From headaches to tight shoulders to refrigerator raids, we’ve all experienced the very-real effects of stress. But its ripple effect doesn’t end with eating an extra cookie or two. In fact, stress can spell major trouble for our overall health.

What Stress Is Normal?

Throughout our evolution, some stress has been necessary—like when we were being chased by lions, for example. In those stressful moments, our bodies flooded our bloodstream with various stress hormones. The hormones increased our energy and pain threshold, and helped us fight—or flee—as fast as possible. Some of the most notable of these chemicals: cortisol, epinephrine (adrenaline), and norepinephrine.

Today this stress response can help us nail a new weight-room PR or run our fastest 5k. In controlled doses, it’s totally normal (and healthy!).

However, what’s not so healthy—although common these days—is to experience a constant trickle of stress for days, weeks, and months on end, explains Rob Danoff, D.O., director of the Family Practice Medicine program at Jefferson Health in Philadelphia.

Many of us feel mentally or emotionally stressed (whether because of work, traffic, whatever) at some point almost every day. Over time, this chronic stress affects us more than we realize, and takes a significant toll on our health. “Many effects are actually very surprising, and you might even call ‘silent,’” Danoff says.

The Health Effects Of Chronic Stress

Below are five of the most unexpected effects of chronic stress—and how to stop them at the source.

1. Constant Illness

Small, acute doses of the stress hormone cortisol can protect your body by signaling the immune system to leap into action. When you lift heavy in the gym, for example, cortisol spikes, letting your immune system know to rush and repair your muscles. However, chronic stress can do the exact opposite, thwarting the body’s normal immune response and leading to increased inflammation, Danoff says.

Related: 7 Supplements That Support Mental Well-Being

In one Carnegie Mellon University study, when researchers exposed people to cold-causing viruses, they found that those experiencing prolonged stress were the most likely to get sick. The researchers believe similar mechanisms could increase risk of asthma, cardiovascular disease, and autoimmune disorders, too.

Strengthen your immune system: In particularly stressful times, prioritize your health. Though it can be tempting to load up on less-than-healthy foods and skip workouts, doing so can compromise your immunity even further, says Minnesota-based exercise physiologist Mike T. Nelson, Ph.D., C.S.C.S. Plus, healthy eating and movement can actually help reduce emotional stress.

2. Jaw Pain

Stress can wreak havoc on your smile. One major reason: teeth grinding, also known as bruxism. In its early stages, bruxism—which typically occurs during the early stages of sleep—can cause you to wake up with a headache, earache, or sore facial muscles, Danoff says.

Over time, it can loosen teeth, aggravate the temporomandibular joints (TMJs), damage existing dental work, and wear down your teeth’s protective enamel, according to the American Dental Association.

Protect your teeth: Since you can’t really control what you do when you’re asleep, dental guards are a common first line of defense for teeth-grinders. However, it can also be helpful to implement a pre-bedtime routine that helps you de-stress and loosen up, Danoff says. Try doing a short meditation (you can use an app like Headspace), yoga flow, or gentle stretching routine.

3. Insulin Resistance

What do stress and insulin have to do with each other? A lot.

Both cortisol and epinephrine tell your liver to produce glucose. This way, if you need to fight or flee, your body has enough blood sugar at the ready to give you energy, according to the American Psychological Association (APA). From there, your body releases insulin to usher that blood sugar into the cells that need it.

When this process repeats over and over, cells become resistant to insulin, and our risk of developing type 2 diabetes increases.

The fact that we often reach for sugary foods when stressed is no coincidence, either. In fact, it’s nature’s way of further jacking up our energy levels, explains Danoff. However, when we don’t need that sugar to escape a lion, this just exacerbates the process.

Keep your blood sugar in check: Fasting blood sugar, a marker for insulin health, is a standard part of annual physicals. If you haven’t gotten your annual check-up, schedule one. If fasting blood sugar comes back high, talk to your doctor about what lifestyle modifications can help lower your type 2 diabetes risk. One important change: stress management, which is nearly as effective as medication in helping people control their blood sugar.

4. Fertility Issues

In both men and women, too-high cortisol levels can interfere with reproductive hormones. In women, specifically, this can even lead to secondary amenorrhea, in which you stop menstruating, Danoff says. In men, sperm and semen concentration, quality, and ability to fertilize an egg decline, according to research from Columbia University.

Care for your reproductive health: Going without a period for three months or having irregular periods for six months both qualify as secondary amenorrhea. “Your gynecologist has seen this all before, so any kind of period irregularity should be brought up,” Danoff says. Reproductive health issues can be hugely stressful, but simply talking to someone and coming up with a game plan can do a lot to eliminate anxiety and get things back on track.

Related: 4 Types Of Foods That Fight Inflammation

Unfortunately, declining sperm quality isn’t as obvious. However, if you and your partner are having difficulty conceiving, consider meeting with a gynecologist, endocrinologist, and/or urologist. Increasing fertility could be as simple as getting more exercise, eating a more anti-inflammatory diet, or cutting down on alcohol.

5. Fitness Plateaus

Though we may refer to it as ‘good stress,’ your body still considers exercise to be stress. “Results happen when your body recovers from that stress,” Nelson explains.

When physiological stress levels are high—whether because of work, family drama, or poor sleep—your body doesn’t get the break from cortisol it needs to recover from exercise. The result: You don’t adapt—or grow stronger, faster, or fitter, he says.

Keep your workouts progressing: To gauge your recovery from stress, monitor your heart-rate variability (HRV). This metric measures the changes in time between each heartbeat, explains Nelson.

Why does that matter? HRV is intricately linked with nervous system function. In fact, a 2018 meta-analysis published in Psychiatry Investigation identified decreased HRV as a consistent marker of increased stress.

To track your HRV, download an app like ithlete. It tests your HRV through your pulse each morning and advises you on how hard you should work out that day based on your current physiological stress levels.

Manage Stress

Because you can’t control traffic jams and toddler temper tantrums, we know that managing stress is often easier said than done. However, eating a healthy, unprocessed diet, maintaining a balanced exercise routine, prioritizing sleep, and having a mindfulness practice (like meditation) all go a long way. Plus, a number of supplements—like l-theanine (an amino acid known for its soothing properties) and magnesium (the mineral that helps the body relax)—can also give your mind and body the zen support they need.

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