This post was originally published by Russak Dermatology Clinic in New York where I work as their Holistic Nutritionist.
A discussion between Dr. Julie Russak and Holistic Nutritionist, Jennifer Hanway.
Upon experiencing a stressor, our brain tells our adrenal glands to release cortisol and adrenaline, hormones that increase our heart rate and blood pressure, putting us into fight or flight mode. Whilst this was useful to us in hunter-gatherer times when we were being chased by saber-toothed tigers, we now still have the same reaction to an urgent email from our boss, or the fear of losing our phones.
As our bodies constantly strive for homeostasis (a state of equilibrium), when we up-regulate certain bodily processes, others have to be lowered, and when stressed we see down-regulation in mental cognition, immune function, thyroid function and our endocrine systems.
Chronic stress (as many of us are experiencing now during this global pandemic) can cause insulin resistance, which will impair how well we use our food for fuel and increase body fat storage. It can also cause chronic inflammation, which shows on our skin through acne, eczema and rosacea. Insulin resistance paired with chronic inflammation are also at the root of most ‘lifestyle diseases’, including Type 2 Diabetes, CHD, strokes and Alzheimers. Consistently elevated cortisol is catabolic to the body, meaning we are breaking down and failing to repair tissues which can lead to muscle loss, poor gut health and decreased collagen and elastin production. Also, with chronic stress we “tire out” our adrenal glands and deplete their ability to react properly to stress.
Our hair, skin and nails are of lowest importance to our survival (although it often doesn’t feel that way) so at times of stress, other valuable vitamins and minerals are prioritized for our bodies vital metabolic processes (and for the production of stress hormones). Our skin really is an external barometer of what is happening internally, and we often see dull skin, thinning hair and weak nails at times of stress and fatigue.
We are also more likely to overeat at times of stress, reaching for high carbohydrate and high sugar foods that release dopamine, a neurotransmitter that makes us feel good, and even just one night of less than 5 hours of sleep can lead to consumption of an extra 300 calories the next day, mostly from sugary or fatty foods. Studies have shown that women with high cortisol levels tend to store more visceral fat (belly fat) than those with lower levels, and this can even be seen in women who are lean elsewhere on the body.
Visceral fat is also the type of fat that is stored around our organs, and high levels are linked to metabolic diseases and increased inflammation. However, it can be reduced with dedicated nutrition, supplementation and lifestyle strategies.
Often we start by asking our patients to do less, not more! Simply by switching out cortisol raising cardio workouts for metabolism boosting strength training we can both lower stress and boost metabolism by working out smarter, not harder. Gut health is of utmost importance in our practice, as poor gut health causes chronic inflammation and malabsorption (even if we are eating the healthiest of diets we need to ensure we are absorbing all of the nutrients for optimum health and beauty, we always joke with our patients and say “it’s not what we eat but what we absorb”), and by balancing blood sugar through lower carb, fiber packed diets we increase insulin sensitivity, which can lower cortisol levels.
We also give our patients a ‘toolbox’ to help manage their stress throughout the day (think breathing exercises, herbal supplements, even dark chocolate), and help them create habits to achieve a night of restful and restorative sleep.
We encourage procedures that increase our patient’s own ability to regenerate skin and hair. For example, we pair collagen induction such as RF needling with PRP (platelet-rich-plasma) injections to boost collagen production, and we inject and infuse PRP into the scalp during our hair restoration therapy.
It really is a cascade of stress-related effects we see in our patients – dysregulated cortisol leading to thyroid down-regulation and hormonal imbalances, which can cause weight gain, poor gut health and irregular menstrual cycles. I personally have lost my period twice for 6 months at a time due to high stress and thyroid issues. Whilst this cascade effect may seem challenging at first, our holistic approach means that by helping our patients manage their stress we can effect incredible positive change on all aspects of their health as they are so interlinked.
Luckily we have the tools to be able to treat both external and internal symptoms in tandem (as they are so closely related)! Firstly, we would find the one aspect of health that they feel successful at, or that they feel most able to improve. Trying to change everything all at once can cause even more stress and overwhelm. In a stressed out patient I would suggest starting with improving their sleep, as restful and restorative sleep can help manage our hunger hormones, leading us to healthier diet choices, and creating more energy for exercise, which can all help decrease external symptoms as well.
We also highly recommend comprehensive blood and biomarker testing so we can see at a cellular level how stress is impacting the body. This means that we can give our highly personalized recommendations resulting in quicker improvements in all aspects of health.
We understand the skin-gut connection and know that food sensitivities can be the underlying culprits of medical conditions such as eczema, skin allergies and chronic inflammation. We always emphasize and support, “beauty from within.” The findings in our wellness analysis reveal important information about what is going on in the body and being expressed on the outside. The analysis also supports healthy gene expression to protect precious proteins, including collagen and elastin.