What exactly is cortisol?
Before I start in with the dangers of high cortisol, let’s begin with a good review of what this steroid hormone is and does. Cortisol is a glucocorticoid. It’s produced in the cortex of the adrenal glands.
The adrenals crank it out in response to stress (physical or emotional) and according to natural cycles that tend to correlate with 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 the pituitary glands secretes 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 then breaks 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.
Cortisol Secretion Schedule
Neither cortisol nor ACTH secrete uniformly throughout the day. They both follow a diurnal pattern, with the highest levels being secreted at around 8:00 a.m. After this time, there is a gradual decline throughout the day. Episodic spikes during the day can certainly occur when the body is under stress or when you eat certain foods. (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. However, 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 frequently, 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).
What about specific conditions of cortisol dysregulation?
A quick note about these two conditions. Adrenal stress, with it’s accompanying high cortisol levels doesn’t initially cause much in the way of symptoms. Note: High is more than around 15 ug/dl drawn as the morning, fasting sample with more accurate readings on salivary specimens if issues are suspected.
After a while, though, it takes a toll on quality of sleep (sometimes), energy levels (sometimes) and always on immune system function. It also increases your risk for coronary plaquing, cancer and Alzheimer’s— three real dangers of high cortisol.
Immune dysfunction manifests as more susceptibility 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 inflammation of the brain, causing a higher incidence of brain health issues, including Parkinson’s and Alzheimer’s disease.
I can’t express my concern enough about this over-looked blood test because, again, it puts people at higher risk for coronary artery disease and 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 to those under constant physical stress such as bodybuilders.
I see elevated cortisol levels 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 having brains which “behave” as if they have had head trauma. However, these studies are ongoing, inconclusive 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 (anabolics) this increases your circulating catecholamines (such as adrenaline), and this then amps up cortisol even MORE.
When does adrenal fatigue happen?
Adrenal fatigue occurs when the adrenals are just cranking away, as the person self-medicates the beginning of fatigue with stimulants and caffeine further taxing the adrenals.
At some point, there is an obvious sleep problem and a decrease in energy.
When hydrocortisone, DHEA, and aldosterone (the two other adrenal hormones) 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. Who wouldn’t get a bit depressed quite honestly? Obviously, adrenal fatigue is one of the dangers of high cortisol but trying to get a “regular doctor” to diagnose adrenal fatigue is quite difficult.
When someone at this stage sees 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 AWS consults and patients I have seen in this situation. They come to me with brain fog due to the anti-depressant, fatigue, dizziness, waking up all night, and with a cortisol level in the basement. Luckily this is easy to treat, and I’ll discuss how later in this article. Follow the link for more in-depth discussions about adrenal fatigue symptoms.
What does cortisol affect?
Cortisol influences, regulates, and/or modulates many of the changes that occur in the body in response to stress. These include things like blood pressure and blood sugar levels. Fat, protein and carbohydrate metabolism is physiologically regulated so that the body can maintain adequate blood glucose levels. As mentioned previously, cortisol has firm control over immune responses. It has anti-inflammatory activity. It also activates and alerts our entire nervous system due to being coupled with an adrenaline (epinephrine) release. In addition, 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?
Cortisol helps us deal with stress. How? It shuts down “unnecessary functions,” like reproduction and the immune system, to allow the body to direct its 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, and when stress is chronic, this becomes a problem.
So, what happens during times of stress? Cortisol 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. If you’re an athlete, this is not how you maximize glucose and insulin use. If this occurs, we then 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 feel stress about your finances.
Cortisol partially shuts down the immune system when levels are high. It interferes with T-cell (a type of white cell) production and function, making your body more susceptible to pathogens like viruses, bacteria, and fungi. Ever notice how people who are constantly under stress are also always getting sick? This is the reason.
Cortisol also affects your muscles and bones. Cortisol 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 in use. Period.
“Traditional Medical” Reasons for high cortisol:
A high-level blood cortisol can mean Cushing’s syndrome, a disorder that results from 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 result from 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 both sexes produce in large amounts. 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 subtle changes in what we call the mineralocorticoids.
Mineralocorticoids, such as the most well-known one called aldosterone, modulate the balance of minerals in the cell, most notably 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 possibly 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 arrhythmias.
Finally, in later AF stages, we see cortisol and DHEA go down. Accordingly, this is when fatigue, sleep disturbances and just plain feeling lousy makes the diagnosis obvious for those who are familiar with the syndrome.
A more detailed list of the ravages/the dangers 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 have a stronger correlation to health issues than fat deposited in other areas of the body. Some of the problems 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 cortisol levels?
How to lower your cortisol 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 coloring, hormones, pesticides, herbicides, and antibiotics. All of these things increase the toxic load in the liver which in turn causes added stress to the body. An anti-inflammatory diet plan is ideal. If you cut out 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 which is the production of sugar from non-carbohydrate sources. Therefore, elevated cortisol will increase your blood sugar levels. Eating a diet heavy in starchy processed carbohydrates and sugar further raises blood sugar levels adding to even more weight gain. Here are some dietary rules of thumb to keep those cortisol levels in check:
This is obviously an integral macronutrient. You need to include this in 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 concentrate, boiled eggs, chicken, turkey and wild caught sockeye salmon are great if you are trying to gain muscle and lose fat.
Cruciferous veggies such as broccoli, cauliflower, cabbage and brussel sprouts (my fave!) are quite detoxifying. Ideally, you’d include these at each dinner meal and at lunchtime if possible.
The latest greatest research shows that we Americans need fewer carbs and more healthy fats. Specifically, eating more anti-inflammatory omega-3 fatty acids 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.
Hydration is necessary for all, but especially for those with high cortisol levels. Water will help hydrate cells and detoxify the body.
Limit the caffeine and get rid of other stimulants, as all stimulants are adrenal stressors.
Yes, exercise is indeed one of the best forms of medicine. However, too much exercise at the wrong intensity level can be inflammatory and further exacerbate cortisol levels in those which have already elevated values. Cortisol levels peak about 40 minutes into exercise. Therefore, to lower your levels, 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 powder with l-glutamine to aid with recovery and repair.
Supplements and “routine”:
If you are in the stage where you are cranking out cortisol, a magnesium replacement (magnesium-threonate is best-it’s the only form of magnesium that crosses the blood-brain barrier) and adrenal adaptogenic or glandular support can “rescue” you.
Next stage, we give both adaptogens and glandulars, and add oral Keto-DHEA. Recent research conveys certain aromatherapy blends such as the one we have in our stress relief kit will knock a high cortisol right down.
I use our multi-oil aromatherapy blend for deeper sleep and to keep my cortisol levels down. I have national bodybuilders as clients—all of whom, by definition have cortisol levels over 20. They all use this “S formula aromatherapy blend” with a diffuser.
We also alkalinize the body with an “AF cocktail” daily. What’s that?
It’s simply 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.
However, if someone is this severe, they need an MSH check. Without getting into a big complicated explanation, some cases of adrenal fatigue can be mistaken for a “biotoxin illness.” If someone feels this lousy from a biotoxin such a lyme or mold mycotoxins, they will have lots of immune and hormonal dysfunction.
Low MSH (melanocyte-stimulating hormone) is a hallmark of severe biotoxin illness where hydrocortisone should not be used.
Important Footnote to escape the dangers of high cortisol entirely:
If you are a small business owner, a multi-tasking 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 on this website, and of course, you can also catch me for a quick consultation anytime.