Lifestyle changes and nutrient replenishment can help patients live a healthier, happier life.
Stress is an everyday part our lives. Whether it be emotional, mental or physical, stress takes a toll on our bodies and can prevent us from completing even the most mundane daily tasks as well as enjoying our leisure time with family and friends. Our bodies respond to stress in a variety of ways, and while all stress isn’t necessarily bad or damaging, the key rests in being able to get proper treatment before it turns into more serious health effects.
“Stress is designed as a survival mechanism and involves the release of glucocorticoid hormones that exert physiological effects to help protect us from danger,” said Penny Kendall-Reed, ND, clinical advisor for the Pennsylvania-based Douglas Laboratories. “Unfortunately, in today’s world, rather than a single ‘fight-or flight’ episode, we are faced with a multitude of smaller but more chronic stressors such as poor sleep, excessive workload and unstable blood sugar, as well as emotional conflict and ‘perceived’ stress.”
According to a recent American Psychological Association (APA) survey, “Stress in America,” stress continues to be a problem for many adults, while high stress and ineffective coping mechanisms remain ingrained in American culture. Forty-two percent of adults report that their stress level has increased and 36 percent say their stress level has stayed the same over the past five years. Adults’ average reported stress level is a 5.1 on a 10- point scale, far higher than the level of stress they believe is healthy (3.6).
Patients face a multitude of obstacles when confronted with stress in their daily lives, and how the brain responds to a given demand can be the difference to how stressful that change actually is and how quickly we can recover. The goal then is not simply de-stressing, but a complete recovery that allows patients to recapture their everyday routine that is free from stress and anxiety.
“I definitely think there is merit in ‘destressing’ but I do think there needs to be equal effort placed on recovery and management,” said Adam Killpartrick, DC, a New Hampshire-based chiropractor and nutritionist who specializes in functional medicine. “This starts with foundational approaches, diet, supplementation, movement and structural integrity. So much progress can be made from strengthening the foundation. From there, you optimize digestive health and hormone levels. Both of these areas undergo an intense assault when people are suffering from chronic stress.
“I also think there needs to be more consistent integration of cost-effective techniques that support a healthy relaxation response such as meditation or emotional freedom technique.”
Although the majority of adults say that stress management is important to them, few set aside the time they need to manage stress, according to the APA survey. Of course, finding the time to “de-stress” in an otherwise stressful environment may present the toughest challenge of all.
“Some issues that patients deal with when facing stress and anxiety are finding the time to include stress management strategies,” said Dr. Eudene Harry, a boardcertified physician and author of Anxiety 101: The Holistic Approach to Managing Your Anxiety and Taking Back Your Life. “Often times they see this an as additional thing that they need to incorporate into a life that already feels as if it’s about to swallow them up.”
According to the APA survey, some adults do not take any action at all to help manage their stress — one in 10 adults (10 percent) say they do not engage in any stress management activities. More than one-third (36 percent) of adults say stress affects their overall happiness a great deal or a lot and 43 percent of adults who exercise to relieve stress have actually skipped exercise due to stress in the past month.
“People don’t have time to recover from the multitude of stressors in our modern day and it is contributing to poor health that manifests in different ways,” said Holly Lucille, ND, a licensed naturopathic physician who holds a position on the American Association of Naturopathic Physicians (AANP) board of directors. “It’s like telling someone to ‘take care’ when they don’t have the tools or the know how to do that. When you’re stressed, teaching de-stressing can be stressful in itself. The best way to address this is by primarily supporting someone’s lifestyle and through education regarding stress management.”
Education does appear to play a key role in helping patients relieve the symptoms of stress in their everyday lives. The APA survey also explored the relationship between stress and health behaviors like sleep, exercise and eating — behaviors that people say are important to them but that the survey showed are negatively affected by stress. Survey findings illustrate that when people are living with high stress, they are less likely to sleep well, exercise and eat healthy foods.
“We need to educate our patients on foundational concepts,” said Dr. Killpartrick. “Most people that exist under significant stress are not aware of the techniques designed specifically to help support a healthy response to stress. It is vital that the information is conveyed in a manner than enables the patient to actually utilize the therapy. It’s a major problem when I see people being bombarded with information but they don’t know how to use it. It’s crucial as providers to be that resource that guides patients to the right therapy and makes it as accessible as possible.”
Another area of caution, Dr. Lucille warns, is when patients self-medicate without the proper knowledge or the guidance of their health care practitioner. This can lead to unforeseen problems and complications and harmful alternatives that only enhance the stress levels in many patients.
“Self-medication can be a slippery slope,” warned Dr. Lucille. “One of the biggest things to look out for is stressinduced nutrient depletion and self-medication. People often lose nutrients which they don’t replete when they are constantly under stress and they start to imbibe in increased use of caffeine and alcohol.”
Practitioners also tend to discount two major areas when it comes to stress, according to Dr. Killpartrick, which can make a world of difference in attempting the help the patient regain normal activity.
“Practitioners tend to discount the cranium and the structure,” Killpartrick said. “Cranial work and manual therapies have demonstrated time and time again in the clinical setting to be able to provide great support to the relaxation response. And don’t sell short the power of listening either, when it comes to helping your patients get back on their feet and working out the stressors.”
One useful tool for health care practitioners to utilize in helping their patients feel less stressed and in identifying the root cause of their anxiety is to gather as much information surrounding their lifestyle and any changes they may have experienced recently, such as diet or problems sleeping.
“Obtaining a comprehensive history can go a long way in determining factors that are contributing to a patient’s feelings of anxiety and elevated stress,” said Dr. Harry. “For example, if a patient is significantly nutritionally depleted he or she would find it challenging to find the energy and focus to incorporate any changes that you may have suggested. If a patient is not sleeping well, that too needs to be addressed promptly. Lack of sleep impairs judgment and memory, increases tendencies toward anxiety and depression, enhances inflammation that can further exacerbate anxiety, and lends itself to poor nutritional choices.
“These individuals may need a step-bystep plan as to what to eat and even when to eat it. If the practitioner has determined that the patient would benefit from additional nutrient or supplemental support, then I would encourage simplifying the regimen as much as possible so that the patient doesn’t feel overwhelmed.”
While many patients are told to simply slow down, deep breathe, or meditate as a form of treatment when they are stressed or anxious, according to Dr. Kendall-Reed, their bodies often do not understand that the “traffic” it is running from is not lifethreatening, thus making relaxation virtually impossible.
“The best thing a practitioner can do for a patient dealing with anxiety is to first explain that anxiety occurs when the central nervous system gets ‘stuck’ in the stress (sympathetic) side of the nervous system,” Dr. Kendall-Reed explained, “and avoiding stress alone will not ‘unstick’ it. The key to treating the condition is to reset the nervous system, allowing it to turn itself off and go back to the quiet, calm side. The practitioner must also explain what contributes to the turning on and off of the sympathetic nervous system and that the patient must use a combination of natural supplements to re-establish the feedback loop. The patient must be willing to recognize and make some changes, large or small, to their lifestyle.”
“Being empathetic is also huge,” added Dr. Lucille. “Listening and understanding but also looking for that exit strategy and working with your patient to help them find the light at the end of the tunnel.”
Supplement Support and Diet
There is certainly no shortage of natural products on the market that claim to help relieve stress and anxiety, but how do you know which ones are right for your patients? And how much does a positive outcome depend on your patient’s willingness to make the necessary lifestyle changes?
“Products are not where I go first,” Dr. Killpartrick said. “I go to diet, structure and mind therapies. Usually I do specific testing to determine whether there is a need for supplemental support. And in terms of changing everyday lifestyle, it’s not about changing everything, it’s about optimizing the right things.”
Among the nutrients that Dr. Killpartrick suggests support a healthy response to stress are: ashwagandha, holy basil, vitamin C, magnesium, phosophitydlserine, rhodiola and Siberian ginseng. Others nutrients/products that have been shown to help reduce stress levels include lavender, lactium, theanine and melatonin. Stress management tools such as meditation biofeedback and yoga have studies to support their beneficial role in stress reduction. None of these products and techniques work in a vacuum, however, without the willingness of the patient to undertake some lifestyle changes.
“When creating a stress recovery program it is imperative to address everyday lifestyle as this may be contributing significantly to fueling excessive stress response and anxiety,” said Dr. Harry. “Habits such as smoking and alcohol consumption can negatively impact the stress response as can decreased activity level and nutrient deficiencies.”
New Product Choices
So what is available to practitioners to help relieve the symptoms of stress and anxiety in your patients?
NeuroScience, Inc. has enhanced its Serotonin/GABA product suite by offering is Kavinace product in chewable tablets. Designed especially for children or patients who have trouble swallowing capsules, Kavinace offers the same benefits as regular Kavinace, including reducing anxiousness, promoting sleep and supporting healthy GABA activity, in an easy-to-chew, vanillaflavored tablet.
Now available throughout North American, Sereniten Plus from Douglas Laboratories offers a formula consisting of a combination of lactium, l-theanine and vitamin D to support the hypothalamic-pituitary-adrenal (HPA) axis and feedback loop for stress management and cortisol regulation.
Adrenal Stress Relief from Forever Health contains four extracts that can help protect against the damaging effects of stress. It includes cordyceps, ashwagandha, bacopa and holy basil. Adapta from EuroMedica is a potent herbal adaptogen formula that fights stress and strengthens the body from within with ashwagandha and rhodiola.
Restoring a healthy magnesium level and balancing your calcium intake can help in the battle against stress and anxiety (see sidebar on pg. 20) and is the target of Natural Calm from Natural Vitality. The magnesium supplement drink, available in an assortment of flavors, gradually reduces accumulated calcium to provide relief to many symptoms of magnesium depletion.
1 “Magnesium deficiency induces anxiety and HPA axis dysregulation by Sartori SB, Whittle N, Hetzenauer A, Singewald N Neuropharmacology. 2012 January; 62(1): 304–312.
2 Magnesium supplementation improves indicators of low magnesium status and inflammatory stress in adults older than 51 years with poor quality sleep by Nielsen FH, Johnson LK, Zeng H. Magnes Res. 2010 Dec;23(4):158-68. Doi: 10.1684/mrh.2010.0220.
What Is The Best Defense Against Stress and Aniexty?
Whether emotional, mental or physical – stress takes a toll on our bodies. Although types of stresses may differ, our bodies react similarly, with an avalanche of responses at a molecular, cellular, tissue, organ and organ-system level. Such responses are stimulated by increased secretion of the stress hormones adrenaline and adrenal cortisone, which are often called the fright, flight or fight hormones.
Stress hormones cause a sudden rise in critical magnesium-dependent reactions. Energy production, nerve-impulse transmission, increased muscle function, and responses of heart and blood vessels all require magnesium. At the cellular level, the inflow of calcium into the cells decreases magnesium and muscles such as the heart, lungs and blood vessels prepare to contract, secondary stress hormones are released and nerves start to fire with more frequency. When the stressful situation is over, magnesium flows back into the cells, forcing calcium out and thereby allowing the cells and muscles to relax, while nerves calm down and blood flow decreases.
This is why magnesium is known as the anti-stress mineral. As we respond to stress our need for magnesium soars and our body’s stores of this mineral can be quickly depleted.
A person whose magnesium levels are already low or inadequate will occasion their stress reaction to continue beyond a healthy and normal response. A magnesium deficiency itself can initiate and perpetuate a stress or anxiety response without a stress trigger even being present. Low magnesium stores can prevent the body from relaxing and cause muscle cramping, heart palpitations, inflammation, stroke, headaches and insomnia. After a stressful situation, adequate magnesium is needed to help the body transition over to a relaxed state.
Coffee, alcohol, medications and perspiration from exercise or work are all factors in depleting the body of magnesium. And our current diets of processed foods and demineralized soils add to the deficiency problem.
A 2012 study in Neuropharmacology entitled, “Magnesium Deficiency Induces Anxiety…” This study proves that in an animal model magnesium deficiency induces anxiety.
How magnesium deficiency can induce anxiety and cause stress is explained further by Carolyn Dean, MD, ND, and Medical Advisory Board Member of the Nutritional Magnesium Association. “A deficiency of magnesium magnifies anxiety and stress. Serotonin, the feel good brain chemical that is boosted artificially by some medications, depends on magnesium for its production and function. A person that is going through a stressful period without sufficient magnesium can set up a deficit that, if not corrected, can linger, causing anxiety, stress, depression and further health problems.”
Another study showed that many individuals have a low magnesium status associated with increased chronic inflammatory stress that could be alleviated by increased magnesium intake.2
According to researcher Andrea Rosanoff, PhD, “With prolonged stressinducing conditions, the need for magnesium remains abnormally high during the body’s response to the sustained stress. Suboptimal magnesium stores can be exhausted. Even with seemingly adequate magnesium nutrition, there can be decreased resistance to chronic stress. It is possible to adapt to a condition of chronic stress, and once you achieve this, everything seems just fine for a while, sometimes for a long while. Such periods of adaptation to a stressful way of life can go on for years, and can delude a person into believing that living an extremely demanding and/or exciting life need not endanger his or her health or even survival. But the ability to adapt to stress can diminish, and if it does, irreversible damage can ensue.”
Magnesium supplementation is a certain way to fight stress and anxiety and avoid the illnesses associated with stress. Not all forms of magnesium are equally absorbed. Magnesium citrate powder is a highly absorbable form can be mixed with water and sipped throughout the day.
A 32-page guide to the benefits of magnesium, along with magnesium deficiency symptoms, is available for free at www.nutritionalmagnesium.org.
Healthy Take Aways
Forty-two percent of adults report that their stress level has increased and 36 percent say their stress level has stayed the same over the past five years.
Patients face a multitude of obstacles when confronted with stress in their daily lives.
Although the majority of adults say that stress management is important to them, few set aside the time they need to manage stress.
When creating a stress recovery program it is imperative to address everyday lifestyle.
FOR MORE INFORMATION:
■ Dr. Adam Killpatrick, (603) 435-6600
■ Dr. Holly Lucille, (323) 658-9151
■ Dr. Penny Kendall-Reed, (412) 642-0642
■ Dr. Eudene Harry, (407) 354-0500
■ Douglas Laboratories, (800) 245-4440, www.douglaslabs.com
■ NeuroScience Inc., (715) 294-2144, www.neuroscienceinc.com
■ Forever Health, (888) 222-2956
■ EuroMedica, (920) 593-6277, www.euromedicausa.com
■ Natural Vitality, (800) 446-7462, www.naturalvitality.com
Lifestyle changes and nutrient replenishment can help patients live a healthier, happier life.