There is a direct connection between stress and the development of autoimmune disease. These links happen at the hormonal level, through cortisol imbalance, in the gut, and also at the genetic/epigenetic level. Read on to find out more and what you can do about it.
Part 2 of Dr. Doni’s Series on Autoimmune Diseases
Many of us have experienced how bad it can feel when worries, anxieties, and traumas go on for days, months, and even years. Sleepless nights, digestive issues, and up and down hormones definitely are part of the equation. But did you know that there is a direct connection between stress and the development of autoimmune conditions? In this article, I’ll dive into how stress can directly affect the immune system, including at the genetic level.
Research Shows a Direct Link Between Stress, Cortisol, and Autoimmune Conditions
First, let’s see what science says about the connection between stress and autoimmunity in general. According to a 2009 report put out by Stanford University, there is a direct link between stress and “asthma, and allergic, autoimmune and inflammatory diseases…”.1
In addition, an investigation conducted by the New York Academy of Medicine on close to 2,500 veterans found a link between Post Traumatic Stress Disorder (PTSD), dysregulation in the HPA axis, and autoimmunity.2
A Swedish survey sent to one million citizens also found a link between ongoing stressful life events and the onset of Grave’s Disease, which is an autoimmune condition that affects the thyroid.3
And a 2017 Italian investigation published in the journal Current Pharmaceutical Design found that emotional disorders, especially anxiety and depression, tend to be more prevalent in those with Crohn’s Disease as well as in those with Irritable Bowel Syndrome and Ulcerative Colitis.4 The common denominator, according to the researchers, is the way in which stress affects the “gut-brain axis.”
The stress-cortisol-autoimmune connection is an area that many immunological studies have been focusing on for the last decade. One review of current literature conducted by researchers at the University of Kentucky found a correlation between trauma experienced in childhood and autoimmune responses.5
The link between stress and immunity is pretty well established in research studies. The connection may not seem obvious at first, however, until you understand the effects of cortisol, our main stress hormone.
Cortisol and Autoimmune Disease
More than likely, you have heard of cortisol as the primary “stress hormone” in the body. For all the basics about cortisol and stress, be sure to check out this article.
What a lot of people don’t know is that cortisol plays a vital role in dozens of everyday functions, including in the immune system. Even when we are not facing a stressful situation, the body naturally makes cortisol in varying amounts throughout the day. When it is in the right amounts at the right times of day, cortisol contributes to healthy metabolism, digestion, inflammatory response, hormonal balance, and more.
Cortisol is produced by the adrenal glands after receiving a signal from the brain via the Hypothalamus-Pituitary-Adrenal (HPA) axis. The HPA axis is stimulated by stress, causing an increase in cortisol production, or in some cases, a decrease in cortisol, depending on your genetics and the extent of the stress exposure.6 Cortisol is responsible for communicating with neurotransmitters and all hormones in the body as well as the digestive system and the immune system. When cortisol is too high or too low for a particular time of day, it can potentially disrupt all of these systems.
Research conducted at the University of Michigan found a significant connection between HPA axis dysregulation and rheumatic autoimmunity.7 Two examples of rheumatic autoimmune conditions are rheumatoid arthritis and fibromyalgia.
We also know from studies that cortisol imbalances cause a change in gene expression which can turn on a tendency toward autoimmunity. Let’s look at these main links between stress and autoimmunity in more depth.
Stress Can Shift Gene Expressions That Lead to Autoimmunity
Stress affects us on many levels, including at the level of genetic expression.
To discover how this happens, we have to look at a part of our genetic makeup called the Major Histocompatibility Complex (MHC). Another name for the MHC is the Human Leukocyte Antigen System, or HLA. This is a specific part of your genetic blueprint which codes for proteins having to do with the immune system.
HLA codes help your immune system tell the difference between “self” and “non-self.” With this information, your immune system determines which substances belong in the body and which pose a threat and need to be removed.
When stress runs amok and cortisol levels go haywire, this can shift the genetic expression of HLA genes. The result is miscommunication and confusion by the immune system. It loses the ability to know self from non-self and ends up attacking healthy cells as if they are harmful.
Research studies have even isolated specific areas of the HLA genes (called alleles) associated with specific autoimmune conditions. Having a specific gene variation predisposes you to the corresponding autoimmune condition. Stress exposure is what turns on the gene that codes for the condition.
Here is a listing of a few common autoimmune conditions and their corresponding HLA activations8:
[Note: the HLA name indicates a particular gene and the number after the asterisk, when there is one, represents specific alleles and allele variants associated with the condition]
- Psoriasis, HLA-C*06:02
- Multiple sclerosis, HLA-DR2
- Rheumatoid arthritis, HLA-DR4
- Thyroiditis, HLA-A24
- Polyglandular, HLA-A3
- Type 1 diabetes mellitus, HLA-DQ2 and HLA-DQ8
Knowing your propensities can help you target your healing and prevention efforts. I, for example, have genetic variations that predispose me to rheumatoid arthritis and Crohn’s disease.
No matter what your genes are, the key to reversing autoimmunity and turning off the gene expression is recovery from stress. This is how we can use epigenetics to our benefit. I have 3 starting tips for you in this article. First, however, let’s look at the other ways stress leads to autoimmunity.
How the Effects of Stress Trigger Autoimmune Conditions
Stress’s ability to cause autoimmunity doesn’t just end at genetic expression. Because cortisol plays such a major role in so many functions in the body, the ways in which cortisol imbalance can create autoimmunity can also come indirectly by affecting other systems.
In fact, as I talk about in my book The Stress Remedy, stress can disrupt the healthy functioning of 4 distinct systems in the body. Each disruption can pave the way for autoimmunity to occur:
#1 The Immune System
As I talked about in this article, when the immune system is confused and starts trying to protect you from yourself, it can lead to tissue damage and inflammation in various areas of the body (specific to the type of autoimmune disease).
In addition to the genetic expression related to immunity that is triggered by stress, studies also indicate that stress also increases the likelihood of imbalanced immune responses, which lead to the production of cytokines that are inflammatory.
For this reason, people with autoimmunity are also more likely to experience infections, histamine reactions, and allergies as well as cancer.9
The majority of your immune system is in your gut, so any stressor that disrupts your ability to digest food, causes damage to the cells that line the intestines, or throws off the delicate balance of healthy to pathogenic bacteria has the potential to disrupt your immune system too.
When the cells of the intestines are not as healthy as they could be, it is referred to as Leaky Gut. And Leaky Gut has been strongly associated with autoimmunity. Studies have shown that Leaky Gut, autoimmunity, and food sensitivities, especially to gluten, were shown to be related.10
Stress also causes a disruption in the microbiome, leading to an overgrowth in certain bacteria that are known to produce toxins (lipopolysaccharides) which trigger autoimmunity.
A mice model study conducted in 2019 at Bar Ilan University in Israel found that social stress was a key factor in changing the composition of gut bacteria. This change in turn led to an immune system imbalance associated with autoimmunity.11
We will be talking in-depth about the Leaky Gut-Autoimmunity connection in the next article in this series.
#3 The Nervous System
Stress can affect key neurotransmitters and cause them to be depleted. Serotonin and GABA, for example, are two calming neurotransmitters – what I refer to as our “buffers to stress.” Without enough of them, we become more vulnerable to the negative effects of stress.
Stress can lead to imbalanced hormone production and utilization, including those vital for reproductive health, metabolism, and “rest and repair” during sleep. Some of the hormones that can be disrupted by stress include thyroid hormones as well as insulin, estrogen, and melatonin.
Stress (of all types), and cortisol in particular, can decrease the production of our hormones. When hormones become imbalanced, inflammation levels rise, immune system dysregulation begins and toxins are not able to be dealt with and dispelled properly.
For example, stress can cause a decrease in melatonin, which is produced by the pineal gland when we are exposed to darkness. Without enough melatonin, you can experience a change in sleep patterns and your ability to “rest and repair” at night may be diminished.
Studies have shown that skewed sleep patterns are connected to autoimmune conditions. In fact, new research conducted at the University of Georgia has made the connection between people with the sleep-related disorder called sleep apnea and a higher rate of autoimmune disorders.12
Also: Oxidative Stress
In addition to the 4 main systems affected by stress, it’s important to consider how stress and cortisol increase oxidative stress.
For example, a 2020 study found that a common characteristic of those with autoimmune conditions is the breakdown of tissues and organs which can lead to higher levels of oxidative stress on an already taxed and confused immune and detoxification systems. This sets up a vicious cycle where increasing oxidative stress continues to exacerbate the autoimmune condition itself.13
A good test to determine if oxidative stress is affecting you is called Urinary 8-OHdG. If 8-OHdG is elevated, it is associated with an increased risk of autoimmunity, as well as other conditions such as cancer, atherosclerosis, and diabetes.14 It’s included in the DUTCH panel, which also allows us to measure cortisol at different times of day, estrogen, progesterone, testosterone, melatonin, and DHEA. We offer this panel through my office – reach out for more information.
C.A.R.E. for Your Immune System and Heal Chronic Stress & Autoimmunity Now!
I totally get it that having to deal with chronic stress as well as the looming specter of an autoimmune condition can be overwhelming. Believe me, I’ve been there!
You don’t have to suffer any longer, however. There is so much you can do to make a difference and turn your health around.
Empowering you on the journey to reverse autoimmunity is one of the reasons why I created the C.A.R.E. Method™! C.A.R.E. stands for Clean Eating ( C ), Adequate Sleep ( A ), Stress Recovery ( R ), and Exercise ( E ).
Stressors to your body system – both external and internal – are going to happen. We can’t avoid them. But what we can do is have some “go-to” strategies at the ready for when they do occur.
Here are 3 activities that are easy and take little time, but have proven to be extremely effective at resetting the stress response and balancing cortisol levels:
#1 Take 3 deep breaths.
The direct link between deep breathing and major healing was established almost fifty years ago. Dr. Herbert Benson of Harvard University paved the way through his research into what deep breathing did for the relaxation response and healing in general.15
To practice deep breathing, first take a deep inbreath. Next, slowly breathe out for twice as long as you breathe in to signify to your nervous system that there is no crisis. This kind of breathing also massages the vagus nerve so be sure to do more than just 3 if you have the time.
#2 Refocus your energy.
Have you ever noticed that when you focus on any physical pain you may be having, it seems to get worse? The same goes for emotional and mental “pain” or stressors as well. In the middle of a stressful moment (and optimally its best to practice this when you’re not stressed too) – close your eyes and focus internally for just a few minutes, and let go of whatever is going on externally. Don’t worry, you’ll be better able to deal with what is going on when you “return.”
Next, put your hands over your heart and take a few of those deep breaths. Think of something or someone in your life that you feel gratitude and/or love for – perhaps a family member, pet or experience that fills your heart.
Refocusing your attention in this way, even for a few moments, can shift your energy as well. It will calm the “pain” of the stress as well as reset your HPA axis and autonomic nervous system (fight or flight).
Best of all, refocusing will allow you to come up with creative solutions to whatever is going on. According to research conducted at the University of Montreal and Columbia University, ongoing stress is neurotoxic and can lower the size of the frontal cortex.16 The frontal cortex is the part of the brain primarily responsible for logic and reasoning.
#3 Put a regular stress reduction practice into place.
Even when you are not facing an outright crisis, you can still practice stress recovery. In fact, this is the best time to do it! And it doesn’t have to just be about sitting still in meditation either (although meditation is one the best ways to reset from stress). People all over the world are rebalancing their cortisol levels and genetic expression by spending time in nature, finding ways to have a good laugh (or practicing laughter yoga), doing tai chi, and listening to calming music.
Make a commitment to a change of lifestyle, not just a change of habit. Live a life where stress does not control you, but where you are in control of your stress responses by practicing stress recovery every day.
Take C.A.R.E. of your immune system and your stress levels and you will begin to see balanced energy enter your life again. It truly is the first step on your journey towards healing autoimmunity and all disease.
The 7-Day Stress Reset includes support for integrating self-C.A.R.E. with daily tips by email and video – and a gluten-free, dairy-free meal plan along with a convenient grocery shopping list based on that meal plan.
15th June 2021
- Enhancing versus suppressive effects of stress on immune function: implications for immunoprotection and immunopathology
- Posttraumatic stress disorder and physical illness: results from clinical and epidemiologic studies
- Stressful life events and Graves’ disease
- The Role of Stress in Inflammatory Bowel Diseases
- Current Directions in Stress and Human Immune Function
- Stress and the HPA Axis
- The hypothalamic-pituitary-adrenal axis in the pathogenesis of rheumatic diseases
- Human Leukocyte Antigen (HLA) System
- Infections and autoimmune diseases
- Food intolerance in patients with manifest autoimmunity. Observational study
- Could gut bacteria explain the link between stress and autoimmune disease?
- Study explores sleep apnea, autoimmune disease link
- Oxidative Stress in Autoimmune Diseases: An Under Dealt Malice
- Urinary 8-OHdG: a marker of oxidative stress to DNA and a risk factor for cancer, atherosclerosis and diabetics
- Relaxation techniques: Breath control helps quell errant stress response
- The effects of chronic stress on the human brain: From neurotoxicity, to vulnerability, to opportunity