Anger, a universal and powerful emotion, is deeply embedded in human psychology. While it serves as a natural response to perceived threats or injustices, chronic anger can have profound implications for our physical and mental health. A key player in this intricate relationship is cortisol, often called the stress hormone. Understanding how anger influences cortisol levels sheds light on the broader effects of unchecked emotional responses on our well-being.

Cortisol is produced by the adrenal glands and is crucial for regulating various bodily functions, including metabolism, immune response, and stress management. Dr. Rahul Chandhok, a psychiatrist specializing in mental health and behavioral science, explains, “When we are angry, the hypothalamus in the brain activates the stress response, triggering the release of cortisol. While a temporary rise in cortisol is necessary to cope with acute stress, chronic anger keeps cortisol levels elevated, disrupting the body’s natural balance.”

This disruption has far-reaching consequences. Prolonged exposure to elevated cortisol can lead to hypertension, compromised immunity, and an increased risk of mental health disorders like anxiety and depression.

Physical Health Implications of Chronic Anger

Anger triggers the "fight-or-flight" response, which elevates both blood pressure and heart rate. Over time, this heightened physiological state can strain the cardiovascular system. Ms. Jasreen Birgi, a counseling psychologist, highlights the risks, “Chronic anger not only raises cortisol levels but also strains the heart, potentially contributing to conditions such as heart attacks, strokes, and high blood pressure.”

Additionally, persistent anger can negatively affect digestion, linking stress-induced cortisol surges to disorders like irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). The immune system also suffers, as excess cortisol weakens the body’s defenses, making it more susceptible to illnesses.

Mental Health Consequences

From a psychological perspective, chronic anger is a double-edged sword. While it can motivate action when managed constructively, unresolved anger can lead to severe emotional imbalances. Heightened cortisol levels amplify symptoms of anxiety and depression, disrupt sleep patterns, and foster feelings of cynicism or aggression.

According to Dr. Chandhok, these disruptions can create a vicious cycle, “Excess cortisol from anger weakens the immune system, disrupts sleep, and raises blood pressure, creating a perfect storm for both mental and physical health challenges.”

Sleep disturbances are particularly concerning, as poor sleep exacerbates emotional instability, leaving individuals more prone to irritability and further episodes of anger.

Anger’s Impact on Relationships

Anger does not only harm the individual; it also affects interpersonal relationships. Elevated cortisol levels during episodes of anger impair clear thinking, often leading to impulsive decisions or hurtful actions. Over time, such behavior can erode trust and connection in relationships, making it difficult to maintain meaningful bonds.

Ms. Birgi elaborates, “Anger can make individuals more aggressive or cynical, hindering their ability to form and sustain healthy relationships. This emotional imbalance further affects overall well-being.”

Resilience and Stress Management

While the effects of anger on cortisol levels are concerning, they are not irreversible. Stress-relief practices can help rebalance cortisol levels and mitigate the impact of anger on health. Techniques such as mindfulness, deep breathing, and regular exercise can counteract cortisol surges and foster resilience.

According to the American Psychological Association, developing healthier ways to manage and release anger is crucial. Constructive strategies include:

• Mindfulness meditation: Helps calm the mind and reduce the intensity of emotional reactions.
• Physical activity: Promotes the release of endorphins, natural mood elevators that counteract stress.
• Therapeutic interventions: Cognitive-behavioral therapy (CBT) can help individuals identify triggers and develop constructive ways to cope with anger.

Anger, when unchecked, has a cascading effect on both cortisol levels and overall health. From hypertension and digestive disorders to mental health challenges and strained relationships, the consequences of chronic anger are profound. However, by understanding the connection between anger and cortisol, individuals can take proactive steps to manage their emotions and build resilience.

As Dr. Chandhok aptly puts it, “Anger is a natural emotion, but its management is critical. With awareness and the right tools, we can transform anger from a destructive force into an opportunity for growth and emotional balance.”

Dr. Rahul Chandhok is Head Psychiatrist, Head Consultant, Mental Health and Behavioural Science at Artemis Hospitals and Ms. Jasreen Birgi is a Counselling Psychologist with a Mental Health Platform- LISSUN.

Auto-Brewery Syndrome, also known as gut fermentation syndrome, is a rare medical condition where the digestive system produces alcohol internally. This happens when certain microorganisms—mostly yeasts like Candida or some bacteria—ferment carbohydrates in the gut, creating ethanol. The ethanol then enters the bloodstream, causing symptoms such as dizziness, disorientation, fatigue, and even slurred speech, mimicking alcohol intoxication.

How Does It Happen?

ABS typically occurs when the natural balance of the gut microbiome is disrupted. This disruption can follow antibiotic use, gastrointestinal infections, or diets high in refined carbohydrates. In some cases, people with diabetes or existing gut disorders are more prone to developing the condition.

When the gut environment changes, fermentative microbes may flourish. These microbes thrive on simple carbohydrates and sugars, converting them into alcohol during digestion. While most people efficiently digest these foods without any issue, those with ABS experience a build-up of ethanol, leading to unwanted and surprising symptoms.

The Role of Bread and Carbohydrates

Bread—especially white or refined varieties—is rich in simple carbohydrates. For most people, eating bread in moderation doesn’t cause harm. In fact, whole grain bread can be beneficial due to its fibre content, which supports healthy digestion and feeds good gut bacteria.

However, when eaten in excess, particularly in its refined form, bread can contribute to an overgrowth of fermentative microbes in susceptible individuals. This can lead to symptoms like bloating, gas, discomfort, and, in rare cases like ABS, internal alcohol production.

A Simple Remedy: Psyllium Husk

To support gut health, many wellness experts recommend incorporating psyllium husk, or Isabgol, into your routine. Psyllium is a soluble fibre that absorbs water and forms a gel-like substance in the gut. This helps regulate bowel movements, slows down carbohydrate absorption, and may prevent the rapid fermentation of food in the intestines.

By stabilizing digestion and reducing the speed at which carbs are broken down, psyllium can help minimise gas, bloating, and the risk of ethanol build-up—making it a helpful tool for those concerned about gut health.

Supporting a Healthy Gut

Managing ABS or preventing gut issues doesn't require drastic changes. Here are a few everyday habits that support better digestion:

• Limit intake of refined carbohydrates and processed foods
• Choose whole grains, fresh fruits, vegetables, and lean proteins
• Include fermented foods like yogurt, kefir, or pickles
• Stay active and hydrate well
• Manage stress through breathing exercises, meditation, or regular routines

Auto-Brewery Syndrome is an unusual and extreme case, but it highlights a powerful truth: the food we eat shapes our internal health in surprising ways. Paying attention to our gut and making mindful dietary choices can go a long way in supporting not just digestion, but overall well-being.

You may know about people who avoid certain foods like peanuts, berries or eggs because they are allergic to it, but what does that mean? Food allergies can happen to anyone. It is a condition where your body’s natural defenses overreact to exposure to a particular substance. The American College of Allergy, Asthma & Immunology explains that our body’s immune system basically mistakes food or a particular particle as an invader or a threat to your body.

This then causes your immune system to release ‘defense’ chemicals that can cause reactions like nausea, swellings, dizziness or worse, anaphylaxis. Anaphylaxis is a whole-body reaction that can impair your breathing and cause a dramatic drop in blood pressure. Life-threatening reactions like such are the reason why many parents are apprehensive about introducing certain foods to their children. However, could that be the reason why children are developing more allergies?

A new study published in the European Journal of Clinical Nutrition found that some parents are waiting much longer—a year or even more. Many parents, understandably worried, might actually be preventing their children from avoiding food allergies. Experts now say that introducing tiny amounts of common allergy-causing foods like peanuts and eggs to babies as young as 4 to 6 months old can help them build a strong defense. This delay could mean their children don't get the chance to become tolerant to these foods, increasing their risk of developing allergies.

Delayed Introduction Trend

The study looked at what parents are feeding their babies and found some interesting, and perhaps concerning, trends:

Nuts: About 35% of babies hadn't eaten nuts by their first birthday.

Eggs: Similarly, around 21% of parents hadn't given their one-year-olds any egg.

Sesame: And for sesame, 16% of babies hadn't tried it by age one.

These numbers come from a survey of parents in the UK, who are part of a study tracking their children's health over time.

Persistent Misconceptions And How It Affects Health

For many years, parents were told to avoid giving allergenic foods to babies and even during pregnancy. The idea was to prevent allergies. However, we now know that this advice might have actually made allergies more common, especially in children.

Researchers explain that studies as such are very important. Parents must update themselves regarding new food allergy guidelines. This understanding is important as if parents keep waiting to introduce these foods, it will continue to fuel the "allergy epidemic" we're seeing.

The researchers talked to nearly 400 parents involved in a project tracking children's health from birth. They found that most children did start eating common allergenic foods like eggs and nuts when they were between 6 and 9 months old. However, many parents still chose to wait longer for certain foods:

Sesame: About 26% of parents waited until their child was older than 9 months.

Fish: 25% delayed introducing fish.

Nuts: 21% waited longer for nuts.

Eggs: 11% held off on eggs.

The researchers concluded that even parents whose families had a history of allergies weren't following the updated advice. Many babies weren't exposed to nuts and eggs by their first birthday, which is a key time for building tolerance.

Bridging the Knowledge Gap

These findings suggest that the new guidelines about food allergies aren't reaching new parents clearly enough. Research consistently shows that introducing allergenic foods early, especially nuts and eggs, lowers the risk of developing allergies. In fact, for babies at high risk of allergies, experts even suggest introducing peanut-containing foods as early as 4 to 6 months of age. It's crucial for this message to get out so more children can benefit from these updated recommendations.

Cervical cancer is usually associated with the human papillomavirus (HPV), a sexually transmitted disease that accounts for nearly all cervical cancer cases. HPV types 16 and 18 have been found to account for more than 70% of cervical cancer cases worldwide. HPV vaccination and cervical screening schemes have had a remarkable impact in lowering the incidence of HPV-associated cervical cancer, particularly in developed countries but can cervical cancer happen without HPV?

Surprisingly, yes—but only rarely. Between 5.5% and 11% of cervical cancers are HPV-negative, and these tend to be missed until advanced stages. This article discusses what we now know about HPV-negative cervical cancers, why they are difficult to diagnose, and what it all means for prevention and treatment in the future.

Dominant Role of HPV in Cervical Cancer

HPV is by far the most frequent cause of cervical cancer and is responsible for almost 99% of cases. The virus is generally transmitted through sexual contact and can remain in the body for years before resulting in abnormal cell growth in the cervix.

In nations such as Australia, where screening and vaccination programs are well organized, the majority of cervical cancer cases can be traced to HPV. Of the 900 women who develop cervical cancer annually in Australia, nearly all have been attributed to this virus. The two most lethal types of HPV—16 and 18—are accountable for as much as 80% of the cases.

However, in a small percentage of cases, no detectable HPV infection is present. These are the uncommon but important outliers that researchers and clinicians are working increasingly harder to comprehend.

What is HPV-Negative Cervical Cancer?

HPV-negative cervical cancers occur in an estimated 5.5% to 11% of all cases worldwide. These are uncommon subtypes of adenocarcinomas, including:

• Clear cell carcinoma
• Mesonephric carcinoma
• Gastric-type adenocarcinoma

In a few instances, tumors that are HPV-negative at presentation can be and were once HPV-positive, yet the virus is no longer detectable because of tumor progression or testing limitations. In any case, such cancers tend to act differently than HPV-positive tumors—and present formidable diagnostic challenges.

Why HPV-Negative Cases Go Undetected?

One of the biggest challenges to tackling HPV-negative cervical cancers is that existing screening tools—both the Pap test and the newer Cervical Screening Test (CST)—are intended to pick up HPV-associated abnormalities. Therefore, HPV-negative tumors usually go undetected early on.

Lacking an independent test that can specifically pick up these uncommon types, many women won't be diagnosed until they start noticing symptoms, including:

• Unexplained vaginal bleeding
• Pelvic pain
• Painful sex
• Irregular discharge

These symptoms usually manifest later, hence HPV-negative cervical cancers usually have a poorer prognosis. A meta-analysis of 17 studies with more than 2,800 patients revealed that the outcomes for HPV-positive cervical cancers are substantially better than those for HPV-negative cancers. Both earlier detection and biologic differences in tumor behavior are likely to be the reasons for this.

Potential Risk Factors Of Cervical Cancer Beyond HPV

Although HPV is still the leading cause of cervical cancer, various factors can contribute to elevating one's risk, particularly in HPV-negative patients:

Smoking: Duplicates the risk of cervical cancer by subjecting cervical cells to carcinogens.

Long-term oral contraceptive use: Prolonged use can raise the risk, although risk dissipates after stopping pills.

Multiple births: Multiple full-term pregnancies can raise the vulnerability through hormonal fluctuations and prolonged exposure to HPV.

Weakened immune system: Diseases such as HIV or immunosuppressive drugs may weaken the body and make it less likely to resist infections and abnormal cell growth.

Family history: There may be a genetic component that contributes to susceptibility.

Chlamydia infection: Long-term infections caused by this bacterium may raise the risk.

Poor diet: Inadequate fruit and vegetable intake has been linked with increased cancer risk from less protective antioxidants and vitamins.

Nevertheless, risk factors above are modifiers and not primary causes. In the case of HPV-negative cervical cancer, there is no single cause, and studies on possible genetic or environmental cause are under way.

Diagnosis of HPV-Negative Cervical Cancer

Since there is no screening test for HPV-negative cervical cancers, diagnosis typically only happens after symptoms arise. Physicians use:

• Pelvic exams
• Biopsies
• Imaging tests like MRI or CT scans

By the point of discovery, the cancer is typically so advanced that the treatment becomes more complex and survival rates lower.

This delay in detection underscores a critical imperative for biomarker identification, cutting-edge imaging, and better awareness both within the healthcare community and among the general public.

Are We Underestimating the Role of HPV?

Some authors believe that the rate of HPV-negative cervical cancers could be overestimated because of false negatives, i.e., cases with the presence of the virus that are not detectable at the moment of testing. This may be explained by:

• Low viral load
• Sampling errors
• Short period of time between infection and testing

This hypothesis is put forward on the grounds that the actual number of true HPV-negative cases may be less than reported, though more sophisticated diagnostic methods are required to support this.

How To Minimize Risk Of Cervical Cancer?

HPV-positive or HPV-negative, there are steps to take that lower the risk of developing cervical cancer overall:

Get vaccinated: The HPV vaccine protects against the most risky types of the virus.

Go for regular screenings: Although they don't catch HPV-negative cancers, Pap and HPV tests are still important for the early detection of most.

Stop smoking: Reducing tobacco use reduces exposure to carcinogens.

Practice safe sex: Wear condoms to reduce the risk of sexually transmitted diseases.

Eat a balanced diet: Provide a nutrient-rich diet with high levels of antioxidants.

Women who have any unusual gynecological symptoms—no matter what their screening history is—should see a healthcare provider early.

Though HPV-negative cervical cancer is uncommon, it poses special detection, diagnostic, and therapeutic challenges. These instances remind us that cervical cancer is not a monolith and highlight the need for ongoing research, improved screening technologies, and heightened awareness.