Managing Nervous System Imbalances in Firefighters

Managing Nervous System Imbalances

PTSD in First Responders

By Jannine Krause

The first responder community, particularly firefighters, faces unique challenges when it comes to aging. Over the past decade, I have observed firsthand the physical and mental tolls that shift work, irregular sleep, high adrenaline levels, and career advancements can take on these individuals in the Seattle-Tacoma area. While it’s well-known that firefighters have a heightened risk of cardiovascular disease, many departments focus on prevention without addressing the deeper, underlying issue of nervous system imbalances.

Anxiety, insomnia, depression, pre-diabetes, and chronic fatigue are widespread among firefighters, regardless of age. These issues often intensify while studying for paramedic certifications or promotions, such as lieutenant or captain, as they juggle additional hours alongside their regular duties. Furthermore, overtime is frequently mandatory, and many firefighters eagerly work extra shifts. The promise of an early retirement drives the culture of taking on more shifts.

Shift work and poor sleep patterns are pervasive challenges. Firefighters often consume several cups of coffee while on shift and through morning meetings when coming off shifts, even if they never had a caffeine habit before joining the force. This reliance on stimulants further stresses their nervous systems. Most firefighters report they rarely sleep well during shifts due to frequent calls. Even on their days off, it can take a day or two to regain a normal sleep pattern, which only gets disrupted again upon return to duty. This cycle of sleep deprivation is a direct contributor to anxiety, chronic fatigue, pre-diabetes, and imbalances in cortisol, testosterone, and DHEA-sulfate levels that are seen in labs.

As firefighters age, spend more time in the industry, and climb the ranks, the strain on their nervous systems becomes more pronounced. Even those who enter the profession in peak physical condition can find themselves struggling with frequent injuries within a decade. Physical injuries can lead to mood changes, especially when paired with traumatic experiences from particularly distressing calls. This combination can result in a perfect storm for developing post-traumatic stress disorder (PTSD). Over the last ten years, I’ve witnessed multiple firefighters requiring inpatient therapy due to nervous systems that can no longer self-regulate under prolonged stress. Addressing the nervous system could prevent many of these cases and reduce the risk of cardiovascular conditions.

In my practice, I incorporate various methods to support nervous system regulation and the overall well-being of firefighters. These include acupuncture, Emotional Freedom Technique (EFT) tapping, breath work, adaptogenic herbs, peptides, and hormone balancing, along with interventions for gut and mitochondrial health.

Many firefighters I see have elevated cortisol, hemoglobin A1c, fasting glucose, and DHEA-sulfate levels, alongside deficiencies in sodium, potassium, vitamin D, B12, and folate. These patterns indicate a body stuck in fight-or-flight mode, driving down adrenaline pathways to cope with chronic stress.Exercise is often the go-to for stress relief among firefighters, but it’s important to introduce them to other relaxation methods. While initially resistant, many have found benefits in acupuncture, meditation, sauna sessions, and breathwork. Acupuncture, particularly after a shift, helps many firefighters re-establish a regular sleep pattern. Additionally, adaptogenic herbs are recommended, like Ashwagandha (600 mg )1 daily or Holy Basil (250 mg)2 daily for anxiety, along with supplements such as L-theanine (200-800 mg at bedtime)3, Magnesium glycinate (120-500 mg at bedtime)4, and glycine (3-5 grams 1-2 times a day)5, have shown to improve sleep and stress levels.

Modalities Supporting Firefighters and First Responders

In my practice, I’ve found it’s beneficial to have firefighters limit exercise to walking or gentle movement, paired with breathwork for the first 24 hours coming off of a shift. I have also found those who’ve integrated sauna therapy6 or HBOT rituals post-fire or high-stress shifts7 have fewer chronic metabolic issues, heal faster from injuries, and have better energy levels compared to those who do not use these modalities. While sauna therapy’s mechanism of mitochondrial repair is related to hormetic stress 6,  HBOT therapy’s systemic oxygen-boosting capability helps counter the excessive production of free radicals produced by the body in response to stress or fighting a fire.  Because firefighting comes with toxic exposures from burning plastics and sometimes hazardous materials, healthy mitochondria and detox capabilities are crucial to avoid cell and organ damage. 

The fast-paced nature of being a first responder can often lead to on-the-job injuries. Previously, I used injectable peptides like BPC-157 and TB-500, which were available through compounding pharmacies, to speed up healing. Although many firefighters now use peptides from research-based sources, the goal remains to support recovery along with redlight therapy, sauna, and HBOT to amplify results.

For older firefighters or those with chronically low DHEA and cortisol levels, supplementation with DHEA and Pregnenolone (25-50 mg doses each daily), along with testosterone replacement therapy, aid in restoring energy and muscle strength after injuries. 

To combat stress-related insulin resistance, I often recommend targeted fasting8, and mineral blends to support adrenal function and blood sugar balance. Key minerals include chromium, magnesium, selenium, and iodine9, which help stabilize blood sugar and support thyroid metabolism.

There’s also a connection between B12, folate, and cardiovascular conditions where homocysteine levels are elevated10. I find these to be elevated in quite a few firefighters. These methylation impairment conditions tend to decrease when nutrients such as choline, betaine, B2, B6, B12, and folate are supplemented11.

Unfortunately, many firefighters are prescribed statins, antidepressants, anti-anxiety, or blood pressure medications, which address symptoms rather than the underlying nervous system issues. A thorough analysis, including organic acids testing and assessments for toxic chemicals, metals, hormone levels, and metabolic markers, can provide insights into tailored health support for firefighters.

It’s essential to dig deeper and ask why certain health issues are prevalent in specific populations like firefighters. In their case, the key lies in protecting and regulating the nervous system while providing the necessary nutrients for resilience. Alongside this, promoting effective detoxification processes is crucial, as many firefighters struggle to detoxify efficiently from both everyday life and exposure to fire-related toxins.

Tools like saunas can aid in relaxation and detoxification, helping firefighters shift into a parasympathetic state. This relaxation is vital for nervous system recovery. Many firefighters retire with chronic fatigue and injuries, outcomes that could be mitigated if nervous system health were prioritized throughout their careers.

Over the years, I’ve taught many firefighters simple methods to quickly enter a parasympathetic state, such as the positional parasympathetic breathing technique. Spending just five minutes a day lying down with legs elevated and focusing on deep breathing, can significantly reduce stress. Small daily practices like these can make a big difference in overall health and help prevent long-term burnout.

First responders are known for their resilience and may often dismiss the need for nervous system care, preferring to power through their challenges. However, finding what resonates with each individual and encouraging it is key to ensuring their well-being. Life is too short to spend it perpetually in fight-or-flight mode, especially for those who dedicate their lives to serving others. Addressing the nervous system and providing holistic health support can help firefighters lead healthier, more balanced lives, during and after service.


Dr. Jannine Krause is a naturopathic doctor, acupuncturist, and host of The Health Fix Podcast specializing in optimizing mental and physical performance for women over 40. She has a doctorate in naturopathic medicine, a master’s in acupuncture, and a bachelor’s in biology. Her work has been featured in outlets including Authority Magazine, Naturopathic Doctor News & Review, SheKnows, Hone Health, “True Health with Ashley James” podcast, “The Gutsy Health Podcast,” and “The Less Stressed Life Podcast.”


References

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