The bidirectional impact of stress on the autoimmune system
Stress is not only an emotional experience, but also a systemic stressor that triggers a series of physiological reactions in the body. Stress has a profound regulatory effect on the immune system through the nervous system and hormone (especially HPA axis) pathways, and is one of the key factors in inducing and exacerbating autoimmune diseases.
1、 Two mechanisms of stress response
Neurological response (sympathetic and parasympathetic nervous systems):
The sympathetic nervous system is activated when sensing stress (the “fight or flight” response), leading to increased heart rate, elevated blood pressure, and directly affecting the lymphatic organs that the heart, adrenal glands, and T cell development depend on.
The parasympathetic nervous system plays a “braking” role, helping the body relax, suppress stress responses, and restore balance. The core of stress management is to enhance the regulatory ability of the parasympathetic nervous system.
Hormone response (hypothalamic pituitary adrenal axis, HPA axis):
Stress activates the HPA axis, causing the hypothalamus and pituitary gland to secrete CRH and ACTH, ultimately prompting the adrenal gland to secrete the core stress hormone cortisol. Cortisol is the main anti-inflammatory hormone in the human body, but it also inhibits immune function.
2、 How stress affects the immune system and triggers autoimmune diseases
Immune system imbalance: Stress can disrupt the balance between immune cells (“soldiers”).
Offensive cells: Killer T cells (attack viruses/bacteria), B cells (produce antibodies).
Control cells: helper T cells (activating attacking cells), regulatory T cells (inhibiting immune responses, equivalent to “brakes”).
Autoimmune disease status: Patients have an excessive number of helper T cells and a low number of regulatory T cells (brakes) in their bodies, leading to the immune system experiencing “excessive throttle and brake failure”.
The double-edged sword effect of cortisol:
Short term acute stress (high cortisol levels): inhibits cytotoxic T cells and inflammation, which is beneficial in the short term, but increases the risk of infection and may prompt B cells to produce more antibodies, attacking their own tissues (such as systemic lupus erythematosus).
Long term chronic stress (adrenal fatigue, low cortisol levels): The adrenal glands are overwhelmed and unable to secrete enough cortisol. This leads to the inability to effectively suppress excessive cytotoxic T cells, causing them to attack their own tissues and trigger or exacerbate inflammation (such as rheumatoid arthritis, systemic lupus erythematosus, etc.).
Other important hormones: Stress can also lower DHEA and testosterone levels. DHEA helps balance blood sugar, lower cholesterol, and inhibit inflammatory factors; Testosterone can kill overactive immune cells. The low levels of these two are associated with rheumatoid arthritis and systemic lupus erythematosus.
Stress and intestinal health (intestinal leakage syndrome): Stress can reduce beneficial bacteria in the intestine, increase harmful bacteria, and weaken the intestinal mucosal barrier, leading to “intestinal leakage”. This allows large molecules such as incompletely digested food proteins to enter the bloodstream, stimulating the immune system, causing food sensitivity and systemic inflammation, which is associated with the use of food as a substitute for medicine.
Stress and Latent Viral Infections: Stress can suppress immune function (particularly cytotoxic T cells), activating latent viruses (such as Epstein-Barr virus) in the body and potentially triggering infection-induced autoimmune reactions.
3、 Identifying Adrenal Fatigue
Long-term high stress combined with unhealthy lifestyle habits (such as insufficient sleep, poor diet, lack of exercise, toxin exposure, etc.) can lead to adrenal fatigue. Typical signs include:
Still feeling exhausted in the morning.
The energy level is slightly better around noon.
Feeling drained in the afternoon, I need to take a nap.
In the evening, I feel my energy restored again (the energy curve shows a “camel hump” shape).
4、 Solution: Stress Management and Psychotherapy
Core Concept: Stress cannot be completely eliminated, but one can control the response to it.
Mind-Body Connection: Through practice, individuals can actively regulate the autonomic nervous system, controlling blood pressure, heart rate, immune responses, and more.
Effective Mind-Body Relaxation Techniques
Meditation, guided relaxation, and guided imagery (introspection).
Soft diaphragmatic breathing.
Explore the self through painting and writing to enhance self-awareness.
These exercises help deactivate harmful stress responses, restore the body’s internal balance, enhance a sense of control over one’s health, and assist in identifying stressors in life that need to be addressed.
Summary
Managing stress is not merely about emotional regulation but also a fundamental step in treating autoimmune diseases. By understanding the complex effects of stress on the immune system and practicing effective physical and mental relaxation along with self-care strategies, patients can actively restore adrenal function, balance the immune system, significantly alleviate symptoms, and promote recovery. Dietary adjustments and stress management together form two pillar-based therapeutic approaches: “treating with food instead of medication” and “stress regulation”.
