August 2008

Stress takes heavy toll on health

Chiropractors have preached for decades that stress -- physical, mental or emotional -- can have a devastating effect on health. They've educated their patients, sponsored community stress management programs, corrected subluxations triggered or exacerbated by stress, and become leaders in the wellness revolution by raising awareness of the "enemy within" our own bodies.

In recent years, a mountain of scientific evidence has grown based on hundreds of research projects into the causes and effects of stress, particularly chronic stress.

It is now commonly accepted that the hormonal system known as the hypothalamic-pituitary-adrenal (HPA) axis serves as a feedback loop by which signals from the brain trigger the release of hormones needed to respond to stress. Because of its function, the HPA axis is also sometimes called the "stress circuit" and affects systems throughout the body. As explained by the National Institutes of Health: "The hormones of the HPA axis exert their effect on the autonomic nervous system, which controls such vital functions as heart rate, blood pressure, and digestion."

In addition, states the NIH, "the HPA axis also interacts with the immune system, making you more vulnerable to colds and flu, fatigue and infections."

Numerous research studies have confirmed the verdict that "stress kills." One that received widespread attention several years ago was conducted by researchers from the University of California, San Francisco. The study, published in the Proceedings of the National Academy of Sciences, determined that chronic stress, and the perception of life stress, each had a significant impact on three biological factors -- the length of telomeres, the activity of telomerase, and levels of oxidative stress -- in immune system cells known as peripheral blood mononucleocytes.

Telomeres are DNA-protein complexes that cap the ends of chromosomes and promote genetic stability. Each time a cell divides, a portion of telomeric DNA dwindles away, and after many rounds of cell division, so much telomeric DNA has diminished that the aged cell stops dividing. Thus, telomeres play a critical role in determining the number of times a cell divides, its health, and its life span. These factors, in turn, affect the health of the tissues that cells form. Telomerase is an enzyme that replenishes a portion of telomeres with each round of cell division, and protects telomeres. Oxidative stress, which causes DNA damage, has been shown to hasten the shortening of telomeres in cell culture.

The results of the study -- which involved 58 women, ages 20-50, all of whom were biological mothers either of a chronically ill child (39 women, so-called "caregivers") or a healthy child (19 women, or "controls") -- were dramatic.

As expected, most women who cared for a chronically ill child reported that they were more stressed than women in the control group, though, as a group, their biological markers were not different from those of the controls. However, in one of the study's key findings, the duration of caregiving -- after controlling for the age of the women -- proved critical. The more years of care giving, the shorter the length of the telomeres, the lower the telomerase activity, and the greater the oxidative stress.

Moreover, the perception of being stressed correlated in both the caregiver and control groups with the biological markers. In fact, in the most stunning result, the telomeres of women with the highest perceived psychological stress -- across both groups -- had undergone the equivalent of approximately 10 years of additional aging, compared with the women across both groups who had the lowest perception of being stressed. The highest-stress group also had significantly decreased telomerase activity and higher oxidative stress than the lowest-stress group.

"Numerous studies have solidly demonstrated a link between chronic psychological stress and indices of impaired health, including cardiovascular disease and weakened immune function," said lead author Elissa Epel, PhD, UCSF assistant professor of psychiatry. "The new findings suggest a cellular mechanism for how chronic stress may cause premature onset of disease. Anecdotal evidence and scientific evidence has have suggested that chronic stress can take years off your life; the implications of this study are that this is true at the cellular level. Chronic stress appears to have the potential to shorten the life of cells, at least immune cells."

In her research report, Dr. Epel noted that there is a need for additional research into whether stress-relief techniques including yoga, meditation or behavioral therapy might increase telomerase activity and slow the rate of telomere shortening. "The findings emphasize the importance of managing life stress, to take it seriously if one feels stressed, to give your body a break and make life changes that promote well-being," Epel said.

For chiropractors, who also know from their own clinical experience that chronic stress can also be associated with vertebral subluxations, research findings such as this are powerful incentives to address chronic stress in patients. Yet, until recently, the only way to determine the level of stress and stress-reactions in patients was by asking them. This is an unreliable way to make such a critical determination. Many people either don't realize or deny the extent of the stress they are under.

To make a more accurate determination, doctors need to perform a Stress Response Evaluation (SRE). "How well a patient responds to stress is at the heart of chiropractic. The ability to measure this information is invaluable," explained DeDe Van Riper, Chiropractic Instrumentation columnist for The Chiropractic Journal. "An SRE measures your patient's response to stress using six different modalities and can show how well a patient responds to meet the demands of the stress. It will also show the doctor how well the patient recovers from the effects of stress."

According to chiropractic researcher Richard Barwell, DC, modern instrumentation can "finally address 'the cause' (abnormal neural activity) which leads to abnormal muscle activity which in turn creates abnormal joint mechanics. This new instrumentation provides information about neurological function at both the cortex (brain function) and at the Limbic System level (sympathetic/para-sympathetic responses), and is designed to test these over time and situations of stress and recovery. It is a dynamic test for a dynamic system which deals directly with cause and can demonstrate the ability and power of chiropractic to alter neural function."

In addition, newly developed SRE instrumentation available to chiropractors today displays the results graphically, which can be a persuasive patient teaching tool.

More information on SRE instrumentation can be obtained by contacting DeDe Van Riper at 877-233-0022.