How Stress Affects the Body

Acute stress prepares the body for action by ramping up metabolism, actually catabolism or the breakdown of food, including old and devitalized organic tissue(by autophagy) to provide energy, usually in the final form of ATP, to help the body move.

The immune system is shut down with cortisol, the stress hormone, to optimize the energy resources needed to fend off or escape from danger. Tissue repair and growth are slowed down by this hormone, for the time-being, for a similar reason. There is the release of stored food and digestion of devitalized or damaged tissue. This happens through adrenaline and glucagon which mobilize glucose and fats and then stimulate corresponding insulin release that enables cells assimilate glucose. Phosphorylation inside the cells increases--of insulin receptor and glucose and these become more chemically active and cAMP levels rise. Glycolysis increases and the Krebs cycle in the mitochondria matrix provides reduced(non-oxidized) intermediates which then enter the mitochondria cristae to finally produce ATP, in the presence of oxygen. ATP further breaks down to help the muscles contract or allow us see, learn or think, aided by adrenaline. The increased turnover of ATP from muscle contraction promotes more production from the breakdown of glucose and fat, mobilized by the stress hormones, adrenaline and cortisol. Blood volume increases so as to increase perfusion through the influence of mineralocorticoids that increase sodium reabsorption. Blood pressure pressure increases from the increased blood volume and vasocontriction imposed by adrenaline and the sympathetic drive mediated by noradrenaline. But if muscles are active, blood vessels in turn mediate the production of nitric oxide, a potent vasodilator which mitigates and may even overcome and overshadow the pressor effects earlier produced

The mitochondrion, the power house of the body, is a unique organelle in that it contains its own DNA(solely inherited from one parent, the mother). Since it uses up oxygen, it accidentally produces reactive oxygen free radicals and the more active it is, as in stress, the more these radicals are formed. Oxygen free radicals damage and convert into plaque, body tissue through the peroxidaton of proteins, including enzymes(the powerhorses of the body) and the mitochondria contain a lot of them; the DNA which they also contain; and fat. Additionally, sparks from these free radicals punch holes into tissues. All these targets on the mitochondria make them to malfunction and be deficient in performing their all important role of ATP production. When this happens, the body functions are highly compromised.

As long as stress is short-lived and mild, food is broken down to provide energy and devitalized tissue is lyzed for a similar reason. During recovery the plaques formed from peroxidation of proteins, fat and DNA are better detected, lyzed(scavenged) with matrix metalloproteinases and then engulfed and further lyzed by white blood cells in what is known as phagocytosis. As stress is resolved, there is a lot of free amino acids and DNA residues from devitalized tissue processed this way from autophagy, phagocytosis and from the pentose-5-phosphate pathway. New tissue and organelles like the mitochondria can be regenerated after this process and this is the rationale for exercise and fasting(forms of stress) in rejuvenation(priming cell division mainly in the day and repair mainly in the night). Rejuvenation is evident after recovery from a stressful illness and in the mother after the birth of a baby.

However, if stress overwhelms the body systems or becomes chronic(resistance), the damage to the mitochondria calls for readjustments to energy conversion. There is accumulation of acetyl CoA because the shutdown of mitochondria pools back on glucose breakdown with the corresponding shutdown of the Krebs cycle. Gylcolysis that still produces some ATP proceeds, ending with excess acetyl CoA which is now more converted to fat, cholesterol and more stress hormones(mainly cortisol) than sent into the Krebs cycle. The debris from free radicals and fat(lipid) accumulation, notwithstanding, the stress hormone, cortisol, will prevent tissue growth, and scavenging by white blood cells and derail these cells from their ever important disease-fighting phagocytosis.

Most cells are very active in acute eustress and are producing oxygen free radicals. These radicals need to be contained to safeguard living cells. This calls for another metabolic pathway. Since all glucose cannot be consumed by this 'dead-end' pathway of fat and cholesterol accumulation, as opposed to its normal ATP production resulting from high a turn-over, the call for the pathway, called the Pentose-5-Phosphate pathway, is crucial, especially if anti-oxidants are not consumed in the diet to scavenge the free radicals. From glucose dehydrogenase it eventually produces glutathione from NADPH which are both strong free radical scavengers. NADPH is used to further promote fat and cholesterol synthesis and build-up.

Chronic stress facilitates blood routing into visceral(internal) organs and under the skin, aided by the extraction from blood and accumulation of fat for storage and hormone synthesis, pulled by the moving plasma fluid. This is opposed to acute eustress that facilitates extraction of glucose and fat in the limbs where blood flow increases and promotes food breakdown to provide ATP for limb function. White blood cells may leave blood and find their way into tissues, but rather than respond to immune cues to fight infection or garbage disposal cues to scavenge debris left behind, they find their function shut down by cortisol. If they ingest microbes these will tend not to get killed but remain inside the cells. In the brain there is no tissue damage by these cells but they secrete cytokines that cause anxiety and depression. There is fear.

With further stress resistance(persistence), more cortisol(stress hormone) is produced and this prevents growth and cell division, hence the low white cell count and further immune deficiency. Adrenaline deficiency may result from exhaustion and this again leads to immune defficiency. New tissue will not be made especially as ATP becomes insufficient and cell division is impaired by cortisol. There is decreased glucose uptake by the body(glucose intolerance) as mitochondria break down; glucose phosphorylation diminishes, and insulin resistance and diabetes set in. Eventually insulin synthesis and secretion are also compromised from lack of ATP. Thinking and learning are hampered. The body becomes weak and psychological depression sets in. Tissue damage is not matched by repairs and garbage disposal is hampered. As cortisol prevents the synthesis of proteins, which means cells are are deficient in structure and function, the stimulation of immune cells by adrenaline, free radicals may produce inflammation instead. Internal cellular proteins are exposed and autoimmunity becomes likely. Diabetes, arthritis, psoriais, lupus may become evident. Proteins may misfold and this will lead to Parkinson's and Alzheimer's diseases.

What set out to be energy booster ends up as energy drainer. And that is what stress is. If poorly managed it takes away all energy and with it all motivation in life.

Eating fruits and vegetables high in anti-oxidants will pre-empt the switch to the pentose-5-phosphate pathway(glucose-6-phosphate shunt) which may drive cell growth and division, hence cancer and inflammation in stress by supplying increased quantities of substrates for growth and thus counteracting the anti-growth role of stress hormone. DNA intermediates(nucleotides and nucleic acids) and aromatic amino acids produced by this Pentose-5-phosphate pathway may well promote cell division and inflammation with many bouts of stress. If there were no cortisol, stress would lead to increased cell division and unwarranted immunity that will be detrimental to health. There would be shock from fluid leaving blood. Anti-oxidants such as vitamin A also promote phagocytosis by preventing oxidative stress. Together other polyphenols they are dechainers of fibers and may be helpful in amyloid and biofilm breakdown. So in chronic stress when most microbes are either intracellular or in the form of biofilm, this vitamin can help expose bacteria and activate dysfunctional phagocytes to eat the microbes up. Vitamins B3 and D3 as metabolic stimulants are also useful in this role.

Exercise which is a eustress causes autophagy that enables damaged mitochondria to be eaten up so as to make way for new ones to form in the resolution phase(after exercise). No doubt, diet and exercise are anti-depressive and rejuvenating during stress. Moving also uses up the ATP and prevents the backlog of this molecule that prevents further glucose breakdown

Having a positive disposition in life--letting go of negative feelings and thoughts --will take away most stress. With this, most stressors will cease to have the negative impact on us. Empathy and bonding, driven this time by the parasympathetic system, as opposed to stress driven by the sympathetic system, produces oxytocin which relaxes the muscles and boosts the immune system and repair that are shut down by cortisol.

Dr. Oliver Verbe Birnso, M.D.

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