I am sure you have heard of the hormone, cortisol, as it is being blamed for so many issues especially the dreaded “cortisol belly”.  Cortisol is a stress hormone that is regulated by interactions between the hypothalamus, pituitary gland and the adrenals, the so called “HPA Axis”.  You need to realize that cortisol itself is not a bad guy.  We need cortisol and without it we cannot respond to physical or mental stresses appropriately.  It even has a role is stress reduction!  However, excess cortisol long term is a problem.  The higher the cortisol and the longer it is hanging around causes our body to store fat in our abdomen due to an increased number of cortisol receptors found in those particular fat cells.

Excess cortisol can contribute to many issues including:

  • Impairing the brain’s ability to metabolize energy
  • Suppression of immune function
  • Decreased bone mass
  • Muscle weakness
  • Mood changes including depression, aggression and lack of behavioral control
  • Difficulty losing weight with the so-called cortisol belly
  • Insulin resistance
  • Sleep issues/insomnia
  • Irregular periods
  • Low sex drive
  • High blood pressure
  • Heart disease

The HPA axis is key because the signals for the body to make cortisol starts in the brain and follows a circadian rhythm using a feedback loop helping to determine when to release the hormone.  Cortisol starts to spike about 2 hours prior to waking up leading to the highest levels in the morning and then gradually declines throughout the day with the lowest levels being at night, at least this is what is supposed to happen.  When cortisol is high it sends a signal back to the brain that says – hold on, we have enough cortisol now so pause production.  This all works great until we mess it up.

READ ON to learn more about how cortisol dysregulation is affecting you and some tips on how to reset this….

A note on measuring cortisol.  Blood tests are limited in what they can tell you but they can still give you useful information.  Cortisol should be measured fasting before 9am and while you want cortisol in the upper ranges you don’t want them too high.  If they are above the reference range then steps to determine if there is Cushing’s disease will be next.  If you have very low cortisol then you will need further workup for a condition called Addison’s disease.  For the majority of us who have stress induced cortisol changes, the ideal test is a four point salivary test where you check your level first thing in the morning, around lunch, mid-afternoon and bedtime.  This will flush out any abnormal cortisol spikes or excessive drops later in the day.

What leads to high cortisol?  Basically, any type of stress on the system.  Where we get into trouble is when we are in situations that are persistent.

Causes of high cortisol include:

  • Chronic stress
  • Medications: prolonged use of steroids, some asthma medication and arthritis medications
  • Sleep deprivation
  • Sleep apnea
  • Excessive exercise
  • High alcohol/caffeine intake and regular use
  • Severe infections
  • Trauma
  • Obesity
  • Certain tumors creating “Cushing disease”

I want to highlight alcohol use because so many people do not realize this is one of the reasons for their issues.  Daily alcohol use will alter the HPA axis enough to create a cortisol issue!  When you dink alcohol cortisol initially increases, then when you go to bed and effectively stop drinking your cortisol starts to level but your body feels like it is withdrawing (since you are drinking daily) producing even higher than expected levels of cortisol in the morning.  Then when you drink again the next day, initially the cortisol will lower as the withdrawal subsides but eventually leads to higher levels later in the day.  This seesaw type of activity leads to more and more HPA dysregulation leading to many symptoms one of them being sleep disturbances which compound the issue.  Even if you quit drinking, the cortisol can remain elevated for months or even years as a result of this dysregulation!  YIKES. This can make abstaining from alcohol difficult and lead to higher levels of anxiety and mood changes.  Anyone up for Dry February?

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Unless you have Cushing’s disease which is an overproduction of cortisol as a result of a tumor, there are some key things you can do to help lower and create more regulation and restoration of your HPA axis leading to better cortisol levels.

  1. Breathing exercises: An easy example is “box breathing”.  Inhale for 4 counts, hold for 4 counts, exhale for 4 counts and hold for 4 counts and then repeat.  Doing this 3-4 times a day can be very beneficial
  2. SLEEP! I cannot emphasize this enough.  If you aren’t sleeping, you aren’t restoring and your HPA axis will be off and therefore your cortisol levels will be, too. Aim for bedtime before midnight as studies show we repair more when we start our sleep cycle before then and try to get at least 7 hours of sleep a night.  Don’t forget better sleep starts with better habits throughout the day.  Also, if you have sleep apnea or think you might (or better yet, if your significant other thinks you have sleep apnea) then get diagnosed and treat this appropriately and consistently as sleep apnea alone will alter the HPA axis.
  3. Exercise – keep it away from bedtime and don’t overtrain
  4. Laugh, spend time with friends, enjoy your life
  5. Eat a well-balanced diet (diets high in carbs will backfire)
  6. Use a vagal stimulator. You have heard me talk about these before.  Still a favorite so try it!  Head to vagal.com as they have one of the best and unless you have POTS syndrome, use this an hour a night consistently.  It may take 4-6 weeks to start seeing the benefit but many studies have shown some amazing benefits with these devices!  People with POTS need to start around 15 minutes or perhaps less and work up very slowly as tolerated.
  7. Meditation/prayer – anything that helps you relax!

There is a plethora of supplements we use when there is HPA dysregulation but if you don’t do your part to help yourself supplements will only get you so far.  When dealing with high cortisol, supplements that contain calming ingredients like ashwagandha, relora, magnesium, taurine and GABA can all be helpful.  One of our go-to choices is Brain Calm for use twice a day and then pulse in Quick Calm which has GABA as needed.  There are many other products we use if this combo doesn’t help.  Even adding magnesium at bedtime can be a great start.  Remember, if high cortisol at night is interfering with your sleep you have to start by addressing the HPA axis during the day!

To your health,

 

Laura