Can Stress Cause Inflammation and Lead to Chronic Illness? - Dr. Michael Ruscio, DC

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Can Stress Cause Inflammation and Lead to Chronic Illness?

When Stress Starts to Lead to Physical Symptoms, It’s Important to Take Notice

Key Takeaways:

  • Although not all stress is “bad stress,” chronic stress appears to increase inflammation levels in the body and, in turn, can lead to developing chronic disease.
  • The immune system seems to respond to chronic psychological stress in the same way it would attack a viral or bacterial threat, which also drives inflammation.
  • Chronic stress can also have a huge impact on brain structures like the amygdala, making it hyper-aware of potential threats and causing nervous system dysregulation that can lead to a number of conditions, including anxiety and depression. 
  • While stress and inflammation seem to antagonize each other, the reverse is also true: lowering your stress can reduce inflammation in the body, and reducing inflammation can lower psychological stress. 
  • Stress and inflammation can even alter your perception of your health, causing you to view your overall health as worse than it actually is. 
  • For all of these reasons, managing and reducing stress is extremely important for our long-term health, even more important than we often give it credit for.

We often tend to dismiss stress as a consequence of modern life. Most of us are dealing with stress on some level, whether it’s work, family obligations, parenting, financial strain, or the constant background anxiety of world events. And it’s one thing to know, okay, chronic stress isn’t so great for your health, but it’s another to develop physical symptoms (fatigue, gastrointestinal issues, brain fog, etc.) due to increased inflammation from an overload of stress. 

How does stress contribute to inflammation in the body, and what can we do about it? Here’s your primer on the different ways stress impacts the body, and a few ways you can counteract it on a daily basis. 

How Can Stress Cause Inflammation and Contribute to Chronic Illness

While we’ve known that stress is a contributing factor to disease and inflammation in the body for a long time, more recent research is showing us just how much this is true. 

Although it’s not easy to set up placebo-controlled randomized controlled trials (RCTs) that directly test the effects of psychological stress on body-wide inflammation, we have decent scientific evidence to suggest that stress can increase inflammation throughout the body and brain.

One research review analyzed several RCTs that injected people with a bacterial endotoxin (a physiological stressor) or saline solution (placebo) to see how their moods and inflammatory markers changed. The toxic stressor appeared to promote inflammation and anxiety, especially in women. The higher the inflammation, the higher the anxiety. However, people who were more anxious before the toxic stressor had a smaller rise in anxiety after the injection than those who were less anxious at baseline. These findings suggest a bidirectional relationship between stress-related disorders and inflammation [1]. 



Another RCT that also injected people with endotoxin or a placebo found that ​​when those with higher stress, social sensitivity, and anxiety or depression are exposed to inflammation, they are more likely to feel depressed and activate genes associated with inflammation. These socio-behavioral factors, which increase the risk of depression, seem to make people more likely to become depressed when their bodies are inflamed [2].

While these studies show that the relationship is probably a bit more complex than we think, stress and inflammation generally seem to chase each other around in a downward spiral, magnifying each other until physical symptoms manifest. Conversely, lowering inflammation in the body can help decrease your perception of stress and vice versa, reducing your stress can help reduce inflammation.

Another meta-analysis of observational studies found that when people experience sudden environmental stress, it seems to cause their bodies to produce inflammation. It’s not certain, but people who have a strong inflammatory response to stress might be less prone to immediate infections but more prone to chronic inflammation and related health issues, particularly if they face ongoing stress [3].

Taking this research into account, our basic flow chart for stress and low-grade inflammation looks like this:

Can Stress Cause Inflammation

The research studies above and others show that, although stress is likely not the only cause of inflammation and any particular chronic illness, it’s a factor that goes unaddressed all too often in the treatment of chronic illness, even in a functional health model. Let’s dig a little deeper now into how stress affects different systems of the body. 

Here’s a short interview I did with Danielle, who explains how brain retraining exercises to reduce her sensitivity to stress changed her trajectory toward regaining her gut health. She found that switching her focus from hypervigilance on her symptoms to focusing on her progress and the improvements she was already seeing made a big difference in her full recovery. 

Stress and the Immune System

You can’t discuss inflammation in the body without the immune system being far behind. Inflammation is a reaction directed by the immune system, ideally in response to a physiological stressor like a bacteria or viral infection. But it seems like the immune system responds to chronic psychological stress in much the same way. 

A 2021 study found that long-term psychological stress (in this case, in women) can actually  change certain inflammatory cells in the body (interferons, interleukin-6, and nuclear factor (NF)-𝛋B), making them very sensitive and reactive to stress. 

It’s like the immune system treats chronic stress as if it were a viral or bacterial threat. Just as the immune system remembers how to respond to infections, it seems to remember how to react to stress, which may explain why chronic stress increases the risk of inflammatory health problems like heart disease and chronic inflammation [4]. 

Putting psychological stress on the same level as a physical stressor shows that it’s just as important to manage stress levels as it is to protect ourselves from things like infections and environmental toxins that can impact our health. We need to make regulating our stress an integrated part of our health journey and even prioritize it in our lives, instead of letting it be the last thing to change. In fact, it may be the first thing that needs to change, so that other interventions like diet modification and routine exercise don’t seem as difficult. 

Dr. R Tip: Personally, one of my go-to tools for stress relief is cold exposure. This may not be everyone’s favorite practice, but it can definitely help lower inflammation and reset your nervous system, especially if you tend towards high stress and anxiety. No cold plunge tank required, even just 30 seconds in a cold shower will do the trick!

Stress and the Brain

We also know that stress can have a significant impact on brain health, from psychological conditions like depression and anxiety to cognitive difficulties, brain fog, as well as nervous system dysregulation. Often these symptoms are a direct result of elevated inflammation in the brain. 

Stress can start to impact the brain when the stress hormone cortisol becomes dysregulated, impacting the hypothalamic pituitary adrenal axis (HPA axis). When we’re overloaded with stress, the body tries to produce more and more cortisol to handle the stress. The hypothalamus, the control center of your brain, begins the process of producing and releasing cortisol from the adrenal glands, along with epinephrine and norepinephrine. This is what’s known as the fight or flight response. With low-grade, chronic stress, we end up living in this fight or flight response, when it should only be activated for short periods of time before we return to a rest and digest state.  

This process also activates the amygdala, another structure in the brain that recognizes threats and files them away to ensure our future survival. The problem is that constant stress causes the amygdala to become overactive, always looking for danger. This adds onto our stress even more, and the HPA axis becomes overwhelmed. This feedback loop may cause conditions like anxiety, PTSD, and panic disorder [5, 6, 7].

However, this cycle of stress and symptoms can be disrupted, if we find ways to actively reduce our stress response and interrupt the pattern of stressor → amygdala trigger → symptom. One resource I’ve found helpful for both myself and my patients is The Gupta Limbic Retraining program, which helps to identify stress triggers and calm the amygdala response so that we can be less reactive to stress and rebuild a more resilient brain.  

What Are Some Common Signs that Stress is Affecting Your Health?

Besides developing a chronic illness, which can definitely be affected by stress, some signs that stress is beginning to affect your physical health include [8]: 

  • Gut dysbiosis
  • Leaky gut
  • Histamine intolerance
  • Food intolerances
  • Brain fog
  • Fatigue
  • Abdominal pain
  • Headaches

Common diagnoses related to stress include [9]: 

  • Atherosclerosis
  • Non-alcoholic fatty liver disease
  • Depression
  • Metabolic syndrome
  • Autoimmune disorders

At first, it may seem like your symptoms came out of nowhere, but upon reflection, you may realize that increased stress is a likely cause. That’s when you know to refocus on stress reduction practices, whether that’s regular exercise, getting better sleep, recommitting to creative hobbies, or spending time in nature

How Stress Alters Your Perception of Your Health

Additional research shows that stress may not only contribute to physical and mental health symptoms, but may also influence how we perceive our health status. 

In this study, people subjected to short-term inflammation (which could be caused by stress) felt much worse about their general and current health for at least 5 hours, compared to those who got a placebo. Higher levels of inflammation and more severe sickness symptoms were associated with a sharper decline in participants’ perceptions of their health. This suggests that inflammation influences the brain to create a negative view of the body’s condition, and this extends to how people perceive their overall health [10]. 

While in some ways this seems frightening, it also gives us a checkpoint to refer back to when evaluating our overall health. If we’re under stress, it may be easier to default to thinking that our health is worse than it actually is. If we can take a step back, do something to relieve some of the stress, and come back to assess the situation with a calmer state of mind, we might realize that all is not as bad as it seemed before. 

Stress Relief Practices for Better Health

Now that you have a better understanding of how stress can impact your health, you need some tools to relieve stress on a daily basis. Strategies I often recommend to my patients include: 

Choose one or two things you enjoy, and integrate them into your daily routine. It may take a little time to notice consistent benefits, but your body will thank you for it. You might choose to incorporate one mental/emotional practice, such as meditation or tapping, and one physical practice, such as walking or other exercise. It’s remarkable what even a small amount of time dedicated to these activities can do for your ability to handle stress and create a more resilient body and mind. 

It’s Crucial to Manage Stress for Your Long-Term Well-being

Stress often has a far greater impact on our health and wellness than we think, but the good news is that we’re able to reduce and counteract the effects of stress. Start to recognize the sources of stress in your life and see what you can do to mitigate them. If stress is seriously affecting your health, you may need to delegate some of your responsibilities as well as support your body’s ability to handle stress. 

If you want further guidance on stress management and how stress impacts your health, visit my YouTube channel or check out my book Healthy Gut, Healthy You.

The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.

➕ References
  1. Lasselin J, Elsenbruch S, Lekander M, Axelsson J, Karshikoff B, Grigoleit J-S, et al. Mood disturbance during experimental endotoxemia: Predictors of state anxiety as a psychological component of sickness behavior. Brain Behav Immun. 2016 Oct;57:30–7. DOI: 10.1016/j.bbi.2016.01.003. PMID: 26790758.
  2. Irwin MR, Cole S, Olmstead R, Breen EC, Cho JJ, Moieni M, et al. Moderators for depressed mood and systemic and transcriptional inflammatory responses: a randomized controlled trial of endotoxin. Neuropsychopharmacology. 2019 Feb;44(3):635–41. DOI: 10.1038/s41386-018-0259-6. PMID: 30391995. PMCID: PMC6333799.
  3. Marsland AL, Walsh C, Lockwood K, John-Henderson NA. The effects of acute psychological stress on circulating and stimulated inflammatory markers: A systematic review and meta-analysis. Brain Behav Immun. 2017 Aug;64:208–19. DOI: 10.1016/j.bbi.2017.01.011. PMID: 28089638. PMCID: PMC5553449.
  4. Barrett TJ, Corr EM, van Solingen C, Schlamp F, Brown EJ, Koelwyn GJ, et al. Chronic stress primes innate immune responses in mice and humans. Cell Rep. 2021 Sep 7;36(10):109595. DOI: 10.1016/j.celrep.2021.109595. PMID: 34496250. PMCID: PMC8493594.
  5. Abuhasan Q, Siddiqui W. Neuroanatomy, Amygdala. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2018. PMID: 30725787.
  6. Hu P, Lu Y, Pan B-X, Zhang W-H. New Insights into the Pivotal Role of the Amygdala in Inflammation-Related Depression and Anxiety Disorder. Int J Mol Sci. 2022 Sep 21;23(19). DOI: 10.3390/ijms231911076. PMID: 36232376. PMCID: PMC9570160.
  7. Tsigos C, Chrousos GP. Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress. J Psychosom Res. 2002 Oct;53(4):865–71. DOI: 10.1016/s0022-3999(02)00429-4. PMID: 12377295.
  8. Benson S, Engler H, Wegner A, Rebernik L, Spreitzer I, Schedlowski M, et al. What makes you feel sick after inflammation? predictors of acute and persisting physical sickness symptoms induced by experimental endotoxemia. Clin Pharmacol Ther. 2017 Jul;102(1):141–51. DOI: 10.1002/cpt.618. PMID: 28074475.
  9. Liu Y-Z, Wang Y-X, Jiang C-L. Inflammation: The Common Pathway of Stress-Related Diseases. Front Hum Neurosci. 2017 Jun 20;11:316. DOI: 10.3389/fnhum.2017.00316. PMID: 28676747. PMCID: PMC5476783.
  10. Andreasson A, Karshikoff B, Lidberg L, Åkerstedt T, Ingvar M, Olgart Höglund C, et al. The effect of a transient immune activation on subjective health perception in two placebo controlled randomised experiments. PLoS ONE. 2019 Mar 6;14(3):e0212313. DOI: 10.1371/journal.pone.0212313. PMID: 30840633. PMCID: PMC6402640.

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