Is stress the cause of hypothyroidism and Hashimoto’s?

Stress. We all have it. Every. Single. Day.

It’s inevitable. We can’t necessarily control how much stress comes our way but we surely can control how we perceive it, deal with it, and let it affect our lives and our health.

Over 50% of doctors visits are due to unmanaged stress.

Our brain can’t really perceive the difference between real or perceived stress. Your mind is a very powerful thing and you can stress yourself out just by the thoughts in your head. Ever have a fight with someone in your head? Do you notice how your body responds to that fight? Quite similar to how it would if the fight were actually happening. That is how powerful your brain is.

Stress disrupts homeostasis in the body which is our natural internal balance. The psychological, environmental, or physical stress we encounter causes a disruption in our body.

Someone coined the term allostasis as a way to describe how our body adapts to stress due to the numerous challenges we now face. The processes that take place physiologically are regulated through allostasis and include our body temp, blood sugar levels, blood pressure, our bodily pH, nutrient status, and our hormone balance.

Examples of this is when you sweat to cool down or shiver to get warm or fear that keeps you from falling off the edge of a cliff. A blood sugar spike due to eating something high in sugar is another example. Any of these is your body’s response to a type of stress.

Stress also can occur within your cells due to things like toxins that can damage the inner workings of the cells through things like free radicals.

There is good stress too - things like being excited to meet a new potential love, or a first day on a job, or a hard workout.

Short term or acute stress is much more manageable. It’s the long term or chronic stress that becomes an issue. Daily stress like the traffic you are in to get to and from work can lead to chronic stress but it doesn’t have to. Things like poverty, child abuse, spousal abuse, toxic relationships, poor food choices, and things of that nature are more chronic. Big life stress like a divorce or death in the family can be short term stressors but they can have a big impact on your health.

We have a healthy stress response when what happens to us doesn’t break us but increases our resilience. We learn from it and adapt accordingly. When something is chronic, our body remains in fight or flight- the stress response is turned on permanently. This is what leads to a breakdown in our health or dis-ease.

You cannot control that your body is attacking itself in autoimmune disease, but you may be able to control some of the factors causing that attack, especially the dietary ones. You can control how you see this need for a diet change. Do you tell yourself it is too hard to take gluten out of your diet or do you tell yourself it is a way to feel better and you are happy to try it and see how it goes?

You are in charge of your attitude about making diet and lifestyle changes and you are even able to control whether or not you make them. You are in control or how organized or disorganized you are, whether or not you take time to exercise or relax and whether or not you have any compassion for yourself.

You have less control over how close the nearest grocery store is or whether or not you can afford to eat or pay for the gas to get there.  Your socioeconomic life is what is called a social determinant of health. If you have little control of your income, support system, community, etc, my job is to help you figure out how to make the best out of this situation.

The goal of this episode is to help you understand how to support your brain and body when it is stressed so let’s talk about what happens in your body when you are stressed.

Your nervous system and your brain are the two main players in the stress response. When exposed to some kind of stressor- physical, emotional, or environmental the brain will activate the fight or flight response in your nervous system. Epinephrine or adrenaline and norepinephrine are released raising your blood sugar and your heart rate to give you the energy you need to fight or flee the stressor.

Very soon after, the hypothalamus, adrenals, and the pituitary gland are signaled to release their stress hormones. If they are busy doing this all the time, the signal to release thyroid hormone may be missed….  The adrenals release cortisol increasing your blood pressure, and increasing heart rate so more blood is shuttled to the muscles and away from other places. Blood also flows through the thyroid so if less blood is shuttled to the thyroid… less thyroid hormone may be circulating.

Cortisol tells your liver to make more sugar so your blood sugar also increases- if there’s too much sugar in the blood it eventually gets converted to fat and stored as such in the body. Usually your mid section.

When this happens chronically, meaning regularly or more often than not, it takes a toll on your health and wellness. You lose the ability to respond to stress in a healthy way, as it was meant to be and that fight or flight mechanism is on all the time.

Your fast paced life, horrible boss, bad relationships, poor finances, the cost of gas and groceries, the doomsday thoughts of potential nuclear war with Russia, politics, crappy diet, chemical exposure, little work-life balance- all of this play a role in chronic stress if not addressed or dealt with.

Over ¾ of chronic health conditions have a connection to our inability to deal with stress and your doctor just isn’t trained to help you with that and they don’t have the time to do it either.

Stress is not the only cause of the breakdown of your body. It is one of many factors involved. That is why whole person healthcare is so important. You cannot just put a bandaid on the stress in your life.

What happens when your blood sugar is raised in response to stress?

I mentioned it before a bit- while in fight or flight, sugar is created by the liver for energy which increases insulin. Insulin is supposed to shuttle sugar out of the blood and into the cells. The liver and muscle are resistant to insulin so the brain can use it to function better to deal with the stress response. This is supposed to happen in the event of a quick need to manage an acute stressor- something happening in the moment like a car accident.

The problem with this occurs when there is a stress response happening all day every day for months or weeks at a time. Blood sugar levels stay higher in the blood leading to insulin resistance which over time can lead to pre-diabetes or type 2 diabetes, and fat gain.

Stress aids in those cravings, overeating, and fat gain you can’t seem to control or figure out why it is happening. Add that to a slow thyroid and you’ve got weight that won’t come off!

Any kind of acute stress like a phone call that turns your world upside down or a car accident or something like that can actually suppress your appetite, the opposite is true for the chronic life type stress because it increases the hormone ghrelin that tells you you are hungry. The release of cortisol will increase ghrelin so those cravings you have may be controlled by fixing your stress response. Ghrelin also lowers your cells sensitivity to insulin aiding in that fat storage and risk of type 2 diabetes.

When adrenaline and norepinephrine are released, your blood vessels narrow and blood pressure increases so extra oxygen can be delivered to your muscles. This is supposed to stop happening after the stressor leaves. Chronic stress can cause this to happen daily leading to an increased risk of cardiovascular issue such as heart disease and stroke. In addition, the stress from childhood trauma, social isolation (think lockdowns), and marriage problems also negatively affect the cardiovascular system.

Your parasympathetic nervous system or rest and digest mode is what the body uses to recover after a stressor has diminished. It is supposed to help your body get itself back to normal function after the HPA axis was activated.

Oxytocin, the feel good hormone is also released by the parasympathetic system which causes you to seek out help or support when you are dealing with stress. It is protective of your heart and cardiovascular system and so could be thought of as an anti-inflammatory hormone. It is said to help keep your heart strong and regenerate cells there that my have been damaged by stress. Your blood vessels also relax instead of constrict when stressed.

What happens when you stay in sympathetic stress more than parasympathetic?

This is the case in chronic stress and it causes the suppression of your immune system and makes it difficult for your body to produce a healthy response to those short term stressors.  It also can cause your body to keep the stress response on even after the short term stress is gone. When this happens, body systems don’t function well creating digestive issues, endocrine problems, and more.

So many people use the analogy of running from a tiger to explain the sympathetic stress response. It is an easy one to understand so let’s think about if you had to spend an entire day, week, month or year constantly evading a tiger to keep yourself alive. You have to be on alert 24/7 in order to save yourself. This, in your brain and body, is not unlike consuming a crap diet loaded with sugar and caffeine, living in poverty, having horrible relationships, staying up half the night, getting little to no exercise and never going outside.

Just imagine a scenario where that is your life and how you might feel. You probably don’t feel very good. Real or imagined stress is the same to your brain and causes the breakdown of many body systems over time.

Weight gain. Overeating. Increased appetite. Blood sugar roller coaster ride. Poor immune system function. Inflammation. Oxidative stress. Imbalanced hormones. Poor digestion. Mental health issues. Imbalanced gut bacteria/microbiome. High blood pressure.

No breakdown in your body systems is because of one single cause. Take the example of type 2 diabetes which is extremely prevalent in the US even for people who are not overweight.  We may think the cause is over consumption of sugary foods like cakes, cookies, pop, and all the refined carbohydrates but things like poor sleep, chronic stress, toxins, no exercise, and bad gut health all can play a role in the onset of it.

Same thing goes with thyroid health. All of the things I just mentioned can contribute to hypothyroidism and Hashimoto’s.

Let’s first dive in to how chronic stress affects your blood sugar.

When the body is in high alert/sympathetic mode/fight or flight cortisol is released to give the body the energy it needs to ‘run from the tiger’ by creating sugar that will enter the blood stream. In fight or flight, cells in the liver and muscle tissue won’t accept glucose for storage so the sugar remains in the blood to be used for energy and to go directly to the brain so it can function better/make the right decisions to flee the tiger. But we don’t actually need to run from a tiger so we have all the sugar in the blood topped off by our bad diet and this leads us to insulin resistance, prediabetes and eventually type 2 diabetes as well as fat storage/weight gain.

Stress contributes to blood sugar issues.

How about appetite, cravings, and weight gain?

Acute stress will actually suppress your appetite but at some point if the stress becomes chronic, ghrelin increases your appetite which would have been for food that was more energy dense but now we gravitate towards comfort foods that are usually refined type carbs. If you can get a test for grhelin, it is an indicator for elevated stress. Stress and high cortisol create high levels of ghrelin and it is thought the increase in ghrelin is to help the body cope with stress by causing a response that is to help prevent the depression and anxiety that can come with chronic stress.

Studies show that mental stress is associated with higher weight and if you stress about your weight or see yourself as fat, you struggle the most with losing the fat. If you are dealing with chronic stress of any kind, the last thing you need to be doing is putting pressure on yourself to go on a diet, start an exercise program, and have to worry about meal prep and planning. Don’t you think that might stress you out even more?

Stress and heart health.

Chronic stress can keep your heart rate and blood pressure a bit higher. It might not be enough for you to notice at first but overtime the blood vessels will narrow enough in response to adrenaline being released which in turn causes your heart to have to beat more to pump blood through your vessels better. This can contribute to plaque forming in your vessels and more cardiovascular issues.

I’m not talking major stress here either, a study of over a half million people who reported just general stress like longer work hours had a higher risk of having heart disease or a stroke.

How does stress affect your immune system?

Chronic stress causes your body to make fewer immune cells that are going to be on the lookout for invaders. You have many immune cells but the ones who are defending your body are things like T Cells, neutrophils ( a type of white blood cell), and cytokines (the ones you heard about in response to covid) which keep pathogens, infections, and bacteria at bay are suppressed leaving you more susceptible to infections and even cancer.

Inflammation increases with chronic stress too which is supposed to happen in response by the immune system to some kind of injury or infection. It helps your body repair injury but inflammation occurring constantly over time is said to cause damage to tissues in the body leading to chronic health problems. A good example of this is when the thyroid tissue is damaged by the immune system in Hashimoto’s.

What about oxidative stress?

This type of stress causes damage to our cells with the production of free radicals. It contributes to us aging too fast and causes the development of chronic health problems. It does happen naturally as the result of chemical reactions happening in the body but it needs to be kept in balance just like everything else. Too much is harmful to our cells and that can cause tissue damage.

Things that cause oxidative stress in the body are alcohol, mold, cigarette smoke, air pollution, that charbroil on your meat, eating too much sugar, inflammation in the body. All of this contributes to autoimmune disease, cancer, type 2 diabetes, cardiovascular disease, arthritis, and more.

Free radicals are formed in grilling or cooking meat at high temps, in the production of certain oils for cooking like canola oil and when those oils are used over and over to cook things like fried foods. Think about how often the same oil is used in a restaurant to cook anything fried. How often do you think most restaurants change out their fry oils? This type of stuff contributes to oxidative stress and cell damage. Cell damage causes inflammation. Inflammation activates the immune system.

Oxidative stress doesn’t start with symptoms or signs that you would notice. Not until damage has occurred. The best thing you can do to get control over oxidative stress is to eat real food. Lots and lots of colorful fruits and veggies, legumes, nuts, seeds, etc.

What about your digestion and gut health?

Chronic stress contributes to a change in the bugs in your gut, causes leaky gut, slow motility and can result in IBS and other GI tract disorders. That stress in the body shuttles blood away from your GI tract which is what causes things to move slower through your gut and can cause constipation and/or diarrhea. Changes in the microbiome will cause inflammation, an increase in bad gut bacteria and leaky gut.

Other things affected by chronic stress are fertility, bone loss, mental health issues like anxiety, depression and eating disorders.

Chronic stress is not our friend. We must get a handle on it if we want to be healthy, live well and long with a high quality of life. It’s time to get clear about your health.