Sunday, March 16, 2014

Just another way that yoga can help

I know, I know. After all these years, you may be thinking, “So what doesn’t yoga help you with?” Recovery from a serious medical condition such as cancer takes a toll on the body. For example, many people who have undergone chemotherapy to treat cancer develop persistent fatigue. Researchers and physicians have been working hard to better understand what causes and what helps fatigue in people who are in recovery from cancer treatment. So far, they found that biological markers immune system functioning, all the way down to gene expression, that are associated with inflammation are linked to persistent fatigue in people recovering from treatment for cancer.

This makes sense if you think about it. Inflammation is the body’s response to harmful invasion. Think of a simple infected paper cut. Inflammation is the process of the area around the cut swelling slightly and getting red and warm. These are all signs that your body is fighting the infection in that wound. When the process of inflammation is working well, inflammation should cease when the infection is no longer present. When the system is unable to shut itself off, or is forced to be active for extended periods of time, people can develop chronic inflammation. Chronic inflammation is where the inflammatory response shifts its functioning and begins to destroy both the harmed tissue in our body but also the healthy tissue. This shift in functioning can be measured through transcription of pro- and anti-inflammatory genes in our RNA from blood samples.

Cancer is a perfect example of the type of harmful presence in the body that may result in the development of chronic inflammation. Thus, it’s not surprising that cancer survivors often struggle with persistent fatigue long after they have successfully been treated for their illness. It is also not surprising that these genetic and immune response biomarkers are related to these persistent problems with fatigue in cancer survivors. But is there anything that can help this?

There is no shortage of popular media opinion that mind-body practices such as yoga have benefits far beyond increasing flexibility and strength. In fact there are people who claim that yoga can help with everything from your attention span to your relationships. Empirically, the jury is still out regarding whether these claims are true, but there are some well-designed research studies showing that immune functioning improves as a result of participation in yoga over time. So…

Can yoga help reduce the biological responses associated with fatigue in cancer survivors?

Well, that was what Dr. Julienne Bower of UCLA and her colleagues were interested in understanding when they conducted their most recent study. To answer this question they recruited 31 women (average age = 54 years) who had completed treatment for breast cancer and who were suffering from persistent fatigue. Women in this study had received their diagnosis an average of 3.5 years prior to the study. The women provided samples of blood and saliva for a pre-treatment assessment of their immunological functioning as well as gene expression of inflammation related markers: NF-κB, CREB, & glucocorticoid receptor activity. They then randomized half of these women to participate in 12 weeks of Iyengar Yoga, while the other half participated in 12 weeks of a health education class. At the end of the 12 weeks, and then 3 months later, the women contributed new blood and saliva samples in order to reassess biological markers of inflammation that may be underlying symptoms of fatigue.

They found that women in the yoga intervention reported significant reductions in their fatigue compared with the women in the health education class. They also found that women who participated in the yoga condition demonstrated decreases in both NF-κB and CREB, as well as increases in glucocorticoid receptor activity. NF-κB and CREB can both increase the transcription of pro-inflammatory genes, while glucocorticoid receptors modulate the body’s physiological and immunological balance. More simply, the women in the yoga intervention were less likely to exhibit proinflammatory genetic profiles and may have been better able to regulate their stress and inflammatory response compared with women in the health class. These changes in physiological and immunological functioning may have resulted in the reduction of fatigue.

What’s most interesting to me about this study is not that yoga is helpful for these symptoms, but why? What is it about yoga that helps reduce inflammatory responses as your body recovers from a serious medical condition? There are a lot of possibilities, but this study does not help us answer them. For example, the observed effects may be related to the fact that Iyengar Yoga is a form of physical exercise while the other condition was not. So, it’s possible that another form of physical exercise for 12 weeks may have the same effects. It is also possible that Iyengar Yoga provided an opportunity for relaxation that the other condition did not, and perhaps something like meditation would have the same immunological benefits.

What we don’t know, is how long after the intervention these biological effects remain. It seems unlikely to me that 12 weeks of yoga can result in permanent changes, but given the relatively short intervention I wonder what 12 months or even 12 years would do to the efficiency of the immune system. The more important point is that these women were physically and psychologically in recovery from a serious experience that included surgery, radiation, and chemotherapy, not to mention anxiety, sadness, pain and profound changes to their lifestyle. What we know is that, not only did feelings of fatigue improve as a result of this intervention, but their body’s ability to fend off future threats may have improved as well. Whatever the reason, practicing yoga for just 12 weeks demonstrated a potent mind-body resolution for a persistent problem. So far, this study’s findings are limited to women in recovery from breast cancer, but are likely to be similar for persistent fatigue following other serious medical conditions.

So if you’re fatigued anyway, then why not be fatigued while trying some yoga?


 Bower, J. E., Greendale, G., Crosswell, A. D., Garet, D., Sternlieb, B., Ganz, P. A., ... & Cole, S. W. (2014). Yoga reduces inflammatory signaling in fatigued breast cancer survivors: A randomized controlled trial.Psychoneuroendocrinology.

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