The Impact of Stress on Autoimmune Diseases: Exploring the Potential of Stress-Reduction Techniques

According to the "Stress in America" poll by the American Psychological Association in 2022, America is one of the top stressed-out countries in the whole world. The level of stress Americans experience is 20% higher than the global average.

While stress is a typical part of life, it can significantly impact our health if it goes unaddressed. Activation of the stress response is suggested to be linked to many human health issues, and studies show that stress-related disorders have a significant association with the development of autoimmune conditions.

There are more than 100 varieties of autoimmune diseases that affect more than 24 million Americans, and the prevalence of these conditions continues to rise. This article will discuss stress's impact on autoimmune diseases and the potential benefits of stress-reduction techniques.

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What is The Definition of Autoimmune Disease?

According to the National Cancer Institute, autoimmune conditions are diseases in which the body's own immune system attacks the healthy tissues, mistaking them as foreign.  

The immune system's purpose is to protect the body from pathogens, like bacteria and viruses, and cancer cells. The body produces proteins called antibodies that signal other immune cells to target and manage these foreign invaders to protect the body from infection.

In autoimmune conditions, the immune system produces proteins called autoantibodies that signal immune cells to target and manage the body's own tissues, mistaking them as foreign invaders.

The tissues that the immune system targets vary depending on which autoimmune condition a person has. For example, in Hashimoto's thyroiditis, the immune system targets the thyroid gland, whereas, in rheumatoid arthritis, the immune system targets certain joints.

Several factors, including genetics, toxins, gut health imbalances, inflammation, hormone imbalances, and stress, can contribute to autoimmune diseases.

The Role Of Stress In Autoimmune Diseases

Stress plays a major role in autoimmune diseases. The body's stress response is regulated by the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis, a communication network of hormone feedback loops between these glands. Over time, chronic stress may lead to dysfunction in the HPA axis, which can result in hormone imbalances. Patients with autoimmune diseases like RA (rheumatoid arthritis), SLE (systemic lupus erythematosus), SS (Sjögren's syndrome), and fibromyalgia have been found to have abnormal HPA axis responses. Studies show that 80% of people report unusual emotional stress prior to developing an autoimmune condition.

The hormones that get released during the stress response are thought to influence immune regulation by altering cytokine release. Cytokines are signaling proteins released by immune cells to modulate inflammation. They help your immune system mount a defense against pathogens. But when levels of cytokines are too high, it can lead to excess inflammation and may contribute to conditions such as autoimmune disease.

Stress is known for its ability to impact the gastrointestinal and immune systems. Chronic stress may increase inflammation, cause dysbiosis, and increase intestinal permeability, also called leaky gut. Evidence suggests autoimmune diseases are associated with these same gastrointestinal issues, indicating stress-induced gastrointestinal dysfunction may influence the development of autoimmunity.

The ANS (autonomic nervous system) plays a role in the stress response. The vagus nerve, which is cranial nerve ten, governs the parasympathetic branch of the ANS. The health of the ANS, and the tone of the vagus nerve, can be assessed by measuring small fluctuations in the amount of time between heartbeats, called heart rate variability (HRV). Evidence indicates that autoimmune conditions are associated with impaired ANS activity, lower vagus nerve tone, and reduced HRV.

Stress Tests for Patients Concerned About Autoimmune Disease

Certain tests can provide valuable information about the body's stress and immune responses to better understand your health condition's root cause and develop an effective and targeted approach.  

DUTCH Test

The DUTCH Plus™ is a dried urine test that measures stress hormones, sex hormones, and the Cortisol Awakening Response (CAR). There's also an option to add a nighttime cortisol sample for those with insomnia. This test offers valuable information about the body's stress response system and the health of the HPA axis, and sex hormones to determine if imbalances in these areas may be a factor in autoimmune disease.

Comprehensive Stool Analysis

Evaluating the gastrointestinal system is important to determine whether underlying gut dysfunction plays a role in your autoimmunity. The GI-MAP + Zonulin evaluates intestinal inflammation, gut immune response, digestion, absorption, and microbiome health to provide an overall view of the health and function of the gastrointestinal system. Adding zonulin to the GI-MAP helps determine whether increased intestinal permeability or leaky gut is present.

Anti-Nuclear Antibodies (ANA)

The ANA Screen by Access Med Labs measures three anti-nuclear antibodies to help identify autoimmune diseases. Further autoimmune disease testing is typically performed when an ANA test is positive.  

C-Reactive Protein (CRP)

A CRP test is often performed to assess inflammation in the body. Inflammation is a factor in autoimmune conditions. So a CRP test helps evaluate autoimmunity and monitor changes and autoimmune flares.

Evidenced Based Stress Reduction Techniques That Are Beneficial for Autoimmune Disease Patients

Stress reduction techniques can have a positive influence on the quality of life for anyone with autoimmune diseases. Here are several mind-body techniques that may show benefits for autoimmunity.

Vagus Nerve Stimulation (VNS)

Stimulation of the vagus nerve may increase vagal tone and help regulate stress. VNS activates the relaxation response by increasing the activity of the parasympathetic (PNS) branch of the ANS. This may produce a calming effect. It also modulates cytokine production and may have an anti-inflammatory effect.

Studies of VNS on patients with autoimmune disease show improvements in inflammatory and immune activation as well as reduced pain and fatigue.

The vagus nerve can be stimulated in several ways using non-invasive techniques such as with a transcutaneous device or by using various mind-body approaches. Techniques that may increase vagal tone include mindfulness meditation, breathwork, yoga, massage, cold exposure, singing, humming, chanting, and gargling.

Yoga

Yoga originated in India and was used as a spiritual practice. In modern yoga, it has evolved into a practice used to promote mental and physical health. As practiced in America, yoga frequently combines physical asanas (postures), pranayama (breathing techniques), and meditation.

Yoga is shown to benefit both physical and psychological measures of stress. In a study assessing the impact of yoga on rheumatoid arthritis patients, yoga was shown to significantly improve psychosomatic symptoms, disease activity, pain, range of motion, flexibility, coordination, and strength.

These benefits may be attributed to yoga's potential anti-inflammatory and immunomodulatory effects. Practicing yoga regularly may help reduce resting levels of inflammatory cytokines and support cellular immunity affected by stress.

Yoga is an excellent form of movement for those with autoimmune conditions who experience high pain levels as it is gentle on the body.

Meditation

Meditation is described as the practice of intentional focus on something specific, such as the breath, an object, a sensation, or a mantra. It's an effective stress-reducing technique with evidence showing beneficial effects on blood pressure, stress hormones, sleep quality, and perceived stress.

In addition to its influence on the HPA axis, meditation may increase vagal tone and reduce inflammatory markers like CRP, making it a potentially helpful practice for those with autoimmune diseases.

Breathing

Slow, deep breathing is shown to have stress-reducing, calming effects via its influence on the autonomic nervous system. Evidence shows that deep breathing may improve HRV (a measure of autonomic nervous system health) in people with autoimmune diseases. When patients with RA and SLE performed 30 minutes of deep breathing, their HRV increased.

Much like meditation, breathing practices can be performed anywhere and don't require physical capabilities other than modulating the rate and depth of the breath. These are simple techniques with potential benefits for the mind and body.

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Summary

Stress is critical in the development of autoimmune diseases. Chronic stress may contribute to inflammation, immune dysregulation, imbalances in gut health, and dysfunction in the HPA axis, all of which may influence autoimmunity.

It can't be overstated how vital stress reduction efforts are. Stress reduction techniques provide a valuable way to help manage inflammation, support immune health, improve gut health, support HPA axis function, and promote mental and physical well-being.

The stress-reduction techniques covered in this article are excellent practices to consider incorporating into a stress-management regimen for anyone struggling with stress or autoimmunity or those simply looking to support their overall health and well-being.