January 11, 2016

By: Dr. Virender Sodhi, ND, MD (Ayurveda) and Dr. Anup Mulakaluri, ND, AWC.

The big news in the world of cancer treatments is the near-miraculous recovery of former President Jimmy Carter, who suffered from an advanced skin cancer, melanoma, that spread to his brain and lungs.[28] President Carter was given a drug called Keytruda®, which activates the immune system.[29] Keytruda®, and similar drugs approved in recent years, inhibits a signal that blocks immune cells from functioning at full capacity. Our bodies naturally produce drugs on demand and can cure almost any disease. But then, questions arise as to why so many of us are not able to receive the benefits of Mother Nature’s own pharmacy.

In the 1800s, Charles Darwin coined the term “survival of the fittest,” as he observed nature. The questions still remain: What factors of fitness contribute to survival? What boosts wellness? And what is resilience?

Definition of Resilience:

The word “resilience” is becoming a growing part of the health-science vocabulary. Scientists have sought to define this term and what it means for our health and wellbeing.

First and foremost, there is acceptance regarding the unavoidable adversities and challenges in human life. Therefore, dealing with problems and recovering are essential factors of human survival and wellness.

Resiliency includes the factors or processes that protect the individual (physical or emotional resources), family, community and culture, and contribute to positive outcomes despite significant experiences with stressors.[1] These factors have been outlined under the following terms:

Personal factors Intellectual functioning, capacity to learn and change, social attachment, positive self-esteem, emotional integrity, self-awareness, spirituality, active coping, hardiness, optimism, hope, resourcefulness and adaptability.
Biological factors The anatomy of the brain and production of neurotransmitters and hormones can be affected positively or adversely by conditions in the womb and early childhood… This sets up a lifetime of behavior and thought patterns.
Environmental factors On a micro-environment level, having support from family, friends and peers is correlated with resilience.

On a macro-environment level, resilience is derived from good schools, community services, sports and artistic opportunities, cultural factors, spirituality or religion, and lack of exposure to violence.

Resilience is essential to help us cope with the various sources of stress in our lives. Some sources of stress are outlined here:

  1. Stress related to performance: Whether performing at the job or at school, putting oneself “out there” is vulnerable and can result in considerable stress. A survey of corporate employees found that high performance demands resulted in more psychological tension, anxiety, anger, depression, fatigue and health complaints.[2] In our society, we are hard-wired for this type of stress since elementary school.
  2. Stress related to inter-personal relationships: Emotional injuries caused by volatile and hurtful relationships can have many negative effects on the psyche. Many have experienced the pain of loss, heartbreak and abuse in our society. Resilience is essential to navigate conflict and restore peace. Individuals in stressful relationships have higher levels of cortisol and more susceptibility to mental and physical health problems.[3]
  3. Stress of unhealthy diet: Diets rich in hollow-calories from processed foods and simple carbohydrates often lack the minerals, vitamins, fibers, proteins and fats that are essential for health. Such malnutrition slows down re-generation of organs, promotes oxidative stress and causes tissue breakdown.4,5
  4. Stress of unhealthy lifestyle: Stress related to performance, trauma or social relationships is associated with sleep disturbances.6,7 On the other hand, delayed or less sleep itself has been shown to increase risk of stress and even neurological disease.[8] Exercise has a similar intimate relationship. Regular exercise helps people manage daily stress and avoid the effects of stress hormones, like anxiety, depression and insomnia.[9] Exercise also contributes to positive personality traits like confidence, courage and calmness.
  5. Early childhood stress: Starting in the womb, childhood years are the most formative time of our life. Exposure to excessive stress can result in a world of changes to the nervous system. Abusive or otherwise stressful living conditions for the mother and baby can result in smaller brain size, abnormality of neurotransmitter production and re-uptake, insensitivity of receptors and low adaptability of neural networks.10,11 This results in greater vulnerability to irritable bowel syndrome, anxiety, depression and other psychological imbalances.[12]

Effects of Stress on Immune Function:

The immune system is known for preventing disease. It is the first line of defense against detrimental infectious pathogens and toxins. Immune cells use the process of inflammation to help destroy invasive pathogens and toxins so recovery and regeneration processes can restore health. With that said, there is no argument that a healthy immune system is essential to resilience.

However, in the presence of constant stressors, the immune system can become a mediator of physiological imbalances that lead to physical and mental diseases. Therefore, the relationship between various stressors, the immune system and disease is becoming an important line of study.

The effects of stress begin in the brain The effects of stress begin in the brain, which produces adrenal stimulating hormones (ACTH) and activates the sympathetic nervous system. The active sympathetic nervous system applies pressure on lymphoid tissue (immune cell factories) to release more immune cells. On the other hand, ACTH stimulates the adrenal gland to produce glucocorticoid (stress hormone), as well as adrenaline and nor-adrenaline. These hormones activate the immune cells released from the lymphoid tissue. The final result is the production of inflammatory signals called cytokines (IL-1, IL-2, and so on). Thus, stressors lead to a cascade of events that produce inflammation in the body.

If the body is dealing with a stressor like an infective bacteria or virus, this cascade is very useful. However, stressors can also cause ongoing low-grade inflammation that leads to tissue destruction, toxin accumulation and disease.

Immune Dysregulation Correlating to Health:

The latest research has been unraveling the connection between immune dysregulation and development of diseases.

  • Cancer: A healthy human immune system has an innate capacity to detect and eliminate cancer cells. Stress hormones, like cortisol, adrenaline and nor-adrenalin, have an inhibitory effect on immune cells—lowering cells’ cancer-detecting capacity.[22] Prolonged stress reduces the production of cancer-detection proteins in immune cells. Elevated stress hormones slow the activity of NK cells, which specifically target cancer cells and inform other immune cells about the detected cancer.[22] The result is increased risk of cancer.
  • Cardio-metabolic diseases: Type II diabetes and heart disease are two of the most prevalent diseases in our society. Diabetes affects one out of three Americans, while heart disease is the number one cause of death among Americans. Studies demonstrate that “overnutrition,” or high carbohydrate food, is the stressor that results in activation of immune cells and low-grade inflammation.[14] Over time, as blood sugar imbalance worsens, so does the immune dysregulation and low-grade inflammation. It begins to affect the activities of liver, heart and kidneys.[14] Heart disease and kidney disease are two of the most common risks following diabetes. One European study showed that diabetes is due to elevated lipids, cholesterol and triglycerides, along with inflammation.[15] This combination leads to plaque in blood vessels and results in heart disease.
  • Digestive diseases: Chronic stress gradually increases the activation of the immune system in the digestive tract. This aspect of the immune system is highly sensitive because of ongoing exposure to food and other man-made materials. Chronic stress leads to elevated levels of inflammation and gradually progressive cellular damage. Ultimate result can be development of inflammatory bowel diseases, like ulcerative colitis and Crohn’s disease.16 Ongoing spikes in stress tend to aggravate disease and symptoms of severe pain, cramping, bleeding and ulcers.
  • Neurological diseases: The blood-brain barrier usually protects the brain from toxins. With chronic low-grade inflammation associated with immune dysfunction, inflammatory signals also increase in brain tissues. The presence of signals like IL-1, IL-6, and TNF have been associated with greater oxidative radicals that damage neurons.[17] This can also cause improper function and formation of proteins inside the brain. In congruence, elevated inflammatory signals produce more β-amyloid plaque in the brain.[18] This finding relates brain inflammation to the development of Alzheimer’s disease.
  • Psychological diseases: Inflammation due to immune system dysfunction can also affect the concentration of and sensitivity to certain neurotransmitters.[17] Serotonin and dopamine reduction due to inflammation is associated with depression.19,20 Over-activation of mast cells, another aspect of brain immune system, can be caused by chronic inflammation or allergic conditions. This is associated with anxiety.[21]

Homeostasis and Restoration of Health:

Homeostasis is defined as the body’s ability to maintain balance within the various physiological processes. Homeostasis is associated with healthy mind and body function. Exposure to stressors causes an imbalance in immune activity and creates declines in resilience, as well as a wide range of diseases.

Extensive research suggests that an individual’s sense of wellbeing is essential to maintaining homeostasis.[22] For example, negative events and traumas may cause an individual to become emotionally disturbed or discouraged—losing a sense of wellbeing. This feeling, or stressor on the system, detracts from homeostasis and ultimately leads to disease. So, the question is, does homeostasis help restore health and resilience?

  1. Restoration of mental/emotional health: Disturbances caused by negative events or traumas first affect the mind. To return to wellbeing, one must be able to adapt and grow with new circumstances and challenges. The factors outlined to support recovery and restorations of homeostasis are:[22]
    1. These may represent resources like finances, access to healthcare, shelter, food, education and safety. 
    2. This is the individual’s capacity to have positive regard for themselves, in terms of forgiveness, acceptance, pride and love for oneself.
    3. Primary control: This encompasses the capacity to control one’s environment. For example, we have more control of our environment at home compared to a homeless shelter or a prison.
    4. Secondary control: This may represent factors that determine one’s environment. For a child, parents provide secondary control of the environment. For an adult, their community or culture helps create safety and stability in the larger society.
    5. The capacity to see “the bright side” includes the ability to process and integrate negative events as part of a positive life story of growth and self-determination.
    6. Social support: The support of family, friends, co-workers and even government systems aid in recovery from negative experiences or adversity.
  2. Health of the digestive system: The digestive tract is populated by trillions of bacteria. These help buffer the digestive tract’s exposure to toxins, as well as aid digestion and synthesis of certain nutrients. Healthy probiotic populations promote proper distribution of immune (lymphoid) tissue in the digestive tract and have anti-inflammatory effects on the digestive immune system.23,24  Eating fresh foods promotes regular restoration of probiotics.[23] Healthy bacterial populations help protect against auto-immunity and stimulate good metabolic function.[24] Therefore, healthy intestinal restoration is essential for developing resilience.
  3. Restorative effects of daily routine:
    1. Exercise: Regular exercise at moderate intensity promotes the regeneration of the immune system and reduces inflammation, while improving immune surveillance against outside infections.[25] Additionally, exercise combats the effects of stress, anxiety, and depression.[9]
    2. Sleep: Sleeping at the right time and for right length of time helps restore cycles of day-night hormones like melatonin and cortisol. These hormones represent basic control over the metabolic and restorative functions of the body. A good night’s sleep helps provide physical and mental rest that is restorative to homeostasis and reduces inflammation.[26] Sleep also supports emotional integration and promotes learning. A good night’s sleep may also help prevent Alzheimer’s disease. Sleep can also reduce inflammation associated with reduced formation of Amyloid plaque, which leads to Alzheimer’s disease.

Homeostasis and immune activation go hand-in-hand when resilience is restored. During homeostasis, the immune system readily regulates itself because it does not have the pressure of stressors affecting normal activity. Normal immune function is maintained by a self-regulation feedback that reduces the number of immune cells and inflammatory signals based on a perceived need for activation.[30] Additionally, when the body returns to homeostasis, the population of immune cells and inflammatory cells is controlled by apoptosis (automatic cell death).[31] Inflammatory signals are also degraded by the liver and other organs to reduce oxidative burden on the body.

Therefore, as normal health conditions and resilience are restored, the body returns to homeostasis.

Ayurvedic medicine’s main emphasis is on disease prevention. By living in any environment, we are bound to be affected with its elements including all physical and emotional stresses. To prevent disease and stay in homeostasis, Ayurvedic medicine prescribes daily routines, seasonal routines, physical exercise, yoga, pranayama (breathing exercises), meditation and nutrition to maintain our resilience.

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