Cortisol Dysregulation: Chances Are You Have It
Your Health May Be At Risk
Cortisol Dysregulation: Chances are you have it
Your Health May Be at Risk
By Dr. C.M. Curtis
6/29/24
It’s a stressful world, sometimes even a scary one. Much is often expected of us and sometimes it’s hard to perform all the tasks and accomplish all the things that are required of us. In short, life can get overwhelming.
And cortisol can become dysregulated.
Cortisol is a steroid hormone produced by the adrenal glands and adipose (fatty) tissue. It is the body’s primary stress hormone, acting on different parts of the brain to control different emotions.
Below is a list of some of the functions of cortisol in the body:
Has a huge impact on mood. It also affects motivation and fear.
Controls blood pressure
Suppresses inflammation
Prevents low blood sugar
Boosts energy during stressful times
Manages metabolism of proteins, fats, and carbs
Controls sleep/wake cycle
Having an occasional elevation of cortisol is not a problem. It’s chronic cortisol dysregulation that causes so many health problems—some of them very serious.
The following is a list of some of the problems that can be caused by cortisol dysregulation:
Facial weight gain (moon face)
Abdominal weight gain (central obesity/belly fat)
Fatty deposits around the shoulder blades
Increased appetite with a preference for high glycemic, high caloric foods
Sugar cravings
All the components of metabolic syndrome
Cardiovascular disease
Increased blood pressure
Increased blood sugar
Type 2 diabetes
Low sex drive
Depression
Anxiety
Insomnia
Low energy
Reduction of growth hormone production
Inflammation
Thinning hair on the scalp
Increased body hair, primarily in women
Weakened muscles in thighs and upper arms
Purple abdominal stretch marks
Weakening of bones
Many more
Loss of muscle and bone mass
Because cortisol is catabolic (as opposed to anabolic), if you are trying to build muscle, elevated cortisol will fight against you It can actually reduce muscle mass, as well as bone mass. At the same time, fat will accumulate, especially on your belly and face.
There can be a definite overlap between symptoms of cortisol dysregulation and symptoms of
hypothyroidism and menopause. Sorting this all out can be challenging because cortisol dysregulation can depress thyroid function and aggravate menopausal symptoms. It can also cause blood sugar dysregulation which can cause multiple symptoms and even result in type 2 diabetes.
As a result, cortisol dysregulation is often misdiagnosed as something else and is left completely untreated.
Testing Cortisol Levels
Some health professionals will use blood tests to check their patient’s cortisol levels.
Continue reading and I will explain why the results of a single blood draw are diagnostically useless, and why blood testing is not the best way to check cortisol levels.
Cortisol is released in a pulsatile manner. Different amounts of it are released into the blood at various times during the day. Blood levels of cortisol can fluctuate drastically from morning to night. Under normal circumstances, cortisol levels go down at night so we can sleep and begin to rise in the early morning so we can wake up and be alert when we start our day.
In other words, sometimes blood cortisol levels are supposed to be at a low level and sometimes they are supposed to be higher.
Another thing to consider is that it is estimated that blood cortisol levels can go up as much as nine hundred percent during a stressful event.
Doing a blood draw to check the level of cortisol will only give a snapshot of where cortisol is at that exact moment.
Furthermore, blood tests for the steroid hormones (of which cortisol is one) are not able to isolate the free portion of the hormone (which is the biologically active portion) from the protein-bound portion (which is not fully biologically active). The free portion of a hormone is estimated to be only between one and ten percent of the total amount of that hormone in the blood at any given time.
There is a Better Test for Cortisol Levels
In my opinion, saliva testing is a far more accurate way to test cortisol levels. Here’s why:
Saliva tests detect the level of the free, biologically active portion of the cortisol in the body.
The patient has the test kit at home with several sample vials and is able to take samples at intervals throughout a twenty-four hour period, thus providing information regarding the fluctuations of cortisol, as well as an average. This is truly useful information as compared to a blood draw which is only a snapshot.
No needles are involved in saliva testing, thus eliminating the possibility of a surge of cortisol caused by fear of the needle and/or the stress of ‘white coat syndrome.’ Sometimes just driving to a clinic, and being in that environment can cause cortisol to go up.
Saliva testing is highly accurate.
(As an aside, the above information on testing applies to all the steroid hormones—the estrogens, progesterone, testosterone, DHEA, etc.)
Hair Analysis Hormone Testing
Hair analysis is another form of testing that can be very helpful, giving a longer-term average of cortisol levels than either blood, saliva, or urine testing.
Urine Hormone Testing
Urine testing is another method of testing cortisol levels. It is a good adjunct to saliva tests, as it tests the metabolites of the hormone which is information that is valued by many clinicians. However, I personally do not feel that urine tests can replace saliva tests for cortisol and sex steroids.
Cortisol and Menopause
It’s a well-known fact that cortisol interacts with other hormones. Studies have shown that cortisol dysregulation may cause early menopause and that regulating cortisol levels may help ameliorate menopausal symptoms.
Cortisol and the Thyroid
A study published in the medical science journal Cureus, on Dec. 15, 2023, makes the following statement:
“The study's results emphasize the complex interaction between cortisol and thyroid function, suggesting a direct relationship between serum cortisol and TSH levels in hypothyroidism. Patients with severe hypothyroidism exhibited elevated cortisol concentrations . . . “
Other studies have shown a connection between elevated cortisol levels and low thyroid function (hypothyroidism). It is clear that elevated cortisol levels can put the thyroid into a state of decreased activity.
Cortisol and Obesity
In an article published in the medical journal Obesity (Siver Spring) in April 2018, the authors make the following statement: “. . . higher cortisol, insulin, and chronic stress were each predictive of greater future weight gain.”
Keeping in mind that excess cortisol can cause all the health problems that are the components of metabolic syndrome, it is interesting to note that those same health conditions can cause an increase in cortisol production. Does that sound like a vicious cycle to you?
Cortisol and Leptin
I have written about leptin in other articles, particularly those concerning weight loss. Leptin levels and leptin resistance have a huge impact on weight control and obesity in humans.
How leptin functions in the body is extremely complex, and we are not even close to fully understanding it. We do know, however, that leptin is primarily produced in white adipose tissue (fat) and that it communicates with the brain, telling the brain when the body has adequate fuel. The brain then does two things: It tells the body to stop eating (decreased appetite) and it stimulates the metabolism so more calories will be burned. But, when there is a state of leptin resistance, the brain does not receive the message and it thinks the body is starving. It thinks you need more food, so it lowers the metabolic rate and stimulates the appetite. Now, you are consuming more calories and burning fewer. This results in stored fuel in the form of fat deposits on the body, and a very frustrated person. Sound familiar?
Glucocorticoids (cortisol is one of them) stimulate the release of leptin from fatty tissue, while at the same time reducing leptin sensitivity in the brain. This can result in leptin resistance. I suspect this apparent contradiction is related to the amounts of glucocorticoids present in the blood. It may simply come down to what we already know: too much cortisol causes too many problems.
Cortisol and Leaky Gut
High cortisol levels can trigger leaky gut syndrome, causing systemic inflammation, another causative factor for leptin resistance, and many other health problems.
Cortisol dysregulation is just another example of how the modern diet and lifestyle are causing an epidemic of obesity and chronic disease.
Healthy wishes,
Dr. Curtis
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I found Cortisol Dysregulation: Chances Are You Have It in Long Life, Healthy Life incredibly insightful! The detailed exploration of cortisol’s impact on various health issues was enlightening. The section on testing methods for cortisol levels was particularly helpful. This is a must-read for anyone interested in understanding and managing their stress hormones better.