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Stress is an inevitable part of life, but its consequences are not just mood swings and mental fatigue. Continual stress makes people produce extra cortisol, a hormone that has a critical role in adapting to short-term challenges, but chronically in high quantities it tends to cause harm to the body causing lots of physical and mental disorders.
The adrenal glands produce cortisol, which helps the body control its "fight, flight, or freeze" response. Cortisol temporarily adjusts blood sugar levels, maintains blood pressure, and assists the immune system, among other functions, in short spurts. But when stress persists, cortisol remains high, and necessary functions of the body are interfered with and rendered more susceptible to disease.
According to one survey conducted by the American Psychological Association, stress negatively affects a third of Americans' physical health. Concerns are reinforced by research where studies have shown 80% of primary care visits are stress-related.
But why does stress have such a profound impact? Elevated cortisol limits the immune system's ability to fight infections, disrupts hormonal balance, and triggers inflammation. Over time, these changes can lead to serious health complications.
Do you have involuntary eye spasms? These harmless but annoying twitches often indicate elevated cortisol. The tiny muscles around the eyes are extremely sensitive to stress, contracting or spasming because of cortisol's stimulant-like effects.
Your skin often reflects what is going on inside your body, and chronic stress can cause inflammatory skin conditions. Elevated cortisol levels stimulate oil production, which exacerbates acne. It also slows down the healing process, worsens conditions like eczema, and contributes to general irritation of the skin.
It also interferes with the body's balance of salt and water, which causes fluid retention and bloating. Excess cortisol also slows down blood flow to the digestive system, which further weakens gut bacteria and causes poor digestion, excess gas, and abdominal discomfort.
High cortisol stimulates the production of insulin, which can cause blood sugar to drop, making people want to eat sugary, high-fat foods. For many, this becomes an excuse to stress-eat and gain weight. For others, the opposite is true: their appetite disappears under stress, causing them to lose weight.
If you’re noticing random bruises, elevated cortisol could be the culprit. This hormone weakens skin proteins and the walls of small blood vessels, making your skin more fragile and prone to damage.
Do you feel rundown or experience muscle aches, fatigue, or upset stomach regularly? Elevated cortisol mimics cold-like symptoms. Long-term stress also weakens the immune system, making you more susceptible to infections.
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Chronic stress can damage your eyesight. Elevated cortisol disrupts blood flow to the eyes, increases eye pressure, and raises the risk of glaucoma. Symptoms like dry eyes, blurred vision, and light sensitivity are also common.
Irregular Menstrual Cycles that disrupt the menstrual period. In females, this leads to hormonal distress causing irregular or missed periods. Over time, it may also disturb fertility.
If you hear ringing, buzzing, or hissing sounds without an apparent source, stress might be the culprit. Cortisol affects the auditory system by interfering with blood flow and nerve function and could be the trigger for tinnitus.
Increased levels of cortisol contribute to inflammation that can exacerbate conditions such as arthritis and promote the development of heart disease. Chronic inflammation is also associated with mental health conditions, including anxiety and depression.
Left unchecked, high cortisol levels can lead to more than just short-term discomfort. Chronic stress has been associated with serious conditions such as heart disease, psychiatric disorders, and metabolic syndromes. A 2013 study published in JAMA Internal Medicine underlined the link between stress and physical health, with recent research in Neurobiology of Stres supporting these findings.
Managing stress and cortisol levels is essential for maintaining overall health. One effective approach is practicing mindfulness through meditation or yoga, which helps lower cortisol by calming the mind and promoting relaxation. Regular physical exercise, especially aerobic activities, helps reduce stress hormones and boosts endorphins. Prioritizing sleep is crucial, as lack of rest can increase cortisol levels; aim for 7-9 hours per night.
Another remedy is an overall balanced diet full of anti-inflammatory foods like fruits, vegetables, and whole grains that could manage cortisol production. Finally, it would prevent burnout and chronic stress if proper boundaries were set at work and in personal life.
Credit: Washington University
A small implanted device that stimulates the vagus nerve may offer substantial and lasting relief for people with severe treatment-resistant depression, according to a large multicenter clinical trial.
The findings, published in the International Journal of Neuropsychopharmacology, showed that improvements in depressive symptoms, quality of life, and daily functioning were sustained for at least two years in most patients who responded to treatment.
Notably, more than 20% of treated participants (39 patients) were in remission after two years, meaning their depressive symptoms had improved enough for them to function normally in daily life.
"We were shocked that one in five patients was effectively without depressive symptoms at the end of two years," said lead author Charles Conway, professor of psychiatry and director of Washington University's Treatment Resistant Mood Disorders Center.
Earlier this week, Republican Tom Kean Jr. revealed that he had been diagnosed with depression, explaining his absence from public life for more than 100 days.
He is far from alone. About 20% of U.S. adults experience major depression during their lifetime. While most people improve after antidepressants or psychotherapy, up to one-third develop treatment-resistant depression, in which standard treatments fail to provide adequate relief.
The RECOVER trial, led by researchers at Washington University School of Medicine in St. Louis, enrolled nearly 500 patients across 84 sites in the US. On average, participants had:
"We believe the sample in this trial represents the sickest treatment-resistant depressed patient sample ever studied in a clinical trial," Conway said.
"There is a dire need to find effective treatments for these patients, who often have no other options. With this kind of chronic, disabling illness, even a partial response to treatment is life-altering, and with vagus nerve stimulation, we're seeing that benefit is lasting," he added.
The VNS Therapy System, manufactured by LivaNova USA, Inc., involves implanting a small device beneath the skin of the chest. The device delivers carefully calibrated electrical pulses to the left vagus nerve, which serves as a major communication pathway between the brain and internal organs.
Although every participant received an implant, only half had their devices activated during the first year, allowing researchers to compare outcomes.
The latest analysis focused on 214 patients whose devices were activated from the beginning of the study.
Among them:
Conway noted that even a 30% improvement can dramatically change the lives of patients with severe depression, who often struggle to carry out basic daily activities and face a higher risk of hospitalization or early death.
The study also found that recovery may take longer for some people.
Nearly one-third of participants who had not responded after the first year reported meaningful improvements by the end of the second year, suggesting prolonged stimulation may continue to produce benefits.
Researchers also observed consistently low relapse rates among patients who improved, particularly among those with the strongest responses.
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In the last few years, biohacker and longevity entrepreneur Bryan Johnson has become famous for maintaining a picture-perfect health in order to defy the norms of aging.
But this week, Johnson shared a shocking health update with his followers. He said that he has been diagnosed with Autoimmune Gastritis (AIG), a chronic autoimmune disease in which the immune system attacks the stomach lining. He said, “My stomach is eating itself.”
Despite years of optimizing his body, Bryan’s Johnson Autoimmune Gastritis diagnosis shocked the internet. While his strict routines, meticulous diet, and million-dollar anti-ageing protocol continue to inspire millions, they also receive equal amounts of skepticism and criticism.
Johnson recently revealed that he had struggled with persistently low iron stores for nearly 11 years, despite taking supplements.
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He said that a detailed evaluation confirmed Autoimmune Gastritis, an illness that damages the acid-producing cells of the stomach. The condition can impair absorption of iron and vitamin B12 and may increase the long-term risk of gastric cancer.
He also disclosed that he has autoimmune thyroid disease, suggesting that multiple autoimmune conditions may be interconnected in his case.
Amid his diagnosis, Johnson's journey raises a practical question: Which of his longevity habits are genuinely backed by science and worth adopting, and which remains experimental?
Among all longevity interventions, sleep has the strongest scientific backing. Johnson consistently aims for a regular sleep schedule and treats sleep as a primary health priority. Unlike expensive biohacks, sleeping 7 to 9 hours consistently benefits almost everyone.
Research has linked quality sleep with:
Johnson follows a predominantly plant-based diet rich in vegetables, legumes, nuts, seeds, and healthy fats.
While optimal health is not connected with veganism, evidence supports that diets including vegetables, fruits, whole grains, beans, and nuts are associated with lower risks of heart disease, diabetes, and several cancers.
Johnson combines strength training, cardiovascular exercises, mobility exercises, and walking throughout the day to stay healthy and fit.
Research, too, recommends at least 150 minutes of moderate physical activity per week to enhance longevity.
One of Johnson's greatest takeaways from his blueprint is tracking basic health markers. His long-standing low ferritin eventually prompted further investigation that disclosed his autoimmune gastritis.
It reminds us that routine health check-ups often identify silent diseases before symptoms appear. For most people, daily monitoring should include:
Bryan avoids alcohol and tobacco completely. Research consistently suggests that avoiding smoking and limiting alcohol significantly reduce risks of cancer, liver disease, heart disease, stroke and other chronic lifestyle disorders.
Many of these approaches have not been proven to extend lifespan in humans, and experts caution against assuming that more testing or consuming supplements automatically leads to better health.
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Every year on July 6, we mark World Zoonoses Day. The date marks the day in 1885 when Louis Pasteur gave the first rabies vaccine. It falls right in the middle of our monsoon, which is exactly when zoonotic diseases claim the most lives. So this year, instead of a routine health advisory, let us go through the questions I get asked most often, by patients, by family, and honestly, by fellow doctors too.
A zoonosis is any disease that spreads from animals to humans. The animal could be a rat, a dog, a bat, or even livestock in your backyard. Sometimes the animal itself looks perfectly healthy while carrying the germ that makes us sick. About six out of every ten infectious diseases known to affect humans started in animals at some point. COVID reminded the whole world of this. We have been living with zoonotic threats for years, quietly, every rainy season.
If I had to list the usual suspects, it would be this:
Leptospirosis is the one that rises sharply and predictably every single monsoon. The bacteria live in the kidneys of rats and other rodents and are released into soil and water through their urine. When the rains come, our fields, drains, and waterlogged roads become the perfect place for the infection to spread. Anyone walking barefoot through flood water, working in paddy fields, or wading through stagnant water near their home is at risk.
Scrub typhus rises a little later, once the rain eases and people go back into overgrown fields and gardens to clear vegetation, exposing themselves to the mite larvae hiding there. Our own data from KIMSHEALTH, based on 241 patients over seven years, shows this pattern clearly. Cases start climbing in September, peak in December, and drop off by January.
This means the disease follows the cool, humid weeks right after the monsoon leaves, not the rainy months themselves. Low temperature and high humidity suit the mites best, which is why the weeks just after the monsoon, not the heavy rain itself, are scrub typhus season. Our data also showed a smaller rise between June and August, so the risk is actually spread across two windows around the monsoon, not just one.
This year, our own health department figures have already shown this pattern. Fever clinics across the state have been seeing well over 10,000 patients a day at the peak, with leptospirosis and Shigella infections climbing sharply. Northern districts of Kerala Kannur, Kozhikode, and Malappuram have reported some of the sharper spikes, and rat fever sadly remains the biggest killer among these in most years.
Nipah is not strictly a monsoon disease. It tends to appear when fruit bats are under stress, often during their breeding season or when their natural food is disrupted. Kerala has had confirmed cases in recent years. The good news is that Kerala now has one of the fastest outbreak response systems in the country for Nipah, with quick contact tracing and isolation.
For leptospirosis:
For scrub typhus:
For rabies:
See a doctor without delay if you have a fever along with any of the following:
Leptospirosis in particular can look just like an ordinary viral fever in its first two or three days, and then get worse quickly, leading to kidney failure or bleeding problems. Starting antibiotics early makes a big difference to the outcome. This is not a disease where it is safe to simply wait and watch.
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