FX Medicine

Home of integrative and complementary medicine

Chronic Stress, Cortisol Resistance & Immunity

melissalee's picture


Decades of research has highlighted the impact of stress on the immune system. Whilst acute stress has been shown to enhance the immune response, chronic stress has been shown to suppress immune function and is a major player in immune depletion and treatment resistance.[7-9]

Chronic stress takes place over an extended period of time and can elicit declines in Th1 (IL-2, IFN-gamma and IL-12) and Th2 (IL-4) responses, i.e. immunosuppression. People reporting more psychological stress have both a higher incidence and a greater severity of illness.[10]

An important finding is that exposure to chronic stress results in glucocorticoid receptor (GCR) resistance leading to a failure to down-regulate the inflammatory response. Consequently, higher levels of IL-6 are produced with an exaggerated expression of the signs and symptoms of infection.[10]

In this infographic, we take a closer look at the effects of chronic stress and how it interferes with the regulation of local pro-inflammatory cytokine response to common infections. We also review some of the key herbal immunomodulators and adaptogens that have been shown to improve the stress and inflammation response and reduce our susceptibility to infection.


  1. 2013 Absence management and wellbeing survey. Direct Health Solutions 2014. Viewed 1 September 2014, www.dhs.net.au/insight/2013-absence-management-survey-summary/
  2. Casey L. Stress and wellbeing in Australia survey 2013. Australian Psychological Society. [Source]
  3. Hayden FG, Fritz R, Lobo MC, et al. Local and systemic cytokine responses during experimental human influenza A virus infection. Relation to symptom formation and host defense. J Clin Invest 1998;101(3):643-649. [Full text]
  4. Chrousos GP, Kino T. Ikaros transcription factors: flying between stress and inflammation. J Clin Invest 2005;115(4):844-848. [Full text]
  5. Braun L, Cohen M. Herbs and natural supplements: an evidence-based guide, 3rd ed. Sydney: Churchill Livingstone Elsevier, 2010. [Source]
  6. Stamets P. Novel antimicrobials from mushrooms. HerbalGram 2004;54:28-33. [Full text]
  7. Padgett DA, Glaser R. How stress influences the immune response. Trends Immunol 2003;24(8):444-448. [Abstract]
  8. Lucassen PJ, Pruessner J, Sousa N, et al. Neuropathology of stress. Acta Neuropathol 2014;127:109-135. [Full text]
  9. Tsujita S, Morimoto K. Secretory IgA in saliva can be a useful stress marker. Environ Health Prev Med 1999;4:1-8. [Abstract]
  10. Cohen S, Doyle W, Skoner D. Psychological stress, cytokine production, and severity of upper respiratory illness. Psychosomatic Med 1999;61:175-180. [Abstract]
  11. Reflection paper on the adaptogenic concept. Committee of Herbal Medicinal Products (HMPC). European Medicines Agency: London, 2008. [Full text]
  12. Dev S. Ancient-modern concordance in Ayurvedic plants: some examples. Environ Health Perspect 1999;107:783-789. [Full text]
  13. Singh N, Bhalla M, de Jager P, et al. An overview on Ashwagandha: A Rasayana (Rejuvenator) of Ayurveda. Afr J Tradit Complement Altern Med 2011;8(S):208-213. [Full text]
  14. KSM-66 Ashwagandha analytical specifications. Viewed 28 Aug 2014, www.ksm66ashwagandhaa.com/specification_sheet.html

Creative Commons License

This image by FX Medicine is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

More information about how to share/use the infographics for personal use.

If you interested in using any FX Medicine content for commercial use please contact us.


The information provided on FX Medicine is for educational and informational purposes only. The information provided on this site is not, nor is it intended to be, a substitute for professional advice or care. Please seek the advice of a qualified health care professional in the event something you have read here raises questions or concerns regarding your health.

Share Infographic: 
melissalee's picture
Melissa Lee
Melissa is a designer turned nutritionist, who has combined the two modalities to create purposeful designs for various health publications and websites. Having initially studied Multimedia Systems Design, she then went on to complete a BHSc in Nutritional Medicine which led to her involvement in the integrative medicine industry and eventually to FX Medicine.