Autoimmunity or endorphin deficiency?

Endorphins… endorphins. Where have I heard that word before? Endorphins?

In most cases, if you’ve had even the faintest brush with what is the cult-like fitness culture in the US, you’ve probably heard the word endorphin nonchalantly tossed around like a sad Caesar Salad at Olive Garden. Who among us hasn’t seen the occasional veiny-muscled body on the boob-tube yelling in a burly voice about how their for-sale training regime is endorphin producing?

Maybe, if you were really lucky, somewhere along the line you would’ve also stumbled upon some pontificating Brainiac on public radio explaining that “everybody likes chocolate and spicy food because… endorphins.”

No matter where our discerning ears have picked it up, if we really rack our brains and stretch those deductive reasoning skills, we can use the context in which endorphins are typically described to draw a complex conclusion:

endorphins are …good?

Yes! Endorphins ARE good. At least from an autoimmunity and gut health perspective. Maybe not so much for people who aren’t into the more rosy-side of life, i.e. Bob from Twin Peaks, The Manson family, Darth Vader, etc. If you are any of these people, a respectful warning: this article won’t be your cup of tea.

But for the rest of you, if your inner monologue is saying something along the lines of: how do I grow me some? By all means, read on.

What are endorphins?

In recent years, some of the most groundbreaking medical research has been in the realm of cellular receptors. Virtually all of our cells have receptors that bind to signaling molecules, which is how the body’s most important processes are regulated.

Endorphins, of which there are over 20 types, are neuropeptides that act as hormones – the ultimate signaling molecule. Here we’re primarily concerned with the Beta-endorphin, which is produced in the brain’s pituitary and hypothalamus glands in response to things like laughter, sex, and, yes, exercise.

The body releases endorphins when it’s under stress in order to mitigate pain response. Think of morphine. Most of us know that morphine acts as a powerful pain alleviator. What you might not have known is that the reason morphine works so well is because its molecular structure mimics the structure of endorphins to the extent that they stimulate and bind to the same receptors. Naturally produced endorphins actually act as an exponentially more potent opiate than morphine or any other externally-derived pain reliever.

What does endorphin status have to do with our health?

The role of endorphins in opiate and substance addiction has been observed in a robust body of scientific work where there is general consensus that substance addicts have lower endorphin levels than their non-addiction-holding counterparts. This may not be too surprising considering regular drug use will naturally deplete endorphin stores. But growing evidence suggests that individuals who have low endorphin levels are particularly susceptible to becoming addicts, even if they’ve never done any drugs. These people may naturally be more prone to seeking out a receptor stimulating high as a way to compensate for their body’s deficiency.

The connection between endorphin deficiency and pleasure-seeking behavior is crucial to keep in mind when thinking about how autoimmunity fits into all of this. While research on the link between endorphins and autoimmunity is less comprehensive than for addiction, the number of studies available on Pub-med has nearly doubled in the last year alone. These studies have shown that people who suffer from chronic illness, and especially autoimmunity, tend to have much lower levels of endorphins than individuals who are healthy, just like for people susceptible to addiction.

While the mechanism is still unclear, the Beta-endorphin seems to regulate the T helper balance by inducing interleukin-4, which modulates a partial anti-inflammatory effect on human T lymphocytes. Beta-endorphin also plays a role in our innate immune system by triggering the conditioned activity of Natural Killer cells. These findings help to explain why nearly all of the body’s immune cells have an endorphin receptor, and suggest the hormones serve as a crucial regulatory component of our immune systems. It follows that the absence of endorphins would result in a less regulated immune response, which would make us more susceptible to autoimmunity.

Before we get all keyed up and start a round of celebratory push-ups because now we know what causes autoimmunity, it’s important to point out that this is a real life, bonified, chicken-or-the-egg situation. What we know is that where there’s smoke there’s fire; where there is autoimmunity and chronic illness there is often lower levels of endorphins. However, we don’t know if the endorphin lows are a cause or an effect. One study found that rats with lower levels of endorphins were more likely to develop autoimmunity than those with normal levels, which may present an argument for the former, but more research is needed.

How do we become endorphin deficient?

While a previous work has made some connection between genetic markers and low endorphin production, suggesting that certain people are just biologically predisposed to deficiency, I suspect the heart of the matter is more complicated.

Let’s talk more about when endorphins get released, and how we replenish our stores.

We know that things like eating a typical western diet, having a stressful and sedentary lifestyle, and feeling socially isolated can cause endorphin decreases. If you’re living a modern life in the West, chances are you’ve encountered at least one of these issues in your own life.

Eating for Endorphins

Eating sugar, gluten, and dairy can produce a well-documented opiate effect that causes the same brain chemistry swings we see in substance addicts: withdrawals, primal urges to binge, sensitization, and tolerance issues. As these foods get digested, their particles enter the blood stream. This is especially true in the context of Leaky Gut Syndrome (which the 133 million Americans with chronic conditions are very likely to suffer from). The food molecules mimic and bind to endorphin receptors just like morphine, which tells the body that we already have more than enough endorphins in our system, and that there is no need to make more. While this temporarily makes us feel great, once we don’t have the stimulating foods in our system anymore we experience a kind of withdrawal as the body realizes it didn’t make enough endorphins after all. This creates the urge to eat the opiate-food again. If we eat the opiate-food often enough, the body continually gets told to make fewer endorphins than it really needs.

Healing your gut and avoiding these opiate-mimicking foods are pivotal steps to take to normalizing endorphin levels.

Managing Stress for Endorphins

Stress is the number one thing that can deplete your endorphin stores. The body releases the hormones to mitigate inflammation caused by the fight-or-flight response, be it physically or mentally stimulated.

Now, if you’re like me, and were exposed to chronic background stress for a period of years, that’s years of the brain constantly working overtime to produce enough endorphins to keep things functioning normally.

Let’s harken back to the glory days for a minute and compare this to how our bodies and brains have actually evolved to deal with stress. Before the modern age’s aversion to outward manifestations of aggression in everyday life, humans would often experience acute stresses, but their avenues for dealing with stress were much different. Fight-or-flight would take over, which would result in one of the two options the response is named for, both of which involve:

1) a physical catharsis
2) a quick resolution

For example, say one night you’re sleeping with your cavemen buddies, when, all of a sudden, intruders come into your camp and try to take all of your group’s resources. You either try to fight them off – which might last hours, days, weeks even, but not years – or you gather what you can and run. Regardless, you’re engaging in a lot of physical activity that will result in lowering your inflammation levels if you happen to survive, and your problem isn’t lingering on for months or years at a time.

Biologically speaking, we just aren’t made to deal with modern stress that doesn’t resolve in a physical way (which would produce endorphins), and that lasts over long stretches of time (depleting our stores).

Managing stress with some sort of physical activity is important. Exercise is one of the best things to do when we’re feeling mental pressure. If rigorous exercise isn’t on the table for you due to physical limitations, you can try to develop other coping mechanisms, like meditation, which has also been shown to increase endorphin levels!

Socializing for endorphins

The last piece of this is social isolation.

Because social interaction plays a key role in generating endorphins, by extension, missing out on these interactions results in less production, less immune regulation, and compromised health. Meanwhile, people who already have low levels of endorphins have been shown to possess a much smaller social network than those with normal levels and are less likely to seek out social interaction. This can result in a cycle of isolation that contributes to decreasing levels even further over time.

A recent Cigna survey found that 47% of Americans felt alone regularly, and that 20% have never felt close to anyone. In January of this year, Britain went so far as to declare a loneliness epidemic and appointed its first Minister of Loneliness. In an age where we are constantly on screens that stimulate us in many of the same ways that we would traditionally be stimulated by face-to-face interactions, and where the luxury of voyeurism is always at our fingertips without repercussions, it’s no wonder we feel too exhausted to engage in more risky physical relationships. Yet, as stimulating as screen interactions may be, studies show that they ring hollow in terms of feeling connected to and understood by other people, and likely contribute to our feelings of loneliness rather than abate them.

Keeping up our relationships and seeking new ones out are perhaps especially important if we’re feeling antisocial. More research is urgently needed to identify the interventions that can best bridge the gap between social needs and social anxiety, but a good bet is to start by limiting screen time.

Another piece of the justification for mind-body connection

In the functional medicine and ancestral health community, we’ve known for a long time that our mental state is linked with our physical wellness. While science has produced lots of work validating this notion, it has been slow to produce the work needed to understand why – what’s the mechanism? The emerging research on endorphins may help to fill this research gap, giving evidence to justify the mind-body connection.

One of the most compelling studies to support this has to do with the previously mystifying placebo effect. Now scientists believe that we can explain the placebo effect by what we know about endorphins. In other words, if people believe they’re getting a great new drug that will ease their ailments, the brain releases endorphins in anticipation of that pleasurable experience, which results in pain relief. A recent study proved this theory by giving opiate-blockers to patients who experienced a placebo effect. After the opiate-blockers were administered (which blocked endorphins from their receptors), the placebo effect magically disappeared.

Definitely a compelling reason to consider cultivating a regular mental health practice, if you haven’t already.

How to increase endorphins?

There are plenty of activities that have been shown to increase endorphins. These activities include but are not limited to:

• Exercise
• Acupuncture
• Meditation
• Massage Therapy
• Eating chocolate and chili peppers (if you’re not on the autoimmune protocol!)
• Having an orgasm
• Laughing with friends
• Taking Low-Dose Naltrexone

It’s unclear whether chronically endorphin deficient people have the ability to return their endorphin levels to normal, nor how long this process might take. It’s possible that autoimmuners may require some sort of therapeutic intervention to increase their endorphin production. One such opportunity is presented by Low-Dose Naltrexone (LDN).

There’s a lot of buzz around LDN right now in the autoimmune community. This medication is much more palatable to those of us who value a less invasive, preventative approach than conventional immunosuppressants. That’s because LDN works naturopathically, by eliciting a stronger healing response from the body rather than directly treating symptoms. LDN temporarily blocks the body’s endorphin receptors, tricking the brain into making higher amounts, and, eventually, returning levels to normal. I’ll link my personal experience with LDN and a more in-depth article about the science behind the medication here in the near future.

If you have autoimmunity stay tuned for more on endorphins…

So, are we endorphin-deficient autoimmuners susceptible to compensating for this by engaging in behaviors that artificially stimulate our receptors? Well, if you’ve done much talking with the people who suffer from autoimmunity, this theory makes a lot of sense. I can only speak for myself, but I know that I always seemed to need things like pizza in my life – I needed my opiate fix, especially when I felt stressed. Looking back on it, it seems plausible that this was likely because my brain wasn’t producing enough endorphins.

Many autoimmuners can also point to a stressful trigger event that seemed to precipitate their symptoms. There’s bountiful anecdotal evidence out there about people who have made all kinds of diet and lifestyle interventions, but never begin to heal until after they’ve addressed their chronic stress levels. That isn’t to discount the role of diet, as paleo and AIP likely improve our endorphin response by eliminating most known opiate-foods.

To me, endorphins translate to a weighty piece of the autoimmunity puzzle and carry a lot of explanatory power for why ancestral interventions seem to work so well. For those of us who hold a big stake in this chronic illness thing, it would be prudent to stay tuned-in to the emerging research on endorphins – which, coincidentally, seems to be coming out faster than I can read it.


Moods and the Immune System

What Are Endorphins? (Plus, Hacks to Trick Your Body into Manufacturing More of These Feel-Good Chemicals)


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