Stress, what is it good for? Not your gut!

Welcome to The Perfect Stool: Understanding and Healing the Gut Microbiome. This is your host, Lindsey Parsons, and today I'm going to be talking about the role of stress in gut health. Stress is obviously unavoidable for most of us, and for so many of my clients, a long period of chronic stress preceded their gut health or autoimmune issues. So in case you're underplaying the importance of stress in your gut I'm gonna help you understand why it's so important today and talk about ways to address it so that maybe you can start to tackle the problem and remove the root cause of your gut health problems. But before I get started, if you haven't yet followed or subscribed to the show, be sure to do so so you won't miss an episode. And if you wanna get transcripts of the podcast, pop over to my website, HighDesertHealthCoaching.com, and sign up for my newsletter. You'll also get my free ebooklet called Finding Your Root Cause Through Stool and Organic Acids Testing when you sign up. Now onto the show. So just to give one super concrete example of what a brief exposure to stress does, think about how you get nervous before public speaking or playing in a sporting event or a blind date or whatever it is that makes you nervous. Think about what happens. Your body immediately starts dumping serotonin into your gut, which in addition to being your feel-good neurotransmitter, is also what prompts peristalsis, or the movement of food through your intestines. And all of a sudden you have to run to the bathroom with diarrhea. This can happen with a super brief exposure to something stressful. So I give that common example because I know we've all experienced it, just to demonstrate how our bodies are such finely tuned instruments that with every thought send chemical messengers or neurotransmitters throughout our bodies, causing seen and felt and also unseen and unfelt, or at least in the short term unseen and unfelt reactions. So let's look at what happens to the gut during a period of acute stress, or strong and immediate but short-term stress. This might be something like almost getting hit in traffic, public speaking, having to meet a deadline at work, or having an argument with your spouse. Your body will go into sympathetic or fight-or-flight mode. So some people will have gut symptoms during these events, like nausea or diarrhea, which is from that sudden release of serotonin. Or if you eat during or after one of these periods, you may experience heartburn or acid reflux. So to avoid some of these unpleasant gut symptoms when you're feeling acute stress, obviously avoid eating or drinking and allow enough time to calm down before you do. I recommend taking several 5-5-7 breaths before starting to eat to trick your system into a parasympathetic or rest and digest state. This is inhaling for 5, holding for 5, and exhaling for 7. Now, chronic stress, on the other hand, is longer-term, lower-level stress like work pressures, ongoing relationship issues, or caring for an aging or dying parent. And this is the kind of stress that can, over time, have significant effects on gut and digestion. If you have chronic stress, you may find that you're developing regular and unpleasant digestive symptoms, even if you're removed from those immediate stressors while you're eating. And some of these symptoms could include nausea, heartburn, acid reflux, bloating, pain, and even vomiting during periods of severe stress. Chronic stress can also change how quickly food moves through the digestive system, causing either diarrhea or constipation. It can also cause muscle spasms, including in the digestive tract, which can be uncomfortable or even painful. So what are the mechanisms behind all this? How is it that the brain and the gut are interacting, and what can you do about it? The gut-brain axis is how the brain and your gut communicate, which happens via the vagus nerve and the microbes in your gut. The interesting thing about that axis is that it goes both ways, meaning the brain can contribute to gut symptoms and the gut can impact brain function. So when you're under stress, your body releases the hormone adrenaline, which I'm sure you're all familiar with what a rush of adrenaline feels like. Adrenaline is also known as epinephrine. Your body also, also releases noradrenaline while under stress, also known as norepinephrine. And together they increase your heart rate and blood pressure and release glucose into the bloodstream to give you energy. And then norepinephrine also helps to break down fat to give you more energy. So epinephrine and norepinephrine along with the transmitter dopamine are known as the catecholamines. And what's important to know about them is that you need tyrosine, an amino acid, to make all of them. So the order op— of operations is tyrosine turns into both thyroid hormones and dopa. Then dopa turns into dopamine, the neurotransmitter that gives you pleasure, motivation, and focus. And dopamine turns into norepinephrine, which turns into epinephrine. So if you're under chronic stress and over time producing a lot of these catecholamines, you're using up a lot of tyrosine for that purpose. Now, tyrosine is one of the 20 amino acids that make up every protein in the human body, with the notable exception of collagen, which doesn't contain tryptophan. But other than that, when I say every, I don't mean that some proteins use 7 amino acids and some use 12. I mean that every single protein except collagen in the human body needs all 20 amino acids. So you probably think of proteins in humans as something that build muscle, but they do a heck of a lot more than that. Beyond creating the structures of our bodies, they create enzymes, like the enzymes you need to digest food, hormones, antibodies, and other immune system cells. They also bind, transport, and store molecules and pretty much do most of the work in cells. So basically proteins are required for the structure, regulation, and function of all the body's tissues and organs. So proteins are not just important, they're fundamental to the functioning of a healthy body. So when you're under periods of acute stress, protein breakdown increases by as much as 20%, and your body will start cannibalizing muscle tissue or the gut lining to get the nutrients it needs to make energy and proteins in your body. This can lead to intestinal hyperpermeability, also known as leaky gut, which can then manifest as food sensitivities and if left long enough lead to autoimmune diseases. You'll also run through the B vitamins at a higher rate when under chronic or frequent acute stress because B vitamins are cofactors with enzymes. And they're used in the production of hormones and neurotransmitters and serve many other important protein-related roles in the body. So some examples are B6, which is required for the production of dopamine, serotonin, and GABA, an important inhibitory neurotransmitter that can make you feel physically anxious when it's in short supply. B12, which is used in the production of serotonin, and B5, which is used in making the steroid hormones like cortisol, which is also released by the body when we're under stress. So basically you're just using up a lot of stuff in your body, basically, which can lead to depletions and then further health problems. So chronic stress also leads to decreased production over time of serotonin, which as I mentioned before, triggers peristalsis or movement of food through the intestines. In fact, 95% of serotonin is produced in your gut. So the lack of serotonin in, in the gut can lead initially to constipation and also stagnation in the small intestine, which can then lead to dysbiosis, Candida overgrowth, or small intestine bacterial overgrowth, also known as SIBO, leading to symptoms of bloating. And then once the microbes become overgrown from that stagnation, depending on which of them take over, you can end up with either constipation, soft stool, or diarrhea downstream, or some combination of those depending on the day. Another thing that happens during periods of chronic stress is decreased production of something called secretory IgA or immunoglobulin A. Secretory IgA is a type of antibody or immune system cell that protects the mucous-lined surfaces of the body, including the intestines, and prevents pathogens from entering the circulatory system. And lowered levels of secretory IgA from stress can allow pathogens to attach to the gut lining, such as Helicobacter pylori, or H. pylori, for example. And that can lead to inflammation in the gut, ulcers, and increased intestinal permeability. Then that gut inflammation in turn can lead to dysbiosis and an overgrowth of opportunistic bacteria. And one of my clients, I saw this exact pattern where a prolonged period of stress led to what was probably a non-troublesome case of H. pylori becoming a symptomatic case, leading to other areas of dysbiosis like overgrowth of certain Clostridia bacteria and streptococcus. And once we then eliminated the H. pylori and addressed some other aspects of her dysbiosis, her symptoms subsided. Stress can also decrease the production of stomach acid, which is important for killing pathogens that come in with your food. One of the reasons for this is that the B vitamins are necessary for the production of stomach acid, and as I mentioned before, they become depleted during times of stress. Now, a brief message from our sponsor, Banatrol. If you suffer from diarrhea caused by IBS or any other types of digestive issues that are preventing you from leaving your house, then you should check out the number one natural anti-diarrheal in the world. Banatrol Plus. Banatrol's all-natural formula contains only 2 ingredients: a combination of green and ripe dehydrated banana flakes paired with a clinically proven GOS prebiotic fiber. You can try Banatrol risk-free for 30 days by going to trybanatrol.com. If for any reason it doesn't work, you will receive a 100% refund of the purchase price. That's trybanatrol.com. T-R-Y-B-A-N-A-T-R-O-L dot com. In addition, during periods of stress, some people turn to eating highly palatable processed foods for comfort or convenience. These foods that are high in sugar and unhealthy fats have a major impact on which gut bacteria and fungi like Candida grow and thrive. It turns out that the good microbes like healthy fiber from plants and the bad ones like sugar and white flour. In turn, these bacteria and yeast that are flourishing off of these highly processed foods and sugar are communicating with the brain by releasing neurotransmitters, metabolites, and endotoxins. Which are part of the cell walls of gram-negative bacteria that can negatively impact your mood and your eating behaviors and your health. Some of these gut microbes that grow can even encourage further dysregulated eating and fuel sugar cravings and carb cravings, which fuels the same cycle of stress and unhealthy eating, as well as puts you at risk of depression and other mental health issues. And studies have found that individuals with depression tend to have less diversity in their gut microbiome. And have species of bacteria that promote inflammation, which is why I've heard practitioners refer to depression as a disease of inflammation. Studies have also shown that gut dysbiosis is promoted by a high-stress lifestyle and a typical Western diet. One study done on university students showed that their balance of unhealthy gut bacteria increased as their stress increased over a period of time. And this unhealthy balance can then deregulate the immune system, causing you to be sick more often, further increasing your stress. Similarly, stress and depression can promote a leaky gut or intestinal permeability, which again promotes an inflammatory response. And then that plays into the cycle of stress, inflammation, gut health problems, and depression. So what are some ways to avoid playing into this vicious cycle of stress, a dysbiotic microbiome, and then the negative health consequences? Well, to start with, you could use a good probiotic during times of stress. Just to increase your healthy bacteria and lower your risk of leaky gut and the consequent inflammation. Some studies have implied that gut diversity can actually improve stress responses, and one that say Japanese medical students found that their sleep, their stress, autonomic balance, bowel movements, and cortisol levels all improved when they began to supplement their diets with probiotics. A few probiotics for general gut health I'd recommend are Bifidomaximus, which is a good high-dose lactobifido probiotic, Proflora4R, which is a spore-based probiotic that also has some gut-soothing ingredients in it, and Seed, which they refer to as a symbiotic, as it also has prebiotic polyphenols in it. And I can link to those in the show notes. And while probiotics are a great addition to any diet, of course the food you consume and your prebiotics has a much larger impact on your gut microbiome. A typical Western or American diet that's high in added sugar, saturated fats, and processed foods will lead to inflammation dysbiosis and leaky gut even without stress. And let me just note that when I mentioned saturated fat, this is in the context of a standard American diet, not in the context of a ketogenic diet, which has benefits that are different because of the endogenous or internal production of butyrate, which feeds the gut colonocytes or the cells lining your large intestine. Otherwise, you would get butyrate from fiber, which you eat and then you can't digest, but your gut bacteria digest and then they ferment the fiber and produce butyrate, which then feeds your gut colonocytes. So a more traditional and gut-healthy diet is gonna be higher in fiber from beans and legumes and whole grains, nuts and seeds, fruits and vegetables. It's gonna be rich in polyphenols, which give plants their color, and unsaturated fats like olive oil, which also contains polyphenols, as well as omega-3 fatty acids like those you get from wild-caught seafood and pasture-raised meats, dairy, and eggs. So this kind of diet promotes a much more diverse and healthier gut microbiome, which decreases inflammation and leaky gut and can promote mental health and lower stress. Studies in mice have even shown that inflammation in the colon significantly increases during periods of stress due to the change in the gut microbiomes of the mice. Now, for people with existing gut conditions such as IBS, IBD, or inflammatory bowel disease, that is Crohn's and colitis, the additional inflammation triggered by stress and the concurrent changes in the microbiome can be even more negatively impactful. In the case of IBS, not only does stress heighten the symptoms, it can even lead to its development in the first place. As I mentioned before, chronic stress can lead to dysbiosis, which is a major cause of SIBO and IBS. Also, in the case of IBS, around 40 to 60% of people also have a concurrent psychiatric diagnosis such as anxiety or depression. Similarly, for people with IBD, stress can also worsen their symptoms. Much like with IBS, many people who suffer from IBD also have a psychiatric diagnosis. And studies show that stress can cause flare-ups of IBD and can cause it to relapse. And interestingly, new research has shown that in two-thirds of people who have both IBD and diagnosed anxiety, their anxiety began on average 2 years before their IBD. Also, people who've been diagnosed with anxiety or a mood disorder early in life were also diagnosed with IBD earlier than those who did not have anxiety or mood disorder as a child. And if you think about what I was talking about earlier with the depletion or, or the excessive use of your catecholamines, or serotonin. Over time, these chemicals and their precursors become depleted, and then you start to have these symptoms of anxiety and depression. So you can start with, with stress, then you can have the mental health diagnosis, and then ultimately the gut health diagnosis. Interestingly though, a condition that many people used to believe for many years to be caused by stress, stomach ulcers, is typically not caused by stress. Now stress can aggravate them, but typically it's not the root cause of the issue. Ulcers are caused by H. pylori and the overuse of anti-inflammatory pain medication. But as I mentioned, stress can give H. pylori the opportunity to cause more trouble in the stomach and become symptomatic when previously it might have just been hanging around as a commensal bacteria in your gut. So of all the things I work with clients around, H. pylori is truly one of the worst in terms of the symptoms of GERD and stomach pain and burping and bloating and insomnia. And when it's gone, people feel incredible relief. So if you have one of these conditions or undiagnosed gut issues and you wanna start addressing your gut health, it's important to address the stress that caused or contributed to it in the first place. So first, think about using mealtime as a moment to enter into a parasympathetic or rest and digest state. Turn off the TV, put away the smartphone. If it's nice outside, sit outside and take at least 20 minutes to eat your food in a relaxed manner. But before eating, if you feel that your body's tense, Try a period of mindfulness where you're just taking in input from all your senses before your meal and smelling your food and getting the digestive juices flowing. Do some 5-5-7 breaths or a brief meditation. Try to chew your food 25 times before swallowing. And if you have others around, try and make mealtime a time of pleasant conversation, relaxation, and taking your time at the table. It's a great time for family bonding. We started some traditions in our family. Like happy, sad, looking forward to when our kids were young. That's when everyone says something they're happy about, something they're sad about, and something they're looking forward to. This, beyond creating a little bit more pleasant conversation, stopped some of the bickering between the kids because it just got us thinking about something else than whatever it is they were arguing about. We also did something we called family rendition, which was my younger son's mispronunciation of family tradition, which is where each person gets to choose one topic and then we all say one sentence about that topic. Getting out in nature is also a great way to combat stress. So much so that some doctors are now literally taking out their prescription pads and writing a prescription for vitamin N. And studies show that the deeper you get into the natural areas away from civilization, the calmer your brainwaves. In terms of managing long-term stressors, this can be more challenging. Obviously you can address the symptoms of long-term stress with practices like mindfulness, meditation, yoga, or tai chi.. And now there's tons of good apps for meditation. A couple that have been recommended to me are Calm and 10% Happier. Getting adequate sleep, of course, is also important for managing stress and incredibly important for detoxifying and rebuilding the body and brain. If you have trouble sleeping, practicing better sleep hygiene, like putting away devices an hour before bed, stopping eating at least 2 hours before bed, making sure your room is completely dark with no blue lights, and sticking to a consistent sleep schedule, even on the weekends. Are some initial interventions. I also recommend to my clients who have issues with waking up worrying to set a time in their calendars each day to worry or list out all the things on their minds so they won't preoccupy them during the night. If you're having trouble going to sleep, a couple good techniques are progressive tightening and releasing of your muscles up and down your body, or forcing yourself to keep your eyes open while repeating to yourself, "Don't close your eyes, don't close your eyes." It really works brilliantly, trust me. Other tips for managing stress include visualization, another type of mindfulness where you would mentally place yourself in a calm, positive space. I like to take myself mentally to North Litchfield Beach in South Carolina and the house we used to vacation at every summer. I then take in input from all of my senses to feel what it felt like and sounded like and smelled like to be there. Positive self-talk is also a key facet to managing stress and improving your self-image. Try and reflect on whether the language you're using with yourself is the kind you'd use with another person. And then if it isn't, if it's a lot crueler, then try and work on being kinder to yourself in your own self-talk. And also just in picturing and believing that you'll have a positive and healthy future. It may also help to keep a journal to note when you have stressful incidents and when they coincide with gut symptoms, so you can be more aware of the connection between the two. And if you're struggling with stress from work, spend some time figuring out how to address it. That may mean being more firm in setting hours and sticking to them and not doing work email or calls outside of work hours, or maybe talking to your supervisor about taking some work off your plate. This may mean having a conversation like, "I won't be able to get to all these tasks this week. Which ones are the highest priorities for you?" Or it may mean delegating some tasks or accepting something less than perfection on others. It's also important to take vacations, if you have vacation time, even if you can't afford to go anywhere or you're still in lockdown mode. Being a workaholic or working long hours is really nothing to brag about if it's hurting your health. Our brains badly need those weekend breaks as well as longer week or two-week breaks periodically. Inevitably, I see my digestion drastically improve within 4 or 5 days of the start of a vacation, so I know this is for real because it's played out in my life. Also, if you have a diagnosis like IBS, IBD, or other consistent gut issues, joining a support group or Facebook group to discuss your symptoms, ask questions, and vent can be really helpful in not feeling so alone and can help alleviate some of the stress that comes with these gut health issues. I have a Facebook group called Gut Healing where you're welcome to come vent or ask questions, and I'll link to that in the show notes. Sometimes getting out from chronic stress may mean taking really courageous steps to make major life changes like leaving a stressful job, Taking a course on better managing your money or getting out of a toxic relationship. While I consider myself to be in a happy marriage now, there were times in my early marriage where the stress of the fighting with my husband was so bad, I remember sitting on the toilet and thinking, this is literally killing me. This is taking years off of my life. Fortunately, counseling, life changes, maturity, compromises, the passing of time, and the releasing of unrealistic and unfair expectations of each other, as well as better self-control on both of our parts, has helped us get to a much happier place. And please don't let fear or stigma stop you from seeking help from a licensed mental health professional. It's done wonders for me in my life. And what's nice is that now, unlike years ago, mental health treatment is covered by insurance just like other regular medical care. You can even get couples therapy covered under insurance if it's causing one of you mental health issues. So please take that courageous step and find a therapist who fits well with you if you're struggling with high stress. Well, I hope that has been helpful and will get you thinking more about how stress is impacting your gut health and your life in general. I have a practice I do every Friday morning. It's called superthinking. I go for a walk for 30 to 45 minutes or so and have no distractions. No, I mean, I have my phone, but only to take notes and email myself of things I think of. And I just think about my business and my life and the problems I need to solve, and I come up with creative solutions for them. And this has really been helpful in giving me the mental space to look at the big picture, especially cuz I'm really detail-oriented and I tend to get buried in the details, but to look at the big picture and just think of more encompassing solutions for day-to-day stressors that aren't going away. So if you're looking to start solving your gut health problems and wanna address the physical side of it as well as the mental, you're welcome to set up a free 30-minute breakthrough session with me. We'll talk about what you've been going through and I'll tell you about my Gut Health Coaching 5-Appointment Program. In which I recommend lab tests, lifestyle changes too, of course, educate you on what the results mean and the protocols used by doctors to fix the problems revealed in the lab tests. And if you're ready to jump in right away or can only afford to do one appointment at a time, you can set up just one appointment or an initial consultation with me. Both are linked in the show notes and you can check out my website, HighDesertHealthCoaching.com, to read more about me and my work if you wanna do that. So that's all for today. I hope you have a stress-free, relaxing day, and here's wishing you all The perfect stool.