As mentioned in the last post, the HPA axis plays a critical role in helping the body respond to stress, but chronic stress can lead to the dysregulation of this system. Unfortunately, elevated cortisol levels for an extended period of time can have serious consequences on our health and overall well-being. Let’s take a look at each system!
Cardiovascular system
Studies suggest that high long-term cortisol levels can increase blood cholesterol, triglycerides, and blood pressure [1,2]. In fact, people with stress-related psychological disorders are more prone to suffer from coronary artery disease, stroke, and hypertension [3].
In addition, during normal circumstances, cortisol triggers the release of glucose (a type of sugar) from the liver and counterbalances the effect of insulin to get rapid energy during a stressful event [1]. Constantly having high cortisol levels can lead to consistently high blood sugar, which can cause Type 2 diabetes. This type of diabetes has a higher risk of abnormal cardiac structure and performance (diabetic cardiomyopathy [4]) and hardening/narrowing of the arteries due to cholesterol plaque (atherosclerotic cardiovascular disease [5]), which could lead to heart failure [6].
Respiratory system
Stress can exacerbate existing respiratory conditions and cause shortness of breath, hyperventilation, and asthma attacks [7].
Gastrointestinal system
During a fight-or-flight situation, cortisol stops functions that would be nonessential or harmful. In the case of the digestive system, the release of cortisol decreases blood flow to this area which leads to alterations in the gut’s mobility, secretions, permeability, and bacteria among others [3,8]. This can exacerbate conditions like irritable bowel syndrome and lead to different problems such as nausea, diarrhea, constipation, and stomach ulcers [9].
Immune system
Overall, cortisol can have both positive and negative effects on the immune system. While short-term cortisol release can help the body cope with acute stressors, chronic exposure to cortisol can lead to immune dysregulation and increased susceptibility to infections.
On one hand, short spurts of cortisol reduce inflammation by inhibiting cytokine production [10] (responsible for amplifying the inflammatory response) and the response of some immune cells, like B-cells and mast cells (more information here) [11,12]. In fact, there are countless inflammatory disorders treated with the synthetic version of cortisol called corticosteroids, such as medication for allergies, asthma, and immune diseases [13].
On the other hand, when cortisol is overproduced, it fails to function, leading to an unregulated inflammatory response [10]. For example, it might not recognize pathogens (making the body more susceptible to infections) and start attacking the body’s own cells (causing autoimmune diseases). Some studies even suggest that stress can be linked to cancer as the immune system would not get rid of abnormal cells [14], although this relationship could be indirect [15]. For example, people under chronic stress may develop unhealthy coping mechanisms like smoking or drinking that are associated with a higher risk of cancer.
Musculoskeletal system
With chronic stress, the muscles are in a permanent state of constriction [7]. Over time, muscle tension can cause chronic pain (back and neck pain for most people) and can contribute to other conditions such as tension headaches [16], migraines [16], and fibromyalgia (a condition that causes pain throughout the body) [17].
Nervous system
Cortisol plays an important role in the body’s circadian rhythm, as its level is lower in the evening before going to sleep, and it peaks right before waking up [1]. Having chronic high cortisol levels can lead to sleep deprivation [18,19], which can increase the risk of mental health problems such as anxiety and depression, and affect mood, memory, attention, and cognitive function [20].
Reproductive system
Chronic release of cortisol can interfere with the production of estrogen and progesterone [21], which are necessary for the menstrual cycle (more information here). Therefore, stress can be associated with absent or irregular cycles, more painful periods, and premenstrual syndrome [7, 21, 22]. In men, high cortisol levels can contribute to erectile dysfunction, sperm motility, and sperm morphology, by interfering with the production of testosterone (more information here) [23]. Overall, these reasons can increase the difficulty of conception and maintenance of a healthy pregnancy. Moreover, cortisol can decrease the libido in both sexes [7].
Experiencing high levels of stress for a prolonged period can have a significant impact on various aspects of our health. It’s important to recognize the impact of stress on health and take proactive steps to manage it before it leads to more serious problems. This may involve lifestyle changes, such as regular exercise, healthy eating, and stress-reduction techniques like meditation or yoga, or seeking professional help. By prioritizing both our mental and physical well-being, we can reduce the negative impact of stress to enjoy a happier and healthier life.
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Written by: María
Edited by: Natasha
BioDecoded is a volunteer group committed to sharing accurate scientific information. We cannot offer any specific health advice. If you have any doubts about your personal health, please speak with your healthcare professional or family physician. Your doctor can revise your medical history and advise you on the best path to follow. If you have any questions about this topic or would like to learn more, please comment below or send us your questions.
References:
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Stress Can Increase Your Risk for Heart Disease - Health Encyclopedia - University of Rochester Medical Center (2023). Available at: https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=2171 (Accessed: 28 April 2023).
Chu, B. et al. (2022) "Physiology, Stress Reaction", StatPearls Publishing, p. Available at: https://www.ncbi.nlm.nih.gov/books/NBK541120/
Borghetti, G. et al. (2018) "Diabetic Cardiomyopathy: Current and Future Therapies. Beyond Glycemic Control", Frontiers in Physiology, 9. Available at: https://www.frontiersin.org/articles/10.3389/fphys.2018.01514/full
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