Stress as a Trigger of Autoimmune Disease
Autoimmune diseases are a rare and poorly understood group of diseases, affecting approximately 5% of Western population. Dr. Betty Diamond defined autoimmune disease in an article in the New England J. of Medicine (2001) as “a clinical syndrome caused by the activation of T cells or B cells, or both, in the absence of an ongoing infection or other discernible cause.” Almost all research papers on the topic of etiology start by saying that there is a multifactorial group of causes, including genetic, hormonal, some environmental and immunological factors. Despite the known causes, at least 50% of autoimmune diseases can be attributed to “unknown trigger factors.” And, that is where stress as a trigger fits in. Stress can affect immune function in individual ways. Subjects of many retrospective studies have identified that they experienced an unusual amount of emotional stress prior to onset of an autoimmune disease.
The bad news is that not only can stress trigger the onset of disease, the autoimmune disease itself can then cause significant stress in the patient. This sets up a vicious cycle. As the stress builds up, the major stress hormones are released, in particular, cortisol. The overproduction of cortisol and failure of the nervous system to regularly reduce it leads to immune dysregulation, which ultimately results in autoimmune disease by the changing of cytokine production.
Cytokines are little proteins that help control the immune system and inflammation response. Immune dysregulation is when your body can’t tell the difference between healthy cells and the invaders that should be attacked. In most cases of immune dysregulation, the person is living with an overactive immune system with joint pain and stiffness.
Since stress is so actively involved as both a trigger and a response to autoimmune disease, effective treatment of autoimmune disease should thus include stress management and behavioral intervention to prevent stress-related immune system imbalance. That brings us back to some thoughts on the role cortisol plays in the autoimmune patient.
Cortisol is essential to the production of steroids. In fact, all steroids are initially derived from cortisol. And, since steroids are often prescribed in the treatment of autoimmune disease, high levels of cortisol are helpful in reducing the symptoms of autoimmunity. When the levels are low, however, it is likely to aggravate autoimmune disease symptoms. Addison’s disease is a rare condition in which your adrenal glands do not produce enough cortisol.
Effective treatment of stress in the case of autoimmune disease requires a serious look at the patient’s life situation in terms of what kind of stressors (psychological, physical, or emotional stress), how the stress is affecting the body (overproduction or underproduction of stress hormones), and how that person best reduces daily stress. Then set up a daily routine and follow it slavishly.