Written by Angela Ysseldyk CNP, BA
We’ve identified adrenal health, gut health, and mental health as 3 areas of foundational wellness that all women should be considering. Here we cover these 3 areas in more detail, and share some tips for supporting them!
The Role of the Adrenal Glands and Hormonal Health.
Stress comes in many forms: internal and external, environmental, and physical. Managing your inner world (aka the inner critic) and responding with grace to external circumstances is key. You can only control certain aspects and your response to what happens to you is a large part of it.
Extra care around stress management and sleep are crucial! For now, as well as for our long term health goals. Stress is a sympathetic response. We only turn on digestion and recovery when we rest and digest. Having grace under pressure is directly linked to the calming parasympathetic response associated with healthy vagal tone. One of the first impacts that stress can have on us is through our digestion.
The adrenals support the stress response and cortisol is central to the stress response. Our stress reaction is usually resolved quickly - once the threat is over, our hormones return to normal. When the stress response persists and we feel constantly under attack, the fight or flight response remains activated.
Cortisol levels rise with aging and are higher in older females than males.1Increased cortisol levels counteract insulin and suppress the immune system.2Prolonged exposure to elevated cortisol has also been associated with a variety of adverse physiological effects, including:
- weight gain 3
- abdominal obesity 4
- decreased bone mineral density 5
- impaired short-term memory 6
- increased risk of cardiovascular disease 7, 8
- increased diabetes-related complications 9
- digestive issues such as IBS 10
There are links between our gut health and our brain health. We have something called a "gut-brain axis" which helps explain why researchers are interested in understanding how psychological or social stress might cause digestive problems and more. The gut-brain axis (or gut-brain connection) describes the two-way (bi-directional) connection and communication between the gut and the brain.16
There are several additional pathways that are involved in the complex functioning of the gut-brain axis including communication through various chemical messengers, the endocrine system, gut hormones and neurotransmitters 17, 18. Many of these hormones and neurotransmitters are made in the gut, such as gamma aminobutyric acid (GABA), dopamine and serotonin and gut bi-products of carbohydrate fermentation such as short chain fatty acids (SCFA). What is happening in the gut can directly influence our brain function and behaviour. Research has recently discovered a missing link within the gut-brain axis theory. The latest theory involves the gut microbiome, which is an equally important part of the communication loop between the gut and brain. 19
Digestion Is Important!
When a person becomes stressed enough to trigger the fight-or-flight response, for example, digestion slows or even stops so that the body can divert all its internal energy to facing a perceived threat. 34Changes in the communication between the gut, brain and gut microbiota may lead to the development of digestive disorders like IBS 34, 35.
IBS and the Gut-Brain Axis
For example, gut symptoms of IBS (gut part of the gut-brain axis) including bloating, stomach pain, wind and altered bowel habits is worsened by stress (brain part of the gut-brain axis). 36When under stress, the body’s in-built fight-or-flight response is activated. The fight-or-flight response is the body’s natural survival reaction that occurs in response to a perceived threat. When activated, digestion slows as the body uses its energy resources on the threat at hand, and in turn, increases gut sensitivity. Low stomach acid creates a vicious cycle of poor digestion, chronic gut inflammation, microbial overgrowth, leaky gut, elevated stress hormones and lowered nutrient absorption. 34What happens is we do not absorb our food -> we do not get the proper nutrients even if we eat super healthy – > blood becomes acidic – > start lacking the basic nutrients to produce the digestive juices (stomach acid) -> even more bad digestion -> food is left undigested in our intestines causing ammonia build-up and inflammation invoking an immune response -> draws upon your cortisol levels from adrenals -> leading to sluggish liver (liver is overburdened by processing too much waste which was left behind by poor digestion) -> leading to fatigue. We need to look after our ecosystem and microbiota (ie gut bacteria balance) because it is linked to our brain and digestion!37
We each have our own unique network of microbiota that is determined in part by genetics and in part by diet and our environment20 Microbiota break down potentially toxic food compounds and xenobiotics21 Microbes synthesize selected vitamins and amino acids, including the B vitamins folate, nicotinic acid, thiamine, pyridoxine, and vitamin B12 as well as vitamin K22 Significantly, the key enzymes needed to form vitamin B12 are only found in bacteria, not in plants and animals.23
Gut Microbiome – Mood and Emotion.
The gut microbiota is known to interact with the brain indirectly, in a bidirectional manner, most likely through a variety of pathways including vagal nerve stimulation, interaction with the immune system, and microbial production of human neurotransmitters 24 25The gut microbiome is also closely linked to psychological mood states, including depression and anxiety, through multiple communication pathways. 32Pathways include neurotransmitters, the immune system, and the inflammatory cascade via the gut-brain axis. 32Research suggests that probiotics promote stress resilience or reduce stress-induced physical symptoms and cognitive deficits in humans. 24
Serotonin and Gut 25
If our body is not producing enough serotonin, we will not feel our best no matter what! Why?
- Serotonin regulates processes including appetite, digestion, and the sleep cycle
- Serotonin is an inhibitory neurotransmitter involved in emotion, memory, and mood
- Also considered a hormone, serotonin is primarily found in the enteric nervous system located in the gastrointestinal tract, but a small amount is synthesized in the brain
- The amino acid tryptophan is the precursor to serotonin, and serotonin is converted to melatonin in the pineal gland
- About 95% of peripheral serotonin is synthesized and stored in the cells found in the gastrointestinal tract with only a small fraction of total body serotonin produced in the brain‐stem neurons
Mood and anxiety disorders are the most common types of mental illnesses in Canada and throughout the world. Mood disorders are characterized by the lowering or elevation of a person’s mood, while anxiety disorders are characterized by excessive and persistent feelings of apprehension, worry and even fear. Both types of disorders may have a major impact on an individual’s everyday life and can range from single, short-lived episodes to chronic disorders. Professional care combined with active engagement in self-management strategies can foster recovery and improve the well-being of people affected by these disorders, ultimately enabling them to lead full and active lives. 30
Steps for Supporting Yourself
Look for BALANCE in all areas for harmony.
- Hormone balance and PMS management
- Swedish word for ‘’just the right amount’’. And depending on where you are at in your cycle and life stage that may differ. Balance between push and pull. Ying and Yang. Yes and no. Good and Bad. Amount of food we eat.
- Track your patterns and symptoms to learn what works for you
- Nourish yourself with the right foods for you
Manage stress levels.
- Say no. Set up a sleep regime and stick with it
- Incorporate intentional calming practices and calming coping mechanisms and breath work
- Take ADAPTOGENS and support vitamins and minerals
- Look after your digestive health and microbiome.
- De-stress and rest! (repeat above) (Allow for rest and digest)
- Eat fibre rich foods and chew your food
- Take combination probiotic and prebiotic supplements such as Gutsmart
Own your mood and honour where you are at.
- De-Stress. Mental: give yourself breaks, meditation, stillness. Set boundaries.
- Get control back. Gain back a sense of control and whatever that looks like to you. Manage what you can control. Own your day. Be intentional. Choose activities and foods that nourish you.
Give yourself some extra self care.
- Try natural herbs such as saffron for better mood.
Remember to connect with yourself daily and check in. Leave room to socialize and connect with others if it nurtures you. You are never alone, but it is always good to listen. Treat yourself as your own best friend and watch your inner world transform. Cheers to a happier, more balanced and centered you!
- Lavretsky H, et al (2012) Geriatr Sep; 20(9): 729–733. doi: 10.1097/JGP.0b013e31826573cf
- Marieb E, Hoehn K. Human Anatomy and Physiology. 7th ed Upper Saddle River, NJ: Pearson Prentice Hall; 2006. [Google Scholar]
- Epel ES, McEwen B, Seeman T, et al. Stress and body shape: stress-induced cortisol secretion is consistently greater among women with central fat. Psychosom Med. 62(5):623–632. http://www.ncbi.nlm.nih.gov/pubmed/11020091Accessed April 22, 2016. [PubMed] [Google Scholar]
- Rosmond R, Dallman MF, Björntorp P. Stress-related cortisol secretion in men: relationships with abdominal obesity and endocrine, metabolic and hemodynamic abnormalities. J Clin Endocrinol Metab. 1998; 83(6): 1853–1859. [PubMed] [Google Scholar]
- Michelson D, Stratakis C, Hill L, et al. Bone mineral density in women with depression. N Engl J Med. 1996; 335(16): 1176–1181. [PubMed] [Google Scholar]
- Sami Ouanes, Julius Popp. High Cortisol and the Risk of Dementia and Alzheimer’s Disease: A Review of the Literature. Front. Aging Neurosci., 01 March 2019 | https://doi.org/10.3389/fnagi.2019.00043.
- Terzolo M, Bovio S, Pia A, et al. Midnight serum cortisol as a marker of increased cardiovascular risk in patients with a clinically inapparent adrenal adenoma. Eur J Endocrinol. 2005; 153(2): 307–315. [PubMed] [Google Scholar]
- März W, Tiran B, Seelhorst U, et al. ; LURIC Study Team. N-terminal pro-B-type natriuretic peptide predicts total and cardiovascular mortality in individuals with or without stable coronary artery disease: the Ludwigshafen Risk and Cardiovascular Health Study. Clin Chem. 2007; 53(6): 1075–1083. [PubMed] [Google Scholar]
- Chiodini I, Adda G, Scillitani A, et al. Cortisol secretion in patients with type 2 diabetes: relationship with chronic complications. Diabetes Care. 2007; 30(1): 83–88. [PubMed] [Google Scholar]
- Qin H. Y., Cheng C. W., Tang X. D., Bian Z. X. (2014). Impact of psychological stress on irritable bowel syndrome. World J. Gastroenterol. 20 14126–14131. 10.3748/wjg.v20.i39.14126
- Patel SR, Malhotra A, White DP, Gottlieb DJ, Hu FB. Association between reduced sleep and weight gain in women. Am J Epidemiol. 2006; 164(10): 947–954. [PMC free article] [PubMed] [Google Scholar]
- López-García E, Faubel R, León-Muñoz L, Zuluaga MC, Banegas JR, Rodríguez-Artalejo F. Sleep duration, general and abdominal obesity, and weight change among the older adult population of Spain. Am J Clin Nutr. 2008; 87(2): 310–316. [PubMed] [Google Scholar]
- Chee MWL, Chuah YML. Functional neuroimaging and behavioral correlates of capacity decline in visual short-term memory after sleep deprivation. Proc Natl Acad Sci. 2007; 104(22): 9487–9492. [PMC free article] [PubMed] [Google Scholar]
- Peker Y, Hedner J, Norum J, Kraiczi H, Carlson J. Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: a 7-year follow-up. Am J Respir Crit Care Med. 2002; 166(2): 159–165. [PubMed] [Google Scholar]
- Generaal, E., et al (2014). Reduced hypothalamic-pituitary-adrenal axis activity in chronic multi-site musculoskeletal pain: partly masked by depressive and anxiety disorders. BMC musculoskeletal disorders, 15, 227. https://doi.org/10.1186/1471-2474-15-227
- Lerner, A., Neidhöfer, S., & Matthias, T. (2017). The Gut Microbiome Feelings of the Brain: A Perspective for Non-Microbiologists. Microorganisms, 5(4), 66. https://doi.org/10.3390/microorganisms5040066
- Mayer, E. A., Tillisch, K., & Gupta, A. (2015). Gut/brain axis and the microbiota. The Journal of clinical investigation, 125(3), 926–938. https://doi.org/10.1172/JCI76304
- Rhee, S. H., Pothoulakis, C., & Mayer, E. A. (2009). Principles and clinical implications of the brain-gut-enteric microbiota axis. Nature reviews. Gastroenterology & hepatology, 6(5), 306–314. https://doi.org/10.1038/nrgastro.2009.35
- Martin, C. R., Osadchiy, V., Kalani, A., & Mayer, E. A. (2018). The Brain-Gut-Microbiome Axis. Cellular and molecular gastroenterology and hepatology, 6(2), 133–148. https://doi.org/10.1016/j.jcmgh.2018.04.003
- Ursell, L. K., Metcalf, J. L., Parfrey, L. W., & Knight, R. (2012). Defining the human microbiome. Nutrition reviews, 70 Suppl 1(Suppl 1), S38–S44. doi:10.1111/j.1753-4887.2012.00493.
- Korecka, Agata, and Velmurugesan Arulampalam. “The Gut Microbiome: Scourge, Sentinel or Spectator?” Journal of Oral Microbiology 4, no. 1 (January 1, 2012): 1–14. http://www.tandfonline.com/doi/abs/10.3402/jom.v4i0.9367.
- den Besten, G., van Eunen, K., Groen, A. K., Venema, K., Reijngoud, D. J., & Bakker, B. M. (2013). The role of short-chain fatty acids in the interplay between diet, gut microbiota, and host energy metabolism. Journal of lipid research, 54(9), 2325–2340. doi:10.1194/jlr.R036012
- Morowitz, M. J., Carlisle, E. M., & Alverdy, J. C. (2011). Contributions of intestinal bacteria to nutrition and metabolism in the critically ill. The Surgical clinics of North America, 91(4), 771–viii. doi:10.1016/j.suc.2011.05.001
- Bastiaanssen, T., Cowan, C., Claesson, M., Dinan, T., & Cryan, J. (2019). Making Sense of … the Microbiome in Psychiatry. The International Journal of Neuropsychopharmacology, 22(1), 37–52. https://doi.org/10.1093/ijnp/pyy067
- Jonnakuty, C., & Gragnoli, C. (2008). What do we know about serotonin? Journal of Cellular Physiology, 217(2), 301–306. https://doi.org/10.1002/jcp.21533
- Montiel-Castro, A., González-Cervantes, R., Bravo-Ruiseco, G., & Pacheco-López, G. (2013). The microbiota-gut-brain axis: neurobehavioral correlates, health and sociality. Frontiers in Integrative Neuroscience, 7, 70–86.
- C., Barbara, G., Buurman, W., Ockhuizen, T., Schulzke, J. D., Serino, M., Tilg, H., Watson, A., & Wells, J. M. (2014). Intestinal permeability--a new target for disease prevention and therapy. BMC gastroenterology, 14, 189. https://doi.org/10.1186/s12876-014-0189-7
- Jamshed, N., Lee, Z.E., Olden, K. (2011). Diagnostic Approach to Chronic Constipation in Adults. American Family Physician Web. Accessed March 16, 2020. www.aafp.org/afp.
- Fenollar, F. (2017). Chronic Diarrhea. In Infectious Diseases (Fourth Edition), 2017. https://www.sciencedirect.com/topics/medicine-and-dentistry/chronic-diarrhea
- Moser, G., Fournier, C., & Peter, J. (2018). Intestinal microbiome-gut-brain axis and irritable bowel syndrome. Intestinale Mikrobiom-Darm-Hirn-Achse und Reizdarmsyndrom. Wiener medizinische Wochenschrift (1946), 168(3-4), 62–66. https://doi.org/10.1007/s10354-017-0592-0
- Mayer E. A. (2018). The Role of Gut-Brain Interactions in Influencing Symptoms of Irritable Bowel Syndrome. Gastroenterology & hepatology, 14(1), 44–46.
- Qin, H. Y., Cheng, C. W., Tang, X. D., & Bian, Z. X. (2014). Impact of psychological stress on irritable bowel syndrome. World journal of gastroenterology, 20(39), 14126–14131. https://doi.org/10.3748/wjg.v20.i39.14126
- Foster, J. A., Rinaman, L., & Cryan, J. F. (2017). Stress & the gut-brain axis: Regulation by the microbiome. Neurobiology of stress, 7, 124–136. https://doi.org/10.1016/j.ynstr.2017.03.001
- Chong, P. P., Chin, V. K., Looi, C. Y., Wong, W. F., Madhavan, P., & Yong, V. C. (2019). The Microbiome and Irritable Bowel Syndrome - A Review on the Pathophysiology, Current Research and Future Therapy. Frontiers in microbiology, 10, 1136. https://doi.org/10.3389/fmicb.2019.01136
- McRae, L., O'Donnell, S., Loukine, L., Rancourt, N., & Pelletier, C. (2016). Report summary - Mood and Anxiety Disorders in Canada, 2016. Note de synthèse - Les troubles anxieux et de l'humeur au Canada, 2016. Health promotion and chronic disease prevention in Canada : research, policy and practice, 36(12), 314–315. https://doi.org/10.24095/hpcdp.36.12.05
- Talbott, S., Talbott, J., Stephens, B., & Oddou, M. (2020). Modulation of Gut-Brain Axis Improves Microbiome, Metabolism, and Mood. Functional Foods in Health and Disease, 10(1), 37–. https://doi.org/10.31989/ffhd.v10i1.685
- Kerry, G., et al. (2018). “Benefaction of Probiotics for Human Health: A Review.” Journal of Food and Drug Analysis 26.3 (2018): 927–939