Stress Management

“If your stress management is ineffective, all of your best laid diet, exercise and health plans can go to waste….”


Managing Stress

We all know that stress management is important…so why do so many of us ignore this advice and do nothing about it?? First of all, let’s look at why stress management is important, even if you exercise and eat healthily (and even more so if you don’t) and then how we can manage it effectively.

Why is Stress management important?

You can see people who exercise regularly and eat really well, but they still don’t feel as good as they should. Even with regular exercise, clean eating and careful supplementation, all your best-laid health, diet and exercise plans can end up going down the drain if you do not manage your stress. If you do not deal with stress effectively, you may still be at risk for developing:

  • Cardiovascular disease (1),
  • Diabetes (2), (3)
  • Worse sugar control if you are diabetic already,
  • Hypothyroidism and
  • Autoimmune diseases.(5).

For example, researchers established that individuals suffering from work strain and/or emotional stress are several times more likely to develop diabetes than those with relatively lower stress levels. Furthermore, early life adversities, job strain and various “negative’’ personality traits (e.g. aggression, anger, hostility) are linked to diabetes too. (4)

Stress is everywhere – be it finances, relationships, or work. Many of us are experiencing it, yet most of us don’t do anything positive to help tackle it. It is, in some ways, much easier to institute a new dietary change or exercise programme than to reduce our stress. The blunt truth is that nobody teaches us how to handle it and we never practice managing it. Therefore, stress management is just not part of our daily routine. However, it is not hard to do and all it takes is a little effort to detach from the hustle and bustle of modern day life and prioritise yourself, even if this is traditionally not encouraged.

Many people may not want to admit to being stressed, or feeling overwhelmed. The “stiff British upper lip” mentality, being stoic or “manning up” may prevent people from wanting to talk about stress. I understand this. Recognising that you are stressed, or attempting to manage it, is not an admission of weakness. But if you just try to ignore it and suffer the effects of it, it will get the better of you. Managing your stress is a vital component to optimal health and longevity. If you even spend a tenth of the time on stress management as you do on diet, exercise, or watching television, I am sure that you will see the benefits, not just on your mental health, but your physical health too.

Why is Stress management important

What is Stress?

The prominent psychologist Richard Lazarus stated that stress is experienced when the “demands exceed the personal and social resources the individual is able to mobilise”. In other words, stress can be seen as a disruption of homeostasis. Homeostasis is the body’s ability to maintain a constant internal environment. Disease can occur when the body is not able to maintain this crucial function.

The sources of stress are everywhere – emails, smartphones, social media, family, work life, money, being stuck in traffic….. the demands of modern life are huge. It’s easy to get overwhelmed very quickly these days.

Stress is not just psychological in nature. It can also result from:

  • Circadian (body clock) disruption.
  • Glycaemic (blood sugar) disruption.
  • A lack of (or even excessive) physical activity.

How stress affects the body

The normal stress response is regulated by your adrenal glands. The adrenals glands are two small glands that sit just above the kidneys. They secrete hormones – such as cortisol, epinephrine (adrenaline) and norepinephrine (noradrenaline). These hormones act on different parts of the body.

  • Cortisol – is released in response to illness and also helps to regulate the body’s metabolism and mobilise sugar..
  • Adrenaline and noradrenaline are responsible for all the bodily characteristics of the stress response, the so-called ‘fight or flight’ response. A raised heart rate, palpitations, mental alertness, raised blood pressure, a feeling of anxiety and sweating.

These are useful physiological mechanisms, especially when faced with an acute stress or threat (like running away from a predator in the past)! However, chronic, long-term activation of this response can wreak havoc on the body. When stress becomes chronic and prolonged, the adrenal glands excrete excess cortisol (6). Cortisol is released in a very particular pattern during the day. Normally, the levels should be high in the mornings when you wake up (this is what helps you get out of bed and get going in morning), and then tail off during the course the day (causing you to feel tired at night time and facilitating sleep).

Research shows that chronic stress not only increases the total level of cortisol in the body, but perhaps more importantly, disturbs the body’s natural rhythm of cortisol release. And it’s this disrupted rhythm that can inflict so much devastation. Because of this, the adrenals are what determine our tolerance to stress, and are also the system of our body most affected by stress.

Among other effects, stress can lead to:

  • Elevation of blood pressure (7).
  • Weakening your immune system (8).
  • Raising of your blood sugar.
  • Making your gut leaky (9).
  • Hunger and craving sugar.
  • A reduction in your ability to burn fat.
  • An increase of your belly fat (7) and makes your liver fatty.
  • Suppression of your HPA-axis, which causes hormonal imbalances (10),
  • Reduction of your growth hormone, testosterone, DHEA and TSH levels.
  • Mood imbalances, anxiety and depression,
  • Cardiovascular disease (7)

All of these effects have been repeatedly described in the scientific literature and the catalogue of health problems caused by stress continues to grow. It could be said that stress has a huge contribution towards many modern, chronic diseases. Hence the importance of stress management.

On a daily basis, most people experience the ever-present forms of stress that can cause the adrenal glands to pump out cortisol: sitting in traffic, busy work schedules, relationship difficulties, financial strain the countless other challenges to our emotional and psychological wellbeing. However, there are a number of other factors that are not traditionally considered as “stress”, but can however tax the adrenal glands. These include:

  • Huge swings of blood sugar,
  • Chronic infections,
  • Autoimmune disease (11)
  • Gut dysfunction,
  • Sensitivity to gluten (Coeliac disease and non-coeliac gluten sensitivity),
  • Very low carbohydrate diets
  • Toxins present in the environment, 
  • Inflammation and
  • Excessive or very little physical activity.


These conditions can also cause the adrenals to release more stress hormones and make problems worse.


Adrenal stress is frequently encountered in Functional Medicine, because almost everybody is dealing some of the stressful situations mentioned earlier. The symptoms of adrenal stress are varied and not always specific, because the hormones released by the adrenals affect many bodily systems. Some of the more common symptoms include:

  • Fatigue
  • Eating to relieve fatigue
  • Cravings for caffeine and sugar
  • Lightheadedness or irritability (getting “hangry” between meals)
  • Mood swings
  • Headaches
  • Digestive symptoms
  • Diminished immunity
  • Difficulty in falling asleep and frequently waking up during the night.
  • Lightheadedness when moving from sitting or lying to standing

By now, you probably don’t require much more persuasion about this. You can probably see the negative consequences of stress in your every day of life. So, now that you know the problems that it causes, what can you do about it?

How to reduce the impact of stress

There are two different approaches to reducing the impact of stress, and both are important as part of a stress management strategy:

  • Reducing the amount of stress that you are exposed to.
  • Lessen the harmful effects of the stresses that you cannot avoid.

Reducing the amount of stress that you are exposed to

This means exactly what it sounds like: reducing all forms of stress that you are exposed to, whether it be physiological or psychological. It’s unrealistic to remove all forms of stress from your lives, but even during the most stressful of situations, it is still possible to reduce the amount of stress that you experience.

It is easy to get stuck in the daily routine and overlook behaviours or thought patterns that add additional stress to our lives, until someone points them out to you. I can provide you with easy to implement suggestions to reduce your daily stress burden. I can provide you with a few simple guidelines to incorporate into your daily life that can avoid or lessen the stress that you experience.

A further way to reduce the amount of stress you experience is to address any health and physiological problems that may be placing a strain on your adrenal glands. These causes include:

  • Swings in your blood sugar,
  • Anaemia,
  • Inflammation of the gut,
  • Reducing your exposure to environmental toxins,
  • Deficiencies of essential fatty acids and
  • Food intolerances (especially to gluten).

If you are suffering from one or more of these conditions, it’s may be best to get help from somebody like me!

Lessen the harmful effects of the stresses that you cannot avoid

There are situations where stress is unavoidable. If you have are going through relationship difficulties with your partner, work in a high-stress environment, or looking after a sick loved one. You may not be able to reduce or avoid these stresses in life, but you can reduce the harmful effects of them. Again, I can provide you with easy to implement strategies to help reduce the harmful effects of stress. These stress relief tips are important, and can make a huge difference to your health, wellbeing and quality of life.

One of the single most important things that you can do in your life to manage stress is to do things that create pleasure, fun and joy in your life. It’s easy to forget this in the hustle and bustle of modern life, but it is crucial to your overall wellbeing to make even a small amount of time for these activities.


Stress management practices and techniques

As life causes a certain amount of stress that you cannot always avoid, this is why it is critical to develop a regular stress management practice for yourself. There are a huge number of activities that you can choose from. Things like exercise, yoga, tai chi, a walk in a park or on the beach, or sitting in the sun (when it is out!) can all relieve stress. Whatever just gives you that sense of peace and relaxation that we all too often neglect in our everyday lives, do more of it and make it a regular habit. Here are some examples.


This is no longer just the preserve of Buddhist monks. There is a reason why Buddhists appear serene, and this is because meditation is part of their daily ritual. But you can’t just meditate for half an hour a day and live the other 23 hours and 30 minutes of your life in chaos – it will just not work.

Meditation is above all, a practice of awareness, concentration and releasing tension. By meditating, you learn to observe your own thoughts, feelings and sensations they cause, while gaining a fresh perspective on them. It teaches people how to stay present in their lives, even while experiencing great difficulty or pain. As the famous saying goes, “there are only two days in the year that nothing can be done. One is called yesterday and the other is called tomorrow”. This is the reason I incorporate meditation into my daily routine, and my life has become immeasurably better for it.

The other issue is that nobody teaches you how to meditate, and this is key if you want to get the most out of it. I can provide you with simple daily exercises, not just to help you meditate, but help reduce the chaos of your every day life.

Optimising your sleep

Just like your diet, sleep is a critical aspect to your health.

It is impossible to be healthy without adequate sleep. Full stop.

Modern day life can sabotage the quality of your sleep in many ways. A whopping 70% of Britons do not get enough sleep as recommended by the national Sleep Council (12). Not getting enough sleep is associated with an increased risk for type 2 diabetes, obesity and cardiovascular disease. Managing stress is a huge factor in getting enough sleep. Again, I can help with sleep optimisation.


There are many other stress management techniques that you can use.

Book an appointment to discuss these in more detail with me.


1) Relation between resting amygdalar activity and cardiovascular events: a longitudinal and cohort study, Dr Ahmed Tawakol, MD  *et al. Published:January 11, 2017

2) Psychological Stress May Induce Diabetes-Related Autoimmunity in Infancy Anneli Sepa, PhD1, et al Diabetes Care 2005 Feb; 28(2): 290-295.

3) Does Emotional Stress Cause Type 2 Diabetes Mellitus? A Review from the European Depression in Diabetes (EDID) Research Consortium. Published on February 11, 2010. Frans Pouwer


5) Association of Stress-Related Disorders With Subsequent Autoimmune Disease Huan Song, et al JAMA. 2018;319(23):2388-2400

6) Yvonne M. Ulrich-Lai, Helmer F. Figueiredo, Michelle M. Ostrander, Dennis C. Choi, William C. Engeland, and James P. Herman . Chronic stress induces adrenal hyperplasia and hypertrophy in a subregion-specific manner. Am J Physiol Endocrinol Metab 291: E965–E973, 2006.

7) Judith A Whitworth, Paula M Williamson, George Mangos, and John J Kelly. Cardiovascular Consequences of Cortisol Excess. Vasc Health Risk Manag. 2005 Dec; 1(4): 291–299.

8) Suzanne C. Segerstrom, Gregory E. Miller. Psychological Stress and the Human Immune System: A Meta- Analytic Study of 30 Years of Inquiry. Psychol Bull. 2004 July ; 130(4): 601–630.

9) Tim Vanuytsel, Sander van Wanrooy, Hanne Vanheel, Christophe Vanormelingen, Sofie Verschueren, Els Houben, Shadea Salim Rasoel, Joran Tόth, Lieselot Holvoet, Ricard Farré, Lukas Van Oudenhove, Guy Boeckxstaens, Kristin Verbeke, Jan Tack. Psychological stress and corticotropin-releasing hormone increase intestinal permeability in humans by a mast cell-dependent mechanism. Gut 2014;63:1293-1299.

10) Žarković, M. , Stefanova, E. , Ćirić, J. , Penezić, Z. , Kostić, V. , Šumarac‐Dumanović, M. , Macut, D. , Ivović, M. S. and Gligorović, P. V. (2003), Prolonged psychological stress suppresses cortisol secretion. Clinical Endocrinology, 59: 811-816. doi:10.1046/j.1365-2265.2003.01925.x

11) J Cutolo M1, Straub RH, Foppiani L, Prete C, Pulsatelli L, Sulli A, Boiardi L, Macchioni P, Giusti M, Pizzorni C, Seriolo B, Salvarani C. Adrenal gland hypofunction in active polymyalgia rheumatica. effect of glucocorticoid treatment on adrenal hormones and interleukin 6. Rheumatol. 2002 Apr;29(4):748-56.


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  • Meke T.23/12/18

    Dr Asim Iqbal is an excellent physician who understands that each person is an individual and that one size does not fit all. He is kind an compassionate and deeply cares for his patient’s wellbeing. As a fellow medical professional who has been treated by him, I would highly recommend him.


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