“The cause of autoimmune disease is unknown.”
That’s one of the first answers that comes up when searching the internet for the causes of autoimmune disease.
And maybe that’s what your doctor told you when you asked her what caused your autoimmune disease.
While it’s true that we don’t know for certain what causes certain people to develop autoimmune disease, there is evidence to support several different potential triggers that, along with genetic susceptibility, can influence the development of autoimmune disease.
One of the most pervasive yet “controllable” causes is chronic stress.
Stress is typically defined as “a state of mental or emotional strain or tension resulting from adverse or very demanding circumstances.” However, scientists have a hard time defining what can be considered stress, because it is a highly subjective experience and when we think of stress we typically are thinking of distress, rather than simply the body’s response to a demand for change. Some people actually perform better or experience improved health when exposed to appropriate stress, for example when exercising or under some level of pressure to perform at work that leads to increased motivation.
For the purposes of this article, I’ll be speaking about stress in the way that we all think about it: as a chronic negative mental, physical, or emotional experience that causes negative health effects in those who are experiencing it.
The primary way the stress of our modern lifestyles causes harm to our physical bodies is through dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis. The HPA axis controls our bodies’ response to external stressors, also known as the “fight or flight” response.
However, in chronic stress, the HPA axis can be over or under-stimulated, and the body is unable to respond with appropriate physiological adaptation. For a great primer on how stress affects our HPA axis, I recommend downloading our free eBook on adrenal fatigue.
How Chronic Stress Affects Your Autoimmune Disease Risk
Chronic stress has been blamed for everything from heart disease, to cancer, to infertility, and even obesity. The more we learn about stress, the more we understand how important it is to manage well so that we reduce our risk of chronic disease in the future.
Autoimmune disease is another class of disease that has been studied for it’s relationship to chronic stress. Impaired HPA axis responsiveness has been shown to influence a number of human inflammatory and autoimmune diseases, including rheumatoid arthritis, inflammatory bowel disease (i.e. Crohn’s disease and colitis), multiple sclerosis, Sjogren’s syndrome, Graves’ or Hashimoto’s thyroiditis, asthma, and dermatitis.
Many retrospective studies have found that up to 80% of patients report uncommon emotional stress before their disease presents, and the stress of having the disease is known to cause disease exacerbation; it’s a vicious cycle.
One theory for this increased risk of inflammatory disease is that chronic stress results in glucocorticoid receptor resistance (GCR), resulting in failure to down-regulate inflammatory response. In other words, chronically elevated cortisol causes “cortisol resistance” and impairs the body’s ability to control inflammation, so inflammatory diseases develop.
This is why levels of cortisol tend to be low in patients with autoimmune disease, despite the higher levels of systemic inflammation.
Stress and HPA axis dysregulation has been frequently studied as a trigger for rheumatoid arthritis, an autoimmune disease that affects over 1.5 million US adults and is more common in women than men. Both daily minor stressors and major traumatic life events have been found to affect disease risk and progression, yet mild daily stressors are considered to be a greater risk factor as they are more able to lead to cortisol resistance and uncontrolled inflammation.
Studies have also shown significant HPA axis involvement in multiple sclerosis, with both hyper- and hypoactivity of the HPA axis being seen in patients with severe symptoms. According to research, the HPA axis is generally activated in MS, but patients with a hypoactive HPA axis have particularly severe MS and more active lesions. This impaired activity can also increase an MS patient’s risk of depression.
Adrenal stress and HPA axis dysregulation impacts not only the development of autoimmune thyroid diseases like Hashimoto’s and Graves’, but can also imitate hypothyroidism thanks to its effects on conversion of T4 to T3, reduction in TSH, and suppression thyroid receptor site sensitivity, among other effects. (Check out Chris Kresser’s excellent overview of how adrenal stress affects your thyroid health.)
Chronic HPA axis activation can also cause a shift in the balance between Th1 and Th2 cytokines, which can cause a multitude of inflammatory and autoimmune conditions depending on an individual’s particular dominance of either type of cytokine. This effect of stress has been demonstrated in mice, and while certain compounds can help resolve the imbalance between the two cytokines, it’s clear that without prioritizing attention to stress management, the problem will likely not resolve.
How To Reduce Stress In Your Life
I hope you all understand why managing stress is so important in preventing and managing autoimmune disease. If you have an autoimmune disease, reducing stress in your life may help ameliorate some of your symptoms, or prevent progression of the disease.
If you have family members with autoimmune disease, start focusing on stress management now so that you’ll reduce your risk of triggering autoimmune disease in the future.
To help get you started on healing your HPA axis and adrenal function, here are five ways to reduce stress in your life:
1. Eat a Healing Diet
Recommending a diet for autoimmune disease would take a whole book. But the best basic advice I can give you is to eat a real foods diet, preferably gluten-free, and consider diving into the autoimmune elimination protocol.
And remember, simply eliminating foods is not enough to heal you from HPA axis dysregulation and autoimmune disease. You need to make sure you’re eating nutrient dense meals with adequate amounts of calories, fat, protein, and carbohydrates to provide your body the nutrition it needs to heal and keep stress low. Under-eating is a stressor in itself, and can stall your progress in healing. Check out our free eBook on adrenal fatigue for more specific diet recommendations.
2. Engage in Mind-Body Activities
Regular stress management is something that all of us could do a little bit more of. In our modern world, we’re under stressors that even our parents and grandparents may not have experienced. 24 hour news programs, laptops and smartphones in the bedroom, and pressure to live a Pinterest-perfect lifestyle are all new pressures that have been added on to the standard bill paying and social interactions of the past.
That’s why engaging in mind-body practices is even more important these days. These practices include things like meditation, yoga, breathing exercises, and tai chi or qigong. Research has shown that regular meditation is able to help people feel calmer and produces positive changes in various areas of the brain, particularly in the areas associated with memory, empathy, sense of self, and stress regulation.
The good news is it only took 8 weeks for participants in this study to see these results, so consider committing to a program of regular mind-body practices for that time. You might be surprised to see how much your mental, emotional, and physical health improves.
3. Exercise Appropriately
Exercise can be a double edged sword when dealing with HPA axis issues. While regular moderate exercise can help reduce stress, lift depression, and even improve your HPA axis’s response speed, over-exercise (also called overtraining) can actually impair your HPA axis function, causing systemic inflammation, immune dysfunction, and increased risk of depression or anxiety and other mental health issues.
I can’t tell you what an appropriate amount of exercise for you is, because every person has different levels of tolerance when it comes to physical activity. And for someone with adrenal fatigue or autoimmune disease, overexercise could be even more dangerous than not exercising enough.
Err on the side of caution, and avoid any heavy duty training regimens like long distance running, or Crossfit and other bootcamp-style workouts. Stick to exercises that energize you and be sure to get adequate rest. Listen to your body above all! For more information about appropriate exercise for adrenal fatigue, download our free eBook.
4. Sleep Well
Sleep has a profound impact on your HPA axis. Sleep restriction has been shown to activate the HPA axis and alters the production of ACTH and cortisol. Considering that 30% of Americans get less than 6 hours of sleep per night, it’s obviously a huge problem.
In addition, there is a strong connection between your body’s clock system and the HPA axis at multiple levels. The clock system, driven by light and dark exposure, controls the HPA axis; this is the basis for the circadian release of cortisol, which reach their highest concentrations early in the morning and their lowest concentrations late at night. If your circadian rhythms are disrupted, your cortisol rhythm will be as well, so getting adequate sleep at appropriate hours is crucial for HPA axis health.
Sleep in a cool, pitch-dark room, and limit exposure to light emitting devices when the sun goes down. Try to get some light exposure during the day, particularly when you first wake up and at mid-day. Aim for 7-9 hours of sleep per night, every night. For more tips on sleeping well, download our free eBook.
5. Build Social Connection
Having a healthy social life is more important to adrenal health and autoimmunity than you might realize. Research shows that a good social support network has many physical and mental health benefits. Having strong social connection can keep you from feeling lonely, isolated or inadequate, allowing you to deal with stress better.
Make sure you have at least a few deep relationships in your life. If you don’t consider ways to cultivate new friendships. If you have your own family, focus on strengthening those relationships and try to address any negative interactions that are happening regularly. Get out of your house and find a community of like-minded people to get involved with.
I’ve personally done this by joining a small group of Christians that I see on a weekly basis, and you can pick any type of common interest group to look into.
Check out our free eBook on adrenal fatigue for more tips on building social connection.