Health

Stress and immunity

It’s been a rough winter this year for many of us, with a lot of illness around. And while diet, exercise, sleep and hygiene can all make a difference, Dr Marissa Kelaher says stress is an area that’s not discussed much, despite the fact it has a huge effect on our immune system.

Studies looking at how stress affects immunity are intriguing and give us a better insight into the role of stress and health. Our sympathetic (fight or flight) nervous system communicates directly with our immune (lymphatic) tissue via nerve fibres. Even previous stress and trauma can be remembered by our immune system and is part of why there is such a strong link between stress and conditions like autoimmune disease and allergies. Cortisol (our stress hormone) also impacts immunity by altering our immune response and white blood cells. Plus, stress affects immunity via its impact on our day-to-day life. When we are stressed, we are more likely to do things that are bad for our immune system (such as eating poorly, not sleeping, not exercising, withdrawing from social contact, and smoking or drinking alcohol. Short and long-term stress affect us differently. Acute stresses (lasting a few minutes or hours) actually help our immunity by boosting immune cell numbers and activity. This is part of our survival response, as it helps our body cope with threat or injury. It’s also how ‘hormetic’ stresses such as exercise, fasting, or coldwater bathing work by creating a short, controlled stressor that stimulates our immune system. Chronic stress has a very different effect, by suppressing immunity, and making us more likely to catch infections. This is why infections such as herpes or shingles can reactivate during times of stress. One of the first studies looking at this was in the 1980s, where blood samples were taken from medical students before and during end of year exams. It showed that T cell and NK cell (white blood cell) levels dropped significantly under stress, and the severity correlated with stress levels.

Hundreds of studies have looked into stress and immunity since and have found similar effects, especially in older people, or people with depression. Another study looked at first year college students and found the higher their stress levels and the more socially isolated they were, the less they responded to a flu vaccine.

Fortunately, there are many proven ways to improve immunity when we’re stressed - they all involve ‘dialling down’ our stress response. The following have all been shown to reduce stress hormones, and measurably improve our immune function:

• journalling • connecting with others • meditation and breathwork • exercise and time in nature • sleep In practice, most things that reduce stress are likely to help immunity, the key is having tools you can use, and making them part of your day-to-day life.

Dr Marissa Kelaher is a GP and lifestyle medicine doctor. She runs health courses and offers one-on-one consults at yourlifestylemedics.com

Talking bowel conditions with Dr Omer Hajelssedig

There is no doubt that living with Inflammatory Bowel Disease (Crohn’s Disease and ulcerative colitis) can have its toll on the patient, but taking a holistic approach to managing this life-long condition can help sufferers live a normal life. We talk to leading gastroenterologist Dr Hajelssedig about what he can do to help alleviate the symptoms and burden of IBD.

Born in Sudan and trained in Qatar, Dr Hajelssedig moved to the region in 2017. Specialising in diagnostic and therapeutic endoscopy, acid reflux disease, bowel cancer screening, and anaemia, Dr Hajelssedig’s interests particularly lie in management of inflammatory bowel disease (IBD) as well as irritable bowel syndrome (IBS). “My interest in this spectrum of bowel disease has begun and kept growing since 2012 when I started my gastroenterology training. I believe that there is a lot we can do to positively impact a patient’s journey with these life-long conditions.” With IBD cases rising in New Zealand, Dr Hajelssedig aims to raise awareness and ensure the diagnosis of IBD is made early. “Diagnosis of IBD often isn’t easy as you really need to be sure before labelling someone with a such lifelong condition. It involves multiple blood tests and medical procedures including colonoscopy and imaging.” IBS is a very common condition of the bowel in which the bowel structure appears to be normal, but its function is hugely disturbed causing sufferers to have a wide range of symptoms including abdominal pain, diarrhoea and constipation. Dr Hajelssedig says it is very difficult sometimes to distinguish between IBD and IBS as the symptoms are very similar. To date, there is no cure for IBD or IBS but both conditions can be adequately managed, through a multifaceted comprehensive plan of care. “My intention is to improve the level of care to patients and provide a more holistic approach for treatment and care.” Dr Hajelssedig can provide both short and long-term treatments and individual care plans, along with ongoing advice on living with IBD and IBS. Talk to your GP about a referral or make an appointment directly with Dr Hajelssedig through one of the Tasman Day Surgery team.

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