High Levels of Cortisol in The Body
As a registered dietitian, I see many clients who are frustrated with their inability to lose weight. They seem to be working longer and harder in the gym, restricting their calories, and eliminating particular foods or groups, but the scale doesn’t budge and they often find their weight increasing regardless of their proactive efforts. I find that their inability to lose weight is associated with frenetic stressors of unbalanced lifestyles, which have become accepted as normal and there is nothing that can be done to change it. The everyday stressors of “normal” life wreak havoc on our metabolism and health due to chronically high levels of cortisol and poor adrenal gland function. The good news is that with proper diagnosis and just a few simple lifestyle changes the problem can correct itself within a matter of months.
Cortisol is a steroid hormone produced by the adrenal glands in the body in response to normal body function as well as acute stress. Cortisol is life sustaining and is essential for maintaining homeostasis. However, consistently high levels of cortisol in the body can have a host of negative effects on bodily functions including: increased weight, suppression of immune function, disrupted sleep patterns, mood swings, and an increase in inflammation which escalates the risk of chronic disease.
Cortisol is best known for the role that it plays in the fight-or-flight response when the body is exposed to stress. In such situations there is a temporary increase in the production of energy which directly impacts every tissue, organ, and gland function responsible to maintain homeostasis throughout the body. An imbalance in the biochemical and hormonal systems of the body associated with high cortisol result in adrenal gland dysfunction which impacts our ability to manage our 24/7 stress response, regulate blood sugar and insulin levels, as well as maintain our immunity against disease.
Body’s Exposure to Stress – What Happens?
The body does not know the difference between physical (e.g. sleep deprivation, caffeine consumption, pain, and extreme exercise), emotional and mental stress (e.g. marital, financial, and occupational). When an individual is exposed to a stressor, there is an increase in the production of cortisol by the adrenals, which soon leads to a complex hormonal cascade. Cortisol (together with another hormone epinephrine) works to prepare the body for the fight-or-flight situation by flooding the body with glucose, which forms an instant energy source for the large muscles. Cortisol suppresses the production of insulin to prevent the fat from being stored (for the production of energy). While epinephrine increases the heart rate, cortisol constricts the arteries. Both of these cause the heart to pump blood faster and harder. When the stress situation is resolved, hormone levels return to normal. However in today’s fast-paced world it is common to have chronically high cortisol production throughout the day from prolonged stress demands. General symptoms of high cortisol include food/sugar cravings, feeling “tired but wired”, insomnia, and anxiety.
Negative Health Effects Due to High Levels of Cortisol
Imbalance of blood sugar: Cortisol increases glucose levels by utilizing protein stores in the body. One of cortisol’s main functions is to suppress the function of insulin and therefore the body remains insulin resistant when cortisol levels are high. This mechanism increases the individual’s risk for developing Type 2 diabetes.
Weight Gain: Cortisol has the ability to move triglycerides from storage to visceral cells that lie in the deeper part of the abdomen under the muscles. Enzyme action at the cellular level cause larger amounts of cortisol to be produced and the cycle becomes vicious. In addition, cells are starved of glucose due to high cortisol levels which cause the brain to send signals of hunger leading to overeating. Cortisol is also instrumental in modulating other specific hormones that stimulate appetite.
Suppression of Immune System: Chronic inflammation throughout the body due to poor lifestyle choices supports high cortisol levels. Cortisol has an inherent effect to suppress inflammation in the body. Over time, this causes a suppression of the immune system which can lead to a multitude of problems including increased susceptibility to illnesses, increased risk of cancer, gastrointestinal issues and autoimmune diseases.
Gastrointestinal Issues: Cortisol activates the sympathetic nervous system and suppresses the parasympathetic nervous system during times of stress. The parasympathetic nervous system is active during activities like eating and this keeps the related enzymes and hormones working to the best of their capabilities. This can lead to negative effects on the digestive health of the individual.
It’s important to know that healthy adrenal function is especially important in mid-life woman and men when the adrenal glands are responsible for taking over hormone production from the reproductive glands. Progesterone is the hormone that is indirectly responsible for cortisol production, and when cortisol levels are high progesterone levels decrease, which can have a negative impact on overall sex hormone balance and lead to infertility problems in men and woman, as well as estrogen dominance.
Why Saliva Testing?
Salivary cortisol testing is a proven method for the diagnosis of Cushing’s Disease (hypercortisolism) and is preferred over serum or urine testing because of its reliability, convenience, and noninvasive collection of the sample to be analyzed. DHEA-S and cortisol are routinely measured in saliva to determine 24-hour patterns of cortisol production. Steroid hormones in the bloodstream are mostly (95-99%) bound to carrier proteins, and in this form are unavailable to target tissues. Only the unbound fraction freely diffuses into tissues, including the salivary gland. Therefore salivary cortisol is preferred to serum measurements as a reliable indicator of adrenal status because it represents the free, bioavailable hormone levels which represent the quantity of the hormone that is currently available to target tissues and actively exerting specific effects on the body.
If you think high cortisol levels are wreaking havoc on your health and weight loss efforts, it’s time to make lifestyle changes to manage stress more efficiently and develop optimal nutrition and exercise habits. Please be sure to seek the advice of a registered dietitian or other qualified health professional to discuss whether or not you would benefit from having your cortisol levels assessed through saliva testing. It’s time to reclaim your health and live the life you love!