Dr. Doni was interviewed by Corinna Bellizzi on the Nutrition Without Compromise Podcast Presented by Örlö. You can listen to the episode here or in your favorite pod player.
Stress is like a termite that slowly eats away your tree of life. How can you master your stress? In this interview we talk about the different types of stress and strategies to overcome health challenges caused by stress. We also talk about why understanding how your stress system works is essential to recover from stress exposure and the nutrition humans need for different stress types.
Key takeaways from this episode:
- What are the different stress types
- Highlights from my book, Master Your Stress, Reset Your Health
- How to overcome stress
- Tools that can help with the stress response
- Nutrition our body needs to deal with stress
Here’s a point-blank question: Is stress the root cause of migraines?
Yes. The thing is that I look at it as no matter what health issue we’re looking at, whether migraines, autoimmunity, or anything, we know that it’s a combination of genetics and stress exposure. It always comes down to that because stress is not just psycho-emotional stress. I’m referring to stress as also infections as stress, toxins as stress, and lack of sleep as stress. Anything that’s happening in our environment that’s not healthy for our bodies is stress.
Genetics is the other piece. While researching genetics, I found that genetics plays very much less of a role than we would think. We used to think that genetics was 100% of the determiner of our health, and now we know that genetics is less than 10% of the determinant of the health outcome that we’re experiencing. Genetics does play a role, but what’s also so interesting is what turns on our genetic predispositions is stress. It’s right back to stress again. If you say to me, “What’s the main cause of any health issue?” I’m going to say it’s mostly stress. There’s only a small percentage of it that’s genetics.
What is the role of the adrenal glands themselves as it relates to stress and then how cortisol comes into play?
That’s the thing. When people hear that so much of our health is determined by our different stress exposures, sometimes then, we almost throw in the towel and give up. I’m hoping that your audiences are getting the message. This isn’t about giving up, and it isn’t about trying to have zero stress, either. There are certain stresses that are stress that we want. We’re not saying that we’re trying to get to zero stress, and we’re not saying you have no chance here up against stress.
We’re saying there’s so much we can do to help you recover from stress exposure that it’s worth putting your attention there. Understanding how stress affects us is the beginning of that. No matter what I’m trying to solve in my daily life, if I first understand the problem, then I’m much more likely to be able to solve the problem. Understand how our stress system works. We have a built-in stress system as humans. It’s built-in. We don’t have to get one at the store, but part of our stress system is what we think of as a fight or flight system that’s known as this sympathetic nervous system.
Let’s say the alarm goes off, and you feel your heart racing. That’s the sympathetic nervous system or a fight or flight system making adrenaline to get you out of danger. We need to have a healthy ability to protect ourselves and get out of danger. The second step of that stress response is when the brain sends a signal to the adrenal glands, which you mentioned. The adrenal glands make more adrenaline, and they also make our main stress hormone called cortisol.
We have a stress signal going throughout every part of our body. Every cell gets the memo, “There’s a stress happening.” They get the memo from the adrenaline and the cortisol. This is a good response if there’s acute stress happening and you need to get out of danger. The problem is that it should turn off but in our modern lives, we’re having so many stresses constantly that the off signal stops working. We end up in a constant stress response. It’s in that constant stress response that we have a more individualized outcome. The cortisol and adrenaline levels at that point look different for you than for me.
How do we emphasize stress recovery? How do we help reset that stress response?
Ultimately, what’s considered optimal health associated with longevity for humans is when we can turn on and off our stress response. It shows up in the heart rate variability. You’ve spoken about that. Some people are aware of the ability. With a device, you can measure slight variations in your heart rate. Those variations in heart rate are associated with the ability to respond and recover from stress.
To your question, how do we help our bodies? How do we build that muscle of the recovery response? It comes back to some things that might seem way too simple, including taking a deep breath. Sometimes we hear that if someone is stressed, someone will say, “Take a breath.” It almost annoys the person more. Anyone listening could try it. When you take a deep breath, you are signaling to the opposite part of your nervous system from the fight or flight. You’re signaling to the parasympathetic nervous system and the vagus nerve, which communicates the anti-stress signal throughout your whole body simply by taking a couple of deep breaths.
Sometimes it’s a matter of becoming more aware of when the stress response is happening and reminding ourselves, “Maybe I need to take a couple of minutes and take a couple of deep breaths.” It’s what you said about animals. They shake it off, even the dog. My dog barks. When whatever she’s barking about is done, then she shakes. We need to move, shake, take a walk, or get out in nature. This is where we even can go into things like mindfulness, meditation, breathwork, and music. There are so many tools that we know help to reset and teach our bodies, “This is how you reset from stress.”
What is the role that sleep plays in this whole system?
I finally realized it for myself because I was also brought up to get lots done. We have a long to-do list. There’s so much to do. We need more hours in the day. We start stealing from our sleep hours to get more of our to-do list done. With that, we’re assuming that we’re doing nothing while we’re sleeping. We’re like, “If I’m sleeping, I’m inactive. Nothing on my to-do list is getting done.” What I started realizing the more research I read about sleep is that there’s a whole lot of stuff getting done while we sleep.
When I remind myself of that, then it shifts the game completely. I’m like, “I need to get myself in bed and get to sleep because my body has a whole long to-do list of things to do while I’m sleeping.” There are all kinds of glymphatic brain cleanout and memory generation, let alone all kinds of autophagy, cellular cleanout, and repair that happens while we’re sleeping. It becomes more of a priority. Once we see it as a priority, then we start to shift our daily routine to appropriately give it the time it needs.
What about the circadian rhythm of people that live in Northern latitudes like Alaska?
Some of us who are in winter darkness a lot of the time end up putting lights on. We have this artificial light at all different hours. We’re working the night shift or traveling and changing time zones. There are so many ways that we, as humans, can scramble our circadian rhythm. It’s about realizing we’re living in human bodies that are so responsive to nature and the fact that we live on Earth that does have a natural dark and lightness cycle. If we lose touch with that, it’s going to throw off a lot of different systems in our bodies.
What I recommend is no matter where you are in light and darkness, look at your daily schedule and make a plan. Set it on your phone or whatever reminder you need to have. Make a bedtime routine alarm. That’s what I do. I was like, “At 9:00 PM, I need to be turning down the lights or maybe even earlier at 8:00 PM if I can.” If it’s light out, turn out the lights. Maybe you need to get blackout curtains if it’s still light outside. Create as much darkness as you can in your space and at least in your bedroom so that you can give your brain the perception of darkness.
Luckily, there are now a lot of ways that we can do that. It’s the same thing with light, though. When we wake up in the morning, we need to give our brains a perception of light exposure, whether we go outside or put on some light. There are a lot of lights that are made to help people with Seasonal Affective Disorder so that they get light exposure in the daytime. There are ways that we can help to say, “Here’s the light when my brain needs to perceive light and darkness. Let’s create that in our daily routine.”
What other nutrition perspectives can help us get better sleep and reduce our stress?
I always think it’s cool to think that even if you’re laying in bed and your eyes are closed, but the room is dark, our brains are able to pick up on that darkness and stimulate melatonin production. That’s one of the key things why you want darkness. I even try to put out and cover any little lights in the bedroom. You don’t want any light. You want your brain to perceive darkness when you’re sleeping so the melatonin is released. Melatonin is made from serotonin, and serotonin is mostly made in our gut or our digestion. Serotonin is made from the amino acid 5-HTP, which comes from tryptophan.
I bring it all the way back to protein in your diet. I find that so many people are not getting enough protein in their diet, and they’re not realizing it. If we’re not getting enough protein, we’re not getting enough amino acids. Those amino acids are not only important for muscle building. They’re also important for liver detoxification. They’re essential for making neurotransmitters like serotonin, which converts to melatonin. You start to go, “My sleep is impacted by what I’m eating during the day, and not only that, but how well I’m digesting that food and how well I’m absorbing those nutrients.”
Can you expect a certain level of tryptophan to be in most animal-based proteins? What about the plant-based ones themselves?
Animal-based proteins tend to have a good array of essential amino acids. We usually think of turkey as particularly high in tryptophan, but there is tryptophan in other animal proteins as well. This is one of the things. There’s research on the benefits of having a plant-based diet, but there are also challenges like anything. This is why I always say, “There’s such a thing as too much of a good thing.” A plant-based diet is great because it’s bringing us back to awareness of getting whole fruits and vegetables from nature versus relying on processed foods and fast food.
I look at a plant-based diet in contrast to going to fast food restaurants and living on hamburgers and cheeseburgers. That’s the contrast but then what I’m doing is I’m looking at a 100% plant-based diet, which I do for certain periods of time every year, I follow a plant-based diet. It’s that I also want to be aware that on a plant-based diet, it can be harder to get enough amino acids in the protein. It can also be harder to get enough iron, B12, and folate. We need to be aware that if we’re going to choose a diet that’s a little bit more extreme, how do we still make sure we’re getting adequate nutrition?
That’s such a critical point. To bring it right back to tryptophan, there isn’t a plant-based source of tryptophan.
I can’t say, “Eat this.” Most of my patients are fully plant-based. I measure neurotransmitter levels. I see when my patients have low serotonin levels. I recommend a supplement of 5-HTP because then you can get the precursor nutrient 5-HTP, and your body can then make more serotonin directly from it. To me, that’s a recovery tactic. I’m seeing there’s low serotonin in phase one of my stress recovery protocol. Let’s address that deficiency. This is anemia of neurotransmitters.
Let’s address it and use 5-HTP to get the levels back to optimal, but at the same time, we want to help your body and your diet so that you are getting more amino acids in your diet. You’re able to digest that protein and absorb those nutrients without triggering inflammation from a leaky gut, and the gut bacteria are balanced so that your gut is a healthy producer of neurotransmitters for you. You’re not going to become deficient again.
Women are still told all the time, “If you’re pregnant you need to be taking folic acid or a supplement that has folic acid in it.” Help us understand this issue.
I talk about this in the Master Your Stress book because I feel so strongly about it too. If a supplement company is going to make a multi or a B complex or put B vitamins in, that’s a measure of quality. I’m immediately looking. Do they have methyl folate and methylcobalamin or methyl B12? I know that the company is paying attention to providing active nutrients that the majority of people are going to be able to use versus the companies that are using low-quality and less expensive nutrients that some of their consumers are not even going to benefit from. That’s a quick check for any of you, “Is it methyl folate and methyl B12 on my multi and B complex?”
The reason is that these are the active forms of these nutrients. Even if we start with the fact that our body uses B vitamins in so many ways, sometimes you’ve heard about that. When we’re under stress, people will say, “I’m under stress. I probably need more B vitamins.” That’s correct because we burn through our B vitamins so much faster when we’re under stress. That’s because the B vitamins are used to make adrenaline, break down adrenaline, make serotonin, break down serotonin, protect our cells and DNA, make new healthy cells, and detoxify. When we’re exposed to toxins, we need more B vitamins too.
These B vitamins are doing so much good stuff in our bodies. It’s no wonder that we run out when we’re pushing ourselves to the max, yet we are left with, “How do I know which ones? How much do I need as an individual?” Some of it is related to genetics to some degree. You can find out. With patients, I do their genetic analysis to see their genetics related to B vitamin metabolism. For example, the gene MTHFR is related to the ability to turn folic acid into folate. At least 40% of us have a decreased ability to do that. If 40% of us are less able to use folic acid, why would we even put it in anything? Let’s use the folate form that all of us can benefit from.
That’s just one of the genes. There’s MTRR. There are all the other genes related to B vitamin metabolism. When I dig in and look at that, what I come away with is I’m going to want to recommend for everyone to make sure if you’re taking B vitamins, take the active form or the methyl form. If you are not feeling well and if you’re getting migraines, you’re getting anxious, or you’re getting fatigue or sleep issues, then we can dive deeper. We can analyze your genes. We can test much more closely. We can look at homocysteine levels and methylmalonic acid levels and understand what it is that’s blocking your ability to benefit from the B vitamins.
Are you also assessing what genome type they are, whether it be an APOE3 or APOE4?
APOE ones are associated with dementia risk. Sometimes some patients do want to know, “What is my APOE status?” What we now know is dementia is associated with a whole long list of genes, and APOE is only one of them. To me, whichever APOE status you have, some of these same strategies are going to help the same dropping inflammation, recovery from stress, and detox from toxins. This is the way we prevent dementia.
What is your perspective on how much we should be eating, what we should be drinking, and when so that we can set ourselves up for the most success?
It is how to find that Goldilocks or that sweet spot for each individual because, as humans, we’re willing to do more for longer. We’re willing to push, but that’s the problem because we’re pushing so much that we’re pushing past the hormetic zone. Hormesis is when we’re giving our body a bit of a challenge or a change, but we only want to do so much change that’s going to be beneficial and create a beneficial effect for us. If we push too much, now we’re putting ourselves into this high-inflammation and high-exudative stress and being hard on our mitochondria again.
How do we find that? How do we identify when we’re in our hormetic zone for ourselves? It does take that body awareness we have been talking about. How do we listen to our body signals more? How do we understand the symptoms that we’re experiencing? How do we understand ourselves as individuals? When it comes to what I refer to as CARE, Clean eating, Adequate sleep, Recovery activities, which is even meditation, and E is for Exercise. Exercise is a perfect example of this.
We know that exercise is beneficial, but we also know that if we overdo it and if we go too intense for too long, we’re increasing cortisol levels. We’re increasing the risk of injury. We’re working against ourselves. Say to people, “Take a breath again and realize that maybe less is more for your body.” Start to realize what that is for you in terms of even quantities of food, “Here’s exactly the quantity of food that I can consume at this moment in time. I know that my body is going to be able to digest it and absorb it.”
“My insulin is going to be able to handle the carbs. My mitochondria are going to be able to use that energy. It’s going to go smoothly. If I eat too much, I’m ending up overwhelming my digestion, overfeeding bacteria, and stimulating leaky gut and inflammation.” It’s the whole snowball effect. It takes practice. I end up deciding that this is what being human is. It’s practicing and learning this zone where our bodies are functioning optimally. That includes cortisol and adrenaline levels. To me, that’s the first thing on the list of everything. That gets missed.
We walk around doing a lot of good stuff. We’re eating healthy, exercising, and meditating, but if we don’t have an optimal cortisol level, it’s for nothing. It’s for naught because there’s still an imbalanced stress signal happening in the background. We need to figure out what is your cortisol level. Is your cortisol too high at certain times of the day? Is it too low at certain times of the day? Whichever it is, we need to work on getting it back to this optimal zone because when cortisol is at optimal, everything else is easier. Everything else works better. Everything else is smoother. It’s this positive ripple effect. To me, the big piece is getting cortisol to optimal.
What is your perspective when it comes to how best to test for stress and when to test for cortisol specifically?
You can test cortisol and blood, but then you only get it at the time your blood was drawn. Cortisol is a hormone that should be higher in the morning and gradually decrease through the day so that it’s lowest at night. To get a sense of what’s happening with your cortisol, we need to measure it at least four different times a day in the morning, midday, evening, and bedtime. That can be done with saliva. That’s what I usually use. A person can spit in a tube, and you can do that from home.
It can also be measured in urine. We can see your cortisol because then it might be fine in the morning but it’s too high in the evening, or it’s low in the morning and fine in the evening. We need to see your cortisol curve. That is not a standard test. If you go to the regular doctor’s office for your annual exam, they’re not going to usually do that because this is not on the radar in the standard medical approach. It’s not generally covered by insurance even.
Every single person should know their cortisol levels. This is essential for health, but we have to realize that our medical system and our health insurance systems are not there for preventive medicine. They’re there once a health issue develops in helping you solve it in the acute state. If we want to be preventing our health, we’re going to need to take care of it ourselves. That involves, “Let me get a cortisol panel done so I can see where my cortisol levels are.”
You can order that usually from what would be called someone like me, a naturopathic doctor, or a functional medicine doctor, or have different practitioners that have this training, but here’s the thing. A lot of times, I find that even if some practitioners are ordering cortisol levels, they might not be doing the right treatment. I also want audiences to know that when you get your cortisol levels back, make sure then that you carefully choose the correct treatment to help optimize your cortisol. I write about this in the book because this should be general knowledge.
If cortisol is high, we’re going to use different herbs. There’s research on these herbs. We’re going to use ashwagandha, banaba leaf, magnolia root, and phosphatidylserine, which is a nutrient. Those are known to bring cortisol down when it’s too high, but we use a completely different set of herbs like rhodiola, licorice, and holy basil and different nutrients like pantothenic acid to raise cortisol when it’s too low. You have to know where you’re starting from to know what to take and at what time of day to take it.
Let’s quickly snapshot the five stress types.
Sometimes when I read them, I’m like, “I sound a little like this.” There’s a quiz I’ve developed by analyzing results and working with patients. I was able to narrow in on a quiz that is also available on my website. You could do it in under two minutes to give you a sense of what your stress type is. First, there’s this Stress Magnet. The Stress Magnet tends to have high cortisol and high adrenaline either all day or part of the day. A lot of times, people assume that’s them.
They’re like, “I probably have a high cortisol.” You might, but once you go through the quiz, I can talk you through a little bit of how I do it. You go, “Am I a Stress Magnet?” The opposite of the Stress Magnet is Blah and Blue. They tend to have low cortisol and low adrenaline for part of the day or all of the day, but the symptom of fatigue or low energy could happen in either a Stress Magnet or a Blah and Blue. It’s just that Blah and Blue is more likely to experience more extreme fatigue.
There’s the in-between. The Sluggish and Stressed have high cortisol with low adrenaline. The Tired and Wired has high adrenaline with low cortisol. They have slightly different symptomology and experience in their body and their life. The fifth one is the Night Owl. The Night Owl tends to have high cortisol and/or adrenaline at night either in the evening or the middle of the night. They’re more likely to have either sleep issues or a tendency to have energy and stay up late at night.
What would you say to someone who says, “I thrive on stress and being super busy.”
A lot of people say, “I’m okay. I’m stressed, but I love it. I’m an adrenaline junkie.” I tend to be a person like that too. I’m constantly thinking of new projects and doing lots of new things. I love new activities. There is some amount that’s fun for humans, but there’s also sometimes an addiction to it because if we’re doing things that stimulate a dopamine release, for example, and dopamine turns into adrenaline, now we are addicted to stress because it’s stimulating a neurotransmitter release. That feels good at first, but the real science behind it is that in the long run, it’s working against you to have high adrenaline and high cortisol a lot of the time.
You might be feeling fine now, but based on research and clinical experience, at some point, it’s going to start causing trouble, whether it’s going to trigger autoimmunity, heart disease, dementia, or cancer even. All of these things are associated with having high cortisol and adrenaline. There’s a way to still enjoy your life, be inspired, and do wonderful things, but do it with awareness for your cortisol and adrenaline and make sure that you are also giving your body a chance to reset them to optimal levels so we’re not in a constant state of high-stress hormones.
How do you advise people to start approaching their eating habits, specifically if they are under a lot of stress?
I’m glad you’re asking this. This is a perfect example of how once you know your stress type, then you can use that in everything you’re implementing, including your diet, stress recovery activities, and exercise. Everything you do needs to have this awareness of your stress type in mind. If we go into a dietary change like fasting, it’s the same thing. It’s a hormetic activity.
We know that if we do some amount of fasting as humans, it can stimulate autophagy, which is cellular cleanout. It can stimulate longevity and so much positive change in the body, but if we overdo it, now we end up hitting the other side of the danger zone where it’s going to work against us. A lot of times, people hear about something that sounds good, “Intermittent fasting sounds great,” and it is, but there is such a thing as overdoing it.
Have that awareness for yourself and ask yourself, “Am I fasting a little too long?” The ways you will know is if you test your cortisol, and your cortisol is too high, “I’m pushing it a little too far. My cortisol is going up too high,” or if you’re getting bloating and digestive issues because what can happen when you have a shorter eating window is now, you’re still trying to get the same amount of calories but in a shorter period of time. We might be consuming larger quantities at once.
When it comes down to it, our digestion can only digest so much food at once. If we pour in a bunch, then we end up overfeeding bacteria, which causes bloating. We’re not benefiting from all those nutrients. Even if it’s a healthy food, you’re not even benefiting from it if you can’t digest and absorb those nutrients. That’s what I see a lot of times for people who are saying they’re excited about intermittent fasting but maybe pushing it a little too far.
They end up noticing their high cortisol. It might disrupt their sleep. They start getting anxiety, digestive issues, hormone imbalances, and menstrual cycles thrown off. These are all signs that it’s a little too much for your body, and we need to back off. To me, the definition of an intermittent fast is not eating while you sleep. That’s a minimum. We’re not going to eat while we’re asleep. At the very least, we’re all getting some amount of intermittent fasting while we’re sleeping. Hopefully, you’re sleeping at least somewhat during the night. If not, we need to solve that first.
Let’s get you sleeping at least 7 and a half to 9 hours. You have that much of a fast even if you ate right before you went to sleep and immediately when you woke up. I start to expand it little by little, “How about we don’t eat within 2 to 3 hours of going to sleep? How about you wait an hour or two to eat in the morning?” You’re expanding your overnight or intermittent fast enough. That much already stimulates a positive change in the body.
We don’t necessarily need to go to more extremes. Sometimes I do. I was in the Amazon. When I go to the Amazon, that’s an extreme detox situation for sixteen days. I’m having two meals a day. I’m already on a very anti-inflammatory, mostly plant-based diet. In that case, sometimes I was fasting 16 to 18 hours, but I was on a very different daily schedule. I wasn’t doing my usual activities or exercise.
We have to keep that in mind too. If we’re going to fast longer, then we need to understand that our body is going to need more rest and more support to get through it. We probably only want to do it for a short period. When we come back to our usual day-to-day activities, we need to adjust. That’s the thing. More than anything, I hope you hear from this that it’s about helping our bodies to be able to adjust to the situation and have a healthy ability to respond and reset. That’s what’s associated with health more than anything.
Are there any particular supplements that you say are generally good for everybody to consider taking?
I would start with making sure you’re getting electrolytes, which may not even have to come from a supplement. You can get that from sea salt. Make sure you’re getting filtered water and electrolytes. From there, magnesium is often deficient. I’m like, “Let’s make sure we have enough magnesium.” Magnesium helps us metabolize adrenaline.
If you know you’re one of the stress types with high adrenaline, you feel that adrenaline and you need to help your body metabolize it, or you’re getting PMS symptoms, that’s another sign, then let’s make sure you’re getting some good magnesium. There are different kinds of magnesium. I can go into so much about that, but I would be thinking more of magnesium 3 and 8 and glycinate to help your nervous system metabolize adrenaline.
Are there any closing thoughts that you would like to share?
Thank you so much for this conversation. I love that you found so many good snippets of wisdom in the book. It was a joy for me to be able to write it and share about it. I do also include in the book about spirituality. If people are interested in that level, too and even psychedelic medicine, I’m willing to say, “What do we need as humans? What can we learn from nature and our experience that can help us reset from stress?” That’s what I would say. Use this as a tool to help you be inspired. I love that you are already doing that, Corinna.
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