to digestive problems, malnutrition, and dehydration. Bloating, diarrhea, acid reflux, maldigestion, gas, and abdominal cramping can all result from not chewing your food enough.

Mindfulness and eating go hand in hand because it promotes the parasympathetic, rest and digest state. This is the state you need to be in for the digestive processes to kick in and do their job. Avoid stress during meal times, and try to eat slowly to really enjoy your food. This should lead to better digestion and nutrient absorption.

How to slow down while eating:

  • Chew your food about 30 times before swallowing.
  • Aim to swallow only a couple of times per minute.
  • Make mealtimes relaxing and practice mindfulness

2. Quit snacking

Spacing out meals is really critical for gut health. We need to have periods of time without food in our system in order for the migrating motor complex (MMC) to fulfill its housekeeping duties.

The MMC is responsible for flushing out undigested materials and bacteria through our digestive tract to eventually be flushed down the toilet.  If the MMC cannot do its job, bacteria in the gut now have a chance to overgrow by thriving off of the undigested materials that continue to hang out in the gut. Repeatedly stalling the MMC can lead to conditions like SIBO (small intestine bacterial overgrowth), which can lead to many other digestive and systemic issues.

A general rule is to wait about 3 to 4 hours after a meal before eating again. This should ensure that your MMC can serve its purpose, leaving a clean slate for your next meal. Getting your MMC functioning optimally is essential to heal your gut.

Another perfect time for the MMC to perform its housekeeping duties is while you’re asleep! Sometimes that midnight snack sounds really appealing, but our digestive functions work best if given a 12-hour overnight break. So be sure to make your meals count: they should be nutritious, balanced, and keep you full until your next meal.

How to stop mindless snacking:

  • Eat balanced meals containing protein, healthy fats, and complex, fiber-rich carbs with sufficient calories that will keep you fuller for longer
  • Meals should be spaced out about 3 to 4 hours
  • Don’t eat between dinner and breakfast for a 12-hour overnight fast

3. Remove stressors from your daily life

Stress negatively impacts many aspects of our overall gut health. Most people are familiar with experiencing digestive issues when going through stressful situations such as job interviews, a big exam, or a presentation at work.

Spending more time doing the things you love, and less time doing things that stress you out is an easy way to elevate your overall health. Not only will you feel happier… you will also become healthier and each of these leads to an overall increased sense of wellbeing. Healing your lifestyle can directly lead to you being able to heal your gut.

Keep track of the moments when you feel stressed and find the patterns. There may be some things you’re able to remove completely.

  • Maybe your home environment is cluttered and messy?
  • What if you have a toxic relationship with social media?
  • Maybe your email inbox is at 13,000 unread emails?
  • Perhaps you’re always running late?
  • Maybe you tend to procrastinate?

These are all situations that can be avoided and removed.

  • Clean your house to help declutter your mind.
  • Take a weekly social media hiatus and spend the time you gain back on a hobby.
  • Break up the big task of going through 13,000 emails into smaller increments, scattered throughout the week.
  • Leave earlier for work, appointments, and plans with friends.
  • Use time-blocking to organize your time better, leaving no room for procrastination.

Doing the work to remove the stressors that are under your control can put you on the path to better overall health.

Sometimes the things that stress us out are out of our control. If it isn’t possible to completely remove certain stressors, the next best thing would be to improve your response to stress.

4. Practice mindfulness and relaxation techniques

Relaxation techniques that are successful in improving gut health outcomes include things like: deep breathing exercises, mindfulness, meditation, and yoga.

Square breathing (AKA 4×4 breathing, block breathing) during a stressful event is an effective way to help pull your focus off of the negative feelings and elicit a state of calm within the body. To do this, inhale for 4 seconds, and then hold for 4 seconds. Next, you exhale for 4 seconds, and then hold for 4 seconds. Repeat this cycle until you feel more zen and less stressed. It is important to note that when you inhale, your belly should expand rather than your chest.

Mind-body practices like mindfulness, meditation, and yoga have been shown to reduce perceived stress and help regulate stress response systems. Mindfulness involves being more aware and conscious in the present moment.

This can be done by tuning into bodily sensations, paying detailed attention to your surroundings, and allowing thoughts to come and go without judgment. Mindfulness is a form of meditation that can easily be performed any time or place. Yoga, mindfulness, and meditation (in the classic, more formal sense) can all improve your reactions to stressors over time.

Using whichever relaxation technique that best works for you can help heal your gut and improve your overall well being. Being able to respond more calmly to stressful situations comes with practice, and this ability is directly related to the function of a very special nerve in your body: the vagus nerve.

5. Improve your vagal tone

The vagus nerve is often under-appreciated. It relays signals between the brain and almost every organ in your torso, however it works best when we are in an unstressed state. This is the reason why digestion doesn’t work properly when you’re stressed out! The vagus nerve creates what we call the gut-brain connection.

Many people live with chronic stress which directly impacts gut function. This chronic stress can lead to poor vagus nerve function, but there are measures we can take to stimulate the vagus nerve and have an increased vagal tone. Increased vagal tone indicates that you can relax quickly after you experience stress.

Stimulating the vagus nerve can be done in several different ways, and can lead to the dampening of the stress response, putting you in a state of relaxation.  A couple of the easiest ways to stimulate the vagus nerve are possible due to the fact that the nerve runs through the muscles in the back of the throat.

One of these simple exercises includes humming or singing at the top of your lungs while showering or driving to work. Gargling warm salt water for 30 seconds (until your eyes begin to water) will also activate the vagus nerve.

Practicing vagus nerve stimulation can serve to modulate your body’s automatic stress responses, and over time you may actually find yourself more capable of remaining calm and stress-free. Tuning in to your body and being mindful of how you respond to stress — and noting how often you feel stress — is the first step in improving how your body reacts.

 

Now you have a few more tools in your toolkit that will help you to heal your gut!

Always pay attention to your body and trust your gut! Never be afraid to ask for help. 

For personalized guidance for how to achieve a healthy gut, schedule your appointment today!

11Nov

Relaxation Techniques: The Top 4 Types

If you’re reading this, you may be feeling the effects of stress and are seeking some relief! This blog will briefly describe the way our bodies – and our gut – respond to stress, and give you some tools to improve your resilience and overall wellbeing. We will discuss the best types of relaxation techniques for stress reduction.

Humans are not well adapted to the modern world 

stressed woman juggling responsibilities

Every day, we encounter minor mental stressors that our ancestors didn’t have to deal with. They had to deal with the physical threat of fighting predators, while we have to deal with things like long work-weeks, financial worries, adapting to life during a pandemic… These things don’t compare when it comes to life and death, but unfortunately for us, our bodies react the same way to both types of situations.

Our bodies have an automatic response to stress, which our brains perceive as a psychological threat. The brain triggers a cascade of events within the body called the stress response, which way back in the day was meant to ensure our survival. Today, the stress response may be triggered multiple times over the course of the day, keeping our cortisol levels high and leaving us in a maladaptive, sympathetic nervous system state.

The stress that so many of us feel on a daily basis can actually be both physically and mentally harmful. Stress has a HUGE impact on digestion and gut health, and luckily for us, there are steps we can take in order to take back control over our gut health in the midst of a stressful life.

The relaxation techniques listed below can be practiced regularly to give you better control over your reactions to stress. But first, let’s discuss the impact stress has on your gut health.

How does stress impact the gut?

For digestion to function normally, we must be in a relaxed, unstressed state where the parasympathetic branch of the autonomic nervous system is in control. Whenever we experience stress, the automatic stress response activates the opposing branch of the autonomic nervous system – the sympathetic branch.

The sympathetic branch inhibits digestive functions, because they are not essential for immediate survival. This can lead to many digestive problems, especially when stress becomes a recurrent aspect of your daily life – when stress becomes chronic.

So what impact does stress have on the gut? Some symptoms (that you may be quite familiar with) that are commonly experienced due to stress can include diarrhea, constipation, nausea, indigestion, abdominal pain, and heartburn.

man in black and white grabbing stomach highlighted in red

Enough bad news… let’s get to the good news! Reducing the stress in our lives is not only possible; it is relatively simple to do. Here are some stress reduction and relaxation techniques that you can add to your daily life today!

Relaxation Technique #1: Vagus Nerve Exercises

The vagus nerve is part of the parasympathetic autonomic nervous system – the branch that dominates only when we’re relaxed. This branch is nicknamed the “rest and digest” branch because digestive processes can only function under a relaxed, parasympathetic state.

Your vagus nerve is connected to every organ in your torso except the adrenal glands, which pump out the stress hormones when you are stressed.

The vagus nerve has many impacts on digestive health, and stimulating this nerve is important for improving resilience in the face of stress. So how do we stimulate this nerve to make it function better?

The vagus nerve runs through the muscles in the back of your throat. Vibrations on these muscles can activate the nerve, which over time can help you bounce back from stress more easily.

Here are a couple simple things you can do to stimulate the nerve and improve your vagal tone:

  1. Gargle warm salt water (until your eyes start watering!)
  2. Sing at the top of your lungs! Or hum loudly.
  3. Use cold water for 1 minute at the end of your showers
woman gargling water in her bathroom

Luckily, practicing vagus nerve stimulation at home can be so simple! Both of these techniques are easy to do and can be added to your daily regimen immediately, so why not try them out today?

Relaxation Technique #2: Practice Mindfulness

Mindfulness involves simply being present in the moment and paying attention to any bodily sensations. We are predisposed to have our minds wander since we are constantly stimulated in our daily lives. Mindfulness techniques center you to notice your current physical and mental state without judgment. The continued practice of bringing attention to the present moment and how you are connecting with your surroundings is clinically shown to reduce stress and negative mental states.

woman meditating at her desk in front of her laptop

A common mindfulness method is to complete a body scan. To do this, you can be lying down, sitting, or standing. Just close your eyes, breathe slowly, and focus on how your body feels starting from your feet upward, or from your head downward. Focus on how your clothes feel on your body, how certain body parts feel touching each other, and any pressure felt from the ground or the chair. Doing this even just a couple times can help reduce stress and induce a feeling of peace.

Relaxation Technique #3: Yoga Nidra

Yoga nidra, also known as “Yogic Sleep,” is a form of pre-bedtime guided meditation that puts you in a very relaxed state. For most people, this form of meditation is much easier to accomplish than sitting still and trying to “clear your mind.” Practicing yoga nidra over time can lead to benefits such as better sleep, reduced stress, and improved wellbeing.

Yoga nidra involves lying down on a yoga mat (or even your mattress), setting a sankalpa (intention), and simply following what the guided meditation says. Some practices are 5 minutes, others can be an hour or longer. There are many audio guides of varying lengths available online that can easily be followed at home, so this practice is accessible to everyone!

woman laying on the floor yoga nidra

Yoga nidra is an easy way to reduce stress, relieve tension and pain, and connect with yourself on a deeper level. Practicing yoga nidra right before you go to sleep can clear the mind and allow yourself to tap into your subconscious self to reach your goals and intentions.

Relaxation Technique #4: Deep Breathing Exercises

One of the best relaxation techniques involves something that we usually do without any thought. Breathing is essential to human life, and is key in both the mindfulness and in yoga nidra practices mentioned above.

The diaphragm is the key muscle that is used in relaxed breathing states. However, many people breathe using their accessory respiratory muscles rather than the diaphragm.

To test whether you’re prone to dysfunctional breathing, place one hand on your chest and the other on your belly. Take a few deep breaths in, and pay attention to which hand is moving. Your belly should be the area that expands when you inhale. If your chest is expanding more than your belly, this is a sign that you might be in a sympathetic state, under stress.

Slow, deep breathing using your diaphragm improves efficiency within the lungs.  Clinical studies also show that deep breathing plays a huge role in our cardiovascular health and helps to decrease blood pressure. It can also promote higher heart rate variability (HRV), which is a sign of high vagal tone.

Studies suggest that practicing deep breathing exercises regularly for 3 months or longer can shift your autonomic nervous system to parasympathetic dominance – this means that deep breathing can modulate your stress response so that you are more resilient in the face of stress!

the words just breathe scratched into the sand on the beach at sunset

Deep breathing exercises have been practiced for centuries, especially in Eastern cultures. Western cultures are just now realizing the advantages of a more holistic approach to wellness, even though many practices have been around for hundreds of years. In yoga, breathing is called “pranayama.” One variation of pranayama is alternate nostril breathing.

How to do Alternate Nostril Breathing:

  • Sit in an upright, relaxed position and close your eyes. Place one hand with your palm facing upwards on top of your knee.
  • With your other hand, raise your pointer and middle fingers and lightly place them in between your eyebrows. Your ring and pinky fingers should cover one nostril, and your thumb covers the other nostril. Do not exert any hard pressure to your nose or forehead.
  • Exhale through your right nostril while holding the left nostril shut.
  • Inhale through your right nostril, then shut the right nostril and release the left nostril.
  • Exhale through the left nostril, while keeping the right nostril closed.
  • Inhale through the left nostril, then close the left nostril and exhale through the right nostril. This step completes one cycle of alternate nostril breathing.
  • Continue these steps for as long as needed to relax the mind.
  • Always inhale through the nostril you just exhaled through.
woman sitting outside in autumn practicing alternate nostril breathing

Another deep breathing exercise that can be used to calm your nerves is called 4×4 breathing (aka square/box breathing).

How to do 4×4 Breathing:

  • Sit or lie down in a comfortable, relaxed position and close your eyes. Release any tension from your body.
  • Inhale through your nose for 4 seconds
  • Hold your breath for 4 seconds.
  • Exhale through your mouth for 4 seconds.
  • Hold your breath for 4 seconds.
  • Repeat this cycle as many times as you want over the course of a few minutes until you feel a sense of calm.

 

Since stress negatively impacts our health, it is important for us to take back control in whatever ways we can. As you can see, none of these relaxation techniques are very difficult, so it is easy to get started today! Pick whichever relaxation technique works best for you, or combine multiple techniques and you may begin to feel less stressed within a short period of time.

woman singing into her shower head in the bathtub

Still feeling stressed over your gut health?

Schedule your appointment today to help you get to the root cause of the problem, so you can start living your best life!

the top 4 types of relaxation techniques

 

 

 

Sources:

https://breathe.ersjournals.com/content/13/4/298

https://www.sciencedirect.com/science/article/abs/pii/S1566070201002673

https://search.proquest.com/openview/9b98ccfa3b77e8dc6667b20e1ca0f96c/1?pq-origsite=gscholar&cbl=37533

https://www.sciencedirect.com/topics/medicine-and-dentistry/heart-rate-variability

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134749/

11Nov

Stress and the Digestive System

Have you ever been so nervous that you felt the urge to go use the toilet immediately because you weren’t sure if you could hold a bowel movement? Maybe you’ve connected the dots and noticed that you experience indigestion or heartburn when you’re stressed out but not as often when you’re relaxed? This blog will explain the connection between stress and the digestive system.

Stress is something that, unfortunately, we are all very familiar with. The gut problems that result from stress are also no stranger to most of us.

This blog will explain some of the physiological changes that happen in the body when we’re stressed out that lead to the discomfort you may be feeling.

Can stress cause gastrointestinal problems?

Think of any gut issue, and it’s extremely likely that it is somehow connected to stress. Many of us have experienced an upset stomach from stress at some point in our lives. There are many gastrointestinal (GI) symptoms that illustrate the connection between stress and the digestive system.

Here are some examples of GI symptoms that are related to stress:

  • Abdominal pain
  • Indigestion
  • Heartburn and acid reflux
  • Diarrhea
  • Constipation
  • Nausea and vomiting
woman holding stomach in pain

To some extent, all of us are familiar with most, if not all, of these uncomfortable symptoms.  Here, we will explain why these symptoms occur to explain the connection between stress and the digestive system.

Low Stomach Acid

Contrary to popular belief, the stomach actually produces less stomach acid (concentrated hydrochloric acid – HCl) when we’re under stress. So how does less acid lead to acid reflux and heartburn?

This happens because the sphincter muscle connection between the esophagus and the stomach relies on sufficient stomach acid production to determine when it should be closed. This means, when stomach acid levels are low, the opening stays open and what little acid there is in the stomach can now enter the esophagus and cause heartburn.

woman in black and white with cartoon stomach on fire

Low levels of stomach acid also cause issues with digestion. Certain nutrients may not be as easily absorbed because they won’t get properly broken down without enough stomach acid.

Also, any bacteria we consume with our food (or even bacteria that naturally live in the mouth) may not be killed, which could lead to food poisoning. This can also lead to other dysbiosis (microbial imbalance) issues in the gut, such as SIBO (small intestinal bacterial overgrowth).

Interrupted Bile Flow

Another symptom that is common with stress and the digestive system is interrupted bile flow. Bile is produced by the liver and stored in the gallbladder. When we’re stressed, bile flow is interrupted and grinds to a halt.

Why does this happen? First of all, the stress response suppresses bile release from the liver into the gallbladder because energy is being diverted away from digestive processes and towards your muscles. Also – since digestion stops when you’re stressed, the stomach doesn’t release any food into the small intestine, which is the signal for the gallbladder to pump bile to aid in digestion.

So why is this a problem? The gallbladder is the storage organ for bile, which assists with fat digestion. When the gallbladder is repeatedly inhibited from releasing its bile stores, the entire biliary system gets disrupted. 

Some issues that can arise include fat malabsorption, fat-soluble vitamin malabsorption, diarrhea, abdominal pain after eating fatty foods, nausea, and feeling heavy after eating. Interrupted bile flow can also cause bile to become over-concentrated with cholesterol and potentially lead to painful gallstones.

gallstones inside gallbladder

Changes to Gut Motility

Gut motility alteration also signals to the connection between stress and the digestive system.

The hormones that are released while you’re stressed out are shown to impact gut motility. This causes the upper gut (your stomach and small intestine) to slow down its digestion process and also decreases the absorption of nutrients. Food stays stagnant in the stomach and small intestine. Stagnant food causes issues such as malnutrition, abdominal distention, bloating, nausea, and vomiting. This is why you can sometimes feel nauseated or even vomit when you’re extremely nervous.

woman holding up cardboard image of intestines

The opposite situation usually happens in the large intestine. During stress, the large intestine speeds up, disregarding its duties of packing our excrement into shape and reabsorbing water. This reduced gut transit time explains why we might experience diarrhea when we’re stressed out.

Heightened Gut Hypersensitivity

Studies also show that sensitivity within the gut increases when we’re under stress. Heartburn and other gastrointestinal (GI) symptoms can actually feel worse when we’re under stress than the same symptoms feel when we’re relaxed.

This relates to irritable bowel syndrome (IBS) – where you experience hypersensitivity in addition to changes in motor function of the gut. Unfortunately, patients with IBS and other GI issues are subject to a vicious cycle where stress contributes to the severity of their symptoms, which then causes even more stress…

Weakened Immune System

Chronic stress can weaken the immune system, making it more likely that we will get sick. When we’re stressed out long-term, the continuous surges of cortisol and other hormones cause widespread inflammation and slow immune cell production, both of which can increase the risk of infection and tissue damage.

sick woman in blanket blowing nose looking at thermometer

Did you know that 60 to 70% of your immune system is in your gut? This makes sense when you really think about it. Our digestive systems are connected to the outside world – humans are essentially just tubes with a lot of complicated accessories.

People consume dangerous pathogens through food and drink every day. Our immune system needs to be especially active in our gut to help protect us from things like food poisoning and small intestine bacterial overgrowth (SIBO).

Hidden Inflammation

Inflammation is valuable in small doses. The inflammatory response is the part of the immune response that promotes tissue healing. Inflammation is supposed to stop once healing is complete, however, this doesn’t always happen. Chronic stress can lead to chronic inflammation, which can then contribute to much larger problems.

woman holding stomach with xray intestines

Inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis, are exactly what they sound like – diseases caused by excessive inflammation and irritation in the intestines. These are autoimmune conditions, where your immune system thinks your own cells are foreign enemies. Studies suggest that these diseases are ultimately triggered by disruptions in the immune function within the gut, imbalances in gut microbiota, and leaky gut – all of which can be the result of chronic stress.

A Quick Note About the Gut Microbiome

The bacteria that live in our digestive systems (mostly within the large intestine) are usually beneficial for us. They can produce various products such as essential vitamins and short chain fatty acids that our bodies need. 

Each person’s microbiome is as unique as his or her fingerprint. We obtain these bacteria throughout our lives, starting with our journey through the birth canal and continuing with exposure to the environments and foods we are raised with. These bacteria are there to work with the immune system to strengthen the gut lining, prevent inflammation, and protect against any intruding bacteria from colonizing where they don’t belong.

intestines with blue bacteria

Bacterial Imbalance of the Gut Microbiome

When we experience stress, the gut microbiome is altered. One way this can happen is because when digestion shuts down, any food in the small intestine just hangs out there. This means that our housekeeping system, the migrating motor complex, cannot sweep the small intestine clean of invading bacteria.

Without this housekeeper, any pathogenic or unwanted bacteria that has found its way into our intestines, through our food or from our mouths, is now likely to take refuge there. This can lead to an imbalanced microbiome, uncomfortable GI symptoms, increased colon inflammation, autoimmune diseases like Crohn’s disease, and conditions like SIBO.

microscopic bacteria in intestines

Something that you may find really interesting is that your personal microbiome also affects how you respond to stress. Research indicates that people who are able to stay calm during stressful situations have similar microbiomes, which are very different when compared to those who react the most strongly under stress.

The gut-brain connection is bidirectional, but the signals from the gut to the brain are much stronger than the other direction. We know that chronic stress can change both the proportions and the diversity of these bacteria in your gut. So when stress causes an imbalance in your gut bacteria, the newly reigning gut bacteria may actually diminish your resilience to stress.

It all boils down to the gut-brain connection!

When we’re stressed, the nerve that controls digestive functions doesn’t work properly. This contributes to the issues we spoke about above, like low stomach acid, low bile flow, issues with gut motility, inflammation, and more.

This extremely important nerve is called the vagus nerve, and it has become the subject of a lot of research in more recent years. It also has a vast impact on our mental health! The proper function of gut-brain connection via the vagus nerve is essential to maintaining our health and overall wellbeing.

brain neurons and nerves

You can get started on some relaxation techniques today in order to improve your vagus nerve function and reduce stress, so that you can achieve optimum gut health and function!

For guided assistance to get to the root cause of your gut problems, schedule your appointment today!

I can order your comprehensive stool analysis so we can look for any maldigestion markers, inflammation, dysbiosis, metabolic imbalance, or infection that could be occurring within your gut!

 

 

 

 

Sources: 

http://www.med.unc.edu/ibs/files/2017/10/Stress-and-the-Gut.pdf

https://gut.bmj.com/content/47/6/861

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859128/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4858318/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1140465/

https://www.sciencedirect.com/science/article/pii/S2352289516300509

https://medicalxpress.com/news/2018-03-gut-bacteria-essential-healthy-immune.html#:~:text=The%20gut%20is%20able%20to,may%20impact%20how%20we%20behave.

25Oct

Adrenal Fatigue Recovery – Your Quick Guide to Adrenal Fatigue

Have you been extra stressed out recently due to the pandemic? Do you feel that your stress levels have negatively impacted your life and have contributed to you feeling burned out? You’re not alone! You may be dealing with something commonly referred to as Adrenal Fatigue. This blog will outline what exactly adrenal fatigue is, and give you some support for adrenal fatigue recovery.

Like many people nowadays you might be facing financial insecurities, unsure how to handle childcare or homeschooling, worrying about online classes, or just generally worrying about the future. All of these things are considered stressors.

stressed out woman with head in her hands at a desk with a laptop, phone, and 2 journals

Life sometimes hits us in a way that creates a cycle of constant stress. Many people have been under an unprecedented amount of stress due to the pandemic. And you are probably aware of how badly stress can make your body feel!

The human body has a hardwired response to stress, which enables us to focus and activate a response in the face of danger. However, the stress we face most days isn’t a matter of life or death… We can have emotional, perceived stress, physical stress from injuries, or chemical stress from smoke or pollutants. The human body reacts the same way to these types of stressors as it does to life-threatening situations.

When stress becomes chronic, the body’s adaptive response to danger becomes dysfunctional and ends up hurting our health in the long run. One of the results of this chronic stress is something called adrenal dysfunction often referred to as adrenal fatigue.

What is adrenal fatigue?

Adrenal fatigue is the end result of the constant cycle of stress. When people say adrenal fatigue, they probably mean adrenal dysfunction or HPA axis dysfunction. If left untreated, adrenal fatigue is often the end result of chronic adrenal dysfunction caused by chronic stress. 

The adrenal glands produce multiple hormones, most notably cortisol and epinephrine (aka adrenaline). These hormones are the ones that help us react to stressful situations. When the brain registers a stressor, a specific cascade of hormones are produced, eventually resulting in the release of adrenaline and cortisol from the adrenal glands. 

However, if the brain is constantly triggering the stress response, eventually the adrenal glands will not be able to keep up with the demands to produce these stress hormones. This is where adrenal fatigue sets in, and your entire body faces the consequences. This can happen quickly, or over the span of decades – it is all dependent on the individual!

Why should I care about cortisol for adrenal fatigue recovery?

Cortisol is a catabolic hormone, meaning that it helps to break things down within the body. This probably doesn’t really sound very good to you, and you would be correct – in chronically high levels, cortisol can do some serious damage. 

Excess cortisol:

  • Suppresses immune function 
  • Breaks down the gut mucosal barrier
  • Increases insulin resistance
  • Fat gain, especially around the abdomen
  • Inhibits the production of testosterone, estrogen, progesterone, DHEA, and more
  • Increases sodium retention and causes high blood pressure
  • Reduces levels of magnesium and zinc in the body
  • Alters thyroid function
  • Stimulates bone loss, contributing to osteoporosis

In addition, the downstream consequences of adrenal dysfunction can lead to the erosion or break down of the gut lining, which contributes to poor gut functioning.

Another problem that occurs is that when cortisol is being produced in excess, a very important hormone called DHEA (dehydroepiandrosterone gets produced in lower amounts than usual. Cortisol and DHEA have the same precursor hormone, called pregnenolone. When the demand to produce cortisol is consistently high over a long period of time, one of the results is that there is much less DHEA production.

What is DHEA?

DHEA is essentially the opposite of cortisol – it is an anabolic hormone, which does jobs that involve building materials and structures within the body.

Some benefits of DHEA include:

  • Opposes the negative effects of cortisol on the immune system
  • Improves muscle mass and decreases body fat
  • Precursor to testosterone
  • Supports recovery from stress
  • Lowers total blood cholesterol and LDL cholesterol
  • Involved in conversion of thyroid hormone to the active form
  • Stimulates building bones to prevent osteoporosis

You should notice that DHEA generally opposes the effects of cortisol.

So, in addition to all of the negative effects cortisol is having on your body, excess cortisol also reduces the positive effects of DHEA by limiting its production.

The relative amounts of these two hormones are important in determining which stage of adrenal fatigue you are in. Knowing which stage you are in helps your functional medicine dietitian determine what kind of treatment is required to get you back to optimal health. In other words, knowing which stage you are in sets the stage for adrenal fatigue recovery.

cortisol vs DHEA

There are 3 stages of HPA Axis Dysfunction / Adrenal dysfunction

A skilled practitioner is able to determine which stage of adrenal dysfunction you are in by looking at your adrenal hormone test results.

  • In stage 1 of adrenal dysfunction, your body is in a permanent alarm phase and is producing extremely high levels of cortisol, and DHEA levels are dropping.
  • During stage 2 of adrenal dysfunction, cortisol levels may seem normal, but DHEA levels are low. 
  • In stage 3, the body is producing very low amounts of cortisol and DHEA. This is the result of the system crashing completely. If this stage is reached, you will need more than just a lifestyle overhaul to address the issue. This is the stage that we consider true adrenal burn-out. 
3 stages of adrenal dysfunction

Possible signs and symptoms of chronic stress, HPA axis dysfunction, and adrenal burn-out:

  • Fatigue
  • Feeling tired but also wired
  • Sugar and simple carbohydrate cravings
  • Insomnia
  • Increased belly fat
  • Low energy and poor recovery from exercise
  • Poor immune function
  • Anxiety
  • Memory problems
  • Depression
  • Nutrient deficiencies
signs of adrenal burnout

Chronic conditions that can be affected by a hyperactive stress response:

  • Diabetes
  • High blood pressure (hypertension)
  • Cardiovascular Disease
  • Autoimmune illnesses
  • Chronic fatigue syndrome
  • Osteoporosis
  • Infertility
  • Digestive conditions (SIBO, IBS, IBD, etc.)

How to know if you are suffering from adrenal dysfunction 

If you are dealing with any of the symptoms or conditions listed above, you might be suspecting that you are in one of the stages of adrenal dysfunction. The only way to truly determine if this is true is to have your adrenal hormone levels tested with a saliva test. Salivary cortisol is used because it is the most convenient way to measure cortisol.

These adrenal hormone tests are noninvasive and easy to do in the comfort of your own home. Saliva testing involves spitting into a tube at specific intervals throughout the day. These saliva samples are then graphed and compared to the range of normal cortisol levels.

saliva test kit

The adrenals produce cortisol in what is called the circadian rhythm. This means that naturally, cortisol is produced throughout the day in a typical, distinct pattern.

Comparing your cortisol values to the standard circadian rhythm allows your functional medicine dietitian to determine whether or not you’re in adrenal dysfunction, and if so, which stage you are in. This information is usually enough for your practitioner to give you a treatment protocol that will help you get back into the normal range. Sometimes, other testing may be required in your personal adrenal fatigue recovery journey.

Graphic showing the cortisol circadian rhythm graph

So how exactly do we begin our journey to adrenal fatigue recovery?

Healing Adrenal Fatigue

The first step to improving your adrenal function is to test your adrenal hormone levels to be sure that you have adrenal dysfunction or insufficiency in the first place, and if you do have it, knowing which stage you are in. Depending on which stage you are in, there are different protocols.

Improve your stress resilience…

Remember that the stress response actually starts in the brain. How you perceive an event is actually more important than the event itself. This is why two different people who experience the same event may have drastically different emotional and psychological responses.

One person may get a parking ticket and think “UGH… this always happens to me! Why am I so unlucky?” and then they ruminate over the ticket all day. The other person who got a parking ticket may brush it off, consider it not a big deal, and not even think about it again. These two people experienced the same event, but only one of them triggered their stress response – and that person triggered it continuously throughout the day!

So, the first thing you can do to improve adrenal function is to dedicate some time to cultivating a more positive mindset and to make an effort to learn how to remain calm in the face of a potential stressor. Reminding yourself of things you are grateful for can help you in working towards a less reactionary approach to stress.

There are many relaxation techniques that you can practice that will help you gain more resilience in the face of stress. These relaxation techniques include: breathing exercises, mindfulness, meditation, vagus nerve activation, yoga, and much more. Find what method works for you, and remember that improving your stress resilience takes time!

Clean up your diet!

Adjusting your diet is also usually necessary. Reducing the amount of added sugars and highly processed foods in your diet is a good first step towards reducing hidden inflammatory stress within the body. Be sure to stay hydrated and to fuel your body with plenty of fiber, lots of fruits and vegetables, and sufficient amounts of protein and fat.

Variety is the key in any diet to ensure you consume adequate amounts of all the necessary vitamins and minerals. Don’t take any supplements without the approval and recommendation from your dietitian. These recommendations should be based on your lab results, because toxicity is always possible, which can do even more damage to your already stressed out body.

Get plenty of sleep!

Since cortisol is linked to our sleep-wake cycles, quality sleep is key to improving health outcomes. Blue light glasses are useful while looking at screens throughout the day and in the hours before bedtime to block the blue light emitted from the screens of our electronics.

Blue light exposure close to bedtime tricks the brain into thinking daylight is still present, and alters the circadian rhythm. Of course, it is much better to avoid this blue light exposure right before you sleep. Getting at least 7 hours of uninterrupted sleep in a dark, cool room is essential for high sleep quality.

Get to the root cause of digestive issues

If you’re experiencing gastrointestinal distress, it is possible that additional functional medicine testing is needed to determine the next steps. Any symptoms you have may be connected to the HPA axis dysfunction, so communicating with your functional medicine dietitian is extremely important. Chronic stress is linked to digestive issues such as microbiome imbalances (dysbiosis), small intestine bacterial overgrowth (SIBO), constipation, diarrhea, and much more. 

healing adrenal fatigue

When one system in the body goes awry, many others may follow. Catching adrenal dysfunction before it gets to stage 3 is ideal. However, there are treatment options if you do find yourself in stage 3.

Following the guidance your functional medicine dietitian sets out for you can improve so much more than just the adrenal fatigue alone.

Improving your quality of life starts with simply knowing where to begin!

 

Have you been feeling burned out? Do you want to get to the bottom of what is causing your symptoms? Schedule your appointment today to get started on your journey to adrenal fatigue recovery!

Sign up for the Adrenal Reboot program for individualized support for your adrenal fatigue recovery

21Oct

Cortisol Circadian Rhythm and its Impact on Health

Before electricity, our ancestors woke with the sun and slept with the moon. Humans have evolved to exist in 24 hour sleep-wake cycles, or circadian rhythms, that operate as part of our biology.

Circadian rhythms can be disrupted by the modern conveniences of technology, and these disruptions have real impacts on our health.

What are Circadian Rhythms?

Your circadian rhythm is essentially a master clock along with a set of other internal clocks that regulate various bodily processes. Circadian rhythms run on a 24 hour cycle, can be trained, and can be affected by temperatures.

This master clock is called the suprachiasmatic nucleus, which is located above the optic nerves that send signals from the eyes to the brain. The master clock directly responds to light, and is the reason why we have sleep-wake cycles that are determined by light exposure.

Light exposure (or lack there-of) can impact these sleep-wake cycles, especially in modern society with light switches and high levels of screen time.

How does the Cortisol Circadian Rhythm work?

The hypothalamic-pituitary-adrenal (HPA) axis, which is in control of your stress response, also follows a circadian rhythm for its release of cortisol from the adrenal glands.

Cortisol levels typically peak when we awaken (6 to 8 am). Then cortisol levels decrease throughout the day, staying low from around 6 pm until we fall asleep, when cortisol release starts to rise again. Check out the cortisol circadian rhythm graph below!

Cortisol’s circadian rhythm is essential for our health, playing a role in various processes that impact metabolism, repair cells, and strengthen our immune system. Disruptions in your HPA axis circadian rhythm can increase the risk of developing chronic conditions like obesity, heart disease, cancer, and diabetes.

There are many symptoms listed below that can be present when you are experiencing HPA axis dysfunction that precede these chronic conditions, which can definitely be addressed before the chronic conditions have a chance to develop.

Being exposed to threats throughout the day, whether real or perceived, causes spikes in cortisol that disrupt this important, natural rhythm. If stress is a normal part of your daily life, then this has an even greater impact on your cortisol circadian rhythm and may mean that you need extra support to reestablish a healthy hormone balance.

Signs you need a Circadian Rhythm Reset:

  • Fatigue
  • Body aches, especially in the neck and back
  • Poor memory and feeling “foggy headed”
  • Poor immunity, or getting sick frequently
  • Gastrointestinal dysfunction
  • Weight gain, especially around the abdomen
  • Hair loss
  • Skin issues like acne, dryness, and dullness
  • Reduced sex drive
  • Depression or anxiety
  • Sleep disruptions, like insomnia or trouble staying asleep

So how do I know if my circadian rhythm has been disrupted? There is a test for that! 

How to Check Cortisol Levels 

One of the most accurate ways to determine whether you’re experiencing some HPA axis circadian rhythm disruptions is to get your cortisol levels tested with a practitioner-ordered home cortisol test.

Your functional medicine practitioner will order your adrenal stress hormone test, and after the results come back you will be able to get a better idea of how your cortisol circadian rhythm is functioning (or malfunctioning). Depending on where you fall within the cortisol normal range, you may find out that you are on the path to adrenal burn out.

This test is an easy and effective means for determining whether your stress response is hyperactivated. Cortisol patterns are considered markers of wellness and can be used to draw a roadmap to recovery. Knowing the effects that stress is having on your stress hormones is the first step from which a personalized protocol can be developed.

How to Reset Circadian Rhythm – Getting Back into Rhythm

Once you get started on the road towards recovering your circadian rhythm, there are many lifestyle factors that can be adjusted in order to achieve maximal results. Getting started by adding some relaxation techniques into your daily life will help set the stage for healthier responses to stressors, whenever they occur.

Woman with arms stretched up at sunrise

If you’re one of those people who is getting less than 6 hours of sleep per night, one of the simplest things you can do to better your health is to improve the duration of sleep to a minimum of 7 hours per night, along with synchronizing your sleep-wake cycles to your natural circadian rhythm.

Humans need to sleep to survive, and we need enough sleep to be healthy. No matter how much we need to accomplish in our daily lives, the fact remains that sleep is essential at the end of the day, and most people should be trying to get more of it.

Sleep isn’t always a simple thing for people, even if we know how important it is.

In fact, if you are under high amounts of stress (and thus consistently have constant spikes in cortisol), it is likely that sleep is quite difficult for you. So, addressing your cortisol circadian rhythm imbalances is actually one of the best things you can do in order to improve your sleep, improve your health, and improve your life.

So how can you get more sleep? There are many ways to improve your sleep hygiene in order to prime yourself for better and longer sleep. You can learn about these methods, along with many other lifestyle hacks, when you sign up for my Adrenal Reboot Program!

Joining my Adrenal Reboot Program will help get you started on a personalized track towards improving your HPA axis function, your cortisol circadian rhythm, and improving your overall health!

Schedule your free 15 minute Discovery Call today!

12Oct

HPA Axis Dysfunction and Chronic Stress

HPA axis dysfunction can lead to a variety of health complications. This dysfunction is typically caused by repeated high levels of stress.

Evolution has hard-wired our bodies to react to threats in a very specific way. The stress response is a survival mechanism that primes our bodies to be able to fight or flee when we are faced with a threatening and stressful situation, such as when you see a lion watching you from a distance.

Nowadays, we don’t get into positions that require us to fight off predators frequently, but we do experience many other situations that stress us out, triggering the hard-wired, automatic stress response.

The modern lifestyle in today’s world throws so many hassles at us that our ancestors never had to experience. Work, worrying about finances and paying bills, sitting in bumper-to-bumper traffic, and navigating life during a pandemic… Consequently, your body treats these non-life-threatening stresses the same way as it would a threat to your life.

When you are in a state of constant stress, this evolutionary survival response is triggered repeatedly, and over time becomes extremely detrimental to your overall health.

Today, the stress response kicks in more frequently than ever and can lead to many different health issues. So what exactly happens in the body when we encounter a stressful situation?

The Hypothalamic Pituitary Adrenal Axis – Explaining the stress response

The stress response consists of a series of physiological events in the body that proceeds like a domino effect almost instantaneously. The sequence of events happen before the brain’s visual centers can even fully process the event, which is why it is sometimes possible to react to a dangerous situation before you even realize what is happening.

When you experience or perceive a threat, physical or psychological, this information is sent directly to the amygdala – the emotional processing center of the brain. Your amygdala concludes that the situation is a threat, and then signals the hypothalamus – the brain’s command center – to sound off both neural and hormonal (AKA neuroendocrine) alarm signals to the rest of the body.

The hypothalamus starts by activating the sympathetic nervous system, which triggers the fight or flight response so your body can respond to the perceived threat. This happens through the sympathetic stimulation of the medulla of the adrenal glands, which releases epinephrine (AKA adrenaline) into the bloodstream.

 

 
 
 
 
 
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Epinephrine/Adrenaline Rush

This surge of epinephrine causes your heart to beat faster and your blood pressure to increase, in order to push blood to your muscles so you can better fight or escape the threat.

Stored glucose and fatty acids are released into the bloodstream to provide energy throughout the body. Your breathing rate increases in order to bring more oxygen into the body, which is sent to your muscles and to the brain to increase your level of alertness.

Meanwhile, the hypothalamus also sends off a second alarm signal to keep the sympathetic nervous system activated so that you’re able to continue to face the threat. This second alarm signal goes through what is called the hypothalamic-pituitary-adrenal (HPA) axis.

HPA Axis and Cortisol, The Stress Hormone

This second alarm signal is a hormone called corticotropin-releasing hormone (CRH), which travels to the anterior pituitary gland where it binds to CRH receptors, triggering the release of adrenocorticotropic hormone (ACTH).

ACTH travels through your bloodstream to reach the adrenal glands, where it binds and triggers the release of cortisol – commonly known as the stress hormone.

chemical structure of cortisol

Cortisol keeps your body on high alert until after the dangerous situation is over with, through mobilizing energy stores and increasing blood sugar levels for a quick energy source to be used throughout the body.

Once cortisol levels start to fall, the parasympathetic nervous system (the rest-digest system) kicks in to diminish the effects of the stress response.

While the stress response is going full steam ahead, nonessential activities (such as digestion) in the body are halted. Blood is shunted away from the digestive system and other non-essential processes, towards the muscles and heart where more oxygen is needed.

Any system that doesn’t immediately serve to address the threat is shut down to conserve energy for the fight or flight response. Our bodies were designed to face stressors automatically and with intensity in order to ensure our survival.

The stress response is supposed to be self-limiting, meaning that once the event is over, the stress hormones should go back to normal levels. The diminishing of the stress hormones allows your heart rate, blood pressure, breathing rate, and blood sugar to also decrease to normal levels.

However, even in the past the dangerous situations that prompted this kind of response didn’t happen continuously throughout the day. Today, many people face constant, daily low (or high) levels of stress that keep the stress response turned on. This leads to HPA axis dysfunction, disrupting normal bodily processes, and over time can contribute to negative health outcomes.

Very stressed out man holding his. head

Sympathetic Dominance – What happens when stress becomes chronic?

Chronic stress triggers the stress response over and over again. Cortisol levels remain high, making it nearly impossible for the parasympathetic nervous system to take over and fulfill its job in certain bodily processes.

When the parasympathetic nervous system is unable to fulfill its duties because you’re spending most of your life using your stress-based sympathetic nervous system – this is called sympathetic dominance.

Chronic Stress, Digestion, and Appetite

One of the roles that the parasympathetic nervous system is blocked from fulfilling due to sympathetic dominance or HPA axis dysfunction is digestion. So, it makes sense that digestive issues are a common result of chronic stress. Indigestion, IBS, malabsorption of nutrients, and many other gut health issues can be caused by – or exacerbated by – chronic stress.

These high cortisol levels also contribute to increased appetite, especially for sugar and simple carbohydrates, that can lead to overeating and weight gain, and eventually even obesity.  There is a huge connection between cortisol and belly fat.

A common sign of high cortisol levels is higher levels of abdominal visceral fat, which appears as a “pot belly.” High levels of visceral fat are associated with type 2 Diabetes, cardiovascular disease, and metabolic syndrome.

Chronic Stress, Inflammation, and High Blood Pressure

Chronic stress can lead to chronic inflammation, which can also keep cortisol levels elevated. Cortisol suppresses the immune system, making you more susceptible to illness and gastrointestinal issues. This can put you at risk to develop an autoimmune disease.

Another job that cortisol has is to help deliver oxygen to muscles by constricting blood vessels, which increases blood pressure. Chronic high cortisol can lead to chronic high blood pressure. This can damage blood vessels and cause blockages, paving the way for a heart attack.

HPA Axis Dysfunction and Chronic Stress

Other common issues that can arise from the overexposure to stress hormones include anxiety, depression, headaches, sleep problems, and memory issues.

Long-term stress causes HPA axis dysfunction or adrenal dysfunction. This puts you at risk for adrenal fatigue, where your adrenal glands have difficulty keeping up with the body’s constant demands to keep pumping out the hormones needed. This results in many body systems shutting down and you end up feeling completely burned out.

The effects of HPA Axis Dysfunction and chronic high cortisol can include:

  • Indigestion
  • Malabsorption of nutrients
  • Gut health issues
  • Sugar cravings and increased appetite
  • Weight gain (especially around abdomen) and obesity
  • Type 2 Diabetes
  • Cardiovascular Disease
  • Metabolic Syndrome
  • Chronic inflammation
  • Suppressed immune system
  • Hypertension (high blood pressure)
  • HPA Axis Dysfunction, Adrenal Dysfunction/Burnout/Fatigue
Graphic listing signs of chronic stress and high cortisol

Low Stress Resilience – Why do some people have stronger reactions to stress?

You may have realized that some people react more strongly than others to stressful events. We all know someone who we would describe as “high-strung”. There is also the type of person who holds in all of their emotions. Finally, we may envy someone who is strangely calm when they’re under pressure.

But why is this the case? There are a few things that determine your stress resilience (your ability to react better under stress).

Genetics and Epigenetics

How we react under stress has a bit to do with genetics. People that react very strongly may have certain genes “turned on” that amp up their stress response The people who can stay relatively calm may have slightly different genes that better protect them.

Epigenetics (alterations to gene expression) in the form of gene tagging may also have an effect on how we react to stressors. For example, certain chemical compounds, like methyl groups, attached to certain genes can act as a block during gene expression. This makes it more difficult for the gene to be translated into a protein by blocking the gene, potentially altering brain signaling.

Early Life Trauma

Early life trauma also has a huge impact on how we react to stress. These traumatic events occur within the first 20 years of life while the stress systems are still developing.

These traumas can include things that aren’t even a part of your explicit memory, such as our time during infancy. Traumas can include anything that impacts you emotionally: trauma is any experience that elicits a negative emotional reaction.  Early life trauma can lead to epigenetic changes to the stress systems and to the gut-brain connection.

Gut Microbiome

Another part of our physiology that early life trauma can impact is our gut microbiota. In early life, the development of the stress response is influenced by our gut microbiota. Our gut microbiome influences the brain through the metabolites and other products they produce within our digestive tracts. This is a relatively new area of research, and we’re now finding out how the bacteria that live in our gut impact our daily lives.

Three things that can negatively affect stress resilience:

  • Genetics and epigenetics
  • Early life trauma
  • Gut microbiota or dysbiosis (imbalance in gut microbiota)

How to lower cortisol levels naturally – what you can do to tone down your stress response

Finding ways to better manage stress can lead to better health outcomes. Eliminating unnecessary stressors is always a good place to start. But some stressors in life are unavoidable and out of our control. For the stressors you can’t control, practicing stress management and using relaxation techniques are great strategies.

Sleeping well and eating healthy are both key factors that can help keep your stress levels low.

It is also important to take time for hobbies and do the things that you enjoy. This is so important for stress reduction and helps you maintain a sense of overall well being. 

Staying active is another essential way to de-stress. Exercise leads to deeper breathing, which activates the parasympathetic nervous system. Muscles loosen up, relieving tension in the body. Yoga is a great way to increase mental focus while getting your muscles moving and producing a sense of calm.

Relaxation Techniques to Repair HPA Axis Dysfunction

There are quite a few self-soothing relaxation techniques that can be used to dampen your stress responses once they are activated.

These exercises include things like deep breathing, mindfulness, and meditation. These exercises can be done when you are experiencing stress to get your parasympathetic nervous system to kick in.

The exercises can also be done throughout the day in order to train your body to stay more relaxed when stressful events do occur. Practicing relaxation techniques can repair HPA axis dysfunction, making you more resilient in the face of stress.

Woman meditating on hilltop at sunrise

Importance of a Lifestyle Overhaul

If you think you’re experiencing the effects of chronic stress, it is helpful to do a complete lifestyle overhaul to put you in a better position to deal with stress.

This lifestyle overhaul isn’t meant to add more stress to your life. It is best to start by adding just one of the things mentioned above. Find out what works best for you, and then slowly add on more stress-reducing activities or exercises.

Improving your resilience to stress is key to long-term health, and can help to prevent many negative health outcomes. When you’re feeling stressed out by things you cannot control, starting with one simple step can ultimately help you to gain more control over your response to stress.

Ways to lower cortisol naturally to Fix HPA Axis Dysfunction:

  • Yoga
  • Mindfulness
  • Meditation
  • Deep breathing exercises
  • Lifestyle overhaul

 

Are your gut health issues adding additional stress in your life? Let’s tackle that together!

Schedule a meeting today to get started on the pathway to better gut health. Let me help you can gain control in your life and stress less.

Take this quiz to evaluate your stress resilience

Woman with arms stretched up at sunrise
12Oct

Restore Gut Health Using the 5 R Protocol

There are so many different problems we can face when it comes to gut health. Constipation, diarrhea, cramping, gas, acid reflux… These uncomfortable symptoms are annoying, but they are also usually signs of a much larger problem! So how do we restore gut health?

Many of us tend to reach for short-term solutions that alleviate symptoms but do nothing to restore gut health! Addressing the root cause is the only way to guarantee better health outcomes in the long-term, but this is something that often requires a bit of guidance.

Currently, one of the best approaches to restore gut health outcomes is to utilize the 5R Protocol guided by your functional medicine dietitian.

This involves correcting the problems in the order that they occur, beginning with the neuroendocrine system (stress), to the gastrointestinal system, and then finally repairing the liver detoxification system. 

Working on the 5R Protocol for a full year is the best practice in order to see ideal results.

This means utilizing adrenal testing for stress hormone levels, organic acid testing for intestinal health, neurotransmitter activity, and detoxification demands, and additional testing, such as micronutrients, SIBO, or food sensitivity testing as needed.

These types of tests help your dietitian obtain enough information to identify the root cause of your symptoms, making them able to restore gut health.

What is the 5R Protocol?

The Institute for Functional Medicine established The 5R Protocol as a comprehensive method to address a variety of gastrointestinal (GI) issues.

This approach is effective because it addresses all aspects of gut health, improving symptoms while also tackling the root causes of dysfunction! This protocol is also individualized. It directly targets your issue based on your symptoms and your distinct needs.

Digestive health is the key to your overall health! Digestion keeps our cells healthy and functional by absorbing nutrients. Your GI tract is also home to many immune cells, so it makes sense that any disorder in the digestive tract can lead to bigger problems if the root cause isn’t sorted out.

Treating symptoms is only the tip of the iceberg. Improving gut health requires a multilayered approach to ensure outcomes that actually last.

So, what are the 5 R’s and what does each step involve?

Description of the 5 R Protocol: Remove, Replace, Reinoculate, Repair, Rebalance

Step One to Restore Gut Health: Remove

The first step of the 5R protocol is to Remove. Remove any stressors, irritants, or excess bacteria that could be causing issues in the gut.

Gut irritation can be caused by:

  • Certain foods
  • Medications
  • Infections
  • Bacterial overgrowth (like SIBO)
  • Emotional stress

This step might involve eliminating triggering foods. This could include food sensitivity testing to determine what kind of foods are causing your issues, temporarily removing a couple foods (or food groups), or following  a therapeutic elemental diet protocol. You could also take a comprehensive stool test to determine whether your issues are the result of an infection or a microbiome imbalance.

Once you determine the irritants, you will eliminate those foods from your diet altogether. If there is an infection (bacterial, parasitic, or viral), a referral to your doctor may be necessary to receive the appropriate medication. You may also be asked to follow a supplement protocol.

Chronic stress is an overarching cause of many bodily ailments. Our bodies release stress hormones (like cortisol) to help combat threatening situations. In modern society, we tend to utilize our stress response far too often.

This results in digestive issues and inflammation, among other issues such as HPA axis dysfunction (adrenal dysfunction and adrenal fatigue). Consequently, reducing your daily stress and improving your ability to remain in a calm state are vital to restore gut health.

Adrenal stress hormone testing, stool analysis, and food sensitivity testing are all extremely helpful for Step 1. 

Step Two to Restore Gut Health: Replace

Eliminating certain foods and food groups from your diet can lead to other issues, so it is meant to be only temporary.

After removing the triggers to your digestive issues, the next step involves replacing anything you are personally missing in your gut that is critical for proper digestive function. 

Depending on your condition, you may need to add digestive enzymes, support stomach acid (important for protein digestion) and bile flow (important for fat digestion), or tackle any nutrient deficiencies. 

Stool testing and microbiome analysis are helpful in Step 2. 

Step Three to Restore Gut Health: Repopulate

The next step of the 5R protocol is to reinoculate your microbiome by reintroducing and supporting beneficial bacteria through consuming probiotics and prebiotics.

Probiotics are live, beneficial microbes that we ingest through certain drinks, foods, and supplements.

While taking a probiotic supplement is convenient, there are also benefits to consuming fermented, probiotic-rich foods and drinks. These include things like kombucha, pickles, yogurt, kefir, sauerkraut, kimchi, tempeh and miso.

Prebiotics are non-digestible fibers that feed your beneficial gut bacteria, helping them to repopulate your GI tract in healthy levels.

Some foods rich in prebiotics include garlic, asparagus, onions, leafy greens, whole grains (quinoa, oats), apples, flaxseed, lentils, jicama, and chicory root. Partially hydrolyzed guar gum (PHGG) is a great option for a supplemental prebiotic fiber.

Microbiome analysis is helpful in Step 3. 

Step Four to Restore Gut Health: Repair

Now, the intestinal wall needs to be restored so you can optimize digestive function.

Leaky gut is a condition where your intestinal wall is unstable, leaking toxins, bacteria, and other large particles into your bloodstream. This can cause systemic inflammation and lead to other chronic illnesses.

Repairing the gut lining reduces this permeability and prevents harmful substances from traveling outside the digestive system. This allows for their elimination when we use the bathroom!

Consuming essential key nutrients such as zinc, glutamine, and vitamins A/C/D/E can help restore the linings of the digestive tract and promote absorption. Many of these nutrients cannot be properly utilized when your gut is out of whack.

Micronutrient testing is helpful with Step 4.

Step Five to Restore Gut Health: Rebalance

Now that you’ve set the stage for proper digestive function by improving the environment of your microbiome, the final step of the 5R protocol is to adjust your overall lifestyle.

Rebalancing your lifestyle is crucial for continued maintenance of your restored, healthy gut. Things like sleep, exercise, diet, emotional states, and stress all impact digestive function

So what kind of things can be done to improve these segments of your lifestyle?

Focus on improving the quality of your sleep by reducing blue light exposure after the sun has set. Possibly attempt a new workout regimen to ensure you get your muscles moving regularly. Eat a nutritious diet that continues to support your healthy gut.

Tune into your emotional states and practice relaxation methods.

Maybe try to practice mindfulness, yoga, and add gratitude exercises to your list of daily tasks. Be sure to reduce stress where possible and nurture your stress response to improve your stress resilience. Practice vagus nerve activation to keep your body in a parasympathetic, tranquil state instead of falling into unhealthy stress response patterns.

Summary of the 5 R Protocol

First, we must determine and eliminate the root cause of your symptoms. Then, any missing components of digestion are supplied and then fortified. Next, nourishing your gut microbiome and your gut lining should set the stage for efficient digestive function. And finally, we fine-tune our lifestyles to maintain the improvements we accomplished in the previous steps.

By now, you should understand the importance of a full lifestyle overhaul to combat your gut issues and restore gut health.

Treating the symptoms alone is usually not enough to cut it, because symptoms are the result of a larger problem.

We use the 5R Protocol to assure that your individual problems are contended with. The 5R Protocol lays the foundation for maintaining gut health by supporting your overall wellbeing.

Why not get started today to restore gut health? Schedule your appointment now to get started on your own individualized 5R Protocol!

07Aug

Substitute Chinese Forbidden Rice for a More Exotic Dish!

The Bran layer between the rice grain and the outer hull gives black rice its nutritional kick. Black rice bran inhibits histamine and can reduce inflammation due to the high antioxidant content.

Studies in animals also indicate that black rice can lower atherosclerotic plaque, raise HDL cholesterol levels and lower LDL cholesterol levels, due to the high fiber. Forbidden black rice has both water-soluble and fat-soluble antioxidants, including vitamin E and anthocyanins, which have been linked to decreased risk of heart disease and cancer.

Try this recipe for Indonesian Black Sticky Rice Pudding! It’s so tasty!!!

  • 1 1⁄4 cup of black glutinous/sticky rice • 11⁄4 cup of water
  • 4 tbsp. palm sugar, divided
  • 1 13.5oz can coconut milk
  • Pinch of salt
  • 1 vanilla bean
  • 1 1⁄2 tsp. cornstarch
  • 1⁄2 cup of dried unsweetened shredded coconut
  1. Soak rice in a large bowl and cover for 4-6 hours, then rice under cold water
  2. Add rice to sauce pan and bring to a boil, add 1 tbsp. of sugar, reduce heat and simmer until water is absorbed, remove from heat covered and rest for 10 min
  3. Bring coconut milk to a boil, add remaining sugar and salt, and reducing to a boil, then cut the vanilla bean, scrape out the seeds then add the seeds and pod to the mixture
  4. Make a dispersion of cornstarch with 1 tbsp. of cold water, then add to coconut mixture, stir on heat until thickened
  5. Toast shredded coconut separately
  6. Plate
  7. Serve!!!

07Aug

Lowering Blood Pressure with Beetroot Juice

bowl of red beets in a blue bowl with a dark background

Most people know that it is important to include vegetables in our diet due to the health benefits of high fiber, vitamins, minerals, and antioxidants.

But did you know that many vegetables, particularly red beetroots and leafy greens, are very high in dietary nitrates? What is so important about dietary nitrates?

These dietary nitrates play a cardio-protective role by lowering blood pressure, reducing the inflammation response, and improving endothelial function. The body metabolizes dietary nitrates (NO3-) by first converting it to the biologically active form (NO 2 ), and then to Nitric oxide (NO).

Nitric oxide is a vasodilator and is responsible for regulating blood flow, muscle contractions, glucose and calcium homeostasis, as well as cellular respiration in the mitochondria. Previously it was though that dietary nitrates could not influence nitric oxide production, however new research challenges that and suggests that beetroot juice has a direct relationship on lowering systolic blood pressure.

Beets are also rich in betaine, which gives it that vibrant red color and has been used in cardiovascular treatments. These high antioxidants also aid in protecting against oxidative stress in the body.

Dietary nitrate supplementation has been shown to increase athletic performance by improving oxygen efficiency, reducing the amount of Oxygen needed to perform the same amount of work. Low levels of nitric oxide has been associated with hypertension and even elevated cholesterol.

Some factors that can alter the nitrate content in vegetables include environmental factors such as humidity, amount of sunlight, and water, pesticides and the genetics of the plant.

Consumers should be cautious however, about proper storage of high nitrate containing vegetable juices. Improper storage can accumulate large amounts of bacteria that accumulate nitrite buildup, which can become harmful. High amounts of nitrite have toxic and even deadly effects, which are seen in nitrate and nitrite containing drug use, such as nitroglycerine, and amyl nitrite.

Nitrites can also form N-nitrosamines in the body, which has been found to be carcinogenic in animals, but still has yet to proven in humans. While it is still unclear what the optimal level of daily dietary nitrate consumption is, the Dietary Approaches to Stop Hypertension (DASH) diet yields 20mmol of nitrate per day.

Current research studies are showing effective improvement of athletic ability, and decreased blood pressure with just 9 mmol (0.5 L beetroot juice or 300-500mg) nitrates daily.

Including vegetables in your diet that are highest in nitrates (>250mg/100g fresh weight) such as celery, cress, chervil, lettuce, red beetroot, spinach, and arugula can improve your overall cardiovascular health. This amount can easily be achieved with 1 cup of raw spinach containing 900mg nitrate, and a half a cup of cooked collard greens containing 200mg.

Recommendations on the amount of vegetables that are optimal for your health can be found in the Dietary Guidelines for Americans and the USDA’s MyPlate website.

References:

1. Coleman, E, MA, MPH, RD, CSSD. Beetroot Juice and Dietary Nitrates. The Integrative RDN. Spring

2016;18(4)98-104

2. USDA Choose Myplate website. http://www.choosemyplate.gov/. Published 2016. Accessed August 7,

2016

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