Cortisol and Good Health

by Baxter

Fallen Tree by Brad Gibson

We have mentioned one of the body’s important hormones, cortisol, on these pages a few times in the recent past, but always with the slant of it somehow being a problem child, a bad actor, a rotten apple, as it were. But cortisol, when it is working in harmony with a well-balanced body and mind, is part of a elegant system that tries to help us respond in the best way possible to short term stressful situations that are bound to arise in our daily lives. So on a daily basis, during the early morning hours - around 4-5 am, the body releases a bit of cortisol to get your inner furnace ready for the first foot hitting the floor in the morning. It releases a bit of sugar into the blood stream, sends a bit more blood to the brain and heart, and really gets us ready for action, however mellow or intense our morning will be. Then, if the day is relatively uneventful, the level of cortisol gradually diminishes to its lowest levels around 10pm.

When released in response to unexpected stressful events, it has many more helpful roles to play. It has a strong anti-inflammatory effect, which is helpful with acute injury, so it can act like a fire truck when the body’s immune response to infection is too strong by decreasing the life span and production of one of our white blood cells known as lymphocytes. Basically, it tries to keep a balanced approach to infections.

Cortisol has an effect on the cardio-vascular (CV) system by controlling the smooth muscles in the walls of our arteries. In normal circumstances, this allows cortisol to help boost our blood pressure in the short run when we need extra work from the CV system. It has effects on the central nervous system (CNS), too, influencing behavior, mood, excitability, and the electrical activity of neurons. When we put all that together, cortisol is designed to respond to stress by providing fuel in the form of glucose, mobilizing fat and proteins for back-up fuel supply, modifying the immune response, heartbeat, blood pressure, brain alertness and the response of the nervous system to get us through the rough spots.

The cool thing about cortisol is that is has evolved to enhance the body’s response to stress while also protecting from excessive response to stress. The key thing about the place that produces cortisol, the adrenal glands, is that they need time to recover after stressful events have passed. And herein lies the rub!  If we give the body some time to recover between stressful events, the adrenal glands can do their job well, cortisol levels are adequate to the demands of the body, and you stay healthy and ready for the next stressful event.

But if you are either under constant stress, or your mind is prone to brooding about the past or anxious musings about the future or even negative assessments about the present moment, your adrenals interpret this as an actual stressful event occurring right now, and cortisol gets released into your system. So cortisol levels remain high in the blood stream for greater periods of time, which can result in swelling of the gland itself, and an increased chance of the following negative effects: loss of immunity secondary to shrinkage of lymph glands, increased risk of stomach ulcers, increased risk of hypertension, heart disease and other vascular disorders, excess sugar in the blood stream and more chance of developing diabetes. Not a good outlook! 

And as I mentioned last week, chronic stress depletes your supply of cortisol and can steal the building blocks of your sex hormones (see Yoga and Male Menopause), thus negatively impacting your sexual function and your reproductive capacity. What’s a yogi to do? 

Supta Baddha Konasana (Reclined Cobbler's Pose)

The good news is that your regular yoga practice, if it includes those much needed restorative poses (see Restorative Yoga), yoga nidra (see Yoga Nidra and Deep Relaxation), long guided meditations and generous Savasana (see Savasana Variations), should be the perfect balancing act for keeping the adrenals healthy and the cortisol cycle in synch with your changing needs. One fact that might influence your asana and even your exercise regimen is that aerobic or effort-full exercise (and some forms of yoga definitely fit the bill) can cause a release of cortisol to deal with the short term “stress” of the increased physical effort. If you work out or do asana in the morning, when there is still a bit of cortisol around from the 4 am release, the effects of the brief elevation are minimal. However, a late day work out could be theoretically more problematic, with a negative effect on sleep patterns as one possible side effect. So I would recommend active workouts and asana for the morning, and restorative practices in the evening if you want or need to do something later in the day.

So remember, cortisol is a good guy just trying to do its job. It’s the stress and our reactions to it that are really the culprits. Fortunately, we have the technology to neutralize this threat to our healthy aging! 

Relax Frequently. Very Frequently.

by Nina

“When we’re renewing, we’re truly renewing, so when we’re working, we can really work.”—Tony Schwartz

On this blog, we’ve talked till we’re blue in the face about how important it is to reduce stress to support healthy aging. After all, chronic stress can cause everything from heart disease and stroke to depression. But when people are busy with their everyday lives, it’s often difficult for them to make lifestyle changes to support a long-term goal. But according to a recent editorial in the New York Times Relax! You’ll be More Productive, there is also a short-term payoff to relaxing on a regular basis:

“A new and growing body of multidisciplinary research shows that strategic renewal—including daytime workouts, short afternoon naps, longer sleep hours, more time away from the office and longer, more frequent vacations — boosts productivity, job performance and, of course, health.”

Yes, author Tony Schwartz says that relaxing on a regular basis “it’s possible to get more done, in less time, more sustainably.” He goes on to say that human beings didn’t evolve to expend energy continuously but rather to pulse between spending and recovering energy. This is a reference to the fight or flight response vs. the relaxation response, which we’ve discussed in previous posts (see Chronic Stress: An Introduction and The Relaxation Response and Yoga). This is not big news to us, of course. What got me intrigued, however, was Schwartz’s statement that “strategic renewal” ideally should come every 90 minutes.

“during the day we move from a state of alertness progressively into physiological fatigue approximately every 90 minutes. Our bodies regularly tell us to take a break, but we often override these signals and instead stoke ourselves up with caffeine, sugar and our own emergency reserves — the stress hormones adrenaline, noradrenaline and cortisol.”

Among other studies, Schwartz cites the work of Professor K. Anders Ericsson and his colleagues at Florida State University. Dr. Ericsson studied elite performers, including musicians, athletes, actors and chess players, and found that in each of these fields, the best performers typically practice in uninterrupted sessions that last no more than 90 minutes. They begin in the morning, take a break between sessions, and rarely work for more than four and a half hours in any given day.

Legs Up the Wall Pose (Better Than Sleep)

 Of course most of us can’t take a nap every 90 minutes—something Schwartz recommends—at work. Besides, unless you’re sleep deprived, sleeping probably isn’t the best way to relax and restore yourself (see Conscious Relaxation vs. Sleep). So—wait for it—how about doing a little bit of yoga every 90 minutes? Maybe shut your office door and do a restorative pose or two (see Mini Restorative Sequence). Legs Up the Wall (Viparita Karani) would be my pose of choice. And if you don’t have a door (yeah, I worked in one of those cubicle thingies back in the day) or feel like being active instead of resting, try some of our office yoga poses. We’ve got a sequence you can do in your office clothes (see Mini Office Yoga Sequence) and a series of seated poses you can do right at your desk (see Chair Yoga Mini Sequence). And, of course, you could always meditate, even in a noisy environment (see Achieving Stillness in Turbulent Situations)!

Yoga, Stress and Weight Management

by Nina

Are you planning to relax over the holidays? Because if you’re not and you are worried about gaining weight, perhaps you should set aside some time for yoga.

You see, I’m helping Baxter with research for his upcoming workshop on Yoga for Healthy Eating at the San Francisco Yoga Journal Conference in January and I’ve learned exactly how stress can induce weight gain. Of course, we all know about so-called “stress eating,” but I wanted to know why that happens (I’m like that, you know, always wanting to the whys and hows as well as the whats). And I found that it’s due to the combination of hormones that are released in our bodies when we’re under stress.

These hormones include  adrenalin, which gives us instant energy, along with corticotrophin releasing hormone (CRH) and cortisol. While high levels of adrenalin and CRH decrease your appetite at first—we usually don’t have much of an appetite during a crisis—the effects usually don’t last very long. That’s when the cortisol—whose job is to help you to replenish your body after the stress has passed—kicks in, increasing your appetite and driving you to eat more. And because most of us no longer expend extra calories while in the acute phase of stress (we’re no longer actually fighting or running when our “fight or flight” responses are triggered), we don’t really need to replenish our food stores. So the increased appetite results in, you guessed it, unwanted weight gain.

Chocolate-Almond Candy Heart Made and Photographed by Brad Gibson

In addition, while we’re under stress, we typically have an impulse to do something, to move. So unless you respond to your impulse to move with actual physical activity—yoga asana, anyone?—eating often becomes the activity that relieves the stress.

This is why both relaxation and exercise are recommended for reducing your appetite. When you use yoga or meditation to trigger the relaxation response (see Stress, Your Health, and Yoga), your parasympathetic nervous system reduces the levels stress hormones in your body. Exercise is also excellent for stress reduction as it, too, triggers the release of biochemicals that counter the negative effects of stress hormones. In addition, exercising will satisfy your impulse to move and hopefully prevent you from turning to food as a way to relieve your stress.

My prescription for preventing weight gain during the holidays? An active yoga practice followed by conscious relaxation (see The Relaxation Response and Yoga). And if you’re short on time, try even 10 or 15 minutes of conscious relaxation.

Yoga is a great thing but...

by Nina 

Stop Sign by Brad Gibson

“Yoga is a great thing but it is not everything or the only thing.”

That’s the sentence that popped into my mind while I was practicing yoga yesterday afternoon (a very enjoyable backbend practice, by the way). In the back of my mind, I was obviously mulling over a post I read on the It’s All Yoga Baby blog (see when the yoga doesn’t work: depression, failure & the purpose of practice), in which Roseanne talked about her depression and her feeling that she is “failing” at her yoga practice.

“Underneath it all, however, is a vague sense that I’m failing at my practice, that I’m as broken and fucked up as I was before I committed to yoga (chronic and clinical depression was what drove me to practice in the first place), that the practice isn’t working. There’s also the vague sense that I’m not allowed to be feeling this way – there are many stories of miraculous healing from depression (and everything else) through yoga, but nobody talks about the relapses. I feel like I’m doing something wrong.”

I’ve already mentioned in a couple of previous posts (see Practice As Many As You Can and Authentic Yoga) how reading Yoga Body by Mark Singleton brought home to me once again that most of what we consider to be “yoga” these days was developed in the 20th century. This means that, contrary to what some teachers claim, the yoga we know and practice these days is not some thousands-of-years-old practice that is the answer to everything, including depression and anxiety, as well as physical injuries and illnesses (though it can definitely help with those things for certain people). And I think those in the yoga community who promote it as such, do us all a disservice. Because the result for people like Roseanne is that when yoga doesn’t provide the answer for them, they feel as if they are at fault, that they are doing something wrong, or that they have “failed” in some way. And the truth is, yoga was probably only used to treat depression and anxiety starting in the 20th century.

When I teach yoga for emotional well-being (including depression, anxiety, stress, etc.), I always add that I while I consider yoga to be a powerful tool for improving mental health, it may not be the only answer for you. In fact, you may need to use it as a supplement to western medicine, including drugs and/or therapy. And I recommend that if you are in a crisis, you should consult with your family doctor or a mental health professional. You need to do whatever it takes to help you get better. And, please, no guilt or shame about this!

The truth is, many years ago, before I became serious about yoga but while I was taking regular classes, I had two nervous breakdowns (the diagnosis was agitated depression), within a five-year period. And I’m convinced that, especially during the second breakdown, that my family doctor and the drugs she prescribed for me prevented me from being hospitalized. Later on, life style changes, including a regular home yoga practice, helped me reduce the stress in my life that seemed to be the main trigger for my illness. And I’ve been well since then. But just as important, I believe that yoga has also helped me come to a state of self acceptance regarding my condition. And this included both overcoming my feeling of shame about taking medication for depression (my therapist encouraged me to stay on a low maintenance dose) and starting to talk—and write—about my experiences as a way of possibly helping others.

I want to be very clear that I’m not here giving any medical advice here. This post is not intended to tell anyone what the best way is to heal from depression. I just felt that it was very important to state that as wonderful as I feel yoga is, I believe it has its limits. And there's no shame in that. Really, all I’m trying to say here is summed up by the sentence that I opened this post with:

“Yoga is a great thing but it is not everything or the only thing.”

Does Home Yoga Practice Make You Healthier?

by Baxter

Over the years, as I have worked with individuals on a variety of health issues using yoga as a therapeutic tool, I have observed that those who do a regular home practice (usually two to four times a week) have more dramatic and sustained improvement in their health. There are always other factors that come into play, but in general, if they do their work regularly, they feel better and function better over time. This has been especially true for the students who have chronic pain conditions. But can what I have observed informally be applied more broadly to our general population of yoga practitioners? And what if you are generally healthy? Does yoga give you an advantage over other things? Well, a new study seems to say yes to that and a few other propositions about yoga’s benefits.

In a recent study entitled “Frequency of Yoga Practice Predicts Health: Results of a National Survey of Yoga Practitioners,”the authors out of the University of Maryland School of Nursing and the National Institutes of Health Clinical Center  looked at the positive health benefits of yoga, not simply the therapeutic benefits of yoga for those with illness and injury. Their stated purpose was to examine the relationship between yoga practice and health by evaluating such things as subjective well-being, diet, BMI, smoking, alcohol/caffeine consumption, sleep, fatigue, social support, mindfulness, and physical activity. They chose the tool of a survey, administered to practitioners of a specific style of yoga with a strict standardization of teaching that would likely contribute to consistent instruction, Iyengar Yoga, which could lead to a more valid set of results.  Out of a pool of over 18,000 potential students at fifteen Iyengar schools in the US, they sent out a cross-sectional, anonymous internet survey to 4307 randomly selected students. They received back 1045 (24.3%) surveys completed and ready for analysis.

Backyard Wild Flowers by Brad Gibson

When they evaluated their data, they found that home practice had the greatest predictive positive effect on health. Frequency of home practice favorably predicted the following: mindfulness, subjective well-being, BMI, fruit and vegetable consumption, vegetarian status, sleep, and fatigue. They also found that the different components of yoga practice also had some influence: “Each component of yoga practice (different categories of physical poses, breath work, meditation, philosophy study) predicted at least 1 health outcome.”

Finally, they concluded, “Home practice of yoga predicted health better than years of practice or class frequency. Different physical poses and yoga techniques may have unique health benefits.” This so wonderfully echoed something I probably say once a week in class: “I love that you come to yoga class once a week with me, but if you want to get the real benefits of yoga, you need to practice on your own a few times a week.” And, of course, Patanjali in the Yoga Sutra says the same thing when he states that you will achieve your goals when you practice regularly over a long period of time!

To recap what the authors were looking at, I quote their study once again:

“The objective of this study is to better understand the interrelationship between yoga practice and health. Specifically, the study addressed the contributions of yoga practice in general (years of practice, classes per month, and/or days per month of home practice) and practice of specific components of yoga practice (physical poses, breath work, meditation, and/or philosophy study) to these aspects of health. It is important to study the unique contributions of the individual components of yoga practice because some aspects of yoga practice may be more effective than others in improving specific health outcomes such as body weight, sleep, and mental health.”

I couldn’t agree more! As I work with individuals, I am always considering which component practices would best serve the unique circumstances an individual is working with in designing a home practice for them. 

When reading the fine print, a few notable specific observations popped out at me, specifically related to the study of yoga philosophy. Notably, frequency of philosophy study was the yoga practice variable that most often predicted health.  In addition, more frequent philosophy study also contributed to a lower BMI and higher odds of being a vegetarian.  And this sometimes equated to only reading philosophy once a week. 

When they looked at categories of poses, “vigorous poses remained an independent predictor of BMI and sleep quality, for every additional day per week of vigorous pose practice, BMI decreased .21 of a point, and sleep disturbance improved .26 of a point.”  And doing gentle poses more often correlated to a greater chance of eating vegetarian diet and drinking less alcohol. In regards to fatigue, it seemed that for older practitioners, even a small amount of yoga had a positive effect on fatigue levels and sleep disturbances.

And since so many of us are concerned about eating in a healthy way as we age, “more frequent practice of gentle poses, including supine restorative poses and relaxation pose (Savasana), were associated with three aspects of health that deal with feeding behaviors or cravings: higher fruit and vegetable consumption, higher rates of vegetarianism, and lower alcohol consumption.”

When the question of how does yoga achieve these impressive results, the authors mention a theory on how yoga decreases stress: “It has been postulated that yoga impacts the Hypothalamic-Pituitary-Adrenal (HPA) axis and the Sympathetic Nervous System (SNS) response to stress, possibly via direct vagal stimulation.” In other words, yoga may have some impact on the endocrine and autonomic nervous systems that results in lowered stress reactions in the body. We have alluded to this mechanism of action in past blog posts, and although this study does not look at the biochemistry of those surveyed, this theory still seems plausible as an underlying explanation for yoga’s benefits.

I need to go back to the philosophy findings. The authors go on to note that all those who had regular philosophy study were also practicing a lot of yoga in general. They concluded,” Thus, any relationship between philosophy study and health may reflect the relationship of frequency and intensity of yoga practice to health. This provides more evidence that an intense practice involving all aspects of yoga practice may be more beneficial to health than a less intense practice that includes only one or two aspects of yoga practice, such as just practicing the physical poses or breath work.” Darn!  I can’t just sit around and read about yoga and expect good health! But we all kind of know that already from our personal experience, don’t we?

So, does yoga lead to good health?  Well, this study does not actually prove this. It infers that may be the case, but it does not conclude that yoga causes good health.  It may seem like semantics, but it simply means more work needs to be done to show causality between practicing yoga and good health.

Like all studies, there were some blind spots. Some of the limitations of the study included: studying only to Iyengar yoga practitioners in the USA; anonymous online surveys have the potential for lots of inaccurate data; the response rate of 27% was low; most of the subjects were predominantly white, female, and highly educated, so diversity was not represented; and this kind of study allows one to draw inferences, but do not allow one to conclude that yoga actually impacts health.

Despite these limitations, yoga still looks like a good bet to help improve your overall health. It seems you don’t necessarily need to practice for years to get benefits, but the more you incorporate it into your daily life, the more likely you are to see the predicted positives come true for you.