Stress and inflammation

Cortisol is a hormone produced by the adrenal glands. Its production is controlled by a special part of the brain. 

In the time of stress or inflammation, the organism needs to be ready to intensive actions. Such actions require energy. So, the organism needs to send a command to all organs to be ready to such actions. Cortisol, or rather its elevated level is such a command. Cortisol also reduces inflammation, by which it mitigates the reaction of the immune system. This is necessary, because its too violent reaction may be dangerous for our organism.

Cortisol acts, at least partially, oppositely to insulin. An increase of insulin in blood gives a command to take an excess of glucose from blood. An elevated level of cortisol gives a command to increase the level of glucose in blood (because intensive actions require energy, which must be readily available), even at the cost of some losses. In particular, this additional glucose can be made out of proteins, not only from the unutilized amino acids, but also from proteins of our body (mostly from muscles), which are being broken into amino acids for production of glucose out of them. 

Also, cortisol reduces the ability of our bones to rebuild themselves and speeds up their disassembly. Yes, disassembly and rebuilding of bones occur all the time, because bones are living organs, which need to be constantly renewed, and this requires resources. And the organism is trying to use these resources prudently, not allocating them when there is no need in them or when they are needed in other organs for survival. Also, cortisol decreases absorption of calcium that is consumed with food and speeds up excretion of calcium from the organism. As a result, a constantly elevated level of cortisol becomes one of the causes of osteoporosis. 

An elevated level of cortisol also reduces production of melatonin, a neurohormone that participates in regulation of our sleep. If this occurs constantly, this results in sleep disorders. 

So, is cortisol a bad hormone? Certainly not. It is a part of mechanisms developed by the nature for survival. Troubles begin only when there is too much of it for a long time – weeks, months, or years. And this happens when there is chronic stress or chronic inflammation.

Imagine a situation, when there is no immediate threat of an attack at us. There is a potential possibility that something may go wrong, and we may suffer from this. And this lasts for weeks, months or years. How do we react to this? With stress. Many people do not even need to imagine this – this is what they live with, and this is chronical stress.

The situation with inflammation is less noticeable, but we consume substances, which are not immediately harmful in moderate quantities, but become rather harmful in excess quantities. But we do not know or do not understand that their consumption in such quantities is harmful. Or we know this, but cannot resist the temptation. And continue to consume them for years. Our organism reacts to this with inflammation. It is much less pronounced than an acute inflammation, but it exists, and it is sometimes called low-grade inflammation. To reduce chronic inflammation, the organism routinely produces more cortisol. 

These words came to us from the ancient Greek through Latin, where sympathy meant what it means in the English language, but also meant a response/reaction (to some events, even when they do not occur to us).  And the prefix para- meant "across the boundary", "beyond" (something).

The sympathetic nervous system initiates activities as a reaction to a change of circumstances. The parasympathetic nervous system initiates activities that are not a reaction to the circumstances. The sympathetic system is more active when there are threats, real or imaginary, external (for instance, a dangerous situation near us), or internal (for instance, an infection). The parasympathetic system is more active when there are no immediate threats, and we can relax.

These two system are autonomous nervous systems. Yes, they interact with the central nervous systems, but also act autonomously, regulating those functions of the organism that must be performed constantly. They "unload" the central nervous system from this routine work, allowing it to take care of more complicated and less routine things.

For instance, breathing. We can consciously control breathing, but rarely do this. Mostly, breathing is controlled by both autonomous systems, at that, the sympathetic systems controls breathing in, and the parasympathetic – breathing out. Also heartbeat – we practically do not control it consciously (though there are people who, with the help of special practices, learn voluntarily speed up or slow down the heartbeat). And there are many other processes in our organisms that occur beyond the attention of the central nervous system, but must be controlled.

The sympathetic nervous system increases production of cortisol as a signal to intensive actions. The parasympathetic nervous system reduces production of cortisol.

Cortisol increases the blood glucose level to prepare the organism to energetic actions. To make this glucose get into muscles and other organs that must act energetically, the organism increases the insulin level. Additional glucose becomes available for those energetic actions, the actions are performed, glucose gets burned, and its level in the blood lowers. The necessity in energetic actions ends, and production of cortisol lowers.

This is what happens at a "normal" stress situation, which lasts from several seconds to several hours, or at a "normal" inflammation, which lasts from a day or two, to two or three weeks.

But what if we have a chronic stress or chronic inflammation, and no energetic actions are not needed right now? Then cortisol stays elevated constantly, and it constantly increased the blood glucose level. And our organism is trying to push this additional glucose into cells, for which it increases the insulin level. And, gradually, cells begin to resist attempts of insulin to push more glucose in them. This is how insulin resistance develops because of chronically elevated cortisol level caused by chronic stress or chronic inflammation, even without constant excessive consumption of carbohydrates.

Appearance of insulin resistance is described in the page "How to break the system", and now you understand why stress is mentioned in the clause "Additional lifehacks". 

Acute inflammation is a way of protection of organism against a disease caused by an infection or poisoning. In this case, it is necessary to cure the disease, and the inflammation will end on its own. Only when it is too powerful and threatens to kill our organism even faster than the disease, it should be mitigated with anfi-inflammatory remedies. Both treatment of the disease and mitigation of the acute inflammation should be better delegated to doctors.

A different matter is a chronical inflammation. When possible, one should exclude or reduce (if complete exclusion is impossible) the factors that cause it – smoking, ecology, poisonous substances, ionizing radiation, unhealthy food. 

As for the food, there are very many things that need to be considered. We cannot review them all. The most common are: too much glucose and, especially, fructose, in our food, a lot of omega-6 and too little of omega-3 (especially EPA and DHA).

Stress is one of the mechanisms ensuring our survival. It becomes a problem only when it is chronic.

Chronic stress forms a center of constantly excited nervous cells, which get looped around a certain thought related to a real or imaginary stressful situation. A person is constantly concentrated on this thought, or very frequently returns to it, thus maintaining the stress.

What to do with this? It is known that, when a steady center of excitation forms in the brain, activity of other centers of excitation decreases at least temporarily. So, to mitigate the stressed center it is necessary to create other centers of excitation.

Control of attention. Those who can control their attention, can control themselves. Attention always has an object – a thing, a human, an animal, a thought, a screen of TV or mobile phone. Attentions jumps from one object to another, and this is natural and necessary. Without this, one can miss something interesting or useful, or not to notice a danger in time. To hold attention on a single object for a long time is difficult, but can be learned. 

Meditation. This is an ancient technique of training concentration of attention. Or, rather, many different techniques, quite often related to religions, but they have one thing in common: concentration of attention on a certain object. This can be a candle, a crystal ball, an icon, a mystical image or symbol, a thought or a concept ("eternity", "infinity", "universe", "God" – to each, their own), prayers or mantras (if this suits), sounds (special music for meditation or any calm music). Initially, attention will constantly skip to something else – it is necessary to calmly and without panic return it to the chosen object of meditation. Five minutes or more (if possible), once or twice a day, or more (if possible). There are lots of descriptions and videos about meditation on the internet. 

Physical activity, especially walking. When we move, our body generates a large stream of information to the brain, and the brain must process this stream and form control commands, for which, centers of excitation form in it.

The world around us. When walking, have a look at the blue sky, or stars and the moon, or dark clouds, at flowers, green or yellow leaves on the trees or trees without leaves, or covered with snow or frost (depending on the season), at birds and their chirping. If there is a possibility to come to a river or lake, look at the water – calm or turbulent, blue or of the color of lead (depending on the weather). Also, a look at passers-by, vehicles, architecture of buildings (especially if you walk along familiar streets and have stopped noticing buildings around long ago). Even a fleeting concentration of attention on such things gives necessary results – at least temporary suppression of the constant center of excitation related to the chronic stress.

An interesting book (or an interesting movie). A book is better, but a movie or an audiobook will also do – they concentrate attention well.

Breathing exercises. Breathing in is controlled by the sympathetic nervous system. Breathing out is controlled by the parasympathetic nervous system. If you make a relatively short inhalation and a relatively long exhalation, the sympathetic system will be active a shorter time than the parasympathetic system, and the stress will reduce. Also, for such breathing, one has to concentrate attention on the rhythm of breathing – that is, breathing becomes an object of attention, like in meditation. There are many recommendations as for the breathing exercises. When choosing them, one need to remember the described principle – a relatively short inhalation, a relatively long exhalation and concentration of attention, 1-3 times a day, 5 or more minutes at a time. By the way, when you are tired, but still need to make efforts, you can boost yourself up a little by doing this in the inverse sequence – a relatively long inhalation and a relatively short exhalation. Yes, this is stress, but a short-term one, and it helps to mobilize oneself when it is necessary. Besides, because of the concentration of attention, this stress will suppress the center of the chronic stress rather than further excite it.

Cold shower and HIIT (high intensity interval training). Both are a short-term stress, and they cause production of several hormones, including cortisol. But, simultaneously and much stronger, they increase production of the human growth hormone. Besides speeding up renewal of cells in the organism of adults, this hormone suppresses production of cortisol. So, the resultant action of each of these procedures is a reduction of the long-term (chronic) stress, while stress tolerance increases; and renewal of cells speeds up.  Several seconds of cold shower 3 to 5 times a week and 2 to 4 series of HIIT 1 to 4 minutes per series 3 to 5 days a week is enough. 

And so on. No need to do all this permanently. It is enough to periodically suppress the center of excitation related to the chronic stress, and its excitation will gradually reduce.

"Popular" methods of overcoming stress. Don't do this! 1) To eat something, especially, something sweet. 2) Alcohol, smoking, narcotic substances. Yes, this gives a short-lasting effect, but in the long run, this worsens the situation with the chronic stress, as well as with many other aspects of health. Besides, excess of carbohydrates, alcohol, smoking and many narcotics cause chronic inflammation, which is not better than chronic stress.

"Positive thinking". Don't do this! Somewhere in 2010s, an "idea" of overcoming stress came into fashion – positive thinking. The peak of the fashion has passed, but there are still many "ideologists" who promote this dead-end idea. "Nothing bad will happen to me," – this is what you must think, and this must protect you from troubles, according to the concept of positive thinking. But troubles happen, and then a double stress comes. One, because the troubles have occurred, and one more, because the positive thinking has not protected from them. The right approach is analysis of possible troubles, measures for preventing them (to reduce the probability that they may happen) and for overcoming them (if they happen), a comparative analysis of costs of prevention and possible losses, and choice of such measures that can give the maximal effect at minimal costs. This must be done calmly and prudently, and this does not mean "to be afraid of the future". Some people may call this "negative thinking", but in business there is a better name for this procedure: contingency planning.