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Health Issues

Cortisol, our stress hormone

Interesting how we learn in layers. In my pursuit of understanding as completely as I can how the body works, first I learned how we can develop health complaints by eating the wrong foods, exercising too little or too much, and not getting enough sleep. But the reason our lifestyle is so fundamental to our health is because everything we do - every mouthful of food, every bout of exercise or lack thereof, every thought and emotion we have, as well as how much light or darkness we expose ourselves to has a hormonal consequence in the body. Because an imbalance in one hormone affects the others, poor lifestyle choices have far-reaching impacts on our systems, and cause widespread, seemingly unrelated symptoms.  For example, we may get insomnia or feel lethargic a lot, we may put on weight and be unable to lose it no matter how much exercise we do, we may become depressed, we may feel too hot or too cold a lot, if female, we may have difficult periods and the worse our hormone balance is the worse our symptoms at menopause. AND it works the other way! If our hormones are off, we crave particular foods (usually the ones that will make us worse), we are not tired at night so we don't want to go to bed, we feel down so we start thinking thoughts that bring us further down.  If we don't improve our lifestyle in order to bring our hormones back into balance, over time we may get a disease. So, because of how vital hormone balance is to our health, I have become fascinated by the endocrine system, a topic I found hopelessly boring in physiology class way back when.  I am no expert in this, so any endocrinologists or biochemists out there reading my tips, if you see a mistake please let me know so I can correct it.

We have four endocrine glands that spit out hormones as needed - the thyroid, the pancreas, the ovaries/testes, and the adrenals. The thyroid puts out T4, the pancreas is responsible for insulin, the ovaries and testes give us our sex hormones, and the adrenals put out adrenaline otherwise known as epinephrine, aldesterone and cortisol. After a woman has gone through menopause and the ovaries are out of commission, the adrenals also make estrogen and progesterone although in lesser amounts.  All of these hormones interact with each other, so if one hormone is out of whack it affects the amounts and functions of all the others. The endocrine glands not only communicate amongst themselves, but they also talk to the nervous system and the immune system as was scientifically proven by Dr. Candace Pert.

Because in my estimation, problems with cortisol are the most common and underlie so many health complaints, I figure it is the best place to start. As I have said in many other tips, cortisol is the hormone that gets secreted when we are under physical, emotional and spiritual stress. Physical stress includes acute stressors like a car accident or medical emergency, and chronic stressors like constant pain, poor nutrition or food sensitivities, dehydration, too much or too little exercise, too little sleep. Emotional stress is usually chronic and includes stuff like financial stress, relationship stress, work stress, time stress, and spiritual stress may include things like conflicts between one's religion and one's sexuality, one's choice of life-partner (different religion possibly), or one's occupation. No matter what the source of stress, cortisol is released into the blood stream to help us cope by increasing sympathetic tone (fight and flight response), and to put sugar into the blood stream so our muscles and brain have the fuel needed to react. When we look at that list, it becomes pretty obvious why so many of us may have problems with cortisol!  Cortisol should be high in the morning, but should subside by evening when our rest and repair system (parasympathetic system) is supposed to take over.

Cholesterol is the base material  from which many of our hormones are made.  Cholesterol gets converted into pregnenalone, which then manufactures cortisol, T4 (thyroxine), estrogen, progesterone, DHEA and testosterone.  So, when cortisol is needed to help us cope with stress, cortisol gets prioritized at the expense of the other hormones.  Your body figures that if you are under stress, reproduction is not important, so progesterone and DHEA (which builds testosterone) are sacrificed to make cortisol, for example.  This causes major PMS symptoms in females, as progesterone is needed to balance estrogen.

Adrenal fatigue eventually occurs if one is under prolonged stress. In Stage 1, cortisol and DHEA levels increase, but if the stressors don't go away and one moves into Stage 2 adrenal fatigue, cortisol levels remain high, but DHEA becomes depleted. Finally in Stage 3, the adrenals give up. They simply cannot sustain the prolonged need for cortisol, so both cortisol and DHEA levels drop. At this point, one can't handle much. These people often can't work, and after one short activity or appointment they are done for the day and have to go home and rest.  Frequently the diagnosis of chronic fatigue or fibromayalgia is given.

So can you see that taking sleeping pills to help one sleep, taking Midol to relieve PMS symptoms, taking stimulants like caffeine and sugar to get through the day, Synthroid for low thyroid, or anti-depressants to boost mood may really only be addressing symptoms of problems with cortisol, but not the cause?  By removing various stressors through improving the lifestyle factors described in these tips, one can help the body return to hormonal balance.  Using functional medicine to measure circadian cortisol, DHEA, and sex hormones, interventions can be made to help the body return to homeostasis.

Much of the info in this tip came from Bev Maya, a medical herbalist in the Vancouver area that practices functional medicine.

Related Tips
How hormones, neurotransmitters and steroids work
Mind and body; psyche and soma
Adrenal Fatigue
Acute vs. chronic stress

Lecture by Bev Maya, Westcoast Women's Clinic, July 11, 2007
Wilson, James Adrenal Fatigue, 21st Century Stress Syndrome Smart Publications, Petaluma, CA 2001.
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Laugero KD.Reinterpretation of basal glucocorticoid feedback: implications to behavioral and metabolic disease. Vitam Horm. 2004;69:1-29.
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Adrenal and Metabolic Interpretive Guide, Biohealth Diagnositcs Inc. 2006
Chronic Stress - The Number 1 Source of Illness
Chronic Stress Response Chart
Steroidal Hormone Pathway Chart

Copyright 2007 Vreni Gurd