The most overlooked aspect of blood sugar balance is STRESS.
Do I Have Stress?
Whether stress is emotional, physical, chemical, or even spiritual, the hormonal onslaught to the body is the same.
To the body...stress is stress, no matter if someone pulls out in front of you during your morning commute to work, or whether you eat a sandwich and silently react to the gluten found in the bread.
Stress can also have a negative effect on the regulation of your blood sugar. In fact, stress is tightly woven with blood sugar control, and it’s an area that I feel most doctors fail to address.
Beyond recommending sleep, meditation, and “taking it easy”, as well as prescribing drugs such as anti-depressants and sleep aids, many doctors are not offering practical advice for stress relief that incorporates diet, vitamins and herbs, as well as consideration for the specific circumstances of your individual life.
To many health professionals, “stress” is just an unavoidable aspect of our lives, and unfortunately, it becomes a neglected aspect of care.
In cases of insulin resistance, metabolic syndrome, and diabetes, clinical focus shifts to more “narrow” & measurable goals such as keeping sugar and lipids (cholesterol, HDL, LDL, Triglycerides) within “normal” laboratory ranges, and screening for serious complications (nerve damage, kidney/liver function, etc).
Contributing factors such as stress, muscle pain, digestive function, and general quality of life issues take a backseat to the medical management of more serious diagnoses.
In this Three-Part Article:
1.) This Article quickly reviews some of the effects of stress on the body
2.) Part II discusses basics regarding the diagnosis and progression of early blood sugar imbalances to diabetes.
2.) Part III connects why stress plays a crucial role in diabetes care.
Stress and Physical Health:
Cortisol, the primary stress hormone, naturally fluctuates throughout the day. It is normally high in the morning and tapers off through the day until nighttime.
The reason that cortisol naturally rises over night is that it helps stimulate sugar production so that our cells can fuel body processes overnight (when we’re not eating anything for 8 hours).
Cortisol will also rises after intense exercise as it has some anti-inflammatory properties, and helps meet the high demand for glucose during intense activity.
In general, cortisol prepares our body for fight or flight, and it becomes less concerned with regards to fighting off infections, scavenging for cancer cells, or digesting food properly - but more concerned about fueling major body processes and getting you quickly out of danger.
There are some benefits to cortisol but different forms of stress will similarly disrupt healthy cortisol rhythm and balance in the body, especially when high levels are chronic.
Over time, disturbances in cortisol production can affect:
- sleep patterns (difficulty falling asleep or staying asleep)
- immune health
- gut integrity
- liver health
- cardiovascular health, inflammation and oxidative stress
- thyroid health
- bone production
- brain health & mood
- kidney dysfunction
- sex hormone metabolism
- and you may have guessed it - insulin sensitivity!
It is safe to say that chronically elevated levels of stress can have a detrimental effect on just about every tissue and system in the human body (1)!
Cortisol is actually a weak steroid, and so many of the long-term side effects of high cortisol are similar to some of the shorter time effects of “stronger” steroid drugs such as prednisone.
Concerns with glucocorticoid/steroid therapy include (and are not limited to):
- insulin insensitivity
- weight gain
- increased risk of fractures
- immune system suppression
- poor absorption of a high number of vitamins and minerals.
Possible drug side effects and interactions should be considered if you are taking any medications. As it is outside of my clinical expertise to discuss whether to take a drug or not to take a drug, please talk with your primary care doctor about potential side effects of your medications and how it relates to symptoms you may be experiencing.
In part II: I will look at the criteria for diabetes diagnosis and how diabetes progresses from minor insulin resistance to full blown diabetes.
In part III: I will explore how stress aggravates the diabetic state, and how it can be both a contributing cause and an indirect effect of uncontrolled diabetes!
Failing to address stress can make blood sugar extremely difficult to manage.