Are you someone who really likes to get into the science behind things? Do you like to get as many details as possible when researching different subjects?
If you do, you’ll like this post.
In the last post we went over how stress is contributing to your acne and what to do about it. In this post we’ll go more into the science behind it.
Where Stress Begins…
Stress can be initiated anywhere in your body, but ultimately, the activation of stress goes to your hypothalamus in your brain and that is where the true stress response happens.
In your brain you have something called the hypothalamus. When you get stressed out (i.e., you eat the wrong food (chemical stress), get in a fight (physical), stress over a meeting (emotional), or stress over your skin (emotional), your hypothalamus produces corticotropin-releasing hormone (CRH). This hormone then travels to your pituitary gland, located just underneath the hypothalamus. The pituitary gland then releases adrenocorticotropic hormone (ACTH). ACTH then travels to the adrenals located directly above the kidneys and tells them to release cortisol. – see HPA Axis image for visual –
Cortisol is known as the stress hormone, and when too much constantly gets released it can cause major problems ranging from hyperglycemia to thyroid malfunction to being chronically fatigued and, yes, to acne.
Luckily for us, the human body is extremely adaptive. If we get stressed out, we produce more cortisol and our bodies adapt to the stress. But if the stress continues for long enough, our bodies eventually fail to adapt to the stress and we can start to experience dysfunction in the HPA axis. This is happening to more and more people today. The chronic, low grade stress on our bodies eventually wears them down and results in HPA-axis dysfunction. We get this way by constantly skimping on sleep, constantly eating nutrient-deficient diets, not hydrating with enough water, over-stressing about things, trying to be there for everyone else while we neglect ourselves, and stimulating our bodies with things like coffee, energy drinks, or sugary snacks because we want to push ourselves instead of taking a step back and relaxing for a minute. Now I’m not saying not to push yourself, but if you have dis-ease in your body or you want to heal, then it might be challenging to go “all out” in all aspects of your life while simultaneously giving yourself the rest it needs to heal.
Sometimes it’s not the chronic, low grade stress that causes HPA dysfunction. Sometimes the body fails to adapt extremely quickly. If the stressor is big enough, such as a dramatic life event, our HPA axis can shut down on the spot. I think that’s what happened with me when my parents got divorced. Before then, I was an extremely healthy child with boundless energy. After the divorce that’s when all of my health challenges started appearing.
So when we get stressed, cortisol and adrenaline get released. Why is that important?
When cortisol and adrenaline are released because we are stressed, our blood sugars go up. Acne is directly related to how well our bodies utilize sugar and how much sugar is in our blood. The increase in sugar from cortisol and adrenaline was originally designed as a survival mechanism of our body because the sugars would go to our muscles and give us the energy to escape a scary situation. We are no longer in life-threatening situations, but the chronic stress is still upon us.
Spikes in blood sugar are usually followed by spikes in insulin release. This is true when we eat high sugar foods such as refined carbohydrates and wheat. However, when we’re stressed, the insulin in our pancreas doesn’t get released because our bodies think the sugar will be traveling to our muscles. This results in sustained elevated blood sugar levels, which is implemented in almost every disease process, including acne.
Other than raising blood sugar levels, chronically elevated cortisol can cause:
- Weight gain in the waist, known as visceral fat, which is highly inflammatory.
- Increased blood sugar that results in increased insulin, increased IGF-1 and all of the malfunctions that occur with elevated levels of these hormones.
- Increased interleukin 6, which is inflammatory.
- Lowered thyroid stimulating hormone, which leads to thyroid disorder.
- Lowered melatonin, which causes sleep disturbances and can lead to gut dysfunction.
- Suppressed bone formation, which leads to bone loss.
- Lowered frontal lobe capacity, which leads to lowered mood and lowered willpower.
- Loss of muscle mass.
- Increased risk of GI infection due to suppression of IgA antibodies in the gut.
- Low sex hormones, low libido and low energy.
- Imbalance of testosterone, estrogen, DHEA (sex-hormone precursor) and cortisol.
Almost all of these can cause or contribute to the acne process in susceptible individuals.
And for those who get really stressed out for a long time, their cortisol could lower and they can experience low blood pressure, depression, a constantly cold body and massive sugar cravings because of hypoglycemia. In 2015 I did a hormone test and discovered that because of stress, my body wasn’t producing adequate testosterone, estrogen, or any other sex hormones. Since I found this out through functional lab testing, I started taking supplements to balance my hormones out and have gained tremendous amounts of energy since. My follow up results showed that my hormones stabilized, and my symptom tracker fell in line with my test results.
Almost everything can lead back to malfunctions within the hypothalamus/pituitary/adrenal axis (HPA axis). This is why I urge you to get this tested using a DUTCH test, especially if you’ve already made the switch to a paleo diet, a healthy vegetarian, or a healthy vegan diet and live a healthy lifestyle, yet still have acne or feel tired all the time. It can give a lot of insight.
How HPA Dysfunction Screws Up Your Hormones
*You should follow along with the image on the next page while reading this.* The steroid metabolic pathway goes like this: There is a master hormone called pregnenolone. Pregnenolone makes Dehydroepiandrosterone (DHEA). DHEA eventually creates the sex hormones testosterone and estrogen. When we get stressed, instead of converting pregnenolone to DHEA and our sex hormones, our bodies convert pregnenolone into a hormone called progesterone. Progesterone is the precursor for cortisol. When we’re under a lot of stress, this progesterone “steals” the pregnenolone so that more cortisol can be produced. When this happens, there’s less DHEA and an imbalance of testosterone and estrogen occurs in the body. When pregnenolone gets “stolen” to make more progesterone and therefore cortisol, that is called “the Pregnenolone Steal.” This hormonal imbalance can lead to inflammation as well as many other issues that can be the underpinnings of acne and other diseases.
For millions of years we would only get stressed for very short periods of time. Say, when a tiger was chasing us or when we ran into another tribe. Then we would run away and our stress would go away. Our cortisol levels would rise and then fall. In today’s world, we’re under constant stress. Our cortisol and other stress hormones are constantly firing, tricking our bodies into thinking we are in life-or-death situations. While we used to run, now we stay still. Stress used to save our lives, but now it’s killing us.
When hormones become imbalanced, this can affect dozens of other functions in the body. Just a few things that are affected by imbalanced hormones include:
- The ovaries – PCOS and infertility have hormonal components
- The thyroid – Imbalanced hormones may contribute to hypo and hyperthyroidism
- Metabolism – Hormonal imbalance can lead to fat storage and weight gain
- Your immune system – Imbalanced hormones can play a role in autoimmune conditions
- Your digestive system – Many times digestive issues are healed by focusing on both the healing the digestive tract and balancing the hormones. Many times just focusing only on healing the gut doesn’t completely resolve the issues.
- Your detoxification system – if you can’t detoxify or chelate certain things such as heavy metals or used hormones as efficiently, the skin may become the “go-to” place to excrete the overabundance of toxins that your liver, kidneys, lungs and intestines can’t handle.
Other conditions affected by imbalanced hormones include
- Mood swings
- Sugar cravings
- Missed periods
- Slowed metabolism
- Lower energy
I hope you can see that imbalanced hormones can lead to a ton of complex things going on in the body. The good news is that most of these things are the result of being stressed out and eating poorly. This means that if you can learn to manage stress and eat healthy foods (and don’t eat unhealthy foods), you’ll fix the majority of these problems.
Because imbalanced hormones can cause so many different problems downstream, fixing the underlying causes of imbalanced hormones can, in theory, help to resolve many issues upstream. But this is only if we get to the root causes. The point of this is to demonstrate how incredibly important it is to meditate, do some form of movement like yoga, not put yourself in stressful situations, eat right for your individual biology and handle the inevitable stress that happens in life in a calm and controlled way. Have realistic expectations about your day-to-day challenges and stay in control.
If you are still experiencing constant stress, I want to give you the best piece of advice I’ve ever heard.
The Best Advice I’ve Ever Heard
We will always go through situations that make us wonder “what the heck was I doing?” We also go through situations where we suck at whatever we try to do. We get rejected. We get denied. We make bad deals. We fail. We fall. When these things happen it’s important to not weep in our own sorrow. The best thing we can do is to ask ourselves what happened in this situation and if there was anything we could have done to get a different outcome? What would have made the situation better? What was the learning opportunity here? I really don’t think that there’s anything as failure. There are only learning opportunities. This shift in my mindset has changed everything in my life. It puts the responsibility on you to improve in order to create a better situation next time. Einstein once famously said that insanity is doing the same thing over and over again, hoping for different results. If something isn’t working in your life, change it. Learn from it and use what you know to create a better life for yourself.
How To Have Realistic Expectations About Your Day-To-Day Challenges And Stay In Control
As a takeaway I want to give you an important piece of advice to use to handle the stress you’re under.
Firstly, understand that it is always your perception of the stress, not the stress itself, that results in the stress response that happens in your body. You can take two people, have them experience the same stressor, but one can perceive the stressor differently than the other and have a completely different stress response in their body. If one of the people perceives the stressor as no big deal, they will keep their cortisol levels within balance. Their sex hormones won’t be depleted due to the pregnenolone steal. And they will physically, mentally and emotionally be happier and more calm.
- It is your responsibility to learn how to manage stress correctly.
- I like to be in the mindset that if something doesn’t kill me, it’s not that big of a deal.
- Let’s say I lose all my money. It’s not that big of a deal.
- Let’s say I make a ton of money in one day. It’s not that big of a deal.
- I get broken up with/break up with my significant other. It’s not that big of a deal.
- I break out in acne. It’s not that big of a deal.
- I lock my keys in my car. It’s not that big of a deal.
- There’s a long line at the checkout counter with a baby screaming loudly. It’s not that big of a deal.
- I get stood up for a date. It’s not that big of a deal.
- I forget my laptop charger at my house. It’s not that big of a deal.
The important thing here is to understand why these things “aren’t a big deal.” Yeah, some of them may be significant (i.e. breaking up with a significant other or losing all your money), but they don’t define you. The reason they aren’t a big deal is because you have enough faith in yourself that you know that you will come back. You know that you are awesome and capable and can create anything in this world. Yes, it’s crushing when these things happen, but if you have enough faith in yourself, you will harness the power to build yourself back up. You take things for what they are, accept them, do what needs to be done, and then learn from the situation. At no point do you let the situation completely turn your life into a downward spiral. You can, however, use the extreme emotions you feel during hard times to push you in an upward spiral. Sometimes a hard situation may be just what you need to motivate you to take massive action. We need to use negatives as springboards into positives. Imagine negative things in your life (having acne, for example) as trampolines that will propel you higher in life. When you jump on a trampoline, you experience a slight dip. Without that dip, you wouldn’t fly as high compared to if you simply jumped from solid ground.
This is a great viewpoint. You experience hardships in your life so that you can jump higher than those who are always on solid ground.
Life is like poker. It’s not the hand that we’re given that matters… it’s how we play it.
*As a side note. If you are doing everything you know how to remediate stress in your life, and you STILL aren’t experiencing the health you desire, you can schedule an appointment with a functional health practitioner. He or she can help get to the root causes of your issues with functional health tests such as hormonal and stool panels.
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