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THE STRESS SOLUTION: Supporting Hypothalamic-PituitaryAdrenal Axis Balance Nutritional Support and Guidance for Energy and Wellness This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 1 TABLE OF CONTENTS The Stress Progression The Hypothalamus-Pituitary-Adrenal Axis The Stress Response Optimizing the Hypothalamus-Pituitary-Adrenal Axis (HPA Axis) Function Balancing Cortisol The Stress Presentation The Stages of Stress Late Stage Sleep Support Should I take a Multiple Vitamin? Specific Treatment Suggestions: Supplement Options Correcting Sleep Pattern Abnormalities Lifestyle Support Dietary Support Tests Available: Food Sensitivity, Salivary Cortisol Closing Remarks References This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 2 The term wellness can be defined as not merely the absence of disease, but as a state of total physical, biochemical, emotional, psychological, and spiritual health. Based on this definition, chronic stress plays a role equally important to physical health in defining our overall wellbeing. Chronic stress is largely dependent on the structure and function of the brain, spinal cord, and peripheral nervous system, and influences the entire body. The Stress Progression In a seminal paper published in 1950 in the British Medical Journal, Hans Selye MD, PhD, described the human physiological response to prolonged stress as a General Adaptation Syndrome (GAS). Selye identified the three stages—alarm, resistance, and exhaustion—as a guide to assist healthcare professionals with their evaluation and early intervention strategies. The impact of stress is a spectrum requiring thorough practitioner analysis of each patient. And the impact of stress on what is now referred to as the hypothalamic-pituitary-adrenal (HPA) axis is individualized and varied in its outcome. Modern therapeutic intervention strategies for stress disorders are therefore focused on the limbic and endocrine system. The limbic system is a small portion of the brain that focuses on maintaining homeostasis or balance. The limbic system is responsible for ensuring our basic human needs are met via control of our hunger and thirst mechanisms, body temperature, sexual drive, response to pain and stress, and emotions. The hypothalamus and pituitary gland, two of the busiest parts of the limbic system, work to regulate multiple body systems via the release of hormones. The hormones released by the pituitary and response hormones released by targeted glandular tissues make up the endocrine system. Another important part of the neuroendocrine system, the adrenal glands, are triangle-shaped glands located above the kidneys that are responsible for releasing hormones in response to stress. The adrenal glands produce a number of hormones including corticosteroids, such as cortisol, and catecholamines, such as epinephrine (adrenaline) and norepinephrine. This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 3 The Stress Response Stress can affect the function of metabolic processes regulated by the HPA axis. Although changes in metabolic function may at first be adaptive, chronic (on-going) stress may necessitate additional support of various metabolic parameters. The HPA axis influences hormones, inflammation, blood sugar regulation, and other metabolic processes. Previously, physicians focused on the necessity of supporting only adrenal function and coined terms such as “adrenal fatigue;” however, we have since learned that the effects of stress affect more than the adrenals. In addition, focusing only on cortisol and/or adrenal function may overly simplify complex interactions among several systems, and miss the contributions of the central nervous system, environmental factors, and other metabolic factors. External stressors are translated into biochemical signals, many of which influence the feedback loops of the HPA axis. Prolonged stress may continually activate the HPA axis and affect the balance of hormone and cell mediators. Cortisol is perhaps the most important hormone involved in the adaption process. This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 4 Cortisol is released by the adrenal cortex in response to stress; however, continued release from chronic stress affects hypothalamic and pituitary feedback loops in a way that may lead to persistent activation. HPA axis activation and cortisol issues can persist for years, with effects on most major body systems including: gastrointestinal, neurological, musculoskeletal, endocrine, respiratory, and immune. Via the HPA axis, stress can affect physical, behavioral, and/or neuropsychiatric function. The American Institute of Stress reports that 75–90 percent of visits to primary care physicians are stress-related; therefore, supporting HPA axis homeostasis is a significant goal for a broad range of people. Optimizing HPA Axis Function The foundational strategy of HPA axis optimization involves effective detection of cortisol release and cortisol impact, followed by an appropriately-designed lifestyle and dietary supplement regimen. Modern understanding of HPA axis involvement in stress provides healthcare professionals with a unique opportunity to address underlying factors thereby improving patients’ ability to respond and adapt to stressful stimuli while promoting energy recovery and restorative sleep. Along the entire stress spectrum, salivary cortisol monitoring can be an important diagnostic tool for some patients, especially during the resistance stage. Glucocorticoids (stress hormones) are significant regulators of physiological reactions to stress, and cortisol is the primary glucocorticoid that helps regulate our stress response. Cortisol also stimulates the release of other hormones to maintain balance. Balancing Cortisol Under normal conditions, blood hormone levels of cortisol peaks before awakening and decreases throughout the day. When cortisol levels are blunted upon awakening, this can indicate HPA axis disruption. Cortisol measurement throughout the day can provide valuable clinical information. Patients who are under stress may have surges of cortisol that are superimposed on their This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 5 innate circadian patterns. HPA activation can also affect normal sleep cycles, and lack of sleep can alter HPA axis function and the cortisol feedback loop. Key clinical goals are to support hypothalamus and pituitary sensitivity to cortisol, maintain healthy circadian rhythm, and support limbic system activity to reduce inappropriate threat perception. Cortisol secretion should ideally peak between 6 AM and 8 AM, with a natural decline throughout the day and the lowest levels achieved between 6 PM and 8 PM. The Stress Presentation The impact of stress is unique to each person; it can manifest through a range of symptoms and laboratory values. The following chart provides a guideline for the spectrum of responses across the 3 Stages of Stress Resistance to help you identify yours. A comprehensive physician analysis can also be valuable at identifying an individual’s stress response stage and unique treatment options. For targeted supplement solutions for each stage, refer to page 11. This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 6 3 Stages of Stress Disruptions in the signaling pathways of the endocrine system can affect both mood and the stress response. Endocrine support for mood abnormalities can be directed towards the hypothalamus and pituitary, the thyroid, and the adrenal cortex. Early-Stage In the Early-Stage of stress resistance, patients can benefit from supplementation with herbs and nutrients that calm HPA axis activation, support healthy cortisol balance, and help relieve occasional anxiety and stress. • Ashwagandha (Withania somnifera) has been shown in clinical studies to reduce stress and occasional anxiety in adults.A literature review demonstrated that ashwagandha exerts “positive influence on the endocrine, cardiopulmonary, and central nervous systems. • L-Theanine, an amino acid found in green tea, has been shown to inhibit cortical neuron excitation, thereby creating feelings of calm, supporting blood pressure already within normal limits, and improving mood. This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 7 • Magnolia (Magnolia officinalis) has been shown to provide calming effects, which can be in part attributed to its interaction with receptors for the neurotransmitter gammaaminobutyric acid (GABA). • Phosphatidylserine (PS) has been shown to support an adaptive cortisol response to stress. One study involving young adults demonstrated that PS positively influenced feelings of stress, heart rate, and mood. Mid-Stage Patients in the Mid-Stage of the stress response can benefit from adaptogens, which are botanical ingredients that support the body’s ability to respond to stress and restore homeostasis. This may, in turn, influence mood, cognition, and energy levels. Rhodiola (Rhodiola rosea) is an adaptogen that that helps to reduce occasional fatigue, improve mood, and promote psychological adaptation. Wild yam (Dioscorrhea villosa) prevents reductions in brain catecholamine and monoamine oxidase levels and may increase dopamine and serotonin levels during stress. Siberian ginseng (Eleutherococcus senticosus) supports adrenal function, regulates neurotransmitters, and may increase resistance to stress. Ashwagandha (Withania somnifera) may modulate hormonal changes that occur during stress. Maca (Lepidium meyenii) has been shown in preliminary human research to have a positive influence on mood, feelings of occasional anxiety, and libido. Late-Stage In the Late-Stage, patients can benefit from adrenal-supportive nutrients and botanicals including Ashwaganda, Licorice root and Magnolia officinalis to support healthy cortisol production. Fortifying the diet with essential vitamins that can be depleted by stress is also important in maintaining adrenal cortex function, combatting occasional stress-related fatigue, and promoting energy recovery. • Vitamin B1 (thiamine) is a water-soluble, sulfur-containing This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 8 member of the B vitamins; the coenzyme form of thiamine plays a role in energy production. • Vitamin B2 (riboflavin) is necessary for energy production as well as normal cell function and growth. Animal research shows that a riboflavin deficiency leads to an initial increase, followed by a decrease, in adrenal cortex activity. • Vitamin B5 (pantothenic acid) is involved in numerous biological reactions, including the production of energy and the synthesis of steroid hormones, including cortisol. Vitamin B5 is required for normal function of the adrenal cortex. • Vitamin B6 (pyridoxine) is a cofactor for approximately fifty different enzymes and plays a role in the production of neurotransmitters, such as serotonin, dopamine, epinephrine, norepinephrine, and gamma-aminobutyric acid (GABA). • Licorice (Glycyrrhiza glabra) root extracts have been shown to influence cortisol production in both animals and humans by inhibiting 11beta-hydroxysteroid dehydrogenase, the enzyme responsible for converting cortisol to cortisone. In one study, supplementing with licorice extract increased saliva cortisol levels in healthy women. Late-Stage Sleep Support Sufficient quality sleep is vital to overall health and well-being. Sleep plays a modest but important role in modulating HPA axis activity by inhibiting cortisol secretion as part of the daily rhythm that controls sleep and wakefulness. Disruptions in this cycle due to abrupt shifts in sleep duration or sleep quality have been found to disturb the daily cortisol rhythm. Conversely, activation of the HPA axis can lead to arousal and occasional sleeplessness. Supporting sleep efficiency and the daily cycle of cortisol secretion can help positively influence daytime performance and a normal stress response. • Melatonin is synthesized from tryptophan and secreted by the pineal gland during periods of darkness. Human research has found that supplemental melatonin promotes sleep, improves sleep quality, and shortens sleep onset latency, particularly in people age 55 and older. • L-Theanine has been shown to increase serotonin and This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 9 dopamine levels in animals and in humans, which may promote muscle relaxation and improved sleep. • Magnesium glycinate is an inhibitory neurotransmitter in the central nervous system. Clinical trials involving healthy human volunteers show that glycine positively influences sleep quality. • 5 HTP (L-5-Hydroxytryptophan) is a serotonin precursor that supports sleep regulation. In a small double-blind trial, supplementation with 5-HTP increased rapid-eye-movement (REM) sleep, which may suggest improved sleep quality. Should I Take a Multiple Vitamin? Although it may be easy to follow a healthful lifestyle under good circumstances, when one becomes stressed the good diet, regular exercise, and routine relaxation techniques like meditation and yoga can often go out the window. As a result, individuals experiencing chronic stress are susceptible to multiple nutritional deficiencies brought on by skipped meals, grabbing fast food onthe-run, mindless munching, and eating the wrong foods. Stress can result in cravings for foods high in fat, sugar, and salt. Cortisol can also result in weight gain, which can then instigate a crash diet. A recent study found that taking a fish oil supplement could inhibit stress-induced increases in cortisol production. Nutrients most likely to become depleted from chronic stress are the B vitamins, vitamin C, zinc, and magnesium – but any nutrient is fair game when one is not eating a healthy diet. Vitamin B1 and vitamin B5 are important nutrients for functioning of the adrenal glands – the most important glands in the fight against stress. Vitamin B6, folic acid, and vitamin C are important for the formation of chemicals called neurotransmitters that are necessary for balancing emotions. GABA is one of the most important calming neurotransmitters during times of runaway stress. GABA, vitamin B3 (in the form of niacinamide), and vitamin B12 (in the form of methylcobalamin) can help provide restful sleep. As you can readily see, many vitamins and minerals are involved in the stress response or can become depleted during times of This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 10 runaway stress. Therefore, it is important to take a good, superior multiple vitamin and mineral formula, especially under stressful circumstances. In addition, supplementation with specific nutrients and/or herbs can help support your adrenal glands, provide a calming effect, and help with sleep. Specific Treatment Suggestions: Supplement Options The following include quality nutritional supplements to support the health and well-being of patients in various stress response stages. Early-Stage: Cortisol Reducer Helps reduce stress hormone, promote relaxation, alleviate fatigue & chronic apprehensiveness, without the use of habitforming ingredients. By balancing cortisol levels, Cortisol Reducer can help reduce stress, which supports a restful night’s sleep without diminishing daytime alertness. Cortisol Manager can be taken in conjunction with Adrenal Forte when additional energy and stress support is needed. Cortisol Reducer features: • • • • Ashwagandha L-theanine Phosphatidylserine Relora (a proprietary blend of plant extracts from Magnolia officinalis and Phellodendron amurense) • Magnesium glycinate • Effective: 71% of study participants experienced improved sleep This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 11 • Fast-Acting: reduced cortisol by more than 60% after only 24 hours A 28-day pilot study using the ingredients in this supplement found that stress was significantly reduced during the course of the study. In a subgroup tested for salivary cortisol levels, a drop of more than 60% was observed after the first dose and averaged 75-83% reduction at study’s end. Mid-Stage: Adrenal Forte Adrenal Forte combines five powerful adaptogenic herbs to help the body better response to both mental and physical stressors. With key ingredient, such as Ashwagandha, Rhodiola root extract, and Eleuthero root extract, combined with standardized extract of Schisandra, Licorice and Wild Yam root, Adrenal Forte supports healthy stress hormone balance via the HPA axis. *Note: Many anti-fatigue formulas use high doses of Rhodiola, this has an opposite, sedative effect on the adrenals. Low doses of Rhodiola (not exceeding 100mg) during the day boosts energy, high doses do not. • • • • • Non-stimulant formula. Reduces mental stress and fatigue. Improves mood and calms occasional anxiety Supports cognitive function. Late-Stage: High ORAC MultiForce + Adrenal Forte • Combats stress-related fatigue and promotes energy recovery. • Includes ingredients to support healthy adrenal gland function. This combination utilizes L-tyrosine in the adrenal formula for added thyroid metabolism support and active forms of essential B-vitamins that can be depleted by stress. Activated 5 MTHF in this formula supports synthesis of serotonin, melatonin and DNA. The inclusion of antioxidants such as Vitamin C, turmeric, alphalipoic, resveratrol, and the organic berry blend helps to further combat stress-related fatigue and promote energy recovery. This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 12 Over the past decade, numerous studies have identified the benefits of antioxidant phytonutrients and compounds found in fruits and vegetables that assist in maintaining cell function. Berries for instance have been found to improve cognitive function and protect delicate brain structures from oxidative damage. Consuming a variety of fruits and vegetables, along with antioxidant nutraceuticals may help protect against harmful agents and preserve the longevity of cell health. Late Stage Sleep Reset: Cortisol Reducer + Any combination of key ingredients below which can be custom compounded to address unique needs. Managing stress can help support healthy sleep patterns. Conversely, obtaining a sufficient quantity and quality of sleep is vital to preserving a healthy stress response system. Sleep plays a modest but important role in modulating hypothalamic-pituitaryadrenal axis activity by inhibiting secretion of the stress hormone cortisol. Cortisol Reducer supports the ability to fall asleep and stay asleep, enhancing overall sleep quality without morning drowsiness. L-theanine promotes alpha-brain wave activity, relieves occasional anxiety, and may counteract the stimulating effects of caffeine. Melatonin is a natural hormone secreted by the pineal gland. Melatonin helps to promote relaxation and healthy sleep patterns. Best taken before sleep while participating in a relaxing activity. Magnesium is needed for more than 300 biochemical reactions in the body. Magnesium glycinate in particular helps maintain normal muscle and nerve function and helps keep heart rhythm steady. Alterations in autonomic nervous system response may be a result of magnesium deficiency. 5-HTP (5-hydroxytryptophan) is the immediate precursor of serotonin, and supplementation provides nutritional support for normal sleep and mood. 5-HTP supplementation has also been shown to have pain-reducing and appetite- controlling effects. Best taken between meals. L-Tryptophan is an amino acid that promotes sleep and is found This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 13 in small amounts in all protein foods. It is a precursor to the sleepinducing compounds serotonin (a neurotransmitter), and melatonin (a hormone which also acts as a neurotransmitter). For tryptophan to have a sedative effect, it needs to enter the brain by crossing the blood-brain barrier and is best absorbed with a lowprotein, carbohydrate-rich snack or meal. GABA (gamma-aminobutyric acid) is an important amino acid neurotransmitter in the brain. It regulates brain nerve cell functions and has been referred to as the brain’s natural calming agent. Botanical herbs: synergistic blends of potent nervine botanicals including valerian root, passion flower, lavender, california poppy, motherwort, avena sativa, scullcap and other calming herbs can promote relaxation and provide relief of occasional muscle stress due to occasional overuse, as demonstrated in controlled trials published in peer-reviewed medical journals. Bio-identical (natural) Progesterone cream or oral capsules in addition to effectively helping to manage the symptoms of pms and menopause, this hormone is also helpful in controlling anxiety and aiding with sleep quality and latency. Correcting Sleep Pattern Abnormalities Sleep is a necessary body function that allows the body to perform many essential tasks. It is during sleep that the brain commits new information to memory via a process known as memory consolidation. Lack of sleep may lead to feelings of irritability, disrupt the ability to concentrate and lower stress tolerance. Getting adequate sleep is also influential on weight. Poor sleep habits can influence the body’s hormonal regulation of hunger, as well as storage of carbohydrates and fat. In addition, sleep influences immunity, as immune cell efficacy appears to be negatively affected by poor sleep habits. Despite its importance, many people still struggle with getting enough sleep. Most people require eight hours per night to function at an optimum rate. Surveys estimate that the average North American is currently only getting six and a half hours a night and many experts feel that the actual number may be even This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 14 less. In addition to not allowing enough time for sleep, sleep pattern abnormalities affect many people and disrupt their ability to receive adequate rest. Individuals with sleep pattern abnormalities may struggle to initially fall asleep or may have difficulty remaining asleep and falling back asleep throughout the night. Although everyone may occasionally experience these symptoms, routine sleep disturbances that are interfering with your daily life may require therapeutic interventions. The physiological induction of sleep is largely dependent upon cortisol secreation and melatonin release. Melatonin is an endocrine hormone synthesized by the pineal gland from the amino acid tryptophan. The body’s release of melatonin is a way of maintaining circadian rhythms, or the biological clock. Melatonin synthesis is triggered by darkness and inhibited by cortisol and bright lights. It is believed that the availability of artificial lighting has led to disruptions in this natural process, resulting in the sleep pattern abnormalities commonly seen today. If sleep pattern abnormalities are due to the consumption of certain substances known to disrupt sleep, such as caffeine or alcohol, then removal of the offending item may be a simple and effective way to manage the condition. Unfortunately, sleep problems are commonly due to deep underlying emotional issues. Stress, anxiety, and depression may all result in sleep difficulties. Avoid foods linked to hyperactivity. These may include caffeine and refined sugars. Maintain regular sleep and wake times. Having a regular rest pattern throughout the week, even on weekends, can strengthen the body’s adherence to its circadian rhythm. Avoid alcohol. Alcohol may cause sleep disruptions. Avoid bright lights. Light interferes with the pineal gland’s release of melatonin, the hormone that induces sleep. Create a comfortable sleeping environment. Consider environmental factors such as mattress comfort, temperature, and noise which may influence sleep quality. Exercise regularly. Routine exercise has been shown to improve sleep quality. Avoid intense exercise within three hours of bed time. This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 15 Foods for sleep: Foods that induce relaxation may encourage better sleep. Foods that contain carbohydrates and the amino acid tryptophan increase both serotonin and melatonin production for a sedating effect: humus, turkey, keifir, hazelnuts, yogurt, cheese, almond butter, organic milk Remember that bedtime snacks should be between 200 to 300 kcal. Large meals before bed may provoke sleepiness at first, but can cause digestive disturbances that interfere with sleep. Also, stay away from foods that contain refined sugars or caffeine which may increase brain activity. Lifestyle Support for a Healthy Nervous System The ability to respond to stress has the potential to interfere with the enjoyment of life and even the ability to perform ordinary daily activities. Incorporating lifestyle, nutritional, and behavioral recommendations can help support healthy HPA axis function. Although specific recommendations differ based on the stage of stress resistance, below are a few considerations: Practice self-love and self appreciation. Happiness and mental wellness come from within. Take time to notice your strengths instead of focusing on shortcomings. Exercise. Physical activity increases the production of endorphins, brain chemicals with “feel good” effects. . Examples of physical exercise include the following: • Organized aerobics • Brisk walking • Hiking • Running • Dancing This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 16 • Bicycling • Stretching exercises • Strength-building (weight training, core conditioning, pilates) • Swimming • Yoga Try aromatherapy. The sense of smell is strongly connected to the limbic system, the portion of the brain that controls emotions. Smells like sandalwood and lavender have been shown to promote relaxation. Smells linked to personal happy memories, such as the smell of baking cookies, can also stimulate mood enhancement. Direct nervous energy into a positive action. Sitting and thinking about worries can enhance feelings of uneasiness. Involving yourself in an activity such as cleaning the house or reading a book can reduce feelings of apprehension. Help someone else. Assisting someone with their personal needs can be very therapeutic for reducing unsettling feelings. Assist a coworker with a job they need done or lend a listening ear to a friend. Improving the well- being of others may put personal worries in perspective. Laugh. Giggling can reduce levels of stress hormones such as epinephrine / (adrenaline) and cortisol. It also works to increase endorphins. Talk about it. Sometimes our problems are too big of a burden to endure alone. Talking to a friend or professional may provide relief. Allow time for meditation and relaxation. Induction of a more tranquil state of mind can reduce stress and improve overall wellbeing. Relaxation techniques help relieve muscle tension, support cardiovascular health, and promote mental and emotional calmness. Examples of relaxation techniques include: • Meditation • Deep-breathing exercises • Progressive muscle relaxation • Yoga This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 17 Focus on calming images. It is believed that 80% of human mental stimulation is derived from sight. Keeping pictures on hand of beautiful scenery or loved ones can provide mental cues that may induce relaxation. Dietary Recommendations for a Healthy Nervous System: Mood Foods. Certain foods or combinations of foods can trigger brain activity that affects mood. Proteins are the building blocks of neurotransmitters. Foods that are high in the amino acid tyrosine promote synthesis of dopamine and norepinephrine to signal alertness. Low-carbohydrate, high-protein, tyrosine-containing foods that rouse brain activity include soy products (e.g., edamame, tempeh, tofu, miso), eggs, low-fat dairy, meat and seafood. Tryptophan-containing foods can increase synthesis of serotonin to induce pleasant and sedating effects. When tryptophan intake is coupled with carbohydrates, rising insulin levels allow more tryptophan to enter the brain to further stimulate these agreeable results. Carbohydrate- and tryptophan-containing foods for calming the brain include chocolate, nuts, legumes, and seeds. Avoid Allergenic Foods. Avoid allergenic foods that can cause immune activation. Research indicates that stimulating the multitude of immune cells in the intestines can lead to an increase in stress hormones. Some of the most common allergy-inducing foods include: • Peanuts • Gluten • Dairy • Soy This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 18 • Yeast • Eggs • Corn • Citrus Choose carbohydrates carefully. Glucose is the primary fuel source for the brain. However, not all carbohydrate-containing foods are created equal. The complex carbohydrates provided by whole grains and some fruits and vegetables are broken down slowly to provide a steady supply of glucose to the brain. Meanwhile, simple sugars provided by refined carbohydrates enter the bloodstream quickly, causing temporary spikes in brain activity followed by a crash. • Eat whole foods rich in minerals and B vitamins- Green leafy vegetables -romaine lettuce, kale, collard greens, spinach. Whole grains – brown rice, quinoa, teff, oats. Raw or dryroasted nuts and seeds – almonds, walnuts, sunflower seeds, pumpkin seeds. Cooked beans – area a rich source of magnesium (a vital stress-relief mineral). • Eat cruciferous (cabbage family) vegetables that support enzymes that metabolize stress hormones more readily. Cabbage, kale, cauliflower, broccoli, brussel sprouts. • Break the fast and eat a good-sized breakfast. Skipping breakfast and drinking a cup of liquid cortisol (coffee) first thing in the morning will surely spike stress hormones. Feed your brain smart fats. Omega-3 fatty acids are the primary fats incorporated into the structure of brain tissue. Diets low in these essential fatty acids could result in deficiencies in brain function. Increasing intake of omega-3 fatty acids has been shown to improve academic performance in struggling students. Cultures whose local diet is rich in omega-3 fatty acids, such as Eskimos, report lower incidences of degenerative diseases associated with the central nervous system. Diets high in saturated fats or trans fats derived from hydrogenated oils have been linked to an increased incidence of neurological abnormalities. Incorporating wild caught fish, walnuts, almonds, freshly ground This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 19 seeds and chia seeds are also a good way to incorporate good fats into your diet and supply healthy sources of fat for your brain. Avoid habitual caffeine use from colas and coffee. Although caffeine can provide an increased sense of mental alertness, reliance on caffeine to stay awake throughout the day may be indicative of poor health habits and caffeine directly assaults the adrenal glands. Green tea does not have the same consequences and is a good alternative to coffee. Increase antioxidant intake. A diet rich in fresh fruits and vegetables will help provide the antioxidants necessary to protect brain cells from damaging free radicals. Both oxidative stress and inflammation have been linked to degenerative neurological conditions. Stay hydrated. Nerve signaling is largely dependent on proper hydration Dehydration impairs nerve transmission to compromise nervous system function. Aim to drink plenty of water throughout the day to maintain healthy fluid balance. Take probiotics and increase fermented foods in your diet. Probiotics have been shown study after study to be a pivotal component of neurotransmitter production in the gut. Research into the gut-brain connection continues to reveal the importance of gut microbes and the benefits of supplementation. This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 20 The most common food intolerances or allergies: Gluten (wheat, spelt, barley, rye), Dairy products, Eggs, Soy, Peanuts, Corn Tests Available: Food Allergy Testing, IGG and IGE mediated blood spot : Food allergies and a buildup of toxic metabolites have also been linked to abnormal stress response, concentration difficulties, and This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 21 moodiness. Patients may wish to complete a modified elimination diet followed by a food challenge to determine if there are food allergenic or food intolerant components to their ailment. Likewise, detoxification programs may also be supportive in order to remove toxins that could potentially further aggravate these conditions. A whole-food, low-allergen diet free of refined sugars and caffeine may be a supportive approach to achieve optimum adrenal health and reduce undesirable behaviors. Salivary Cortisol Test – this 4 tube test kit is currently considered the gold standard for measuring the diurnal secreation pattern of cortisol and therefore is helpful in identifying the stage of hypothalamus-pituitary-adrenal dysregulation and corresponding treatment. Closing Remarks The first defense in supporting a healthy stress response is the use of therapeutic interventions directed towards supporting the hypothalamus-pituitary-adrenal axis itself. It is commonly believed that a decline in energy, along with a physical deterioration of the adrenal gland, is a natural part of aging. However, new research suggests that individuals with healthy hypothalamus, pituitary and adrenal cells (HPA axis) can avoid experiencing a deterioration in energy and vitalness as they age. The HPA axis determines the individual’s ability to interact with their environment, learn and retain information, and express healthy emotions. It is also responsible for orchestrating a complex symphony of hormonal, neurochemical and electrical signals to maintain the body in a state of optimal health. Preservation of HPA axis function is dependent on healthy nutrition and lifestyle habits as well as engaging in activities to support rest and rejuvenation. Sustaining adrenal and autonomic nervous system health is important throughout life to optimize vital mental functioning and energy. Regardless of what your stress-relief program involves, make a commitment to incorporate these changes into your daily routine – for your health and for those you love. This is your life. Live it well. This information is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. © Dr. T Adatya 3750 Oak Street P: 604-224-2124 www.dradatya.com 22 In health, Dr. Tesnim Adatya Naturopathic Physician 3750 Oak Street Vancouver, BC P: 604-224-2124 www.dradatya.com Dedicated to supporting the optimal health and well being of patients for nearly twenty years References: • Selye H. Stress and the general adaptation syndrome. British Medical Journal. 1950; June 17. • Edwards LD, Heyman AH, Swidan, S. Hypocortisolism: An evidencebased review. Integrative Medicine. 2011;(10)4:30–36. • Kumari M1, Badrick E, Sacker A, Kirschbaum C, Marmot M, Chandola T. Identifying patterns in cortisol secretion in an older population. Findings from the Whitehall II study. Psychoneuroendocrinology. 2010 Aug;35(7):1091-9. • Chrousos GP. Stress and disorders of the stress system. Nat Rev Endocrinol. 2009;5:374–81. • Chrousos GP. 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