October 17, 2016

I have long wondered what it takes to reach the mind of a healthful person heading down the wrong path toward disease. I have unfortunately found that the vast majority of people refuse to hear the word of health until disease hits them hard and even then a subset still refuse to listen. What I find even more frustrating is the abject lack of caring of many parents to learn how to keep our next generation healthy and moving forward.

After being a 5th grade school trip camp doc for a few days and witnessing the abnormal volume of poorly nourished and dehydrated children presenting daily to the infirmary for the same complaints, I was stuck asking the question WHY? I was not surprised to find these children informing me that this is how their parents feed them at home and that their frequent headaches, stomach aches and other malaise symptoms are medicated away with ibuprofen, benadryl, tylenol, and various other stronger drugs!

The sadness that I was left with spurned me to do what I know to do, teach. So, I informed these kids that they must eat a balanced meal and drink more water and then explained why. They now understand why it matters and have a proof of concept when they feel better after the intervention. The camp counselors spread the word to the remainder of the camp and on day two, we saw a nice drop off in return visits.

I fear that these poor kids are getting no help at home and the band aid of medicalizing their symptoms with drugs only encourages another generation of pill for ill patients who morph into chronic stressed and diseased adults. Here is the logical progression of my worry.

What happens when you are poorly fed and chronically stressed?

Chronic stress is the number one cause of altered hormonal function and subsequent fatigue and poor feelings. Humans and mammals in general are capable of responding to acute stress with a robust adrenal gland response that releases cortisol hormone as well as the sympathetic nervous system's release of epinephrine to stimulate physiologic changes that we call the fight or flight response. This is a good thing when you need to flee from a predator or win a race.

However, if you are always running away from that same predator, sooner or later this beneficial function will break down and disease will ensue. This is exactly what happens when parents go through a prolonged and nasty divorce or a child is abused over a long time or chronic bullying occurs in school in the face of poor nutrition.

The science: When you are exposed to a short stressful event the brain releases a hormone called corticotropin releasing factor, CRF, which in turn stimulates the anterior pituitary gland to release adrenocorticotropic hormone which stimulates the adrenal gland to release cortisol. Cortisol is responsible for activating pathways that help us stop digesting food and wasting energy while simultaneously cranking up our ability to run and survive.

CRF also increases the serotonin signal pathways that keep us alert and hyper in order to get away from the stress. CRF changes the gut permeability, our response to pain and increases our inflammatory pathways. You can clearly see how all of these changes in the short run are advantageous.

Now lets change the dynamic to the chronically stressed child. CRF continues to be released for too long over stimulating the adrenal gland hormonally to a fatigue state and these previously beneficial properties are now causing anxiety from continued hyper alertness, food sensitivities/allergies from intestinal permeability, fibromyalgia symptoms from abnormal pain sensing, and fatigue from exhausted adrenal glands and mitochondrial energy centers. This is not a good place to be. And believe it or not, antidepressants are not the long term answer.

The most dangerous part of this messed up scenario is the toll that the CRF has taken on the gut. The chronic stimulation has opened up pores in the intestinal lining allowing food proteins, neuroactive compounds and metabolites to cross into a place that they are forbidden. This gives these substances access to the whole immune system as well as to our brain. We believe that this is the major factor involved in damaging the brain.

Think about this for a second. Chronic stress opens the gut lining to the passage of forbidden proteins that cause the symptoms that we perceive as anxiety, depression, fatigue and malaise! We know that this is reversible because animal studies have shown us that fecal transplants have temporarily cured these same symptoms. I have personally seen hundreds of young men and women throw away their anti depressants after they clean up their diet, work on stress and fix micronutrient/gut function. Even yesterday, I had two back to back teenagers report that they are medicine free and living a mentally disease free life.

How do I wrap this up?

It is clear to me that stress will never leave us, so we have to learn to deal with it effectively. We need to be prepared to do battle when stress arises and then relax when it abates. We need to have a garden in our intestines that is bountiful and ready for the stress. We need to have support.

Here is a list of options for stress readiness:

1) Eat a diet that is predominantly plant based and has little to no added sugar, gluten/dairy (unless you are sure that neither food type bothers you - see previous newsletters at www.salisburypediatrics.com or here. Search keywords dairy and sugar) Read the Autoimmune Paleo Cookbook by Trescott. Here is a diet PDF.

2) Practice the 4/7/8 relaxing breath daily. This induces an increase in the parasympathetic tone that reduces stress and in turn cortisol release.

3) Consider adding prebiotic foods and probiotics to your diet. Unmodified potato starch is a fabulous food for our good bacteria. Promoting our good bacteria may be one of the most important avenues to a healthy outcome. I cannot stress this point enough. I am testing the micro biomes of sick children frequently now and a depleted bacterial flora is the norm. This is correlated with increased stress and disease.

4) Develop a village of support around you but do not become a victim of circumstance. The village is there to help you stand back up, not to keep you up. Own your choices and all circumstances good and bad. Taking ownership of everything is the first step to overcoming any obstacle.

5) Exercise or physically work daily. Exercise is a natural stress reliever. The benefits of exercise are clearly anti inflammation, anti stress, and anti aging as recent newsletters have touched on.

6) Reduce your exposure to toxins and chemicals which place more pressure on your cells to function in a stressful hormonal environment.

7) Start meditation relaxation and prayer daily. Think of three things that you are grateful for everyday.

8) Make sure that you are getting 8 hours of restful sleep or more based on age.

9) Consider supplements that support the adrenal and stress systems. Consult with your provider.

10) Believe in yourself and the healing properties that are inherent to your genes.

Dr. M


How emotional and Physical stress affect health part 3: Stress, depression and the microbiota. M. MacDonald PhD

Textbook of Functional Medicine