Stress is a funny word. Loaded with the emotional bias of being a “bad” thing, the word stress can be quite deceiving, making it harder to handle than it needs to be. So we will offer a new way to look at it—and very effective ways to address it.

As the healing arts grows, it is important to remember that there are four key domains in healing:

1. Biochemistry. This includes herbals, nutrition and medications.
2. Structural. Including areas such as manipulation, surgery, breathing, exercise, and ergonomics.
3. Biophysics. For example, Acupuncture, Chakra work, Yoga, and NAET.
4. Mind-Body-Spirit. Understanding how the body is a metaphor for what is occurring at a deeper level. For most illnesses, including anxiety and even cancer, complete healing is unlikely to occur unless this is also attended to.

You will find that healing occurs best when all four of these areas are addressed. No individual healer is likely to have complete expertise in all of these areas. As our new healthcare system evolves, and the current one heads to extinction, it is good to see health practitioners from diverse backgrounds communicating and working together more.

So let's look at how a Comprehensive Medicine approach works when addressing anxiety and stress. I will focus predominantly on mind-body and biochemical aspects, as these are where my expertise is.

Treating Mind-Body Issues
Stress is not inherently good or bad. In fact, stress can be used to force flowers to bloom, and this analogy applies to people as well. The problem is when stress becomes chronic, and is no longer enjoyable. This then contributes to chronic elevation of the stress hormone cortisol, directly triggering anxiety. As the excessive stress becomes chronic, cortisol levels then go too low—ironically also triggering anxiety by causing recurrent bouts of low blood sugar.

A simple way to tell if stress is healthy? Simply check in to see how it feels. If it feels good, it is healthy. What is enjoyable can vary markedly from person to person. For example I enjoyed the stress of skydiving, while for my wife it would feel awful.

A Novel Treatment
The key stress antidote? Check in to see how things feel. This is so important, that I am being purposely redundant. Learn to say NO to things that feel bad. Leave your brain out of it. Our brain is the product of our societal and family training. It simply feeds back to us what we were taught that we should do to make others happy. Our feelings, on the other hand, tap into our own personal authenticity. So choose to focus on, and do, those things that feel good. Once you've determined what feels good, then your mind can figure out how to make it happen.

And yes, it is OK to simply choose to focus on what feels good in life, without being in constant battle mode against things you don't like. Like food choices at a buffet, we don't have to protest for the removal of those foods we don't choose to eat. Simply ignore them and pick those things you like. You will find that the rest will soon stop appearing in your life. This is part of how I suspect “free will” works. Our focus is like the remote control on our TV. What we focus on keeps showing up on our screen. This is why our constant “Wars on…” just seem to create more of what we are attacking.

Is it truly OK to do what feels good? Some will make the argument that “Heroin feels good, and perhaps also smacking that person who makes me angry over the head with a two-byfour.” This is why we add two caveats:

1. Don't hurt others.
2. Ask yourself “How is that working out for me?”

Doing this, people will find their anxiety is often coming from their choosing what they think they should do over what feels good (i.e. doing what others want, instead of what is authentic to them). Notice if you are constantly feeling, “I should do this, or I should do that.” This is euphemistically called “Shoulding on yourself.” I invite you to change that toxic behavior.

If hyperventilation is present, one will usually have buried feelings that are bubbling to the surface during periods of relative calm. Counseling to help them learn to feel their feelings helps over time. Also, as panic attacks often leave people feeling like they are going to die, understanding that the symptoms are not dangerous helps. Simply being told this may not be enough to reassure you though. You can confirm hyperventilation is the cause by breathing rapidly for up to 30–60 seconds and seeing how it amplifies your symptoms. Unfortunately, this can also precipitate a full-blown panic attack, so be forewarned, and pick a safe time and place to do this test!

My e-book, “Three Steps to Happiness—Healing through Joy,” can help guide you through the mind-body healing process.

Balance The Biochemistry
Begin with ruling out and treating overt issues, including:

1. Overactive thyroid. Consider this if your Free T4 thyroid test is even in the upper 20th percentile of the normal range.
2. Low progesterone (women). Progesterone is like our body's natural Valium. Consider this if anxiety is worse around menses and ovulation.
3. Low testosterone (men). Consider if testosterone levels are in the lower quarter of the normal range.
4. Adrenal fatigue—caused by drops in blood sugar. A key tip-off? Irritability and anxiety that triggers sugar cravings and improves after eating.

Also optimize nutrient status, especially magnesium and B vitamins. Instead of blood testing, which is of questionable value here, I simply recommend (for most people—whether or not they have anxiety) a high potency multi powder called the Energy Revitalization System (by Enzymatic Therapy). With this, one drink replaces well over 35 pills, optimizing levels of most nutrients. Also have the person decrease sugar and caffeine intake to see if this helps.

Herbals can also be very helpful. For example, there is a unique extract, which can be as effective as Xanax, but is very safe. This special extract stimulates one of the most abundant neuroreceptors in the body, the cannabinoid receptors. Many of you may recognize this as the marijuana receptor, and in fact many people use cannabis to self-medicate for their anxiety. But what if you could get the benefits without the sedation and side effects?

The good news is that now you can. Recent research showed that a special extract of the roots of the narrow leafed coneflower (Echinacea angustifoliae) was more effective than the tranquilizer Librium, with none of the side effects. It also worked quickly, with effects building with continued use. This is not the same component used for immune enhancement, and isn't found at needed levels in standard Echinacea. It is available though as AnxioCalm (by EuroPharma—20 mg per tablet).

Let's look at a few studies of this unique extract.
A study published in the March 2012 issue of Phytotherapy Research included 33 volunteers. All experienced anxiety, assessed using the validated State-Trait Anxiety Inventory (STAI). The extract decreased STAI scores within three days, an effect that remained stable for the duration of the treatment (seven days) and for the two weeks that followed treatment. There were no dropouts and no side effects.

Another study looked at higher dosages (40 mg 2 x day) in a multi-center, placebo-controlled, double-blind Phase II study involving 26 volunteers diagnosed with generalized anxiety disorder (GAD). Over a three week period, the number of severely anxious patients (HADS-A scores larger than 11) decreased from 11 to zero!

So I begin with two tablets of AnxioCalm 2x day for severe anxiety. After three weeks, the dose can often be dropped to one 20 mg tablet twice a day. It can also simply be used as needed, and serves as an excellent sleep aid.

Other helpful herbals include valerian, passion flower, hops, theanine, and lemon balm. These can be found in a combination called the “Revitalizing Sleep Formula,” which helps anxiety during the day and sleep at night. I personally use both AnxioCalm and the Revitalizing Sleep Formula at night to ensure 8–9 hours of deep sleep.

The smell of lavender oil is also calming, and a small drop on the upper lip, or even having a lavender bouquet in one's room, can be helpful.

Structural And Biophysics
Simply going for regular walks in the sunshine, and doing yoga, tai chi, and meditation can be very helpful. A technique called centering can help people feel that they are in the calm “eye of the cyclone” when panic attacks hit. In addition, it is helpful to explore a technique called Butyko breathing, which can be very helpful for anxiety and hyperventilation.

For PTSD or old emotional traumas, a technique called EFT (Emotional Freedom Technique) can give near miraculous benefits in as little as 20 minutes (see EFT.Mercola.com). It may seem odd, but try it and you'll be amazed. Releasing old traumas through a simple “trembling” technique is also helpful, and the person can do it on their own. It is easy and simple instructions can be found in the book Waking the Tiger.

Dear Readers,

Welcome to the August 2017 issue of TotalHealth Online.

In "Journaling to Lasting Weight Loss Success" Ann Louise Gittleman, PhD, CNS, presents a way to focus entirely on yourself to progress to a healthier and happier you. The NEW Fat Flush Plan provides the help to do it.

Dallas Clouatre's, PhD, article, "Meditation, Stress and Aging," suggests real and tangible benefits from meditative practices. These benefits are backed by research and include stress reduction, a balancing of blood pressure and blood sugar and, perhaps, greater longevity.

Charles Bens, PhD, calls attention to a topic currently in the news, "Is Artificial Intelligence Going to Save Healthcare?" By all accounts its coming and here is one author's comments.

"Acid Blockers Are As Deadly As Cigarettes," by Jacob Teitelbaum, MD. Suprising statement from a doctor. He goes on to discuss stomach acid, how it works in our bodies and how dangerous long time use of the drugs being prescribed can be for us.

Gene Bruno, MS, MHS, RH(AHG), in "Reduce Body Fat with CLA," describing what CLA is, how it is used by our body and that it may help you lose a little weight.

Gloria Gilbère, CDP, DAHom, PhD, presents "Quinoa Burgers & Patties" a healthy alternative to our standard burgers. Gilbère provides a history of quinoa and includes with her recipes a complete description of the healthy benefits of all the ingredients.

Shawn Messonnier, DVM includes our pets with, "Zinc for Our Pets."

Elson Haas, MD, "Is It Dental Pain Or Mental Pain?" Haas takes us on a trip to the dentist and provides us with an unconventional narrative on how he handles the pain and suggests a whole new approach for us to consider when we go in for our next checkup.

You'll be first introduced to telomeres in the second article in this issue when you read Dallas Clouatre's, PhD, article in "Meditation, Stress and Aging." In the ending article, "Telomeres: The Tape Measure For Aging," by Charles Bens, PhD, you will find more history and explanation of how they work in the body plus an extensive personal evaluation to take so you can have a grasp of how you are doing from an aging prospectus.

Best in health,

TWIP The Wellness Imperative People

Click here to read the full August issue.

• Journaling to Lasting Weight Loss Success
  Ann Louise Gittleman, PhD, CNS
• Meditation, Stress and Aging
  Dallas Clouatre, PhD
• Is Artificial Intelligence Going to Save Healthcare?
  Charles Bens, PhD
• Acid Blockers Are As Deadly As Cigarettes
  Jacob Teitelbaum MD
• Reduce Body Fat with CLA
  Gene Bruno, MS, MHS
• Quinoa Burgers & Patties
  Gloria Gilbère, CDP, DAHom, PhD
• Is It Dental Pain Or Mental Pain?
  Elson Haas, MD
• Zinc for Our Pets.
  Shawn Messonnier, DVM
• Telomeres: The Tape Measure For Aging
  Charles Bens, PhD

Click here to read the full August issue.

There is probably nothing—and I mean nothing—like unrelenting stress to sabotage weight loss. Stress really does a number on your body. The sad thing is that stress, no matter where it comes from, will have the same detrimental biochemical effect—a spike in cortisol, your body's premier fat storage hormone. Cortisol is released by the adrenal glands as part of our "fight or flight" mechanism. While you may be aware of stress—whether it is physical, emotional, or psychological—you may be completely unaware of steadily accumulating "silent" stress caused by electropollution thanks to our smartphones, tablets, cordless phones, routers, smart meters and even baby monitors. All of these digital wonders emit biologically active, disruptive man-made radiation that surrounds us 24/7 in a sea of invisible energy—a major autonomic nervous system stressor that nobody is talking about.

It turns out that our DNA is exquisitely sensitive to even the minutest amount of non-ionizing (non-heating) electromagnetic radiation from wireless technology. Our bodies respond to this type of radiation in a number of ways including the secretion of heat shock proteins—around 20 to be exact—with a corresponding elevation of cortisol.

Out of control cortisol levels and non-stop stress can send your health into a downward spiral resulting in a series of negative consequences besides stockpiling on tummy fat. Practically every single disease known to man is due to unmanaged stress. Your brain can actually shrink; the happy hormone serotonin can take a nosedive, your bone density and strength can diminish, and mental illness can set in.

The two hormones that are most impacted by various types of stress are the ultimate fat promoting cortisol and insulin. Remember, the stress hormones, more than any other hormones, will inhibit your ability to lose weight even if you are on the best diet and exercise program!

STRESS HORMONE # 1 – CORTISOL

This fat storage stress hormone is blocked by omega-3 rich oils:

• Walnuts and walnut oil
• Camelina (wild flax) oil
• Fish and fish oil

When cortisol—your main stress hormone—is behaving itself, it truly is your BFF hormone. It gives you that "get up and go" and provides you with just the right surge of energy in emergency situations whether you are emotionally upset or physically challenged or suffering from low blood sugar. But when you can no longer hit the pause or refresh button, and that cortisol surge won't quit, then you run the risk of some very unpleasant side effects—including weight gain.

The human brain contains more than 60 percent fat. It also happens to need more omega-3 fatty acids than any other organ or system in the body. The EPA and DHA (docosahexaenoic acid) fats are major players in regulating emotions, mood and warding off depression. These Smart Fats can help to reduce aggression and hostility in a number of clinical studies. They can help to fortify your system so you can mentally handle and cope with stress more efficiently to minimize the damage created by elevated levels of cortisol.

OMEGA-3 FATS EASE STRESS
According to the National Institute of Health, omega-3s help to balance stress hormone levels and provide direct weight loss benefits. They can be supplied by ALA-rich walnut and walnut oil, Camelina oil, as well as fatty fish and fish oil.

Walnuts and walnut oil contain high levels of the omega-3 plant-based ALA, which have many added benefits besides their ability to regulate stress hormones. Camelina oil is also a rich source of ALA, but contains an amazingly high amount of stable monounsaturated fatty acids (omega-7s), as well as vitamin E, which makes it a very beneficial oil for medium-heat cooking. Due to its high antioxidant content, it's known as the "better" flax. Of course, an even more direct source of the omega-3 fatty acids is fatty fish like wild caught salmon, sardines, anchovies and mackerel.

Walnuts, however, unlike fish or fish oils, are rich in trace minerals like zinc, selenium, calcium, copper, and manganese. Walnuts and walnut oil also pack a serious dose of vitamins B1, B2, B3 and vitamin E— all notably worthy vitamin stress relievers that soothe the nervous system. Walnuts are also one of the richest natural sources of melatonin—second only to tart cherries. Melatonin is the hormone that regulates your body's sleep-wake cycle. It ensures that you get the sleep you need for restorative rest that also prompts weight control.

Omega-3 rich foods right before bed—like a couple of walnuts or walnut oil in a smoothie—will come in very handy when you consider that just one night of poor sleep can raise cortisol by 45 percent.

As it turns out, sleep and cortisol are intimately entwined. Chronically high cortisol levels disturb sleep, and lack of sleep can make you fat.

SLEEP: THE SECRET WEIGHT LOSS AID
Sleep deprivation has reached epidemic proportions here in the US. Approximately 7 out of 10 Americans report sleep-related problems. Lab tests show that cortisol levels are much higher in sleep-deprived people. A landmark study in 2000 by the University of Chicago's Department of Medicine revealed that not only does sleep deprivation affect tiredness and immunity, but too little sleep impairs the way your body actually handles food, creating impaired glucose tolerance. This can result in insulin resistance and obesity.

And it's not just cortisol and insulin that become out of whack without proper rest. A lack of quality sleep also impedes surges of growth hormone, resulting in increased fat tissue and reduced muscle mass—just what you don't need. Growth hormone is released while you sleep, raising gradually from about 10 PM and peaking at about 2 AM. It also prompts your body to burn fat in order to repair the tiny tears in your muscles caused by exercise. This gives you a higher muscle-to-fat ratio, which boosts your metabolism, helping you to lose weight and keep it off.

In order to boost growth hormone, even more, eat a light cortisol-containing snack of walnuts or a smoothie with walnut oil or even an omega-3 deviled egg—providing your gallbladder can tolerate eggs—just before you retire.

CORTISOL AS FAT MAKER
Cortisol is such a primary fat storage hormone because it activates enzymes to store fat when it comes into contact with any and all fat cells. Abdominal fat has four times the amount of cortisol receptors than any other fat cells and so is a telltale sign of cortisol imbalances that your body can't hide.

High cortisol levels over a long period of time have huge consequences, such as chronically high blood pressure, memory changes, depression, insomnia, slow wound healing and diabesity (diabetes + obesity, a term coined by my buddy, the late, great Dr. Atkins).

Elevated cortisol levels also depress thyroid function, interfere with progesterone (your body's natural anti-depressant), raise blood sugar and cause your body to break down muscle tissue to be used for energy—a big setback for weight loss since muscle is a natural calorie burner. The less lean muscle mass you have, the lower your metabolism and the easier you gain weight.

In contrast, extremely low cortisol levels are associated with thinning skin, brittle bones and fibromyalgia—probably due to burned out adrenals. Maintaining balanced cortisol levels that are not too high and not too low is truly a lifetime balancing act and one I find my most challenging!

Cortisol has a nasty habit of making you wake up in the middle of the night. Intermittent frequent awakenings—especially at 3 AM or 4 AM in the morning are often related to cortisol surges, which should be lower to allow you to sleep through the night. When melatonin levels naturally rise, cortisol should be lower. Taking melatonin before bed or drinking several ounces of diluted tart cherry juice may help neutralize excess cortisol and prevent it from keeping you up at night—when you need to be stacking ZZZs and snooze to lose.

FLOWER POWER FOR EMOTIONAL STRESS CONTROL
Repressed emotions can trigger over-eating and bingeing as many of us know. Also, this can impede our best weight loss efforts unless we can learn to cope with emotional issues. Impatience, discouragement, bitterness, frustration, and anger are often common triggers. Granted for many psychotherapy may a viable solution. For those that want to either augment this therapy or find a natural alternative, I would recommend the Bach Flower Remedies. They are a kind of energy medicine similar to homeopathy that offsets emotional turbulence that can be at the root of physical disorders. Developed in the 1930s by Dr. Edward Bach, an English immunologist, the most renowned formula, Rescue Remedy is a five-flower extract combo that is used to help alleviate trauma, whether emotional, physical or psychological.

COMMUNITY CALMS CORTISOL
Women, in particular, benefit from the support of others in being able to handle all aspects of life including stress. A landmark study from UCLA proves something that many of us have already suspected: a unique bond forms between women. A circle of friends makes life brighter and the tough times easier.

The researchers at UCLA demonstrated that women that were under stress produced brain chemicals that opened them up to making and maintaining friendships with other women.

It was generally assumed that when a person experiences stress, the hormonal release creates the typical "fight or flight" response. Women have a very distinct response to stress, as opposed to men. In women, the hormone oxycotin is released which acts as a buffer to cortisol and encourages females to gather with their girlfriends. Men do not have this response because of the high amounts of testosterone they produce. So, when men are stressed they tend to go off by themselves, and when women are stressed they gather others around them.

SMART TIPS: CORTISOL

Here are some smart tips to balance cortisol levels and tame the stress hormone monster so it can't scare away your best weight loss efforts:

1. Eat walnuts and enjoy walnut oil. This omega-rich nut can be popped into salads and side dishes. The oil—when roasted—is absolutely delicious (one of the tastiest oils I have ever used) and packs serious health benefits. Roasted walnut oil will lift an ordinary salad to the sublime with a basic mix of Romaine lettuce, chopped green onion, cilantro, celery and Celtic sea salt. Serve one tablespoon of roasted walnut oil per salad.
2. Count on Camelina! Camelina is also an excellent oil for those with heart issues—because of its high vitamin E content, it works wonders for blood clots! It's a tasty salad dressing and can be used in medium-heat sauteing.
3. Eat fatty fish and take fish oil supplements. Try to consume some wild caught fish at least twice per week and also supplement with fish oil on a daily basis to help manage stress better. Just make sure that the fish oil you buy is molecularly distilled and free of heavy metals. Do be aware, however, that fish oil is a natural blood thinner so caution should be taken if you are also taking blood-thinning meds. Choose the newer orange and lemon flavored fish oil liquids or softgels, which seem to be better tolerated.
4. Shake MORE salt. Yes, you heard that right. Most of us are sodium deficient and the right type of salt (I like Celtic sea salt) can support adrenal function and help your body better cope with stress. It may then indirectly balance elevated or depleted cortisol levels. I would recommend at least 1/4 teaspoon in warm water first thing in the morning. Gargle with this and then swallow, as the salt is anti-bacterial to your mucous membranes.
   For an extra boost, try my Adrenal Cocktail. I have used this for years for my overstressed and overworked clients. It's best taken mid-morning and/or mid-afternoon. Mix four ounces fresh squeezed orange juice, 1/4 teaspoon cream of tartar and 1/4 teaspoon Celtic sea salt. Take a blood test to actually measure your serum sodium so you can better take care of your body's sodium needs. Without sodium, muscles become stiff and hardened. Sodium relaxes soft tissue and is incredibly important when you are under stress.
5. Lights out! Let's talk sleep—a key underlying cause for stress fat. Do try to be in bed by 10 PM when your cortisol levels diminish to their lowest levels (three hours after sunset), and to give muscle-building growth hormone a fighting chance to properly release. Ideally, your body will start to lower cortisol between midnight and 4 AM. If this important cycle is interrupted at all, you can kiss the prospect of ever melting that belly fat goodbye!
6. So, by all means, shut off lights and start to dim them after dark to prepare your body for sound sleep and melatonin activation. Unplug all electronics and keep digital gadgets out of the bedroom to reduce invisible EMF stress. Disable wireless routers before bed and put your cell phone on airplane mode. Aim for seven to nine hours of peaceful, restorative rest.
7. Eschew the blue—at night that is. On the light spectrum, blue light is great for helping you stay alert. One reason: studies show it suppresses melatonin production. As you get ready for sleep, it becomes increasingly important to filter out blue light to keep melatonin production at its peak. That's why dimming lights before bed may be so helpful to protect melatonin so it can do its job. And, that also means that you should avoid the blue light emitted from computer screens, iPads and your smartphone at night—especially in the hour or two before bedtime.
8. Go barefoot. Going barefoot on your lawn or on the beach for at least 15 minutes a day can help your body get grounded. When you are grounded you discharge chaotic electromagnetic energies and absorb healing electrons from the earth through the body. These healing electrons can start to repair stress damage from elevated cortisol and curtail inflammation and pain by quelling free radicals.
9. Curb the caffeine. Caffeine is an underestimated cortisol spiker that gives you instant energy in the short term but will come back to haunt you later. It also makes you lose key minerals like calming magnesium and calcium due to its dehydrating effects. It is a known blood sugar disruptor and contributes to anxiety and sleepless nights. While a tablespoon of high MCT oil like coconut can help regulate coffee's blood sugar peaks and valleys, it is even better to opt for a decaffeinated green tea or dandelion root tea, both of which will help give you energy without the crash and fall effect. If you MUST drink your Morning Joe, however, along with that coconut oil, you can spike your coffee with vanilla whey protein powder for a dose of Smart Fats and healthy protein to prevent cortisol spikes.
10. Axe the alcohol. It can raise cortisol and dial down metabolism by greater than 70 percent. You may hate me for this, but alcohol (yup, even wine) makes it difficult for your liver to keep up with its other metabolic duties so it's not able to balance the rest of your hormones properly.
11. Walk, don't run AWAY stress. If you are a fitness buff, then you know that intensity, not duration, is the current exercise hot button. Yet, any type of daily movement with deep breathing is a terrific combo to beat stress. Think yoga, Pilates or Tai Chi. But, DO give up that long-distance running. It elevates cortisol—as will any continuous exercise over a two-hour stretch. Burst running is a different story though, so mix it up. As far as I am concerned, I prefer brisk walking or jumping on my mini-trampoline to get my lymph flowing and thoughts in order. At least 20 minutes a day—and 40 minutes is even better—of consistent movement and frequent breaks from sitting at the computer are in order here. Exercise can help you cope with stress more effectively while you rev your metabolism, increase lean muscle mass, burn off belly fat, improve bone mineral density and reduce insulin resistance. You can't afford NOT to move.
12. Take supplements to relieve tension. In this regard, the very best dietary supplement of all, which controls over 350 bodily processes, is magnesium. It literally acts like a tranquilizer in a bottle. You can take an Epsom Salt Bath (two cups to a tubful of water) to relax your muscles, or consider an easily absorbable magnesium supplement. I am especially a fan of magnesium formulas, which contain a mix of the best co-factors for absorption like the glycinate, malate, taurinate and orotate forms that target blood sugar, muscles, cardiovascular health and ATP energy. I am also a fan of adrenal tissue glandulars and pair this with the highest quality Rhodiola (an adaptogenic herb from Siberia), ideally taken at 7 AM, 11 AM and 3 PM —the times when blood sugar can be at a low ebb, creating physiological stress.

Some of my clients also swear by phosphorylated serine—taken at least four hours before bed—to dampen cortisol surges that disturb peaceful sleep.

Meditation, yoga, tai chi and other practices often are mentioned in passing as being good for health. However, it is surprising how little medical research has been devoted to testing such claims. Perhaps equally surprising is that until recently little work had been undertaken to quantify the impact of stress on aging. Of course, people often talk about reducing stress and note that too much stress is not good for us, but how much is too much and what, exactly, is the impact on the length of life? It took the interest of a Nobel Prize Winner finally to direct research at medical schools towards these questions. A paper by Epel and Blackburn on the impact of stress on the length of telomeres, a direct cellular measure of successful aging, only appeared in the Proceedings of the National Academy of Sciences in December 2004.¹ More than a decade later, meditation has begun to be accepted as a low cost /no cost approach to health benefits.

Stress and Adrenal Fatigue

In medical circles, two syndromes often are discussed with regard to what laymen consider to be the consequences of stress. The first is adrenal insufficiency. Adrenal insufficiency is a condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol; it also may include impaired production of aldosterone (a mineralocorticoid), which regulates sodium conservation, potassium secretion, and water retention. Craving for salt or salty foods due to the urinary losses of sodium is common. Adrenal insufficiency is a medical condition that requires intervention beyond dietary supplements.

Adrenal fatigue occupies a bit of a nether world in many medical circles, meaning that allopathic medicine is not quite sure that it is real. According to the Mayo Clinic, adrenal fatigue is a term often applied to a collection of nonspecific symptoms, such as body aches, fatigue, nervousness, sleep disturbances and digestive problems. However, it also is used as a catch-all for the exhaustion caused by placing demands upon the body that are beyond its normal recovery capacity. Very important in this picture is cortisol, a hormone manufactured in the adrenals, but also exhibits a metabolism that is regulated strongly in various peripheral tissues, such as in fat stores.

The counter-regulatory or "stress" hormone cortisol plays crucial everyday roles in the regulation of blood sugar levels, inflammation and the circadian rhythm. Cortisol should be relatively low late in the day as we unwind and prepare for sleep and should rise quite significantly starting an hour or two before waking. The circadian pattern of cortisol release generally is considerably more important than is its total 24-hour level.

Acute demands outside the normal range and chronic stress alter this picture. Recurrent increases in stress levels, both from psychological and physiological sources, can result in excess cortisol production or alterations in cortisol release timing leading to a disrupted homeostasis and directly affecting the hypothalamic-pituitary-adrenal (HPA) axis, the nervous system, and an array of other body systems.

Immediate responses to stress
Typical acute phase reactions to stress are increases in heart and respiratory rates, elevations in blood pressure and blood sugar, and a general increase in cellular metabolism.

Post-stress reactions
Those in good health, especially younger individuals, quickly recovery equilibrium. However, stress in excess of immediate recovery capacity can lead to bouts of hyperglycemia, fatigue, insomnia, irritability, anxiety, etc.

Poor recovery from stress
Chronic stress disrupts the normal equilibrium of the body. Chronic elevations of cortisol and the neurotransmitters epinephrine and norepinephrine initially cause people to feel energetic, yet unable to rest. Indeed, there is increasing dysregulation of an array of hormonal systems, including growth hormone, glucocorticoids, adrenocorticotropic hormone (ACTH), mineral corticoids, angiotensin, and others. Ultimately a number of vicious cycles can be set in motion. These include set points involving mineral corticoids and insulin. One example of this is a cycle involving blood sugar, insulin and cortisol:

chronic ↑ blood sugar => ↑ insulin + ↑ leptin => insulin resistance + leptin resistance => ↑ cortisol => ↑ blood sugar

Depending on the individual's starting constitution and habits, this can lead to elevations of blood sugar and lipids, water retention, mood swings, a loss of lean tissue followed by a gain in fat tissue, generalized fatigue and other symptoms.

The goal of any program aimed at controlling stress and reducing adrenal fatigue is to promote adaptation. One classic way of thinking about this issue is to consider the medical concept of allostasis, the process of achieving stability, or homeostasis, through physiological or behavioral changes. This can be carried out by means of alterations in HPA axis hormones, the autonomic nervous system, cytokines, or a number of other systems, and is generally adaptive in the short term. This adaptation calls upon mediators such as adrenalin, cortisol and other chemical messengers with the obvious corollary of increasing demands on precursor substrates and the production of downstream metabolites.

Repeated episodes of allostasis increase allostatic load. This means that repeated episodes of stress increase the demands that are placed on the body. Even the body's attempts at rebalancing can lead to cumulative damaging effects. The burden of the level of responses required either repeatedly or chronically itself becomes an insult (stressor) in its own right.^2,3

Meditation, Stress and Telomeres
The pioneering work of Epel and Blackburn linked perceived stress to shorter telomeres in healthy women as well as in Alzheimerfs caregivers, victims of domestic abuse and earlylife trauma, and people with major depression and posttraumatic stress disorder. Telomeres are a repeating DNA (deoxyribonucleic acid) sequence that "caps" or shields the ends of the chromosomes each time that cells divide and the DNA is copied. With successive cell divisions, the protective caps wear down. Blackburn received a Nobel Prize for discovering an enzyme called telomerase that can protect and rebuild telomeres. This enzyme slows the slide towards telomeres becoming too short to protect the chromosomes and leading to a loss of the ability of cells to divide. The length of telomeres thus is one measure of how many cycles the cells have left, a measure of aging. The key finding regarding stress and aging is that stress and our ability to cope with stress strongly affect telomere length. Subsequent work in other labs revealed that the stress hormone cortisol reduces the activity of telomerase. Oxidative stress and inflammation—the physiological fallout of stress—appear to erode telomeres directly.^4,5

There are various ways of attempting to control stress its negative effects, including exercise, social support groups, eating advice, and so forth. One of the most successful in trials is meditation. As reported in an excellent 2104 BBC review,⁶

In one ambitious project, Blackburn and her colleagues sent participants to meditate at the Shambhala mountain retreat in northern Colorado. Those who completed a three-month-long course had 30 percent higher levels of telomerase than a similar group on a waiting list. A pilot study of dementia caregivers, carried out with UCLA's Irwin and published in 2013, found that volunteers who did an ancient chanting meditation called Kirtan Kriya, 12 minutes a day for eight weeks, had significantly higher telomerase activity than a control group who listened to relaxing music. And a collaboration with UCSF physician and self-help guru Dean Ornish, also published in 2013, found that men with low-risk prostate cancer who undertook comprehensive lifestyle changes, including meditation, kept their telomerase activity higher than similar men in a control group and had slightly longer telomeres after five years.

Western style research thus increasingly is validating meditation as a tool for combatting known markers for aging. The next issue is whether meditation improves individual conditions, such as high blood pressure and high blood sugar.

Meditation and Specific Conditions
Telomere length and the production of telomerase to regenerate telomeres are indirect measurements of health. Impacts on these markers can suggest anti-aging benefits, but true clinical findings involve endpoints, not markers, i.e., were subjects followed long enough to demonstrate an actual increase in longevity? With long-lived animals such as human beings, this type of follow-through is difficult. However, meditation has been tested in regard to specific medical conditions, including blood pressure, blood sugar and mental aging. Results have been positive in all three.

Blood Pressure
Although statistical reviews typically have found that clinically meaningful changes in health related to blood pressure usually take place only when systolic blood pressure (SBP, the upper figure) exceeds 140 and diastolic blood pressure (DBP) exceeds 90, in recent years increasing attention has been paid to the category of prehypertension. Nearly 60 million Americans have blood pressure (BP) in the prehypertensive range (SBP of 120– 139 and/or DBP of 80–89). These numbers do not yet warrant medication, yet may signal that changes in diet, exercise and other habits should be undertaken to prevent the emergence of the clinical condition that does require treatment.

Mindfulness-based stress reduction (MBSR) is a change in habits that has been tested under controlled conditions. In a trial published in 2013, it involved body scanning exercises, sitting meditation and yoga exercises performed in eight supervised group sessions totaling 2½ hours per week. Subjects also were encouraged to practice at home. The trial examined 56 men and women averaging 50.3 years of age with BP in the prehypertensive range randomized to eight weeks of either MBSR or active control conditioning consisting of progressive muscle relaxation training (PMR) (the control arm).⁷

Patients in the MBSR group exhibited significant reductions in blood pressure measurements; systolic blood pressure decreased by an average of 4.8 millimeters of mercury (mm Hg) compared to 0.7 mm Hg with the control group, which did not receive the mindfulness intervention. Diastolic blood pressure also was lower in the mindfulness-based intervention group with a reduction of 1.9 mm Hg compared to an increase of 1.2 mm Hg in the control group.

Blood Sugar
As is true of blood pressure, in free-living populations meditation and other mind-body practices long have been associated with better body mass index and blood sugar regulation.⁸ Nevertheless, without prospective clinical trials, such benefits cannot be definitively claimed to be due to any given factor. Over the last handful of years, studies have gone some way towards remedying this issue.

In 2015, the Endocrine Society presented information on the effects of MBSR on fasting blood glucose in overweight and obese women. The NIH National Center for Complementary and Alternative Medicine (NCCAM) and the NIH National Center for Research Resources and the National Center for Advancing Translational Sciences funded the study.⁹ A pilot randomized controlled trial of 86 overweight or obese women (similar in age and body mass index) tracked eight weeks of either MBSR or health education control (HEC) with tests of fasting blood work and completed questionnaires at baseline, eight weeks and then at 16 weeks. The MBSR group's mindfulness scores significantly increased and its perceived stress scores significantly decreased compared to the HEC group's scores. Fasting glucose dropped significantly and quality of life improved significantly in the MBSR group, but not in the HEC group. Other measures were similar between the two groups.

Results with the MBSR intervention were good with regard to blood sugar just as with blood pressure. A different form of meditation may be even more successful. Traditional Buddhist walking meditation in a 2016 trial improved not only fasting blood glucose and blood pressure, but also glycosylated hemoglobin (HbA1c, a measure of long term blood sugar control) and other factors above the results found with walking alone in diabetic test groups.¹⁰ Twenty-three type 2 diabetics were split into two groups that performed a 12-week exercise program that consisted of walking on the treadmill at an exercise intensity of 50–70 percent maximum heart rate for 30 min/session, 3 times/week. In the Buddhism-based walking meditation exercise (WM) training program, the participants performed walking on the treadmill while concentrating on foot stepping by voiced "Budd" and "Dha" with each footstep that contacted the floor to practice mindfulness while walking.

Both arms in this trial improved. After 12 weeks, maximal oxygen consumption increased and fasting blood glucose level decreased significantly in both groups. In contrast, walking meditation exceeded simple treadmill exercise in other areas. There were significant decreases in HbA1c and both systolic and diastolic blood pressure only in the WM group. Again, arterial stiffness was improved only in the WM group and blood cortisol levels were reduced only in the WM group.

Brain Aging
Another area, one that concerns all of us who are getting a bit older, is brain aging. Observational studies and a number of studies have indicated that meditation can exert a positive influence, yet the question of "how" remains poorly determined. Does it involve telomeres, inflammation, stress regulation, macroscopic brain anatomy or other mechanisms? Answers suitable to the Western allopathic medical model only now are beginning to be uncovered.

A review published in 2017 attempts to survey the relevant issues.¹¹ It judges that "preliminary evidence for possible age-defying effects of meditation mostly stems from cross-sectional studies and/or from using indirect markers associated with aging. In contrast, controlled longitudinal studies between meditation and diminished brain aging are still missing." Nevertheless, "[w]ithout a doubt, the accumulating scientific evidence is very encouraging, especially given that meditation is relatively easy to integrate in everyone's every-day life."

Conclusions
A philosophical person—a lover of wisdom—indulges his appetites neither too much nor too little, but just enough to lay them to sleep and prevent them from interfering with higher activities. He collects himself in meditation to pursue spiritual investigations, seeking and discovering unrealized realities of the past, present, and future. Through identifying with his Higher Self in meditation he avoids being the victim of fantastic and uncivilized vagaries and most effectively attains Truth.

We tend to think of meditation as an "Eastern" tradition, but, in fact, very similar practices existed in the ancient Greco-Roman world until the closure of the Platonic Academy in 529 AD by Justinian I. A major goal of meditation is to attain inner balance neither by indulging the passions nor by stifling them. Many different techniques exist. Overall, the goal of classic meditation exercises was and remains spiritual benefit. Modern research has discovered that even those not directly interested in religious or philosophical paths can obtain quite real and tangible benefits from meditative practices. These benefits include stress reduction, a balancing of blood pressure and blood sugar and, perhaps, greater longevity.

References:

1. Epel ES, Blackburn EH, Lin J, Dhabhar FS, Adler NE, Morrow JD, Cawthon RM. Accelerated telomere shortening in response to life stress. Proc Natl Acad Sci USA. 2004 Dec 7;101(49):17312–5.
2. McEwen BS, Seeman T. Protective and damaging effects of mediators of stress. Elaborating and testing the concepts of allostasis and allostatic load. Ann N Y Acad Sci. 1999;896:30–47.
3. McEwen BS. Central effects of stress hormones in health and disease: Understanding the protective and damaging effects of stress and stress mediators. Eur J Pharmacol. 2008 Apr 7;583(2–3):174–85.
4. Marchant J. Can Meditation Help Prevent the Effects of Aging? July 1, 2014. http://www.bbc.com/future/story/20140701-canmeditation- delay-ageing
5. Epel E, Daubenmier J, Moskowitz JT, Folkman S, Blackburn E. Can meditation slow rate of cellular aging? Cognitive stress, mindfulness, and telomeres. Ann N Y Acad Sci. 2009 Aug;1172:34–53.
6. Marchant (op. cit.)
7. Hughes JW, Fresco DM, Myerscough R, van Dulmen MH, Carlson LE, Josephson R. Randomized controlled trial of mindfulness-based stress reduction for prehypertension. Psychosom Med. 2013 Oct;75(8):721–8.
8. Younge JO, Leening MJ, Tiemeier H, Franco OH, Kiefte-de Jong J, Hofman A, Roos-Hesselink JW, Hunink MG. Association Between Mind-Body Practice and Cardiometabolic Risk Factors: The Rotterdam Study. Psychosom Med. 2015 Sep;77(7):775–83.
9. The Endocrine Society. "Stress reduction may reduce fasting glucose in overweight and obese women." ScienceDaily, 6 March 2015. www.sciencedaily.com/releases/2015/03/150306181815.htm
10. Gainey A, Himathongkam T, Tanaka H, Suksom D. Effects of Buddhist walking meditation on glycemic control and vascular function in patients with type 2 diabetes. Complement Ther Med. 2016 Jun;26:92–7.
11. Kurth F, Cherbuin N, Luders E. Promising Links between Meditation and Reduced (Brain) Aging: An Attempt to Bridge Some Gaps between the Alleged Fountain of Youth and the Youth of the Field. Front Psychol. 2017 May 30;8:860.
12. An admittedly idiosyncratic, yet helpful translation found at http://www.hermes-press.com/meditation0.htm

Caring for our selves and finding ways to handle our stresses are clearly important practices for assuring our long-term health. They are definitely key aspects of Preventive Medicine, Along With the right nutrition and exercise programs for our body, getting proper sleep, and maintaining a positive attitude toward our self, others, and the world. Learning the individual lifestyle path that generates health rather than disease is really the finest art of medicine and personal development, and an extremely important process in which to invest. Let's look at ways to protect our body and heart from the negative effects of stress and to create better health.

A self-inventory
One of the first steps in stress reduction is an honest inventory of where we are. Ask yourself:

• What is my biggest life challenge now?
• Is anything very out of balance in my life? If so, what is upsetting me?
• Why don't I feel fully relaxed, happy, and able to sleep well?
• What do I need to do to restore balance?
• Is there anything I can do something about?

1. Health–how we care for ourselves and the result we hu-manifest,
2. Career–what we share with the world and the support that is returned, and
3. Relationships–how we give and receive love.

If we can master these three primary areas of life, some might say we're near enlightenment.

Expectations
One of the sources of stress is inner tension between what we expect of ourselves and what actually happens. Often these expectations are quite unconscious. It's important to identify unspoken expectations or attachments. Sometimes we need to work a little harder to bring reality in line with our expectations— and to really go for our dream.

Letting Go
At other times, we need to develop more detachment to let go of counter-productive thoughts or desires. In this effort, a meditation practice can be very valuable. All the major religions of the world include some type of meditation or prayer. Your practice can be aligned with your spiritual beliefs.

Types of Stress(adapted from the Anti-Stress Program of Staying Healthy with Nutrition textbook)

Stress comes in many forms. For example, many of us are surprised to learn that intense joy is a source of stress, but since it requires more of our body and mind, it genuinely qualifies as stress (with an increased heart rate and the manufacture of certain neurotransmitters, such as adrenaline). Exercise can also be a stressor even though it is great for us. This is because of the repetitive movement in certain areas of the body, and because we create and release more free radicals and toxins into the blood and tissues. This biochemical process can best be handled by being sure you drink enough water and take antioxidant nutrients, such as vitamins A and C. According to researchers on stress, the most optimal combination for vitamin C is to pair it with the bioflavonoid, quercetin.

The various types of stress and some of the factors that contribute to them include:

• Mental—high responsibility; financial or career pressures; working long hours at mental tasks, perfectionism, anxiety, and worry
• Emotional—attitude toward self; issues or imbalances in our relationships; anger, fear, frustration, sadness, betrayal, and bereavement
• Psycho-Spiritual—issues of life goals; spiritual alignment, imbalance, or lack of spiritual nurturing; general state of contentment
• Physical—exercise and physical labor; pregnancy and giving birth; developmental or life changes (adolescence, menopause, and aging)
• Traumatic—infection, injury, burns, surgery, and extreme weather and temperatures
• Biochemical—deficiencies of vitamins, minerals, specific amino acids, protein, or fats and fatty acids; food allergies; genetic errors in metabolism that can result in alcoholism, other addictions, or mental illness
• Toxic—environmental pollutants such as pesticides, cleaning solvents, and other toxins; non-organic foods with additives; and the use of chemicals such as prescription and OTC drugs, in cosmetic and hair products, and overuse/abuse of sugar, alcohol, caffeine, or nicotine

What is Stress?

Please realize that stress is not dictated by situations or incidents themselves; rather, real stress comes from the way we react to the issues of our lives. For stress to negatively influence our health, we must experience something as danger. If we experience a threat as stress, we may go into fight-or-flight mode, which shifts us into the sympathetic (adrenaline) side of our nervous system. That means our body actually prepares to battle or run, i.e. "fight or flight." Our circulation slows and there may be greater muscle tension; our digestion slows down, heart rate goes up, and we begin using up important nutrients. Often immune function is affected—our level of T-cells may even be depressed. And clearly then, we are more prone to become ill or "catch whatever's going around."

Sometimes there's no way around stress. For example, when a child falls on the playground, or we're putting out a fire, our body prepares us for the emergency so we can respond immediately. That's the way it should be as this level of response/reaction allows us to be more alert and ready for action.

But sometimes stress is subtler—and it may be more psychological or emotional. When there really is no physical danger, our body may still react as if there is. Then, if there's no physical activity to provide an outlet for the increased internal activity, the response may remain inward and play havoc with our physiology and organs, as well as with our emotions and our mind. At that point, we run the risk of exhausting the adrenal glands and flooding our body with metabolic toxins, such as damaging free radicals (associated with the aging process and diseases such as heart disease and cancer). This example also shows the reason why "a walk to cool down" really is a good idea.

When we're under emotional or mental stress, and still stay in a relaxed mode, we can respond more calmly and experience less emotional and biochemical wear-and-tear. Then our body doesn't shift into full battle mode and begin pouring out the chemical signals that we're in danger and must react. This relaxed approach usually leads to a better outcome as well.

Anti-Stress Nutrients
Many anti-stress formulas are based on the B-complex vitamins and vitamin C because these important nutrients are all significantly depleted by stress. In addition, stress-related problems may be compounded by deficiencies resulting from generally poor nutrition. All of the B vitamins are important here—especially pantothenic acid (B5). B5, folic acid, and vitamin C are essential for the functioning of our adrenal glands. The adrenals carry perhaps the greatest load when our body is under stress.

The B-complex vitamins are ideally taken two or three times a day, particularly when we are under a lot of stress. This is especially important if the stress lasts over a period of months— for example from a big project at work or a challenging job, a chronically ill child or parent, unemployment, divorce—any of the life events that tend to deplete us over time. It's best to take the B-vitamins before dark so that we don't become over-stimulated when it's time to wind down and relax. I do suggest more minerals in the evening, as they tend to help with relaxation, especially a calcium and magnesium supplement. However, most vitamins and minerals are best assimilated if they're taken with a meal.

Note: Prolonged stress or lack of sleep can lead to a myriad of health problems. If these issues do not resolve with home treatment, you may need to see your doctor or other health professional.