Why You Get Sick After A Stressful Time Ends

You’ve just put in a long, busy week at work.  Two projects were due, one of your most trusted employees was out sick, and your boss was in a foul mood all week because she was feeling pressure from the C-suite…  Finally you achieve Friday!  You get home, peel off your work clothes, relax for the evening and go to bed.  Then Saturday morning you wake up with a fever, sore throat, swollen glands and a cough.  What the heck?!

Why does this happen?  Wouldn’t you think you’d get sick WHILE you were under so much stress?  There actually is a good reason why you get sick AFTER a stressful time ends, not during the stressful time.

To explain this, we have to look at how the body reacts to stress.  Stress increases the fight-or-flight hormones by activating what’s called the sympathetic nervous system.  You know the feeling you get when you narrowly avoid a car accident?  Nervous, shaky, heart racing?  That’s due to adrenaline.

High adrenaline levels over more than a few minutes will make the adrenal glands increase the amount of cortisol and other stress hormones they are making.  Cortisol raises blood sugar and helps mobilize metabolic resources for dealing with stress.

However, these hormones are not meant to be high for days on end.  At some point the stress drops and the cortisol and other hormone levels drop again.  The drop in hormones can trigger migraines (something my son and I know from personal experience) and also can weaken the immune system.

When you’re under stress levels of IgA decrease dramatically.  IgA is the antibody involved in the immune system of the nose, throat and GI tract.  Unfortunately germs are always there, whether you’re under stress or not.  While your systems are revved up the immune system can keep the invaders off the walls, but after the stress releases and the hormone levels drop (and antibody levels are low) you are more prone to get sick.

So how can you reduce the likelihood that you will fall prey to a cold, flu or migraine after a period of stress?  The key is in managing the stress well DURING the stressful period so that the “let-down effect” isn’t so dramatic.

Make sure you’re getting plenty of sleep.  Sleep deprivation increases stress levels and suppresses the immune system.  Exercise also reduces stress hormone levels and improves sleep.  Make sure you’re choosing an exercise you enjoy too, forcing yourself to do something you hate is NOT going to reduce your stress!

Reach out to family and friends.  Social isolation and feeling you’re “going it alone” increase perceptions of stress.

Practicing active relaxation techniques like meditation and yoga are very powerful ways to keep adrenaline and cortisol levels manageable.

Remember, you can’t keep stress away.  Being a grownup (or a teenager or a kid, LOL!) means demands are going to be placed on us that we will have to deal with effectively.  The key is in managing how we deal with the stress.  Avoiding big swings in our body’s stress hormone levels is key to staying healthy.

QUESTION: Do you tend to get sick WHILE you’re under stress or AFTER the stress lets up?


Syrup of Ipecac

Guess what?  A patient’s grandmother taught me this week that something I learned in residency is completely obsolete.  AWESOME!

When I was a resident I was taught to advise parents to have syrup of ipecac in the medicine cabinet in case their child swallows a poison.  I was taught to tell parents never to USE it unless told to do so by Poison Control, and to have the Poison Control phone number posted by the phone and easy to find.

What is syrup of ipecac?  It is a liquid medicine that reliably makes people vomit.  The point of having it ready in the house is that if you need it, that’s not when you want to be heading to the pharmacy to buy it.  If you need it, you need to use it NOW.

My patient’s grandmother listened carefully to my advice and then headed to the pharmacy to buy syrup of ipecac.  Guess what she found?  It’s not on the market anymore.  Not produced anymore.  Hasn’t been available for years.

What?!  Well I’m nothing if not willing to admit I might be wrong.  However, before changing the advice I give parents I wanted to look and see what the rationale was behind the change, and find out what I AM supposed to tell parents to do in case their child swallows a poison.

There are 3 main reasons why the use of syrup of ipecac is no longer recommended.  First of all it is not very effective.  It is pretty reliable at causing vomiting, but it generally does not completely empty the stomach.  If your child has swallowed a poison you want to get rid of ALL of it, right?

Second, it could cause more damage if used improperly.  There are poisons that do as much or more damage coming up than they did going down in the first place.  I would always tell parents NEVER to use syrup of ipecac without specific instructions from Poison Control, but I can see how a panicky parent might just reach for ANY remedy without making that all-important phone call.

Third, syrup of ipecac has the potential to be abused.  Patients with bulimia are known to use it to make themselves vomit.  Repeated abuse of ipecac can cause heart problems and trouble with the salts in the bloodstream.  Also, there is a terrible (but thankfully rare) mental illness called Munchausen syndrome where people deliberately cause themselves to be ill.  Some people are seeking attention or malingering.  In a truly horrible variant of this called Munchausen syndrome by proxy, parents or other caregivers cause illness in those under their care.  Ipecac was one substance frequently used to cause illness in these cases.  Taking it off the market takes it out of the hands of those who would choose to use it to hurt themselves or someone else.

So what should parents do in case of an accidental poisoning at home?  Please remember that the most important aspect of treating poisoning is not letting it happen in the first place.  Keep all cleaning products, household chemicals and medications locked up and secure.  Even vitamins should be kept out of children’s reach.

If your child gets into something and swallows a substance, and you’re not sure if it might be poisonous, the first thing to do is to call the National Poison Control number at 1-800-222-1222.  The experts will help figure out what your next step should be.

I just called and double-checked the number is still right (and it is).  I also have my own Poison Control story.  My oldest child got into his father’s underarm deodorant when he was a toddler and took a couple of bites.  (Why he didn’t stop after one bite is a mystery, that stuff CAN’T taste good!)  The Poison Control guy was so nice and supportive.  I suppose they get a lot of calls from moms who feel like they’ve lost their chance at Mother of the Year, right?

After looking up the active ingredient and making sure it wasn’t toxic, he laughed with me gently and reassured me that they get lots of those calls and mine certainly wasn’t the first child to develop a taste for deodorant.

What do you do if you have a 13-year-old bottle of syrup of ipecac sitting in your medicine cabinet?  Give that bottle the honorable burial it deserves, in the trash can.

Thank you Connie for letting me know what the pharmacist told you when you went looking for syrup of ipecac at the drugstore.  You’ve given me a great chance to improve my practice and give my patients the most up-to-date information.

They told me in medical school that 50% of what they were going to teach us was wrong.  It’s up to us to keep reading, keep researching and keep learning to figure out which 50% it is!

QUESTION:  Do you (or did you) have syrup of ipecac in your house?


Is Soy Healthy To Eat?

I seem to have this conversation a lot, especially with patients and with other health professionals.  We know that incorporating more plant foods and reducing or eliminating meat and dairy is effective for decreasing the risk of heart disease.  One of the best plant sources of protein is soy.  Is soy healthy to eat?

In a recent conversation with a personal trainer, I mentioned that I recommend soy supplements for those looking for weight loss.  You would have thought I was recommending arsenic!  In short order, he rattled off a number of concepts that I had heard before and knew were either myths or highly exaggerated.

Many of my patients use soy for weight loss.  You, Dear Reader, may be one of them 🙂  Just in case your family, friends, or (God forbid) health care professionals tell you soy is dangerous or unhealthy, I want to give you some scientific evidence to use as ammunition.  This of course is not an exhaustive list and new research is coming out all the time, so if you hear about a new study about soy and health, please let me know!

Soy has estrogen and increases breast cancer risk

This one has been pretty definitively disproven.  I reviewed a lot of research about this one recently.  In fact, soy food intake DECREASES breast cancer risk and prolongs survival in women who already have breast cancer.

Soy has estrogen and causes menstrual problems and infertility

Soy isoflavones are plant compounds that bind to estrogen receptors in human cells.  The theory is that since they bind to estrogen receptors they will behave like estrogen in the cells.

Estrogen is a powerful regulator of female fertility and the menstrual cycle.  There is some evidence that a diet high in soy foods can make menstrual periods a little farther apart but there is no evidence that it will interfere with female fertility.  I did find one study that suggested that male sperm count is lower in men who eat a lot of soy, but whether that will interfere with fertility is unclear.

Soy has estrogen and will make men grow “man boobs”

I had to laugh out loud at this one.  I personally have never seen this happen in male patients eating soy foods.  “Man boobs,” or gynecomastia, is growth of the male breast tissue in response to estrogen.  This happens to men who are obese because fat tissue has aromatase, an enzyme that changes a man’s testosterone and other male hormones into estrogens.

I went to the literature and found a study.  Soy doesn’t make men grow breasts.  ‘Nuff said.  If you are a man who is obese and feel you have too much breast tissue, the best option is to work on losing weight.  Soy can help with weight loss and will NOT cause your breast tissue to grow.

Soy has estrogen and will interfere with babies’ growth and development

This has been discussed and debated for years.  Obviously, human breast milk is the best, most perfect food for human infants.  However, if breastfeeding is not possible then soy formula is an option many families choose, especially if the baby seems not to tolerate cow’s-milk formula.

There was a concern that the isoflavones in soy might interfere with babies’ growth and development.  However, studies have shown that babies who are fed soy formula have no difference in growth and development compared to babies who are fed cow’s-milk formula.

Soy causes thyroid problems

This one is interesting.  There actually IS some evidence that the soy isoflavones interfere with production of thyroid hormones, but the evidence is conflicting.  One study showed that people with borderline (called subclinical) hypothyroidism are more likely to progress to clinical hypothyroidism if they eat a lot of soy foods.

There is evidence that eating a LOT of soy (2 grams daily per kilogram of body weight, or 5 ounces for a 150 pound person) can affect thyroid hormone levels very quickly, but the effects do not appear to be permanent.  Eating soy can interfere with the absorption of synthetic thyroid hormone replacement, but so can eating any food too close to taking your thyroid medication.

On the whole, it appears that for healthy people who get enough iodine in their diet (most multivitamins contain the 150 mcg of iodine that people need on a daily basis), eating soy foods does not lead to permanent thyroid problems.

In short, soy is a healthy food that provides plenty of plant-based protein and isoflavones that help reduce blood pressure, heart disease and the risk of breast cancer.  There is no significant danger to the reproductive or hormonal health of people who choose to eat soy.

If you would like to add healthy soy to your diet in an easy, tasty form, please check out Shaklee’s Life Shake.

QUESTION: Do you eat soy?  Why or why not?  (I have soy every single day.  I love it!)