Adverse Childhood Experiences: Understanding Your ACE Score + The Link Between Childhood Stress & Adult

Throughout my years of consulting patients in my telehealth functional medicine clinic, I’ve seen firsthand just how much influence your thoughts, stress, and past trauma have on your physical health. Often referred to as the mind-body connection, research is continuing to show us how everything from anxiety to PTSD plays a role in chronic conditions like gut dysfunction and hormonal imbalances.

But one of the biggest pieces of this mind-body connection that is finally getting the weight it deserves is past trauma — specifically traumatic events that occurred during childhood. This period of rapid brain development shapes not only how we think and how we behave, but also how we feel for the majority of our adult lives. And now thanks to emerging research and initiatives like ACEs Aware, there are new ways for us to assess and address this particular type of trauma in your life.

The ACE Score is an essential part of my comprehensive health history intake in my clinic. This evaluation helps to identify traumatic childhood events in order to give us a better understanding of how they may have shaped your current health. Although no single test can give us a complete look into a person’s emotional and mental health struggles, evaluations like this can get you one step closer on your journey to reclaiming your health. Let’s take a deeper look at the connection between Adverse Childhood Experiences, chronic health problems, and exactly what the ACE Score can tell you about your overall health.

What are Adverse Childhood Experiences?

Adverse childhood experiences, more commonly known as ACEs, are potentially traumatic events that happen at any point during childhood before the age of 18. These traumatic events are referred to as adversities, often involving various household challenges, and are broken up into ten categories:

• Physical abuse
• Emotional abuse
• Sexual abuse
• Physical neglect
• Emotional neglect
• Living with someone with mental illness
• Living with someone who struggled with substance use disorder
• Witnessing domestic violence
• Parental separation or divorce
• Having a household member in incarceration

The concept was derived from the CDC-Kaiser Permanente ACE Study — one of the largest public health studies ever conducted on the connection between childhood experiences and its influence on your health as an adult. (1) Using this evaluation, the study looked at the results of over 17,000 adults and found that the higher the ACE Score the higher the likelihood of various health problems such as:

• Heart disease
• Stroke
• COPD
• Cancer
• Obesity
• Depression
• Anxiety disorders
• Diabetes
• Liver disease

The study also found that an ACE score of 4 or more resulted in higher rates of smoking, substance abuse, alcoholism, and attempted suicide.

Understanding your ACE score

ACE scores range from 0 to 10 and measure your level of childhood trauma and your risk of experiencing physical and mental health problems down the road. Every adversity equates to one point, resulting in a score of 0 to 10.

• 0: No reported adverse childhood experiences
• 1–3: Moderate exposure to childhood adversity
• 4-10: Increased risk for chronic health conditions and mental health challenges

While these ranges give us a glimpse into your health history, it’s important to note that it doesn’t give us the full picture of childhood trauma, or your health as a whole. There are other factors to take into consideration like environmental exposures, diet, and genetics. Since the evaluation is just measuring how many different types of trauma you have experienced, it doesn’t take into account the frequency, duration, or severity of the trauma. There are also experiences that aren’t listed here that could also be considered traumatic such as bullying, discrimination, poverty, food insecurity, death, natural disasters, medical trauma, or chronic illness in childhood.

Not only is everyone’s experience unique, people can have varied levels of emotional resilience and protective factors that help them move through traumatic events easier than others. Even so, we do know in functional medicine that the body keeps score, and it can give us a lot of insight into the onset and development of chronic health problems over time. 

Unfortunately, ACEs are not rare. In fact, according to the CDC three out of four high school students have experienced 1-3 ACEs and one out of five have experienced 4 or more. (2) With the rise of chronic health problems, it doesn’t necessarily come as a shock that these ACEs are also more commonplace.

READ MORE: The Science Behind How Toxic Relationships Affect Your Health

How do ACEs impact your health?

It’s easier to understand how ACEs can impact your emotional and mental wellbeing, but how exactly do they change the course of your physical health? In functional medicine, we understand that stress can play just as big of a role, if not more, in your health as what you do or don’t eat. 

Your body is designed to deal with stress, but it is not designed to experience chronic stress that never goes away, often referred to as toxic stress. This prolonged stress response affects nearly every area of your health, as it can influence numerous pathways in your body that can result in a cascade of long-term biological changes.

1. Poor metabolic health

One of the first things I often see affected by chronic stress is a person’s metabolic health. Stress hormones play a role in blood sugar regulation and fat storage, leading to a slew of metabolic consequences. When this happens early in life due to ACEs it can lead to insulin resistance, weight gain, weight loss resistance, and eventually type 2 diabetes. (3)

2. Autoimmune disease

Autoimmune disease is ultimately the end stage of the autoimmune-inflammation spectrum after chronic inflammation has been allowed to run rampant for far too long, altering immune cell activity. Having a history of ACEs, even just one, significantly increases your likelihood of being diagnosed with an autoimmune disease later in life. (4)

3. Gut problems

Your gut and brain are inextricably linked through the gut-brain axis. What affects one, affects the other, especially when it comes to stress. For example, your enteric nervous system (ENS) lives within the walls of your gastrointestinal tract and works directly with your central nervous system to modulate digestion and is involved in your body’s stress response. Chronic stress is bound to mess up this connection with studies showing it is linked to everything from leaky gut syndrome to bacterial dysbiosis. (5,6)

More specifically, multiple studies have directly linked adverse childhood experiences with an increased risk of gut dysfunction. In fact, people with ACEs involving household instability and emotional abuse are twice as likely to develop irritable bowel syndrome and their symptoms are more severe. (7) But that’s just the tip of the iceberg. A recently published study in the International Journal of Environmental Research and Public Health correlated ACEs with changes in the gut microbiome that lasted well into adulthood with side effects like diarrhea and depression. (8) While the connection is still being studied, you can’t deny the evidence that these experiences have a greater impact on our gut health than we once realized.

4. Impaired cognitive function

Your brain is in constant development, with two of the most significant stages happening in childhood. From birth until approximately 9 years old, your brain is going through vital structural and functional changes before it moves into the adolescent phase of development. Which, surprisingly, new research indicates can last until age 32! (9) Any sort of repeated trauma and stress during childhood impacts how your brain forms connections, with research showing that adverse childhood experiences can hinder development in areas of the brain involved in short and long-term memory, emotional regulation, and fear processing. (10,11,12)

5. Generational health

Intergenerational trauma is something that isn’t talked enough about in conventional medicine. As with many things that get passed down through families, like genetic conditions and physical characteristics, trauma can be inherited too — like cellular heirlooms — due to the fact that trauma can literally change the way your DNA expresses itself leading to genetic changes that can be passed down. Ultimately, ACEs can be a trigger for health problems whether you have personally experienced them or not. This is so important to understand, especially when we talk about breaking the toxic cycle of abuse and dysfunction that can happen within families. When you work on healing from ACEs, you are not only advocating for your own health but the health of future generations.

LISTEN: Shame-flammation & Gut Feelings: Trauma, Toxins & Your Nervous System | Dr. Will Cole (Solo Episode)

Natural tools to help navigate ACEs

Everyone’s health case is unique, and so are the exact strategies used to help move through the physical and emotional effects of ACEs. However, I have found these three foundational tools to be the most impactful.

1. Feed your physical health

It is true that your mental and physical health are dynamically influenced by every single bite of food you take. By eating a nutrient-rich diet consisting mainly of clean, whole foods you’ll be fueling your body with the exact things it needs to thrive. From balanced hormones, stabilized blood sugar, enhanced cognitive function, a strong immune system, lowered inflammation, and a healthy gut your meals will help you overcome any physiological dysfunctions happening beneath the surface triggered by ACEs.

Supplements can also be beneficial especially during healing as a way to target any specific nutrients that are deficient and to fuel pathways that are in dysfunction.

SHOP: My supplement duo, Gut Feelings, contains two personally curated supplement blends designed to target both ends of your gut-brain axis — Gut to soothe a damaged and inflamed gut and Feelings, to facilitate neurotransmitter production and overall healthy brain chemistry balance.

From calming effects to adaptogenic support, my Mood Support Stack is also a fantastic holistic companion if you are looking more specifically to support emotional balance and mental clarity. Embrace a brighter mood and a more centered life with this synergistic blend of mood-supporting nutrients like magnesium, ashwagandha, CoQ10, and L-theanine.

2. Reset your nervous system

ACE’s have put your body in a state of “fight or flight” for far too long and the stressors of daily life don’t always help either. Help shift your body towards a parasympathetic state by incorporating mindfulness practices into your daily routine like meditation, breathwork, grounding, gratitude, or journaling.

3. Prioritize therapy

You are not alone in your experiences and you don’t have to navigate them on your own. Working with a trained professional who can help you process your childhood trauma without shame or guilt is often the first step towards emotional and physical healing. Whether you choose traditional talk therapy like CBT (Cognitive Behavioral Therapy) or EMDR (Eye Movement Desensitization and Reprocessing), taking the time to find what works for you is an investment in yourself that you won’t regret.

The Takeaway

While it’s true that adverse childhood experience can significantly impact your health, it is also true that what happened in the past doesn’t have to dictate your future forever. Even though we may not have had the ability to control what we went through during childhood, as adults we can begin to reclaim our mental and emotional wellbeing with the proper therapy, lifestyle changes, and healing tools. In my functional medicine telehealth clinic we specialize in taking a whole-body approach to your health care by focusing on all aspects of your wellbeing — physical, mental, and emotional. 

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe. 

Photo: Unsplash.com

Sources

• Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8
• Centers for Disease Control and Prevention. (2025, September 24). About adverse childhood experiences. U.S. Department of Health and Human Services. https://www.cdc.gov/aces/about/index.html
• Huang, H., Yan, P., Shan, Z., Chen, S., Li, M., Luo, C., Gao, H., Hao, L., & Liu, L. (2015). Adverse childhood experiences and risk of type 2 diabetes: A systematic review and meta-analysis. Metabolism: clinical and experimental, 64(11), 1408–1418. https://doi.org/10.1016/j.metabol.2015.08.019
• Dube, S. R., Fairweather, D., Pearson, W. S., Felitti, V. J., Anda, R. F., & Croft, J. B. (2009). Cumulative childhood stress and autoimmune diseases in adults. Psychosomatic medicine, 71(2), 243–250. https://doi.org/10.1097/PSY.0b013e3181907888
• Madison, A. A., & Bailey, M. T. (2024). Stressed to the core: Inflammation and intestinal permeability link stress-related gut microbiota shifts to mental health outcomes. Biological Psychiatry, 95(4), 339–347. https://doi.org/10.1016/j.biopsych.2023.10.014
• Beurel E. (2024). Stress in the microbiome-immune crosstalk. Gut microbes, 16(1), 2327409. https://doi.org/10.1080/19490976.2024.2327409
• Park, S. H., Videlock, E. J., Shih, W., Presson, A. P., Mayer, E. A., & Chang, L. (2016). Adverse childhood experiences are associated with irritable bowel syndrome and gastrointestinal symptom severity. Neurogastroenterology and motility, 28(8), 1252–1260. https://doi.org/10.1111/nmo.12826
• Kazemian, N., Zhou, T., Chalasani, N., Narayan, A., Cedeño Laurent, J. G., Olvera Alvarez, H. A., & Pakpour, S. (2024). Long-Term Impact of Childhood Adversity on the Gut Microbiome of Nursing Students. International journal of environmental research and public health, 21(1), 68. https://doi.org/10.3390/ijerph21010068
• Mousley, A., Bethlehem, R.A.I., Yeh, FC. et al. Topological turning points across the human lifespan. Nat Commun 16, 10055 (2025). https://doi.org/10.1038/s41467-025-65974-8
• Hawkins, M. A. W., Layman, H. M., Ganson, K. T., Tabler, J., Ciciolla, L., Tsotsoros, C. E., & Nagata, J. M. (2021). Adverse childhood events and cognitive function among young adults: Prospective results from the national longitudinal study of adolescent to adult health. Child abuse & neglect, 115, 105008. https://doi.org/10.1016/j.chiabu.2021.105008
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