I’m just going to say it – this pandemic is stressful! As I’ve been meeting with patients via telemedicine these past couple of weeks, it is clear that COVID-19 is affecting everyone. You may be worried about job security, paying your bills, juggling work and homeschooling your kids, or you may be working on the front lines in healthcare or the food industry. As we shelter in place and practice social distancing strong emotions arise. Collectively we feel a lot of uncertainty, fear and stress about living in a pandemic as well as what the post COVID-19 future looks like.
It is completely normal to feel stress right now. In fact, I’d be worried if COVID-19 didn’t faze you at all. However, I know first-hand – through my own health journey and as a medical provider – that the impacts of stress over time lead to burn out, chronic disease, and symptoms of HPA-axis dysfunction or “adrenal fatigue.” Not to mention that stress dampens the immune system’s ability to fight a virus.
I can’t take all of your stress away right now, but I can teach you to support your adrenals during this pandemic.
In this article, you will learn:
About the adrenal glands and your body’s stress response
The stress-immune connection
Supplements to boost immunity by supporting the adrenals
My top 6 self-care strategies to soothe stress
Let’s dive in!
Understanding Your Adrenals
Your adrenal glands are walnut-sized glands that sit on top of your kidneys. Their job is to produce hormones in response to stress – please meet your adrenaline and cortisol hormones! They also help to regulate metabolism, blood pressure and play a role in your immune system.
“Collectively we feel a lot of uncertainty, fear and stress about living in a pandemic and the future.”
As like everything in the body, the adrenal glands don’t act alone. Instead, they work with the brain as part of an orchestrated symphony of your mind body connection or what’s known as the hypothalamus-pituitary-adrenal axis (or HPA-axis for short). The hypothalamus is the part of the brain that interprets signals. When it perceives stress, it signals the pituitary, the “master gland,” to then signal the adrenals in a “fight or flight” response. If you’re interested in learning more about your HPA Axis, watch this quick and insightful video.
When stress hormones rise, blood is pulled to the extremities and blood sugar goes up, providing energy to run and fight. This is exactly what we want to happen when we come face-to-face with a bear in the woods or hear our child scream for help. We have a stress response and then we return to normal.
This is what happens when your body is chronically bathed in stress hormones:
The problem arises with our modern world. The stress signals never seem to stop! We face the typical sources of stress around money, jobs and relationships. However, there are a lot of other signals that the body perceives as stress as well. These stressors include:
Exposure to toxins – air pollution, water pollution, plastics, chemicals, processed foods, beauty products, perfumes, personal hygiene products and so much more.
“I know first-hand – through my own health journey and as a medical provider – that the impacts of stress over time lead to burn out, chronic disease and symptoms of HPA-axis dysfunction or ‘adrenal fatigue.’ Not to mention that stress dampens the immune system’s ability to fight a virus.”
As you can see our modern lifestyle is very good at contributing to stress signals that fire up the HPA-axis. This initially leads to an over production of stress hormones. And, over time, with chronic stress such as what we are currently experiencing, the whole system gets overwhelmed. Have you ever felt like you were “burning the candle at both ends?” Or, have you ever experienced burn out on a very physical level? This is what the term “adrenal fatigue” or HPA-axis dysfunction refers to.
At The Fork Functional Medicine, we use functional testing to get a clear picture of adrenal hormones. I often look at a salivary or urine test for cortisol levels throughout the day. Cortisol, a main stress hormone, has a daily rhythm in the body. It is supposed to be highest in the morning and then drop throughout the day, allowing for alertness during the day and help to facilitate sleep at night. However, when this rhythm is off symptoms of HPA-axis dysfunction appear. These include:
Feeling unrested, even after a full night’s sleep
Decreased resiliency to stress
Frequent colds, low immunity
Frequent urination at night
Feeling “wired and tired” at night
Changes in thyroid or sex hormone levels
Increased inflammation in the body
Dizziness with standing
Low blood pressure
Low blood sugar
Insomnia
Brain fog
Salt cravings
Fatigue
Weakness
HPA-axis dysfunction is a contributing root cause to many symptoms and conditions that I treat regularly using functional medicine. So just like most things, there is a sweet spot with cortisol and we don’t want it to be too high or too low at any point throughout the daily cycle.
Boost Immune System By Soothing Stress
There is a lot of talk these days in the media and from functional medicine experts about how to “boost” the immune system using supplements and health practices such as relaxation techniques, stress management, proper movement and exercise and so much more. However, a piece that I see missing is the connection between the immune system and HPA-axis.
The bottom line is that when stress is ramped up, immunity goes down. If you come across a bear in the woods and are also infected with a virus, the body sees the more immediate concern as running from the bear. The stress hormones from the adrenal glands effectively shut down the immune response.
This makes sense and is protective during those short-term stresses, but the day-in-day-out chronic stress actually suppresses immunity and isn’t doing our health any favors.
In addition to supporting the immune system, I suggest using supplements and lifestyle tools to provide adrenal support in order to correct any current HPA-axis dysfunction or prevent any down the road. This will also help to support the immune system should you be exposed to COVID-19 any time soon.
Vitamins To Boost Immune System and Nurture Your Adrenals
Here are some of the adrenal support nutrients and herbs that I often include as part of a personalized functional medicine plan for my patients. By nurturing the adrenals, the immune system benefits.
B Complex. The body burns through B vitamins in a stressed state and if they aren’t replaced fast enough, you’ll notice that metabolic health suffers. By taking a B complex, you provide a steady stream of B vitamins to the body for adrenal system support, and therefore immunity. If you have symptoms of HPA axis dysfunction, you may notice improvements in energy and mental clarity with B vitamins and I consider this foundational support during times of stress. (This is the info link for the B Complex, the company provides the link to be used on my website. It is a product card that takes them to my Fullscript site where they can buy the recommended product. Im not sure what to do with it but here is the code.)
For adults, I like Methyl B Complex.
For children, I like Kids B Complex.
Vitamin C. Vitamin C might be a nutrient you are already taking to boost your immune system in the face of COVID-19. Did you know that the adrenals have the highest concentration of vitamin C in the body? By replenishing vitamin C, you not only support the immune system, but also your body’s ability to respond to stress. (This is the info link for the Vitamin C… same as above, here is the code.)
For adults, I like Ultra Potent – C 1000.
Forchildren, I like Chewable Vitamin C by Little DaVinci.
Adaptogens. Adaptogens are a group of herbs that support the HPA axis and help the body regulate the stress response. In essence, they help you adapt to your environment. These herbs include ashwagandha, eleuthero, licorice, tulsi, rhodiola, reishi, ginseng and others. Herbs can be used as single herbs or in combination and the timing can be based on your unique cortisol test. Each of the adaptogens above addresses a different aspect of the cortisol pattern so it’s important to tailor the product with your particular pattern. Please reach out if you are interested in working with me to develop a personalized herbal protocol to support you right now.
Probiotics. Since stress impacts the microbiome and there is a profound connection between gut health and brain health, supporting the gut is incredibly important during times of stress. What’s more is that 70-80% of the immune system resides in the gut, so you influence immune health as you correct imbalances in the gut. I often recommend probiotics to my patients for these reasons and more. (This is the info link for the Probiotics… same as above, here is the code.)
“There is a lot of talk these days in the media and from functional medicine experts about how to “boost” the immune system using supplements and health practices such as relaxation techniques, stress management, proper movement and exercise and so much more. However, a piece that I see missing is the connection between the immune system and adrenals. The bottom line is that when stress is dialed up, immunity dials down.”
Two favorites that I alternate between are:
MegaSporeBiotic
and Proflora4R Restorative Probiotic Combination.
And for children, I like Flora Bites.
For infants, I like MetaKids Baby Probiotic.
Please visit The Fork Functional Medicine Apothecary for discounted access to the professional supplements that our team recommends and loves.
How To Boost Your Immune System: Chyrl’s Top 6 Ways To Soothe Stress
In addition to the adrenal supportive supplements discussed above, here are my top strategies to soothe stress and support immunity during this time.
Include plants in your diet. The adrenal glands like good nutrition. This means including nutrient-dense plant foods as part of your daily diet to provide vitamins, minerals, fiber and phytonutrients to reduce inflammation and oxidative stress. Try to include a variety of colorful produce each day (and YES it’s perfectly great to choose frozen depending on what is available in your grocery store from week to week!). Some of my favorites right now are:
Dark leafy greens – kale, collards, arugula, parsley, etc.
Oranges and other citrus fruits
Avocados
Berries – blueberries, kiwis, blackberries, etc.
Cherries – especially dark red (they are quite anti-inflammatory!)
Nuts and seeds such as pumpkin seeds and almonds
Starchy vegetables like sweet potatoes and plantains
Balance blood sugar. Another dietary strategy is to be sure to keep blood sugar balanced throughout the day. This takes some of the pressure off of the adrenal glands and helps with any symptoms related to low blood sugar that can be common with stress. I suggest including protein and fat with each meal and not skipping meals.
Prioritize sleep. Just like the adrenals like regular meals, the adrenals like a regular sleep-wake schedule and getting enough, quality sleep each night. Good sleep and a regular circadian rhythm helps immunity as well.
Move your body. Ideally, move your body in a joyful way. This could be walking, dancing, yoga or anything else that feels good. Movement helps to reduce stress and support immunity. Be careful that too much high intensity exercise especially cardio can have the opposite effect. So during times of high stress, gentle, restorative exercise is preferred and training for a marathon or other chronic cardio is not recommended.
Practice mindfulness. Mindfulness practices, such as conscious breathing and meditation, support the parasympathetic nervous system response which is the opposite of “fight or flight.” These practices not only calm stress in the moment, but also help to build resiliency against stress. Research shows that meditation regulates the stress response, calms inflammation and helps to maintain a healthy microbiome. This is good news for the immune system too.
Get outside. Spending time outdoors, and ideally in nature, reduces stress and anxiety and boosts immunity and well-being. Many of us are spending more time indoors these days, so make it a priority to get out in the yard or in your neighborhood.
“Instead, or in addition to, supporting the immune system, I suggest using supplements and lifestyle tools to provide adrenal support in order to correct any current HPA-axis dysfunction or prevent any down the road. This will also help to support the immune system should you be exposed to COVID-19 any time soon.”
One silver lining during the COVID-19 pandemic and shelter in place orders might be that without commuting, activities and social events, some of us have access to more time in the day to devote to self-care. Perhaps this is a wonderful opportunity to incorporate relaxing and nourishing activities that support the adrenals and immunity. You might already be spending more time in the kitchen cooking, taking an afternoon walk or be able to get to bed on time. Giving your adrenals a little extra love right now is an incredible gift to yourself, your immunity and your future health.
References
Miller W. L. (2018). The Hypothalamic-Pituitary-Adrenal Axis: A Brief History. Hormone research in paediatrics, 89(4), 212–223. Abstract: https://pubmed.ncbi.nlm.nih.gov/29719288/
Adam, E. K., Quinn, M. E., Tavernier, R., McQuillan, M. T., Dahlke, K. A., & Gilbert, K. E. (2017). Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis. Psychoneuroendocrinology, 83, 25–41. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5568897/
Patak, P., Willenberg, H. S., & Bornstein, S. R. (2004). Vitamin C is an important cofactor for both adrenal cortex and adrenal medulla. Endocrine research, 30(4), 871–875. Abstract: https://pubmed.ncbi.nlm.nih.gov/15666839/
Lange, T., Dimitrov, S., & Born, J. (2010). Effects of sleep and circadian rhythm on the human immune system. Annals of the New York Academy of Sciences, 1193, 48–59. Abstract: https://pubmed.ncbi.nlm.nih.gov/20398008/
Househam, A. M., Peterson, C. T., Mills, P. J., & Chopra, D. (2017). The Effects of Stress and Meditation on the Immune System, Human Microbiota, and Epigenetics. Advances in mind-body medicine, 31(4), 10–25. Abstract: https://pubmed.ncbi.nlm.nih.gov/29306937/
Hansen, M. M., Jones, R., & Tocchini, K. (2017). Shinrin-Yoku (Forest Bathing) and Nature Therapy: A State-of-the-Art Review. International journal of environmental research and public health, 14(8), 851. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5580555/
