Posted on November 1, 2018 by Natural Practitioner Magazine
Lifestyle changes and supplements can help patients alleviate day-to-day or chronic stress.
Stress is an inescapable, inevitable part of life. Our bodies are equipped to handle a modicum of stress. In fact, some amount of stress it is integral to our survival. Stress is not all bad if it is managed properly.
“Without stress, there would be no impetus to move, change and transform. Additionally, acute stress responses in response to danger can be life saving. So the question is when does ‘stress’ become ‘distress?’” said Lise Alschuler, ND, FABNO, with Naturopathic Specialists, LLC, in Arizona. “Stress can be thought of as an equation where distress equals what is happening around us plus how we interpret those happenings.”
“Although stress is normal, certain chronic anxious feelings in the body can come to be recognized as fear and thus trigger a low-level version of the ‘fight-or-flight’ response from the adrenal glands. Over time, the adrenal glands function can decompensate,” explained Jeremy Appleton, ND, vice president of science and education with Klaire Labs, a Nevada-based manufacturer.
“Stress, like many things in life, can be a productive thing if in balance. Our bodies are created to handle a stressor and then have the ability to rebalance. Unfortunately, our base line of stress has risen over the years. This shifts stress from acute stress to chronic stress. This increase in baseline stress puts constant pressure on our endocrine system in its attempt to create homeostasis,” added Robin Rogosin, vice president of product development at LifeSeasons, a manufacturer based in Texas.
Why So Stressed?
There are a number of reasons why people are super stressed. For one, our lives are too complicated.
“It is my belief that this stress is a result of living rather chaotic, incredibly busy lives devoid of ritualistic activities that would otherwise serve as daily anchors to calm and settle ourselves. If you study the lives of long-lived individuals and communities, one of the most consistent commonalities that these people have are daily rituals and a tendency toward more simple day-to-day living,” said Dr. Alschuler.
Others believe that excessive screen time plays a causative role.
“More and more people are using their phones right before they go to bed and reaching for their devices first thing in the morning. This exposure to blue light, as well as the stress response that comes from being constantly plugged in, is robbing many Americans of the necessary essential sleep,” said Evan DeMarco, chief marketing officer and product innovator with Omax Health, a manufacturer based in California. Amy McKelvey, CEO of her vital way, a manufacturer based in California, agreed.
“There is a direct link to anxiety and social media, and we’re seeing this pop up in all ages. We are not physically or mentally wired to stare at screens while limiting face-to-face contact with other human beings, and so we’re beginning to see the fallout from this.”
Just the sheer number of anxiety diagnoses that Americans carry is indicative of this fallout.
“Of the many types of anxiety, the most diagnosed is social anxiety disorder (SAD), at about 15 million American adults. SAD is a real equal-opportunity condition, and it affects men and women at approximately the same rate,” said Cheryl Myers, chief of scientific affairs and education at EuroMedica, a Wisconsin-based manufacturer. “General anxiety disorder (GAD) is diagnosed at just under half that amount, at about seven million and affects more women than men.”
The Effects of Stress
Like sunshine, too much stress can burn you out.
Sometimes stress can be caused by external factors or situations in life that, once resolved, will restore order to your mental state. Still, an overabundance of mental stress, particularly when its ongoing, can manifest itself in physical problems.
This mind-body connection plays itself out in many ways. Stress starts in the brain with the amygdala, explained Dr. Alschuler. Any stimulus perceived as hostile will activate the amygdala. “The amygdala, in turn, causes our nervous system to release norepinephrine which contributes to sympathetic nervous system activation. This is characterized by a rapid heartbeat, sweating, irritability and mood changes such as anger. At the same time that this is happening, another area of the brain, the hypothalamus, receives the alarm signal and triggers the pituitary gland to release adrenocorticotropic hormone (ACTH). ACTH binds to receptors on the adrenal glands which causes the adrenal cortex to secrete cortisol,” she said.
“Once the cortisol receptors are activated, cells up-regulate their production of various proteins involved in inflammation, immunity, digestive function, cardiovascular function and cognition and mood. When we constantly activate this stress response, the enduring influence of cortisol begins to unravel our physiology,” she added.
“It can throw hormones out of whack, cause fluctuating GI (gastrointestinal) issues, account for loss of sleep or lack of quality of sleep, impact fertility, create impotence, attribute to weight gain, hair loss, weakened immunity, skin issues and acne, and diminish cardiac function—all of which cause more stress,” said McKelvey.
“Due to extra stressors, the adrenals pump more cortisol which affects insulin levels, the immune system, sleep, inflammation levels, thyroid function, and so much more,” said Laurel Sterling, MA, RD, CDN, the national educator for Carlson Labs, an Illinois-based manufacturer.
Myers added that stress and anxiety can affect sleep and can “…cause or perpetuate inflammatory states throughout the body and mind, make us revert to less-than-skillful habits like stress eating or drinking, and set the stage for more deeply ingrained dysfunctions. Anxiety and depression are closely related, as are anxiety and a weakened immune system.”
Moreover, should these inflammation levels get too high, that in turn can raise the risk for a number of other diseases, such as cancer and cardiovascular disease, added Dr. Appleton. Chronic stress also could play a significant role in headaches, irritable bowel syndrome, chronic fatigue and alcohol abuse.
Other physical manifestations of an inordinate amount of stress can include muscle weakness or atrophy, osteoporosis, hypertension, menstrual disorders and digestive diseases, said Dr. Jorge Enrique Angel with WeLife Naturals, a manufacturer based in Spain and Idaho.
Traditional Methods of Treating Stress/Anxiety
When patients mention stress and anxiety to their doctors, they are often prescribed Selective Serotonin Reuptake Inhibitors (SSRIs), antidepressants, sedatives, anxiolytics and/or nerve pain medications to help their patients manage anxiety and stress symptoms.
One in four women takes some sort of anti-anxiety medication, reported McKelvey, adding, “While this approach might work in the short term to alleviate symptoms, it certainly should not be a long-term solution.”
The problem with these drugs, said DeMarco, is that they don’t address the underlying cause of the problem.
Rogosin added that there are often unpleasant side effects, which can include “…nausea, digestive disturbances, nervousness/restlessness, dizziness, fatigue, tolerance, headaches and nightmares. It seems that some people are more prone to stress and anxiety than others, and for those who suffer from these conditions, they’re searching for effective alternatives without the discomfort of side effects.” Other side effects, for women in particular, added McKelvey, can include constipation and bloating, reduced sex drive and weight gain.
An overabundance of stress can deplete essential nutrients in your body, including B vitamins; B vitamins are found in not only supplement form but in certain foods like whole grains, meat, eggs and legumes. The dietary changes recommended by McKelvey include fresh fruits and vegetables, healthy fats, wild caught seafood and nuts.
“Notably, high consumption of refined sugar amplifies the cortisol response to psychological stress, so those ‘comfort foods’ are not perhaps as comforting as we think,” Dr. Alschuler pointed out.
“Encouraging lifestyle changes is always the best course of action. Diet, exercise, supplements and social optimization can have a major lasting impact on a patient’s health,” said DeMarco.
“Exercise even in short spurts, everyday. Ten minutes of brisk exercise increases mood improving hormones and neurochemicals; an hour-long walk is therapeutic,” advised McKelvey.
“Mind-body techniques—such as biofeedback, relaxation training, tai chi, yoga and meditation—have all demonstrated efficacy in helping to manage stress,” added Dr. Appleton.
Therapy can also be beneficial for many people.
Some practitioners recommend supplements as part of an overall approach to managing stress and anxiety; there are an abundance of such products on shelves.
LifeSeasons Adrenal-T, an amino acid, supports the body’s natural ability to rejuvenate, manage stress and conserve energy. “It supports healthy endocrine system functions, which supports healthy mental and physical performance,” said Rogosin.
Other LifeSeasons products include Anxie-T, which includes such herbs as holy basil, rhodiola and ashwagandha, among others, and it supports the body’s natural ability to deal with such common stress symptoms as nervousness and muscle tension. Mood Stabili-T supports a feeling of calmness and emotional well being.
Carlson Labs manufactures Pharma GABA. “GABA is a naturally occurring amino acid and one of the most important inhibitory neurotransmitters in our brain. Inhibitory neurotransmitters are the ‘off’ switches and help prevent overstimulation and act as a calming mechanism. GABA promotes a healthy mood, relaxation, and restful sleep,” explained Sterling.
Carlson Labs also manufactures several products that are targeted to support stress relief and anxiety reduction. One of these, Mellow Mood with GABA, “…promotes calmness and mental clarity. It is a multi-nutrient formula with [vitamin] Bs, GABA and L-theanine to promote a better frame of mind and relaxed state of being,” said Sterling.
In fact, L-theanine is a popular ingredient in products designed to support stress. A product made by her vital way to address stress and anxiety is Extra Strength L-Theanine AlphaWave; L-theanine is made from an amino acid from green tea. “L-theanine is unique in that it calms and focuses the mind and the body through enhanced alpha brain wave activity and increased synthesis of GABA within 20 minutes of ingestion,” said McKelvey. Another of the company’s products is Schisandrala Berry, an adaptogen that is targeted to combat fatigue and revive energy. “It is a powerful anti-anxiety herb and a wonderful adrenal and liver-supporting herb but it also supports the heart,” she added.
Natural Vitality CALM is a product manufactured by Nutranext, headquartered in Florida. The main ingredient is magnesium, which is “an essential mineral that plays a vital role in many cellular and physiological functions. Symptoms of magnesium deficiency may include low energy and fatigue, weakness, muscle tension, spasm, and cramps. Natural Vitality CALM supports healthy magnesium levels,” said Susan M. Piergeorge, MS, RD, LDN, nutrition education manager. It comes in a powdered drink mix and gummies.
EuroMedica manufactures two products that are for anxiety relief and for adapting to stress: AnxioCalm, which contains a specialized root phytocannabinoid extract of Echinacea angustifolia, and an adaptogenic supplement called Adaptra, which combines ashwagandha with rhodiola, two ancient botanicals; Myers explained that all of these ingredients have been researched for its positive effects on stress and anxiety. Of the ingredients in Adaptra, Myers said, “They both stand out because they can both start having a positive effect on anxiety and stress for patients on the very first day of use. But unlike conventional prescription drugs, they don’t cause side effects.”
DeMarco said that Omax Stress Remedy is a triple action formula that is targeted to help manage daily stress and improve sleep quality; it is comprised of CBD, omega-3 and L-theanine. “The three ingredients in Stress Remedy work synergistically to help lower stress chemicals like C reactive protein, homocysteine, cortisol and prolactin. When we lower these, the body helps resolve inflammation better and is better prepared to enter deeper levels of REM sleep, which is essential for the body to repair itself,” he said.
Klaire Labs manufactures Cortisol Management, which contains a proprietary blend of magnolia and Phelodendron as well as an ashwagandha extract called Sensoril. “It is used to help the body defend against stress-produced cortisol elevations, and thus supports sleep and stress management,” said Dr. Appleton. Other products are Stress Support Complex; Adrenamin; Target-gb-X; and several B-vitamin formulations. The company also produces several products containing standalone ingredients that target stress, such as L-theanine, melatonin and GABA, the later of which is an inhibitory amino acid and neurotransmitter with relaxing properties.
Holoram Equilibrium, manufactured by WeLife Naturals, combines adaptogens (substances that activate the ability to stimulate the biological responses of adaption to stress) and energy regulators of the neurovegetative system. The harmonious balance of the ingredients in this product, explained Dr. Angel, promotes the balance of the nervous system when under conditions of strong adaptive demand.
“There are four modifiable contributors to stress and anxiety including: cortisol levels, occasional inflammation, neurotransmitters and thyroid (HPT Axis). At Integrative Therapeutics, we have developed a broad range of products to address these contributors to chronic stress. Some of the key products within this protocol are: Cortisol Manager, HPA Adapt, Lavela WS 1275 and Theracurmin HP,” said Jeremy DeWitt, brand manager for the Wisconsin-based company.
Some of these products contain a blend of clinically studied ingredients. To illustrate, Cortisol Manager contains ashagandha, magnolia, L-theanine, epimedium and phosphatidylserine, which helps support sleep, while Lavela WS 1275 is a lavender oil extract that is designed to calm occasional anxiety.
State of the Market
Unfortunately for the populace, stress and anxiety are not going away anytime soon. So long as there is work and family obligations, there will be stress.
“According to the National Institute of Mental Health, 40 million adults in the U.S. are affected by anxiety. We can attribute the cause to the lifestyles we lead, without enough down time and family/community support. We can also point to the lack of exercise, not enough time outdoors in natural sunlight, and food that contains carbohydrate, fat and protein density without the water, fiber and micronutrients we need to support good health,” said Rogosin.
Jamie Langston, BSN, RN, CCRP, chief research officer with LifeSeasons, said that many practitioners recommend or dispense supplements, as they are more accepting of the science behind supplements; she noted that even many major medical centers have integrative functional medicine departments.
The growing recognition of the efficacy of natural compounds and a more holistic view of health will only strengthen the practitioner market, opined Myers, along with the well-known side effects deriving from some prescription medications.
As patients experience stress and anxiety from different causes and experience its side effects in different manners, there is no one size fits all solution to treating patients.
For that reason, it is best to take a holistic/whole person approach.
“A thorough clinical evaluation should always be the foundation of treatment and this includes a nutritional evaluation. Nutrient replacement is a starting point and often the beginning of the return to optimum health for a patient,” said Langston.
“It’s very calming when a practitioner explains that occasional anxiety and stress is normal but that it is important to address it in a comprehensive way that works with the body. The key is having remedies and ‘coping’ tools on hand,” added McKelvey.
Practitioners can learn more about supplements from company websites. For example, on LifeSeasons’ website, the company makes transparent the current research and safety information about each ingredient used in their formulations as well as links to supportive studies. “We encourage our practitioners to use this valuable resource,” said Langston.
Many manufacturers provide practitioner support, such as product literature and personalized training. “We believe in supporting our practitioner partners with frequent webinars and clinical summaries,” said Myers.
McKelvey said that her vital way offers free samples and ingredient informational cards as well as make their studies available to practitioners.
Other companies, such as Klaire Labs, have physicians on staff that are available to consult with health care practitioners should the latter have questions about products, as well as provide monographs, technical data summaries, webinars and publications in third-party journals.
“Practitioners are uniquely positioned to use lab data and experience to help craft a supplement program for their patients where success can be measured not only by patient feedback, but by ongoing lab work,” said DeMarco, adding that his company is committed to helping practitioners with collateral including brochures, video content and clinical validation.
“Practitioners aim to improve the wellness of their patients. We do this by removing disease or pathogenic insults and also by restoring vitality and wellness,” concluded Dr. Alschuler. “The latter requires that we query our patients about their stress levels, stress perception and identify where stress is implicated in their disease. By equipping patients with strategies for better stress management, restoring optimal Circadian rhythms and lowering elevated cortisol, we will optimize wellness in a profound and lasting way.”
Healthy Take Aways:
• Everybody experiences some level of stress and/or anxiety.
• Lifestyle changes, including diet and exercise, should be the first tools in the arsenal when it comes to helping patients to alleviate stress and anxiety.
• Supplements that aim to help reduce cortisol levels and restore sleep function can be useful for many patients.