In this series, the hormone cortisol, a.k.a the stress hormone, has been mentioned several times. Today, I want to spend some time discussing what it is, what role it plays in our bodies, and how to keep its levels in check so that it doesn’t wreak havoc on our bodies.
What is cortisol?
Cortisol is a steroid hormone produced from cholesterol. It is made and released by the 2 adrenal glands located on top of each kidney in response to stress as well as to the natural circadian rhythm.
The biggest complaints that my clients share with me are tiredness, constant feelings of sluggishness, irregular sleep patterns, and blood sugar crashes. All of these symptoms may partly be due to adrenal dysfunction. Therefore, the doctor at our practice orders a saliva test to measure our clients’ adrenal and cortisol levels. The results are compared against the normal curve, which looks like this.
The cortisol levels in healthy individuals basically follow the circadian rhythm (source). It is high in the morning, providing us with the energy to get our day started. By nighttime, levels are low, helping us to fall asleep.
It’s been an eye opener for me, even, to see how many people have dysfunctional patterns - e.g. low cortisol levels in the morning that continue to increase during the day and stay high through the night. No wonder they struggle with getting out of bed in the morning and, equally so, falling and staying asleep come bedtime, despite feelings of complete exhaustion. In severe cases, the body is unable to produce enough cortisol, and its levels just stay low throughout the day (as seen on the diagram above). This phenomenon is what’s often referred to as adrenal fatigue or HPA (hypothalamic-pituitary-adrenal) axis dysfunction (source). Check out this website for a thorough explanation of the HPA axis.
What regulates cortisol?
There are 3 main factors that regulate cortisol - time of day, blood sugar levels, and stress. I want to focus on stress.
While we normally associate stress with feeling overwhelmed, out of control, or anxious, it can also be caused by many other factors, including:
- poor diet (eating too much sugar, skipping meals, drinking too much caffeine, etc.)
- over-exercising
- lack of sleep (staying up too late to watch T.V.)
- food allergies/sensitivities
- exposure to environmental toxins
Simply put, stress is anything that places an extra demand on your body.
What is Cortisol's Role in Stress?
As one of the hormones involved in the “fight-or-flight” response, it allows the body to handle stress and restore homeostasis. While it has many functions, its primary function lies in metabolism and the body's use of carbohydrates, fats, and proteins. Cortisol raises the glucose level in the blood stream so that it can be used immediately to combat the stress. How?
- By increasing energy production
- stimulates gluconeogenesis, a process in which new glucose is made, in the liver
- indirectly assists in glycogenolysis - glycogen that’s stored in the liver or muscle is broken down to glucose
- inhibits insulin from shuttling glucose from the bloodstream into cells by decreasing the translocation of glucose transporters to the cell surface
Cortisol is absolutely necessary for our ability to adapt to the demands of life. But what happens when cortisol is constantly released in our bodies?
Well, it affects the whole body.
Blood sugar imbalances
As I described earlier, cortisol increases the production of glucose, and when its level is constantly elevated, so remain blood sugar levels. To make things worse, cells eventually become insulin resistant due to cortisol’s inhibitory effect on insulin. Eventually, the pancreas can not keep up with the high demand for insulin and the glucose level in the blood remains high. Hello, type 2 diabetes.
Weight gain
This can happen in several ways. Cortisol
- Increases visceral fat storage (found deep under the muscle - e.g. abdomen)
- Facilitates the development of mature fat cells through the action of an enzyme that converts cortisone to cortisol in visceral tissue. So now, along with the adrenals pumping out cortisol, it is also being produced at the tissue level. A double whammy!
- Remember the blood sugar-insulin problem? Blood glucose is unable to get into the cells starving for energy. So what do the cells do? They send hunger signals to the brain, which can lead to overeating.
- Stimulates appetite in two ways
- Binds directly to hypothalamus (the command center) receptors in the brain (source)
- regulates other appetite-stimulating hormones
Fertility
For females, it is of no surprise that when you’re under constant stress, you may see changes in your menstrual cycle (e.g. missed period, spotting, etc.). This can be very problematic if you're trying to conceive. For men, it can cause erectile dysfunction. Too much cortisol production can decrease the production of androgenic sex hormones since they’re produced in the same glands as cortisol.
GI Issues
Remember what I said about our bodies diverting energy and resources to specific areas in order to fight the stressor? Since digestion and nutrient absorption are not critical during this time, the blood gets diverted away from the GI tract. This is why when you eat under stress, you can experience a variety of GI discomforts, including gas, bloating, diarrhea, constipation, ulcers, irritable bowel syndrome, bacterial overgrowth, etc.
Immune system
Have you noticed that when you are constantly stressed out, that’s when you tend to get sick? One of cortisol’s functions is to reduce inflammation in the body. However, when it’s chronically high, its attempts at combating inflammation result in a compromised immune system. This type of person is now at greater risk of developing various illnesses, including cancer, GI issues, food allergies, and autoimmune diseases.
In fact, I work mainly with clients that have food allergies/sensitivities and leaky gut, and it is not surprising that the majority of them have elevated cortisol levels.
Others
Continuously elevated cortisol due to chronic stress can cause numerous other problems, including thyroid disorders, chronic fatigue, depression, the development of cardiovascular disease, and on and on.
How to restore the adrenal glands and reduce cortisol naturally
For most of us, stress has become the norm, and as a result, we don’t even realize that we're putting our bodies through hell. The good news is that chronically imbalanced cortisol levels or adrenal fatigue is NOT a terminal illness. So what can we do?
Diet:
- Eat regularly! This will help prevent those blood sugar crashes and save you from feeling cranky and irritable. Eating every 2-3 hours is highly encouraged. Do not skip breakfast! Snacks/meals should be balanced with a bit of carbohydrate, protein, and fat. No low-carb diet here.
- Fuel up with wholesome, real foods! Take advantage of the fiber, phytonutrients, and antioxidants that only fresh whole foods can provide. Lovingly embrace fresh fruits, vegetables, beans, nuts, seeds, salmon, etc. Say no to prepackaged and highly processed foods with crazy amounts of sugar and eternal shelf-lives.
- Don't be afraid of fats. Check out my previous post, "Stop labeling fat as good or bad."
- Befriend probiotics. Become well acquainted with fermented foods and yogurt. If that’s challenging, consider supplementation. In our gut resides trillions of bacteria. To put it into perspective, that’s 10 times the number of cells in the human body! Studies have shown that not only does our gut microbiota affect the brain but also the HPA axis as well (source).
- Additional supplementation? Maybe. This really depends on the individual. But B vitamins (particularly pantothenic acid and pyridoxine), vitamin C, and magnesium supplementation may be helpful in those with hypoadrenalism. They are important for steroid biosynthesis and secretion and support healthy adrenals. In fact, the highest amount of vitamin C, a powerful antioxidant, is found in the adrenal glands. (source). Magnesium is a cofactor for more than 300 enzymes that regulate a wide array of biochemical reations in the body, including protein synthesis, blood glucose control, and blood pressure regulation. This vital mineral has been found to be significantly lowered during chronic stress (source). As I said, while supplementation may be helpful, do try to get these nutrients from whole foods.
Lifestyle:
- Go to bed! // Be Truly Nourished
- Do restorative exercises like meditation // Karalydon
- Honor your body with your workouts // Delights and Delectables
- Stop the diet mentality // Delicious Knowledge
- Be selfish. Take time for yourself // An Avocado a Day
- 20 scientifically backed ways to de-stress right now // Huffington Post
- Make time for fun. Unplug. Socialize. Read. Dance. Listen to music. Cook. Do what makes you happy!
Surround yourself with wonderful people (and pets). 😉 Smile often! And don't forget to spread the love!
Melissa Burton says
What an excellent post! This is why I love to follow RD's - they talk about the science (and the art) of nutrition.
Your explanation was so well written and easily accessible (although I have to admit that I needed a refresher on the HPA Axis). I'm keeping this as reference for the future.
So glad to have found your site (via Linsday Cotter)!
Traci | Vanilla And Bean says
Thank you for this well written and informative article, Min. Adrenal fatigue can be a difficult issue to resolve. I've struggled with it, and have been working with my Naturopathic Doc to get me feeling great again! I find once I get 'off' it's sometimes so hard to get back to healthy adrenal function, and cortisol plays such a key role. We all have stress in our lives... and especially in today's modern world, our bodies are under an almost constant string of stressors. I want to focus on more of the anti stressors! That is the goal! Thank you again, Min!
Jessica @ Nutritioulicious says
Min, this is such a great explanation of this complex subject. Thanks for putting this post together!
Min says
Thanks, Jessica! You know my tendencies to be super wordy so putting together this post was quite a challenge. #aworkinprogress
Serena says
Wow! I learned so much from this very well-done article! Will be sharing the love this week- I know just a few stress bunnies who could benefit! (:
Min says
Thanks, my sweet friend! Haha I think there are too many stress bunnies running around these days
Katie @ Mom to Mom Nutrition says
Such a great article Min. I seriously read through this twice, enjoying a cup of coffee while doing so. I especially like your last line and picture. Positive people and pets make everything better!! xo.
Min says
Aww thanks, Katie! I tried to pack in as much info as possible without being too wordy, but that was nearly impossible. My husband read it, and halfway through he was like "you lost me." Oops...Yes yes, positivity is def contagious 😉
Alex Caspero says
Amazing article! Can't wait to shared this-and I didn't know you worked with food sensitivities. Do you do LEAP? Would love to chat sometime on how you test for adrenal fatigue and incorporate that into your practice!
Min says
Yea just started to actually. I'm in the process of getting my certification, but I'm working with a doctor who orders all the blood tests. I shall shoot you an email 😉
Lisa @ Healthy Nibbles & Bits says
I always enjoy reading your RD chats because I learn so much from them! Sharing these now!
Min says
Thanks,Lisa! That's so encouraging to hear 😉
Marisa @ Uproot from Oregon says
Just learned so much in reading this. I figured you could test for cortisol levels, but thanks for sharing the nitty gritty! Very interesting. Also: Guess it's time to adopt a puppy so I have some snuggly time and smiles? 😀
Min says
Haha yes yes you must ;). Or you can cuddle with your man. I'm sure he wouldn't mind hehe
rachel @ Athletic Avocado says
Wow there is so many things I didn't know about cortisol! I think everyone should read this! totally sharing it 🙂
Min says
Thanks, Rachel! 😉