More threads by David Baxter PhD

David Baxter PhD

Late Founder
Jolting System May Be What Autoimmune Patients Need to Counter Chronic Effects
September 03, 2004
Dallas Morning News

DALLAS (KRT) -- The brain and the immune system are at times like members of a dysfunctional family. Sure, they're close. They depend on each other. But under stress, one can drive the other to self-destruction.

Perhaps few people feel this more than the millions who already have a love-hate relationship with their immune systems. People who suffer from any of a host of autoimmune diseases rheumatoid arthritis, multiple sclerosis or psoriasis, to name a few can feel the pressures of stress literally in their every move.

Scientists who study the interplay between the brain and immune system are trying to help people with autoimmune conditions buffer themselves from the mental backlash of daily life by studying the effects of proper rest, stress management and other coping strategies. And one idea may be surprising: Fighting stress with stress.

"The key to chronic stress is acute stress," says Dr. Andrew Miller of Emory University School of Medicine. He believes that short bursts of benign stress - a scary movie, say - may actually be good for you.

But where the immune system is concerned, he and others point out, no answer is simple. The immune system is one of the body's most intricate operations, run by the chemical cross-talk between nerve cells, hormones from the brain and glands throughout the body. Troops of cells in the blood can quickly storm and retreat.

In autoimmune disease, something goes awry, and the system designed to attack outside threats starts to attack itself. The target varies by disease. In arthritis, it's the joints. In multiple sclerosis, it's the central nervous system.

Then on top of this comes stress, which can wreak havoc on even a healthy immune system. Human beings evolved in a world of mostly short-term threats, like an attacking bear. In modern life, the most menacing bear usually comes out of the stock market. Stress resonates at a sustained, yet unpredictable pitch. Fight or flight has become cope or mope.

Stress excites a trigger in the brain called the HPA axis. "HPA" stands for hypothalamus, pituitary gland and adrenal gland. It is the key relay that translates mental stress into physiological action. When you feel stressed, the hypothalamus in the brain fires a chemical signal to the pituitary gland, which then sends another signal to the adrenal glands. The adrenal glands (where the name "adrenaline" comes from) start pumping out a variety of substances that talk to the immune system and the rest of the body. One of the key substances is cortisol.

Cortisol is a potent compound that affects systems throughout the body. It raises blood sugar and works with adrenaline to increase heart rate, for example, readying the body for the stressful situation. It also sends a "message received" signal back to the brain, so the hypothalamus and pituitary don't stay all atwitter. And when things operate as they're supposed to, cortisol calms the immune system.

Thus, a paradox: Stress leads to cortisol, and cortisol can control a raging immune system - which is just what someone with arthritis wants.

"You would think that stress would tend to suppress the disease," says Dr. Esther Sternberg. A rheumatologist by training, Dr. Sternberg now directs the Integrative Neural Immune Program at the National Institute of Mental Health.

Yet that's not how people who have autoimmune conditions say they feel. Under stress, their conditions often get worse. And it's not just perception. For example, one study published earlier this year from researchers at Arizona State University found that people with rheumatoid arthritis have higher amounts of a naturally occurring inflammatory substance during stressful periods.

"What happens in chronic stress," says Emory's Dr. Miller, "is that cortisol doesn't work anymore." Prolonged stress affects either the production of cortisol, or the body's ability to respond to it. Some scientists believe the system may simply burn out. For whatever reason, the immune system loses a key chaperone.

What might help, he believes, are short-term stressors that would give the body a blast of cortisol. As evidence to support this idea, he points to a study of multiple sclerosis patients in Tel Aviv. The study happened to take place in 1991 during the first Gulf War, when Israel came under fire from Scud missile attacks. Researchers were surprised to find that the patients reported an improvement in their symptoms. According to a review published last year, this is the only study that has found multiple sclerosis symptoms actually improving under stress.

"The question for us is, why is chronic stress different?" says Dr. David Mohr of the University of California, San Francisco. Mohr, who studies the effects of stress among people with multiple sclerosis, concludes, "the short answer is, we don't know."

Researchers, including Miller, emphasize that cortisol isn't the sole cause of all things good and evil in the immune system. And its ultimate role in the exacerbation of autoimmune disease is still under study. The immune system has several kinds of soldiers, depending on the threat, and cortisol isn't the only colonel. There is even evidence suggesting that gender makes a difference, that men's and women's bodies don't respond to stress in the same way.

"You don't have just one thing going on in the body at the same time," Sternberg says. Which means there's no one thing to advise people with autoimmune conditions, but a host of possibilities that might help. "Listen to your body," she says. "Listen to your body because everyone is different. Different people will have different reactions to different kinds of stresses."

Pacing yourself is also important for people with autoimmune conditions, she says, because of its contribution to stress relief. So is moderate exercise. "You need more sleep than most people," she says. "There's nothing wrong with that."

By mastering stress, people with autoimmune conditions may feel like they have more control over their health. However, UCSF's Mohr cautioned that patients shouldn't feel like they have failed if their disease flares up. "This type of information should never be used by patients to place blame," he says. "These aren't diseases that people cause by themselves."

Millions of Americans suffer from autoimmune diseases, which occur when the immune system begins to attack targets within the body. For reasons that are unclear, these conditions affect women more than men. Many autoimmune conditions are rare. Here are some of the more common diseases, and the area targeted:

  • Rheumatoid arthritis (joints)
  • Crohn's disease (intestine)
  • Multiple sclerosis (central nervous system)
  • Type 1 diabetes (pancreas)
  • Lupus (connective tissue)
  • Psoriasis (skin)
  • Grave's disease (thyroid)
For more about autoimmune disease:
The National Institutes of Health offers general information at www.niaid.nih.govublications/autoimmune/autoimmune.htm#what

The American Autoimmune Related Diseases Association has details about many such conditions, advice on coping, research and other information at :: American Autoimmune Related Diseases Association, Inc ::


Thank you. That was very useful. I have Hashimoto's Disease, which is auto-immune underactive thyroid, as opposed to Graves, which I think is overactive...

I knew stress had a lot to do with initially triggering it, but I have always had questions about, why should something that is meant to defend me - attack me.

I do think women may be more prone to auto-immune disorders because we tend to internalise things a lot more than men (in general), and may 'beat ourselves up' a little bit more than men if we don't cope with life, or make mistakes etc...

Generalising again, I have noticed men seem more prone to putting their anger on others, and women at pushing it inside...

Don't know if this makes any sense... I'm tired, I should be in bed :) It's 11.30pm here in England.

David Baxter PhD

Late Founder
sammy said:
why should something that is meant to defend me - attack me.
It's a fascinating phenomenon, isn't it (if you'll pardon the Mr. Spock-ism). And they are so common, although fortunately not always as destructive. Other examples are allergies, where the initial response is to protect your body from an environmental irritant but that protective response ends up being more irritating than the irritant and in some cases lethal -- and the autoimmune reactions of pregnancy, which are necessary to prevent the woman's immune system from attacking the fetus and sometimes end up by attacking the mother instead.

I do think women may be more prone to auto-immune disorders because we tend to internalise things a lot more than men (in general), and may 'beat ourselves up' a little bit more than men if we don't cope with life, or make mistakes etc...

Generalising again, I have noticed men seem more prone to putting their anger on others, and women at pushing it inside...
Like all generalizations, there are many exceptions but I do think there is some truth in that - how much is biology/hormonal and how much socialization isn't clear, but women do tend to be more nurturing and to assume responsibility for things that "go wrong"...

There are two excellent books about the differences in how boys and girls are socialized -- both, by the way, are fascinating reading even if you're not a parent and for teens and adults alike:

Pipher, Mary. Reviving Ophelia: Saving the Selves of Adolescent Girls. Ballantine Books, 1995.

Pollack, William. Real Boys: Rescuing Our Sons from the Myths of Boyhood. Random House, 1998.


Hi Sammy and David :)

Thanks David ... for this posting. It IS intersting.

I have issues with rheumatoid Arthritis (genetic predisposition), lots of diabetes in the family (not me or my kids tho... touch wood ) and I belive lupus and MS somewherein the tree.
Funny strange timing for the arthritis ... I began first with irritable bowel, then carpal tunnel, then arthritis stuff AFTER my youngest was born. By the time she was 5 I progressed from just IB all the way to Rheumatoid arthritis. Also funny timing was... okay ... postpartum then too. I went thru PTSD whammy's for the first extreme reactions...

hmmmm .... HORMONES???????????????????????? and what causes the hormones to be out of whack etc...

I would like to format my brain actually ... not simply delete stuff to agitate and erode subversively GRIN come to think of it, a new carcass without the aches and pains and eroded joints would be cool too. Oh...I want red hair ... and to be taller than 5'1" because they don'tbuild standard furnitur for small people ... or tall people. One size fits all? grin

must go... very tired

David Baxter PhD

Late Founder
One flaw

I know this should probably be in the Humor section if anywhere but someone sent this to me and it seemed to me to fit some of the content of this thread. I don't want to get into a "who has a harder time -- women or men?" thing, but there's no doubt that the hormonal swings and pregnancy/childbirth take a toll on women's bodies.

The One Flaw
By the time the Lord made woman, he was into his sixth day of working overtime. An angel appeared and said, "Why are you spending so much time on this one?"

And the Lord answered, "Have you seen my spec sheet on her? She has to be completely washable, but not plastic, have over 200 movable parts, all replaceable and able to run on diet coke and leftovers,have a lap that can hold four children at one time, have a kiss that can cure anything from a scraped knee to a broken heart-and she will do everything with only two hands."

The angel was astounded at the requirements. "Only two hands!? No way! And that's just on the standard model? That's too much work for one day. Wait until tomorrow to finish."

"But I won't," the Lord protested. "I am so close to finishing this creation that is so close to my own heart. She already heals herself when she is sick AND can work 18 hour days."

The angel moved closer and touched the woman. "But you have made her so soft, Lord."

"She is soft," the Lord agreed, "but I have also made her tough. You have no idea what she can endure or accomplish."

"Will she be able to think?", asked the angel.

The Lord replied, "Not only will she be able to think, she will be able to reason and negotiate."

The angel then noticed something, and reaching out, touched the woman's cheek.

"Oops, it looks like you have a leak in this model. I told you that you were trying to put too much into this one."

"That's not a leak," the Lord corrected, "that's a tear!"

"What's the tear for?" the angel asked.

The Lord said, "The tear is her way of expressing her joy, her sorrow, her pain,her disappointment, her love, her loneliness, her grief and her pride."

The angel was impressed. "You are a genius, Lord. You thought of everything! Woman is truly amazing."

And she is! Women have strengths that amaze men. They bear hardships and they carry burdens, but they hold happiness, love and joy. They smile when they want to scream. They sing when they want to cry. They cry when they are happy and laugh when they are nervous. They fight for what they believe in. They stand up to injustice. They don't take "no" for an answer when they believe there is a better solution. They go without so their family can have.

They go to the doctor with a frightened friend. They love unconditionally. They cry when their children excel and cheer when their friends get awards. They are happy when they hear about a birth or a wedding. Their hearts break when a friend dies. They grieve at the loss of a family member, yet they are strong when they think there is no strength left.

They know that a hug and a kiss can heal a broken heart.

Women come in all shapes, sizes and colors. They'll drive, fly, walk, run or e-mail you to show how much they care about you. The heart of a woman is what makes the world keep turning.

They bring joy, hope and love. They have compassion and ideals. They give moral support to their family and friends.

Women have vital things to say and everything to give.

But, they do have one flaw: they tend to forget their own worth.


that is a brilliant post dr,b. i just unearthed it and i hope by putting a response here it will bring it back up to be read by others as well.


I think that a lot of people are unaware that "Rheumatoid Arthritis (aka RA) isn't just a "joints" disease ... it's a systemic disease that can effect organs of the body as well. Many people even refer to it these days as Rheumatoid "Disease" because calling it "arthritis" is misleading. So many people are totally blown away when I explain that RA is systemic. They don't know that as common knowledge. It's dealt with differently and with different medications than is the usual "joints arthritis" known as osteoarthritis. They're ALL bummers to deal with though and lots of people have more than one type of arthritis going on :)

I don't wish any of this on anyone ;)

Very interesting article, thank you David.

All three of us siblings have something attacking our immune system. I have Graves' Disease (well, used to, had to take the radioactive iodine because I couldn't stand it anymore) and my youngest brother has Hashimoto's... Interesting that we both have thyroid problems... My middle brother has vitiglio, which (my understanding) may be caused by stress when the immune system attacks the pigmentation in the skin... Even my dad's thryoid was hypo until he took medication for it (although no one has told us kids if it is actually Hashimoto's or something else). It could also be inherited, because my dad's father had thyroid issues (he died from Alzheimer's later).

You may remember me from other threads... I was wondering if perhaps because we were all chronically stressed, living with or dealing with someone in our family who has a personality disorder all our lives, plus of course the regular stressors of normal everyday life (or not so regular)... I wouldn't be surprised if we all have a bit of PTSD lol ... I could be a bit over-dramatizing and over-associating but I find it interesting that a mother is supposed to look after you and not attack you, but in our case she does attack us on a mental/emotional level, and would on a daily basis if we still associated ourselves with her. And as it's mentioned further up from this thread, our immune system is attacking when it should be protecting... Just find the parallel very interesting. 8P
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