Seems like “detoxing cortisol” is all the rage on social media with a variety of recommendations on how to do this.  It has gotten the attention of traditional medicine which you can imagine discourages this idea of rushing to your doctor’s office to measure cortisol.

READ ON to learn why both points of view have some validity ….

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Let me give you the background about cortisol.  Cortisol is a hormone made in the adrenal glands which are considered your “stress gland”.  This is because when our body is stressed the adrenal glands release your norepinephrine and epinephrine (your fight-or-flight hormones) as well as cortisol and DHEA.  All of these help your body react, be alert and potentially run if needed.  However, when you have too much for too long it can create that tire around your midline that just won’t go away.

Endocrinologists recognize two forms of adrenal issues.

  1. Hypoadrenalism: meaning your adrenals have quit producing these hormones and are underfunctioning. Cortisol is very low as a result. This condition is called Addison’s and is a very serious condition that can create life threatening issues when the body is stressed by anything especially illness.  Additional testing looking at the signal to the adrenal glands is done to help define this by measuring ACTH and the response of the adrenal glands to this signal called a cortrosyn stimulation test.  All of these tests are done using blood work.   Symptoms of this condition include significant fatigue, skin darkening, muscle weakness, weight loss and low blood pressure.
  2. Hyperadrenalism: meaning you are producing too much cortisol. A true hyperproducing state is called Cushing’s syndrome.  When full blown the cortisol will be markedly elevated.  However, this is an underdiagnosed issue because our tests are not very sensitive so will miss early stages.  One of the hallmark tests is to do a salivary test at midnight several nights in a row.  If elevated then this condition is likely.  24 hour urine tests are also utilized as well as a dexamethasone suppression test basically to help identify what type of overproduction.  This can occur from too much signaling (a brain problem) or the adrenal glands going rogue on their own (an adrenal tumor type of problem).   Symptoms of cushing’s include weight gain in abdomen, face (so called moon face), hump on back of neck, bruise easily, purple stretch marks on body as many others.  *it is important to realize just because you have a slightly elevated cortisol level on blood testing does not mean you have cushing’s!

Functional medicine adds in the gray area between complete shut down and overproduction of cortisol.  Social media calls this adrenal fatigue.  This term really isn’t a very accurate term but more of a visual of how chronic stress impacts the body.  The real issue is a HPA axis dysregulation (hypothalamus-pituitary-adrenal).  In simple terms it just means long term stress plays a role in how much hormones our bodies produce and this changes over time with the duration/severity of the stress.  Keep in mind stress not only means what is happening externally with our environment such as family drama but an internal stress like an illness, surgery or burn.

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Regular blood work looking at cortisol and DHEA-Sulfate is easily done and should be done fasting before 9am for the cortisol.  DHEA can be checked anytime.  Cortisol can be in normal ranges and still have HPA dysregulation so blood work is really making sure it is not bottomed out or sky high.  Everything else in between is a gray zone.  This is why doing a four point salivary test is helpful.  NASA helped instigate this test to measure the stress response to the astronauts while in space.  Doing a salivary sample in the morning, around lunch, midday and again before bed gives you a better idea of how you are responding on a day-to-day basis.  This test will help define the dysregulation.  Cortisol should be highest in the morning and gradually come down like a ski slope throughout the day.  If cortisol isn’t high enough in the morning you will be tired when you wake up or have difficulty waking up.  If too high at night you will have trouble falling asleep.  Elevations in the middle of the day can increase anxiety.  Insurance doesn’t cover this type of testing typically so specialty labs are used.  This is why some people with HPA axis dysregulation can feel tired, others feel wired and moods can be all over the place.

Now comes the big question, how do you detox cortisol?

The word detox implies at least to me that the body gets rid of something toxic floating around.  So detoxing cortisol is really not a good term because once cortisol is produced we really can’t get rid of it.  The KEY is to decrease the amount of cortisol being produced, repairing the HPA axis and blunting the effects of higher cortisol on the system which is very excitatory.

Here are 5 tips to help reduce your cortisol:

  1. Meditate: countless studies have proven that meditations helps your stress response and improved outcomes especially when anxiety, sleep and even improving certain health conditions.  Even practicing deep breathing can help.
  2. Sleep: if you aren’t sleeping then you aren’t repairing this HPA axis and the tendency for more dysregulation increases.
  3. Exercise: Careful on this one.  High intensity and vigorous exercise will actually increase cortisol so this is best done earlier in the day.  Gentle walks and stretching all help bring it down.
  4. Healthy diet: decreasing caffeine, hydrating and limiting processed foods are all good for a healthy response.  Limiting ALCOHOL is also important.  You may think you are unwinding with that glass of wine every night when you come home but with consistent use this actually leads to changes in the HPA axis and INCREASES your cortisol….even when NOT drinking!  Yikes!
  5. Supplements: there are so many supplements that can help in this area.  Key calming ingredients include the following:
    1. Ashwagandha
    2. Rhodiola
    3. Lemon balm
    4. Chamomile
    5. Fish oil
    6. L-theanine
    7. Taurine
    8. Combinations of these ingredients have additive affects

Regardless of what you want to call this, long term stress leads to higher cortisol production, dysregulation of the HPA axis resulting in cortisol being produced at times of the day when it shouldn’t be and over time can create some health issues.  Working on lowering your stress and adjusting your lifestyle to lower the production of cortisol is all beneficial!

To your health,

 

Laura