All About Allostatic Load: A Functional Medicine Perspective of Stress & Body Burden

Honestly, this post is just me “nerding out” about the topic of stress. Did you think that was even possible?

There’s actually a researched medical term for the way your body responds to the internal and external stressors you constantly experience — it’s called allostasis!

I want to discuss this because “stress” has so many different, subjective, and sometimes obscure meanings. But the concept of allostasis attempts to ground it in our measurable physiology and function.

Understanding the basics of this concept can be both validating and empowering as it relates to how stress affects us physically and emotionally.

Allostasis is also a central principle in a functional medicine approach to understanding health holistically. We can even gain insights into the cumulative burden of stress with functional medicine lab testing.

Please indulge me, and let’s dive into this topic! If you’re really feeling it, maybe even bring it up at your next get-together with friends!

Understanding Allostasis & Allostatic Load

Allostasis is basically your body’s way of maintaining balance by adapting to stress and change.  It’s like the conductor of your body’s symphony of chemical reactions that are constantly being fine tuned to maintain stability and health.

Now you may recall the concept of homeostasis back in middle school science – homeostasis is how the body maintains a stable internal environment (body temperature, heart rate, etc.) in response to changes in the external environment.  However, allostasis is different – it doesn’t have fixed set points and has adaptive functions in response to stressors of all forms!

This brings us to the concept of allostatic load!  Allostatic load is the term for the cumulative effects of stressors and the body’s adaptations.

Let’s use blood pressure as an example.  The cumulative effects of a high-stress work life coupled with inflammatory stressors from fast food lead to adaptive changes that may raise your blood pressure over time.

Remember, stress is more than just emotional stress!  And you don’t have to be feeling “stressed out” for your allostatic load to be building.  There are hidden stressors, dietary stressors, and inflammatory stressors such as environmental toxins and chronic gut infections that challenge these set points!

We are constantly using hormones and nervous system signals to fine tune allostasis, and so these are the systems that are often affected over time!

The Consequences of High Allostatic Load

Your brain orchestrates most of these processes through systems such as the HPA-Axis for example.  You can think of allostatic load as a measure of the physical effects of stressors (of all kinds) and that we each have a unique threshold!

If a stressor is large enough or chronically sustained enough, it can lead to overwhelming our allostatic load, and this is what results in disease and dysfunction throughout the body.  In fact, you could say all chronic disease is a result of high allostatic load!

Here are just a few examples of the consequences of high allostatic load:

  • Chronic fatigue
  • The autoimmune spectrum including Hashimoto’s thyroiditis
  • Mitochondrial dysfunction
  • “Tired but wired”
  • Body composition concerns, and diabetes
  • High blood pressure, high triglycerides, high cholesterol
  • Hormone dysregulation
  • Leaky Gut, irritable bowel syndrome, acid reflux (GERD)
  • Adrenal fatigue (HPA Axis Dysfunction)
  • Insomnia and other sleep disturbances
  • Depression, anxiety, and brain fog
  • Alzheimer’s disease

Practically, I see this play out in my patients’ health experiences when they consider the question, “when was the last time you felt well?” or “what else was going on in your life when this all started?”  Just like “throwing out” your back by picking up a pencil, it can be the seemingly smallest stressors that overwhelms our allostatic load.

And to be honest, emotional stress, grief, transition, traumatic life experiences, and so many more situations often correlate to the tipping of the allostatic load scale!

The Connection Between Stress, Allostasis, and Allostatic Load

In our society, we have more sources of chronic stress than ever – financial pressures, work/life balance, chronic illness, poor sleep, inflammatory dietary patterns, and information overload!  These are just a handful of factors that act as signals that contribute to allostatic load.

Our brain and bodies react to stressors through a coordinated system such as the hypothalamic-pituitary-adrenal axis (HPA Axis, which you can read about more here).  However, our systems were designed to respond to stressors, and then return to a normal, relaxed, and balanced state.

The contemporary dilemma is that your boss or family or dietary patterns don’t just go away after a quick chase.  We are like zebras running 24/7 away from the lions, which is understandably draining and dysfunctional.  It leads to the adaptive changes of allostasis and contributes to our allostatic load.

Are you seeing how this all fits together?

 A Functional Medicine Approach to Assessing & Managing Allostatic Load

Functional medicine takes the concept of allostatic load as a central part of a health assessment.  It does so through three main mechanisms – A functional medicine timeline and history taking, functional lab testing, and an emphasis on what I call the 5 lifestyle pillars.

Functional Medicine Timeline and History Taking

A core tenet at the beginning of a functional medicine intake is a thorough health history.  I call this a functional medicine deep-dive, and with paperwork and a detailed discussion, explore the nuances of your personal health journey from conception to present day!  

I sometimes joke with patients that they’re about to complete the most detailed review of their health journey – and this is usually the case.  After this exploration, many functional medicine practitioners plot the patient’s history on a timeline, and use it to tease out patterns.  Sometimes, the “tipping point” of allostasis is quite apparent with this approach alone!   

Functional Lab Testing

There are many ways to gain insight into the systems that help maintain balance with allostasis with functional lab testing.  Here are a few examples of common functional labs and what they assess.  

  • Adrenal Stress Testing – By tracking DHEA and cortisol levels throughout the day, this test can give insight into the complex “control center” called the HPA Axis
  • Organic Acids Testing – This test can help to locate major blocks in one’s metabolism and nutrition status, sometimes revealing a burden on the liver, brain, and other systems.
  • Functional Stool Testing – This test can be useful for identifying hidden sources of inflammation in the gut such as parasitic infections, imbalance in the microbiome, and inflammatory stress on the digestive tract.
  • Food Sensitivity Testing – Sensitivity to a wide array of foods can suggest a increased load or increased reactivity of the immune system
  • Heavy Metal & Toxic Element Testing – Both heavy metals and toxic elements can disrupt the nervous systems, hormones, and generate inflammation that contributes to body burden.

The 5 Lifestyle Pillars

By focusing on the 5 lifestyle pillars for both assessment and treatment, we can use each of these to our advantage.  Each one of the pillars contributes to resilience of our complex nervous and hormonal systems that control all of our body functions!  

In a sense, these pillars can help to raise the threshold of our allostatic load and make allostasis more regular and balanced.  The 5 lifestyle pillars include the following:

  1. Stress Management & Meditation
  2. Restful Sleep
  3. Movement & Exercise
  4. Quality Nutrition
  5. Connection & Purpose

 Practical Tips for Lowering Allostatic Load

  1. Focus on the 5 lifestyle pillars above – using these levers to create resilience and avoid or manage common stressors can be profoundly impactful
  2. Mindfulness, meditation, prayer, and breathwork are more important than ever to balance the overstimulation and overactivation of our nervous systems in our contemporary lives
  3. Sleep is profoundly important to recovery and resilience, and we don’t fully understand the mysteries that take place when we sleep.  There’s a reason it’s a third of our lives though.  Humans are the only creatures who voluntarily delay sleep.
  4. Use self-assessment tools such as a mood journal or heart rate variability trackers to notice trends if your major stressors.  There are so many great tools and wearables to choose from to support this awareness.
  5. Consider seeking professional help, whether it’s through mental health counseling or functional medicine lab testing.


Understanding allostasis and allostatic load can be transformative for managing stress and improving overall health. By recognizing how your body adapts to various stressors, you can take proactive steps to reduce the cumulative burden of stress in all its forms!

Embracing the 5 lifestyle pillars—stress management, quality sleep, movement, nutrition, and social connection—can help build resilience and maintain this delicate, priceless balance. 

If you have questions or want to explore how functional medicine can support your journey, don’t hesitate to reach out via Instagram or here on the blog! Here’s to your health and well-being always!

About the Author

Headshot of Dr. Kenny Mittelstadt for Author Bio in Color

Kenny Mittelstadt is an acupuncturist and functional health practitioner based in San Antonio, Texas.  He is trained through the Institute for Functional Medicine and received both of his doctorate degrees with highest honors from Southern California University of Health Sciences. He focuses on empowering patients through creating opportunities for integrated understanding and personalized root-cause healing - starting with gut health and growing beyond!

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