Stress and the Immune System. Stay Healthy by Managing Your Stress Level.

Dr. Sheila Saltzman, PT, DPT, IFMCP

Stress is a fact of life. We all face stressors of some sort in our day-to-day lives; whether psychological, physiological, or physical. Especially during this unpredictable time in the world around us! With the threat of COVID-19 exposure growing rapidly (not to mention the economic consequences of this very real threat)- it makes sense to explore the biological ways in which stress impacts our immune system and affects our resiliency to illness.

Research has shown that varying degrees and durations of stress affect each of us differently. Short-term stress (lasting from minutes to a few hours) may actually benefit our immune health. On the other hands, weeks to months of prolonged stress can be detrimental to our health.

Physiological stress

Many of us are familiar with the “fight-or-flight” response in which your body responds to stress by elevating your blood pressure and heart rate, shunts blood to muscles and releases glucose into your bloodstream so that you can escape a dangerous situation if necessary. This reaction is the result of adrenaline, released by the sympathetic nervous system. In a perceived threatening scenario, where the sympathetic nervous system response is stimulated, adrenaline potentiates an increased arousal, alertness, focus, and core temperature. At the same time, pain thresholds, cardiovascular output, respiratory rate, and blood flow to the brain and skeletal muscles also increase.

Interestingly, a review of the science suggests that acute stress activates the immune system. Immune activation may be critical for responding to the immediate demands of a stressful situation, especially if the situation results in infection. Mechanisms of immuno-enhancement include changes in neutrophils, macrophages, and lymphocytes, as well as local and systemic production of cytokines. All of these factors support the onset of the inflammatory process, which is necessary to fight off an infection (viral or bacterial).

While short-term stress can be an immune stimulator, the same is not true of long-term stress. Long-term stress suppresses the innate and adaptive immune responses. This is achieved by altering cytokine balance, inducing low-grade and chronic inflammation, and by suppressing the numbers and overall efficacy of immune protective cells…..This is not good folks!

Psychological stress

There are significant individual differences in stress perception, processing, and coping. So what about psychological stress that poses no pressing physical danger? Perhaps a stressful work project requiring a few long days and nights? Or the worry that goes along with a looming health pandemic?!! 

Multiple studies have been done to look at the effect of stress on the immune system. One study showed that students took 40% more time for wound healing during final exams than they did over summer vacation. The students took an average of three days longer to completely heal a 3.5-mm wound during examinations. Multiple studies have also evaluated the immune response to long-term emotional stress such as that related to the role of caregiver to an ill relative, or the emotional stress following a difficult divorce.

Common to these studies was the increased risk for viral illness, reemergence of latent viruses (Epstein-Barr, herpes simplex, and cytomegalovirus), and onset of autoimmune disease. In other words, prolonged emotional stress will increase your susceptibility to viral illness. 

Lifestyle approaches for stress management

While the side effects of stress are far-reaching, there are some lifestyle-related activities that can help reduce the immune suppression that goes along with prolonged stress. One method, supported by considerable evidence, is the practice of mindfulness and meditation. Meditation represents a mental training framework for cultivating the state of mindful awareness in daily life. Regular aerobic exercise, acupuncture, and breathing exercises are all techniques that can help individuals to manage stress.

Have you ever noticed that you always seem to get sick when you are most stressed out? This is not a coincidence. It is not the universe trying to add “one more thing” to your overly stressed life. It is actually your body’s physiological response to prolonged stress— stress that lasts weeks to months will ultimately effect your cytokine production, and can increase your chance of becoming susceptible to illness. True story!

Tips to help you stay healthy:

Ensure that your D3, Vitamin C and zinc levels are optimized for immune health. It is ideal to source your nutrients from actual whole foods, but it may actually be beneficial during this time to supplement with these nutrients. 

Adult recommended dose of Vit D is 1000-2000iu during the winter months.

Vitamin C is well known as being readily available in citrus fruits; but some vegetables are also very high in this crucial vitamin— such as bell peppers, tomatoes, and cauliflower. 

An additional 200mg daily may help boost your immune system further. 

Zinc is easy to find in foods such as meat, eggs, shellfish, legumes, and seeds. However supplementing with lozenges can be helpful because they can help to prevent and/or shorten the duration of viral upper respiratory illnesses.  There are actual studies on zinc specifically on coronavirus, which demonstrate that zinc can impair viral replication. 30mg/day is sufficient.

Glutamine is an amino acide which helps restore mucosal integrity to the mucosal layer of our small intestine. By promoting the ability of the cells of the small intestine to regenerate, this actually improves the mucosal lining of all our mucosal membranes, including those in our sinuses. Improved mucosal integrity means a better first line of defense when faced with any pathogen.

Make sure to get your Omega-3’s. Omega 3 fatty acids help to protect the fatty lipid membrane of our cells. This protects our cells from damage. Sufficient Omega-3 fats also help to prevent oxidative stress, and also reduce overall inflammation in the body.

The best way to get through this season without succumbing to a virus is to be your healthiest self! Now is not the time to go on a sugar and alcohol binge.

Maintain a healthy, nutritionally dense diet, mind your stress, take your vitamins, and get your sleep. Minimize sugar consumption. Identify your individual health challenges, and work to optimize your health at this time. 

“Be Mindful about your Health”