Chronic Stress, Cellular Function, and Longevity

By Christy Cael
[Functional Anatomy]

Bodyworkers and health practitioners are aware of the importance of stress management to health and disease prevention; however, it can be challenging to articulate exactly why this is true—and how specific modalities and behaviors contribute to both. Fortunately, researchers are finding specific mechanisms to assess health on a cellular level and the effects of acute and chronic stress on those mechanisms. This serves as an effective foundation for communicating the importance of developing tools to regularly manage stress and how our work contributes to that end.

Telomeres and Telomerase

In 2009, the Nobel Prize in Physiology or Medicine was awarded to Elizabeth H. Blackburn, Carol W. Greider, and Jack W. Szostak for their discovery of the protective function of telomeres and telomerase on chromosomes. They had unraveled the mystery of how cells are able to successfully replicate over and over without losing chromosomal stability during the replication process.

The researchers discovered a protective “cap” at the ends of chromosomes made up of DNA-protein complexes. These caps, or telomeres, protect the fragile ends of the DNA strands and prevent loss of genetic information during the replication process. Each time a cell replicates, the end of the sequence is lost and must be “filled in” or completed by a section or sections of the telomere. Each time that end replication problem is corrected by the telomere, a small section of the telomeric sequence is lost. This results in a measurable shortening of the telomere until it becomes critically short and the cell can no longer replicate fully. Telomere length can therefore be utilized as a reliable measure of a cell’s biological “age” with the potential for further cell division diminishing as the telomere shortens.

In addition to telomeres, researchers also identified an important enzyme that supports the function and longevity of the telomeres. Telomerase extends telomere DNA and provides a platform for replication that copies the entire length of the chromosome and counteracts telomere shortening. By helping to maintain telomere length, telomerase promotes cell longevity, allowing the cell to continue replicating without loss of genetic information.

Chronic Stress, Aging, and Disease

Once they had unraveled the mystery of how cells are able to successfully replicate, researchers sought to understand factors that impact a cell’s biological age and the implications for human health and disease. They noted that telomere length and telomerase activity both decrease with chronological age. Additionally, they noted that shortened telomeres and decreased telomerase activity predicted risk factors for cardiovascular and other chronic, age-related diseases independent of chronological age.

Further investigation revealed a direct correlation between telomere length, telomerase activity, oxidative stress, and specific hormonal changes in the body. Decreased telomere length directly correlated to elevated levels of the stress hormones cortisol and epinephrine.

Stress hormones have specific effects on the body including:

• Narrowing arteries

• Increasing blood pressure

• Increasing blood sugar

• Decreasing insulin sensitivity

These are normal responses that ensure the body has enough energy to cope with a perceived threat. Proper recognition of, and response to, stress is essential to survival but when excessive and particularly prolonged, these stress responses can negatively impact cellular longevity and organismal health.

Health consequences associated with prolonged stress responses include:

• Arterial damage

• Atherosclerosis

• Depression

• Insomnia

• Metabolic syndrome

• Myocardial infarction

• Suppressed immune function

• Type II Diabetesdiabetes

• Weight gain

Researchers also noted that increased levels of anabolic hormones—specifically growth hormone IGF-1 and estrogen—measurably increased telomerase activity. These hormones are activated during the parasympathetic nervous response, a “rest-and-recover” state that is the opposite of the “fight-or-flight” sympathetic nervous response (or stress response) described above. The findings identified a clear correlation between prolonged stress response, decreased telomere length, decreased telomerase activity, increased cellular oxidative stress, and increased incidence of chronic disease. In short, the cellular changes that result from prolonged, chronic stress increase the likelihood of chronic diseases and premature aging.

Application to Bodywork

While there have not been specific studies correlating the effects of massage and bodywork on telomere length and telomerase activity, a good deal of research has investigated the effect of massage and bodywork on the stress hormone cortisol. As assessment measures using saliva and urine rather than blood tests have become more accessible and reliable, data is showing consistent results of decreased cortisol levels with massage therapy application. If there is indeed a positive correlation between lowering cortisol and increasing telomere length and telomerase activity, this provides a solid scientific argument for massage and bodywork improving general health, reducing likelihood of chronic disease, and increasing overall longevity.

Of particular note, this analysis highlights the health benefits of massage and bodywork on a chemical and associated cellular level. Many practitioners are comfortable detailing the positive health benefits of massage and bodywork on a structural level: decreased scar tissue and adhesion formation, increased circulation and tissue mobility, improved range of motion, etc. It can be more difficult to describe the generalized, systemic benefits beyond relaxation or accessing a parasympathetic response. Understanding the relationship between prolonged stress, chemical changes that occur as a result of chronic stress, and the effect on cellular aging clarifies the issue.

Stress is a normal part of life and stress responses are essential to survival. Shifting out of a stress response and allowing the body to rest, repair, and recover is equally essential. Cellular function and longevity suffer when exposed to prolonged stress and this phenomenon is both measurable and repeatable.

Maintaining a constant stress response, while common in our modern lives, is not sustainable. Studies are revealing the effects of elevated stress hormones and correlating these changes to cellular consequences like shortened telomeres and decreased activity of telomerase. Chronic stress is literally prematurely aging people, contributing to chronic diseases and potentially early death. Massage and bodywork is one of many modalities that help shift the body out of that stress response, improving function and longevity on a cellular level. These studies support the anecdotal response we see in our clients every day: calm, content, relaxed individuals who have been reminded what it feels like to be at peace in their own bodies.

Christy Cael is a licensed massage therapist and certified strength and conditioning specialist. Her private practice focuses on injury treatment, biomechanical analysis, craniosacral therapy, and massage for clients with neurological issues. She is the author of Functional Anatomy: Musculoskeletal Anatomy, Kinesiology, and Palpation for Manual Therapists (Lippincott Williams & Wilkins, 2009). Contact her at


1. MBInfo, “What Are Telomeres?” accessed November 2019,