What is cortisol?
Cortisol is a glucocorticoid. It’s also called hydrocortisone. It’s produced in the cortex of the adrenal glands.
The adrenals crank it out in in response to stress (physical or emotional) and according to natural cycles that tend to correlate to circadian rhythms.
It is made from cholesterol. It’s synthesis and release is controlled by ACTH (adrenocorticotropic hormone) released by the pituitary gland.
The adrenal glands are controlled via the HPA (hypothalamus-pituitary-adrenal) axis.
There is a negative feedback loop which controls the amount of adrenal hormones secreted under normal circumstances.
The HPA axis adjusts cortisol levels according to the body’s need via ACTH that is secreted from the pituitary gland in response to signals from the hypothalamus.
When ACTH binds to the walls of the adrenal cells, a chain reaction occurs. It leads to the release of cholesterol where it is made into pregnenolone, the initial hormone in the “adrenal cascade.” Pregnenolone is then broken down into progesterone and (primarily) cortisol. The cortisol is then released into the blood stream and eventually makes it’s way back to the hypothalamus.
Neither cortisol nor ACTH are secreted uniformly throughout the day. They both follow a diurnal pattern, with the highest levels being secreted at around 8:00 a.m. in the morning. After this time,there is a gradual decline throughout the day. Episodic spikes during the day can certainly occur when the body is stressed or when certain foods are eaten. (Think caffeine,for instance). Your levels are at their lowest (during normal circumstances) between midnight and 4:00 a.m. It’s crucial for your adrenal glands to secrete more cortisol in response to stress. But on the flip side, it’s also crucial that both cortisol levels and associated bodily functions return to normal following a stressful event.
Due to our hustle-bustle, high-stress culture, our stress response is activated so often that our bodies often don’t have the chance to return to normal.
This can lead to health problems resulting from too much circulating cortisol (adrenal stress) and/or from too little cortisol if the adrenal glands become chronically fatigued (adrenal fatigue).
A quick note about these two conditions-adrenal stress, with it’s accompanying high cortisol levels (high would be more than, say 15 ug/dl drawn as the morning, fasting sample-with more accurate readings on salivary specimens if issues are suspected) doesn’t cause much in the way of symptoms.
But it takes a toll on quality of sleep, sometimes, on energy levels (also sometimes) and always on immune system function. And coronary placquing and risk of cancer and Alzheimer’s-just to get your attention and hold it.
Immune dysfunction manifests as more suseptibility to colds, for example and a higher incidence of auto-immune diseases, including the “quasi” auto-immune condition called “leaky gut.” Long term, cortisol elevations cause neural inflammation and a higher incidence of brain health issues, including Alzheimer’s which we now know often starts as losing short term memory.
It also puts people at higher risk for coronary artery placquing and for most types of cancer.
Populations at high risk for these maxed out cortisol levels range from those with chronic mental stress such as corporate CEO’s and stock traders and those under constant physical stress such as bodybuilders.
I see elevated cortisols in these three populations ALL the time and am just waiting for someone to study it!
There have been suggestions in the literature that bodybuilders are more prone to trauma-like brains in later life, but these studies are ongoing and there is no speculation that I’ve read which postulates WHY this is. I firmly believe it’s due to all the untreated high cortisol levels with perhaps some microvascular issues due to high blood pressure and cholesterol issues. Remember, if you are taking AAS’s -this increases your circulating catecholamines (like adrenaline) and THIS amps up cortisol even MORE.
Adrenal fatigue occurs when the adrenals are just cranking away, with the person self-medicating the beginnings of fatigue with stimulants and caffeine which further tax the adrenals.
At some point there is a noticeable sleep interferance and a noteable decrease in energy.
When hydrocortisone and DHEA and aldosterone levels finally just “poop out” someone can be severely exhausted.
At this stage of adrenal fatigue someone is sleep deprived, unable to work out and starts getting depressed.
Then, when they see a doctor who is not versed in how to recognize adrenal fatigue, they receive a prescription for an anti-depressant. You would not believe how many patients I have seen where this is the case. They come to me with brain fog due to the anti-depressant, with fatigue, dizziness, waking up all night, and with cortisols in the basement. Luckily this is easy to treat and I’ll discuss how in another section of this article.
Hydrocortisone influences, regulates and/or modulates many of the changes that occur in the body in response to stress. These include things like blood pressure, blood sugar levels as well as fat, protein and carbohydrate metabolism to maintain blood glucose. As I just mentioned, it has a firm control over immune responses. It has anti-inflammatory activity. It activates and alerts our entire nervous system as it is coupled with adrenaline (epinephrine) release. It regulates heart and blood vessel tone and contraction/relaxation responses. It has a role in energy, sleep, mood, anxiety levels and more!
What exactly does cortisol do?
Hydrocortisone helps us deal with stress. How? It shuts down “unnecessary functions”, like reproduction and the immune system, to allow the body to direct it’s energy towards dealing with the presented stressor. These functions are supposed to be short-lived, just long enough to deal with the stress. However, our modern lives are full of stress-when stress is chronic this becomes a problem.
So, what happens during times of stress? Hydrocortisone stimulates new glucose production (gluconeogenesis) in the liver, using amino acids, and other compounds.
Cortisol is also involved in the breakdown of glycogen stored in the liver and muscle cells (glycogenosis).
It inhibits insulin from shunting glucose into cells by decreasing the translocation of glucose transporters.
Think about it-especially if you’re an athlete (a bodybuilder as the best example) who wants to maximize glucose and insulin useage.
All of this means we have a lot of glucose just “floating around.” This is a wonderful thing if you are escaping a grizzly bear. It’s not so great if you’re stressed out about your finances.
Hydrocortisone partially shuts down the immune system when levels are high. It interferes with T-cell production and function, making your body more susceptible to pathogens like viruses, bacteria and fungi. Ever notice how people who are constantly stressed are always getting sick? This is the reason.
Muscles and bones muscles are also affected by all of this. Hydrocortisone is “catabolic.”
It inhibits the uptake of amino acids into muscle cells, making it pretty much impossible to fuel muscle cells.
It also inhibits bone formation and decreases intestinal calcium absorption.
When cortisol is high, there’s no bone growth and no muscle growth unless exogenous steroids are being used. Period.
“Traditional Medical” Reasons for high cortisol:
A high level blood cortisol can mean Cushing’s syndrome, a disorder that can be caused by overactive adrenal glands, or an adrenal gland tumor. Rarely some types of cancer will elevate cortisol levels and so can long-term use of high dose synthetic corticosteroids. A high blood cortisol level can be caused by severe liver or kidney disease and hyperthyroidism. Even things like obesity and depression can cause it. Bodily stress such as recent surgery, illness, injury, or whole-body infection (sepsis) can cause high cortisol levels.
What happens to our body when it’s under stress?
First, we see hyper-secretion of the flight-or-fight hormones cortisol and epinephrine (adrenaline). Next we see hypersecretion of DHEA. DHEA is a weak androgenic hormone that is made in large amounts in both sexes. DHEA, together with testosterone and estrogen, are made from pregnenolone which is elevated in the early stages of what we call “adrenal stress.” Next we will see suble changes in what are called the mineralocorticoids.
Mineralocorticoids, such as the most well known one called aldosterone, modulate the balance of minerals in the cell, noteably sodium and potassium.
It thereby regulates our blood pressure and the fluid in our bodies.
Stress increases the release of aldosterone, causing sodium retention (leading to water retention and possible high blood pressure).
It also leads to the loss of potassium and magnesium in the early stages of adrenal fatigue.
Magnesium is involved in 300+ enzymatic reactions in the body. When the body lacks magnesium, you can suffer from cramps to cardiac arrythmias.
Finally, in later AF stages we see Cortisol and DHEA go down-this is when fatigue, sleep disturbances and just plain feeling lousy make the diagnosis obvious for those who are familiar with the syndrome.
A more detailed list of the ravages of high cortisol:
Impaired cognitive performance/ Dampened thyroid function/ Blood sugar imbalances, such as hyperglycemia/ Decreased bone density/ Sleep disruption/ Decreased muscle mass/ Elevated blood pressure/ Lowered immune function/ Slow wound healing/ Increased abdominal fat.
Note that increases in abdominal fat has a stronger correlation to health issues than fat deposited in other areas of the body. Some of the issues are heart attacks, strokes, higher levels of “bad” cholesterol (LDL) and lower levels of “good” cholesterol (HDL). YIKES! Why would you NOT want to know and control your “cort” levels????
How to lower your “cort’ levels:
Your focus should be on REAL food. Limit or avoid fast foods and other highly processed foods. Go organic and Non-GMO. Avoid preservatives, dyes, food colorings, hormones, pesticides, herbicides and antibiotics. All of these things just plain increase the toxic load to the liver which in turn causes added stress to the body. An anti-inflammatory diet is ideal. If you cut out the sugars and starches the foods you eat will act as natural appetite suppressant foods so if you are looking to drop fat pounds, it will happen a lot more easily eating “right.”
Recall that cortisol causes gluconeogenesis- the production of sugar from non-carbohydrate sources. Therefore, elevated cortisol will increase your blood sugar levels, right? Eating a diet heavy in starchy processed carbohydrates and sugar further exacerbates elevated blood sugar leading to increased fat around the waist line as well as weight gain. Here are some dietary rules of thumb to keep those cortisols in check:
Protein: This is obviously an integral macronutrient. It needs to be included at each meal to help stabilize blood sugar and improve immune function. Organic, free range, grass fed-you know the routine-proteins from animal sources will limit hormones, antibiotics and inflammatory fats. High BCAA proteins like whey concentrates, boiled eggs, chicken, turkey and wild caught sockeye salmon are great if you are trying to gain muscle and lose fat.
Non-starchy vegetables: Cruciferous veggies such as broccolli, cauliflower, cabbage and brussels sprouts (my fave!) are quite detoxifying. Ideally, you’d include these at each dinner meal and even at lunchtime when able, as well.
Fats: The latest greatest research shows that we Americans needs less carbs and more healthy fats.
Specifically eating more omega-3 fatty acids are anti-inflammatory and help counter the inflammatory effects of cortisol.
Take omega 3 fish oils rich in DHA and EPA (at least a 3:1 DHA to EPA ratio) and eat omega-3 rich foods like wild-caught sockeye salmon, sardines, and chia seeds into your daily diet.
Water: Hydration is needed for all, but especially for those with with elevated cortisol levels. Water will help hydrate cells and detoxify the body.
Stimulants: Limit the caffeine and get rid of other stimulants other than a little tea, as all stimulants are adrenal stressors.
Exercise: Yes-exercise is indeed one of the best forms of medicine, but too much exercise at the wrong intensity level can be inflammatory and further exacerbate cortisol levels in those with have already elevated values. Cortisol levels peaks about 40 minutes into exercise, therefore to lower your “cort” you need to limit cardiovascular activity to less than 40 minutes, 2-3 times per week.
Sorry, bodybuilders,you need to tone it down too. Workouts with weights need to dial down in frequency and intensity. I also recommend increasing rest times between sets and decreasing both sets and rep range. Don’t forget to include BCAA bodybuilding powder with l-glutamine to aid with recovery and repair ( it also decreases DOMS-great muscle soreness relief) and mitigates loss of lean body mass. I would also add acetyl-l-carnitine for a host of reasons you can read about, including muscle mass but also “for your brain.”
Supplements and “routine”:
If you are in the stage where you are cranking out the cortisol you can be “rescued” with magnesium replacement (Mag-threonate is best-only one that passes blood-brain barrier), and adrenal adaptogenic or glandular support.
Next stage, we give both adaptogens and glandulars, add Mg+ and relaxation with Epsom salts baths, or even topical Magnesium and oral Keto-DHEA. Lately it has been demonstrated that certain aromatherapy blends such as the one we have in our stress relief kit (all products 15% off) will knock a high cortisol right down-best used with a diffuser.
I use this for deeper sleep and to keep MY cortisols down. I have national bodybuilders as clients – all of whom, by definition have cortisols over 20-HIGH-who also use this S formula with a diffuser.
We also alkalinize the body with an “AF cocktail” daily. What’s that?
It’s just a glass of filtered water, a pinch of baking soda and for taste you can put in a packet of stevia and a squeeze of lemon or lime if you want. In super severe cases where someone has no energy, is not sleeping and cortisol and DHEA are both low, someone needs bioidentical hydrocortisone. This is a super-prevalent issues for those under mental and or/physical strain and if not salivary cortisols, EVERYONE needs a first-thing A.M. fasting cortisol done.
If you are a small business owner, a multi-taking mom, a corporate CEO-type or a high level athlete (especially if you’re a bodybuilder) this is likely you.
I see case after case where that elevated cortisol turns into a need for a special adrenal fatigue diet and adrenal fatigue supplements. All of the information you need about treating AF is in this website and of course you can also catch me for a quick consultation anytime.
Speaking of consultations, if you need to talk to me about your symptoms and are sure you have adrenal fatigue just take a look at the adrenal fatigue treatment kit.
All products are 15% discounted, and you receive a 10% lifetime products discount too. And you also receive a free optional consultation with me! So there is no need for you to wonder or to question- check out the kit, chat me up and do what you need to do to feel and perform at your peak!
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