The Physician on Call, To Make Sense of it All!


2735 Ponce De Leon Blvd. Coral Gables, Florida 33134

Stress and Internal Medicine

There is plenty of information readily available for people online and still it’s quite amazing how often stress is singled out as a basis for a multitude of illnesses.

Stress is commonly associated with a plethora of medical conditions and is often said to either cause or aggravate them.

The physiology of stress has been well documented. The human body releases different hormones and chemicals such as adrenaline, cortisone and serotonin. The ancestral origins of these likely evolved due to survival needs of humans. It’s natural and even healthy for these hormones to go up and down, they give people the tools they need to ready them for the trials and tribulations that come and go each day with work and life in general.

It is typical for stress and the related hormones to manifest as physical symptoms. Headaches, palpitations, muscle tension, chest pain, cramps or even diarrhea. And if stress is a common issue in someone’s life, it can interfere with sleep patterns and lead them to fatigue, stress can affect appetite, it can lead to erectile dysfunction, premature memory loss, overindulgence in drugs or alcohol and more.

Yet, stress does not cause the conditions of hypertension, diabetes, reflux esophagitis, or sleep apnea, to name a few. These medical conditions have their own physiology, and evolve completely independent of stress. Apparently, it is easy to confuse the fact that when humans become aggravated or stressed, their blood pressures, sugars, and stomach acid levels may temporarily rise. Yet, smoking a cigarette, having a full bladder, or experiencing pain, can also transiently elevate blood pressure. It is not the acute spike that defines those conditions, but rather the chronic patterns that make it a meaningful illness.

Hypertension, or high blood pressure, is a reflection of elevated blood vessel tone. It is common, affecting one of three people in the United States, and, for the most part, it is silent, without symptoms. There is a genetic basis that predisposes individuals to hypertension. Diabetes, particularly the adult form of it, reflects a relative resistance to insulin, due to cellular effects of obesity. Eventually, the pancreas cannot make enough insulin to drive glucose or sugar into cells and levels rise. Reflux esophagitis is not the result of too much acid, but rather from acid leaving the protective environment of the stomach and getting into the vulnerable esophagus above. And sleep apnea results from the subtle crowding of the oral airway from obesity that obstructs and actually ceases breathing in the middle of the night on a repetitive basis.

Therefore, in contrast to stress, it is obesity that most often causes or aggravates those conditions. Two of every three people in this country is considered obese when using BMI scores or basal metabolic indexes; a function of one’s height and weight. And the numbers are rising. Remaining diligent to diet, exercise, and sleep habits would be the correct path, as opposed to inappropriate concern about stress.

Finally, it should be noted that much of stress is attitudinal. After golfer Rory Mcllroy’s infamous Masters Tournament collapse, he noted, ‘If that’s the worst thing that happens to me in my life, I must have had a pretty good life’.