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  • Writer's pictureDr. Kogan

Chronic Illness and Stress

a Functional Medicine Perspective


A whopping 80% of adults over 65 years of age have one chronic disease. And a full 77% have at least two! But it’s not like we get the disease suddenly and out of the blue. We’ve been on the path our whole lives. Stress is one of the crucial factors which slowly but steadily works on our decline. It comes as no surprise to anyone that how we think and feel affects our health. The trouble is that we are unable to objectively scrutinize our own feelings. The people we trust will often not take the time to do it with us either. As the decorated researcher, Dr. Candace Pert, Ph.D., once said: “As our feelings change, this mixture of peptides travels throughout your body and your brain. And then they are literally changing the chemistry of every cell in your body.” I would humbly add that it is not just what we think and feel but it is also how long those thoughts and feelings last that will yield the undesirable consequences.

The so-called, “fight or flight” stress response is protective in the context of short periods of stress. It was designed by Mother Nature to protect us against clear and present danger. However, the same inborn system can cause damage and illness in the setting of chronic/continuous stress, whether it is physical or psychological. Doctors call the state of chronically stressed autonomic nervous system—a sympathetic dominant state. Emotional stress increases catecholamine metabolism which increases oxidative stress by increasing the production of free radicals.

It is important to note that stressful events in early childhood affect our sensitivity to subsequent stressful events. Thus, taking a very thorough history dating back to our early childhood, and sometimes even to the time preceding our birth, is of paramount importance in uncovering the triggers and antecedent mediators of the current illness and addressing them. For example, a 2010 study published in Child Development magazine found that increased maternal stress was significantly associated with infant temperamental difficulties from birth to three years of age (period studied). Another 2004 study revealed that high levels of prenatal stress may negatively affect fetal brain development as evidenced by lower language and intellectual abilities in five-year-old toddlers. In a 2014 study, scientists evaluated children born to mothers who lived in Montreal and were pregnant during the severe two-week 1998 ice storm, that cut the power off in the large residential areas. The mothers experienced profound physical and psychological stress and their children born after the storm were found to be prone to asthma and autism. Stress damage can truly transcend generations. I am sure you all have your own examples of how the stress of World War I and World War II has affected the health of more than one generation in your own family.

If we treat the client’s presenting chronic illness without addressing their stress-generating Mind-Body imbalance, we are then missing the entire point of functional healing, which recognizes the body’s innate wisdom and the need to remove the disruptive stressors. A comprehensive study in the National Review of Immunology confirmed the chilling implications that stress can have on a person’s health:

  • Increased susceptibility to infection

  • More severe illness

  • Diminished response to vaccines

  • Reactivated latent viral infections

  • Delayed wound healing

  • Increased production of pro-inflammatory cytokines which are associated with a spectrum of age-related diseases

  • Exacerbation of neurodegenerative disorders

To this, I would add that chronic stress is associated with a higher risk of developing hypertension and with a preference for sugary and high-fat foods. By making poor food choices, stressed people close the catch-22 loop by increasing the toxic burden for their bodies to deal with. A 2019 study in Clinical Gastroenterology & Hepatology found that chronic stress can impact digestion, absorption, appetite, and nutrient bioavailability by affecting our microbiome. In fact, we have all heard about the connection between chronic stress and the development and severity of irritable bowel syndrome (IBS) symptoms.

Functional Medicine utilizes Mind-Body therapies to create a shift from a sympathetic dominant state into a healthy and safe, parasympathetic-dominant (relaxed) state. These types of therapies have been shown to decrease inflammation and improve brain function, related to attention, learning, and emotional self-regulation.


The author of Diet Slave No More!, Svetlana Kogan, MD is a Board-Certified Internal Medicine, Holistic & Functional Medical Doctor with 25 years of experience. Her website is Office phone: 239.676.6883


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