Stress and Autoimmune Diseases
Ongoing pain and malaise bring patients into your clinic regularly. But, what’s behind these chronic health conditions? In many cases, stress causes these symptoms. Thankfully we can test stress hormone levels to get a diagnostic view of the patient’s presenting medical need to help detect risk factors and guide your treatment plan.
According to The National Stem Cell Foundation, autoimmune diseases — including multiple sclerosis, rheumatoid arthritis, scleroderma, type 1 diabetes, and more — are the third most common chronic illnesses in the United States. Let’s discover the link between stress and chronic autoimmune health conditions, which hormones you should test, and the most common diagnoses.
The Relationship Between Stress and Autoimmune Disease
Scientists at the National Institutes of Health are discovering the prevalence of autoimmune disorders is on the rise in the United States. This phenomenon occurs when the immune system reacts or fights against cells in the body. There are over 100 diseases that identify as autoimmune or chronic, debilitating conditions. The risks of various cancers are also triggered when the immune system is weakened by an autoimmune disease, or when stressors trigger the release of cortisol which may increase inflammation. Cancer cells can more easily divide and grow in an autoimmune body.
The study that derived this information looked closely at the number of antinuclear antibodies (ANA), a biomarker for autoimmunity, in the test subjects. Over the years, there’s been a steady increase in ANA, with 11 percent (or 22 million individuals) affected from 1988 to 1991. From 2011 to 2012, the numbers jumped to 15.9 percent or 41 million people with ANA present.
The most significant spike in ANA was found in the youngest participants, ages 12 to 19, with two to three-fold increases throughout the study. Populations identified as having an increased risk for dysregulation of the immune system and autoimmune conditions include adolescents, adults age 50 and older, males, and non-Hispanic white people.
Scientists are reasoning that changes in lifestyle and environment — which may be stressful events — are behind the spikes in ANA. Research and observational study are ongoing in this area. Plans for a national directory of autoimmune diseases that tracks changes in patients over time (including their immune responses), and geographic hotspots, have been proposed to help better understand this type of illness and its triggers.
Which Hormones Are Indicators of Stress in the Body?
When the body perceives a dangerous, problematic, or difficult situation, the endocrine system shifts into survival mode. This stress response, also known as fight or flight, may lead to physical changes in the nervous system and reactions like a racing heart, changes in our breathing pattern, or sweaty palms.
For some patients, the stress response stays perpetually activated due to ongoing life stressors, such as family dysfunction, a toxic workplace, medical comorbidity, mental health issues, managing grief, post-traumatic stress or post-traumatic stress disorder (PTSD), or even driving in traffic jams daily. Harvard Medical School finds that chronic psychological stress can lead to high blood pressure, changes in brain functioning, obesity, insomnia, clogged arteries — and eventually, autoimmune diseases.
When the fight or flight response triggers stress reactions, hormones are released inside the body. These stress hormones can be measured and tracked over time to help identify and monitor the progression of autoimmune disorders in patients.
The Indian Journal of Endocrinology and Metabolism suggests requesting the following serum tests when evaluating a patient’s risk of autoimmune disease and stress-related disorders:
- Antinuclear antibodies (ANA): This is the most common biomarker of autoimmunity.
- Cortisol: The neuroendocrine stress response produces corticotrophin-releasing factor (CRF), adrenocorticotropin (ACTH), 8-lipotropin, and 3-endorphin.
- Glucocorticoids: These are cholesterol-derived steroid hormones secreted by the adrenal gland. They include cortisol, thyroid hormones T3 and T4, and others.
- Growth hormone (GH) / Prolactin (PRL): When the body is subjected to acute physical stress, growth hormones may spike two to ten-fold.
- Thyroid-stimulating hormone (TSH): During times of stress, T3 and T4 levels tend to decrease, down-regulating the functioning of the thyroid.
- Vasopressin: Acute, chronic stress may decrease the release of antidiuretic hormone (ADH) or arginine vasopressin (AVP) from the hypothalamus in the brain.
Three other response systems to consider testing include:
- The hypothalamic-pituitary-adrenal axis (HPA)
- The hypothalamic-pituitary-gonadal axis (HPG)
- The hypothalamic-pituitary-thyroid axis (HPT)
Which Autoimmune Illnesses are Caused by Stress Hormones?
As you evaluate the results of these tests, remember there are over 100 autoimmune diseases currently documented. Here are a few of the more common ones to be diagnosed.
The American College of Rheumatology shares that elevated ANA tests may indicate:
- Autoimmune hepatitis
- Hashimoto thyroiditis
- Inflammatory bowel disease
- Juvenile arthritis
- Lupus
- Polymyositis/dermatomyositis
- Scleroderma
- Sjögren’s syndrome
A relationship between altered levels of growth hormone is evident in:
- Addison’s disease
- Autoimmune thyroid diseases
- Celiac disease
- Psoriatic arthritis
- Rheumatoid arthritis
- Systemic sclerosis
- Systemic Lupus Erythematosus (SLE)
- Type 1 diabetes mellitus
Additional autoimmune conditions to consider include:
Arthritis
There are many variations of this disease. Elevated glucocorticoids, prolactin, and cortisol levels may lead you to an arthritis diagnosis. Rheumatoid arthritis (RA) (also known as Rheumatic Disease) has genetic, hormonal, environmental, and immunological factors. According to “Autoimmunity: From Bench to Bedside,” physiological stress influences the development of cytokines, which may lead to an inflammatory response, causing damage to joints and bones over time.
Graves’ Disease
The presence of hyperthyroidism, emotional stress, adverse life events, and physical stress may lead to a diagnosis of Graves’ Disease. Additional testing of genetic markers Human leukocyte antigen (HLA) and Cytotoxic T lymphocyte antigen-4 (CTLA-4) can help determine a predisposition to Graves’ Disease.
Systemic Lupus Erythematosus
More common in women than men, lupus often presents with normal pituitary function, decreased cortisol levels, and normal adrenocorticotropic hormone (ACTH). Alterations of the hypothalamic-pituitary-gonadal axis (HPG) may help diagnose lupus.
How to Determine the Stress Hormone Levels in Patients
At Access Medical Labs, we offer precision lab testing so you can maintain your mission of excellence and innovation for patient care. Consider the Autoimmune Analyzer (ANAZ), a 16-point serum-based test when you suspect autoimmune disease. This screening includes testing for:
- Antinuclear Antibodies (ANA),
- Double standard DNA
- CHRM
- Ribosomal autoantibodies (RIBO)
- Sjögren’s syndrome/Lupus antibodies (SS-A)
- Sjögren’s syndrome/Lupus antibodies (SS-B)
- Systemic lupus erythematosus antibodies (SM)
- Systemic lupus erythematosus ribonucleoprotein antibodies (Sm/RNP)
- Ribonucleoprotein antibodies (RNP)
- Centromere antibodies (CENT)
- Systemic Sclerosis SCL70
- JO-1 antibodies
- Thyroid Peroxidase (TPO)
- Complement component 3 (C3)
- Complement component 4 (C4)
- Rheumatoid factor
Contact Access Medical Labs today to learn more about our cutting-edge stress hormone testing and health care services.
