Part 8: Stress
Stress (or cortisol) can wreak havoc on our bodies. Alterations in a healthy cortisol rhythm can lead to weight gain, trouble losing weight, poor immune function, blood sugar imbalances, brain fog, chronic fatigue, aches and pains, salt and sugar cravings, insomnia, hormonal imbalances, gastrointestinal distress... you name it. Cortisol and adrenal imbalance are the biggest demons to your health, happiness, and well-being.
Do these questions sound like you?
-Am I constantly tired, even when getting 8-10 hours of sleep?
-Do I feel energized, or worn out after exercise?
-Do I notice blood sugar swings throughout the day or random mood swings?
-Do I wake up in the morning not feeling refreshed?
-Do I need coffee and caffeine to get through the day?
-Do I wake up in the middle of the night?
-Am I “tired but wired” at night?
-Do I get sick often?
-Does my body feel inflamed and puffy?
-Do I feel stressed or have a lot on my mind?
-Do I notice aches/pains, especially in the morning?
-Do I have a craving for salty and/or sugary foods?
-Do I have a sensitivity to chemicals or fragrances?
-Do I have problems concentrating, remembering things, or deal with brain fog?
If you answered yes to any of these questions, then you may have a cortisol imbalance.
How do your adrenal glands and cortisol work? Your adrenal glands sit right on top of your kidneys and are a part of the intricate HPA axis (hypothalamic-pituitary-adrenal axis) that influences your thyroid and hormonal health. They are in charge of secreting hormones like cortisol, epinephrine, and norepinephrine (also known as adrenaline and noradrenaline, respectively). Together, they influence your flight-or-flight response- aka the stress response. The hard truth is that your body can’t distinguish between types of stress, whether it is physical, mental, or environmental. To your body, stress is stress. Whether the stress is intentional (such as dieting, over-exercising, poor sleep, or poor diet quality), or unintentional (such as emotional mental stress, inflammation, or disease/infection), stress will play out the same way physiologically. Long term, any chronic stress not addressed can lead to cortisol, adrenal, hormonal, and digestive imbalances. Now not all stress is bad, and neither is cortisol. Although chronic stress and high cortisol can be devils that wreak havoc on your health, we need cortisol in our bodies. Cortisol is essential for life and can: regulate blood sugar and blood pressure, manage the sleep-wake cycle, maintain immune function, improve insulin sensitivity, impact digestion, respond to stress and danger, decrease inflammation, and regulate digestion, growth, and reproduction. Cortisol is part of the glucocorticoid family in your body (aka- it raises your blood sugar). This is important because it helps to increase glucose levels and release them from the liver in times of stress and starvation when glucose is needed. Your body thrives on glucose. Ever have a terribly rough workout or go hours without eating? Your body pumps out cortisol to signal for more glucose to be released for energy. You need cortisol in your life. Just not too much, or too little. To reiterate- not all cortisol is bad. If you don’t have enough, this can lead to electrolyte imbalances (which can be life-threatening), chronic fatigue, bone loss, hypothyroidism, hormonal imbalances, dizziness, muscle loss and weakness, as well as anxiety and depression.
Chronically high cortisol can:
-Shift your hormone creation and conversion- such as inhibiting ovulation and reducing progesterone secretion, leading to PMS, infertility, or irregular menstrual cycles. The limit does not exist on how high cortisol can wreak havoc on your hormones. Upregulate your regulated androgen and DHEA levels, contributing to acne, weight gain, male pattern hair loss, or PCOS -Impair your thyroid hormone conversion, reducing the amount that is able to be utilized by the cell. It also can inhibit the absorption of thyroid hormones into the cell. Slow digestion and prevent release of digestive enzymes from your stomach, pancreas, and gallbladder, contributing to constipation, food intolerances, gas/bloating, and risk of bacterial overgrowths -Decrease insulin sensitivity and increase insulin output, contributing to blood sugar dysregulation, weight gain, and accelerated aging Accelerate the continued release of glucose from your liver contributing to insulin resistance and weight gain (also leading to acne and blood sugar dysregulation)
-Decrease your immunity and increase risk of illness and infection- causing you to get sick often or decrease your ability to fight illness Impair workout recovery and contribute to muscle and joint pains- making you feel like you got “hit by a truck” (at least that is what it felt like for me!) -Impact mood and motivation – in turn increasing anxiety or depression Inhibit sleep and sleep quality- further contributing to your chronic fatigue Increase cravings for salty and sugary foods, further troubling issues with weight loss
-Increase total body inflammation and decreasing the capability fight and reduce inflammation, which can increase your risk of autoimmune flare-ups, development of chronic disease, and further hormonal imbalances
Low Cortisol and Your Health:
Though you won’t hear about it in conventional medicine, and some conventional doctors may deny its existence, sub-clinically low cortisol levels can be a devastating cause of chronic aches and pains, fatigue, low thyroid, and hormone imbalances. Conventional doctors may not recognize this without the diagnosis of Addison’s disease or an adrenal crisis, however what the author calls “subclinical hypercortisolism” is real, and can be crippling.
Low cortisol levels can:
-Downregulate sex hormone production, leading to total low sex hormones and infertility, -Contribute to low blood sugar and low blood pressure (including orthostatic hypotension or dizziness upon standing quickly), creating energy crashes throughout the day and possible caffeine sensitivity
-Create electrolyte imbalances, leading to alterations in blood pressure, salt and sugar cravings, water retention, increased urination, and heart palpitations
-Decrease immunity and wound healing capabilities
-Worsen chronic fatigue and fibromyalgia- leading to a vicious cycle of low energy, motivation, impaired memory, and chronic pain Increase risk for bone loss- leading to increased fracture risk and osteoporosis
-Disrupt sleep – causing insomnia, abnormal cortisol rhythms, and muscle loss
-Cause weight gain (especially around the abdominal region) or trouble losing weight
-Create exercise intolerance- in which any form of exercise makes you feel worse and worse -Heighten stress, anxiety, and depression
A healthy cortisol rhythm starts with your cortisol awakening response (CAR) in the morning, where cortisol levels should be the highest, and then slowly drops throughout the day, until cortisol reaches its lowest levels in the evening. Your CAR is what kick starts your cortisol production in the morning. It also participates to help scavenge free radicals through a process called apoptosis (aka killing of “failed cells”) and combat inflammation. Ever notice increased aches and pains in the morning that go away in the evenings? This can be tied to a disruption in your CAR, or the lack of one. Your cortisol then steadily drops throughout the day until it reaches its evening low. This low allows for the production of melatonin, which helps you to fall and stay asleep, as well as triggering the secretion of growth hormone. Melatonin is produced by your pineal gland in response to darkness. This production of melatonin can be interrupted by artificial and blue light, which prevents your body from releasing melatonin as well as alter your natural cortisol patterns. Symptoms of low melatonin include insomnia, chronic fatigue, poor immunity, constipation, increased appetite, weight gain, and mood instability.
Cortisol Phases 101
Stage 1- You are a Boss. Getting the job done and high on life. Adrenaline kicks in and some feel the energy bunny effect
Stage 2- You are wired and tired. You start to develop energy crashes midday or blood sugar swings, low motivation, trouble falling asleep or waking up in the middle of the night, poor recovery, and getting sick easily. You may be relying on caffeine.
Stage 3- You are anxious and tired, but pushing through. You may notice extreme morning fatigue, irritability, aches and pains, salt and sugar cravings, exercise intolerance, and brain fog. Caffeine may not do the job anymore or make you feel worse.
Stage 4- You are just plain exhausted. Nothing can get you through the day. Everything hurts and you may be depressed and anxious all the time. You are constantly craving food and salt and gaining weight, especially in your abdominal region.
Top Tips for Adrenal Health:
-Learn to say “No”- if it doesn’t serve you or depletes your life of happiness or impacts your health, cut it out. Including toxic relationships with friends or significant others, and toxic relationships with yourself.
-Ensure you are eating a nutrient-dense diet full of the vitamins and minerals involved in your stress response. These include vitamin C, vitamin D, GABA, zinc, folate, B-12, iron, magnesium, and trace minerals.
-Incorporate healthy fats, various colors from fruits and vegetables, healthy fibers, and lean proteins.
-Avoid too many added sugars, refined grains, and processed vegetable oils, and if you suspect a food intolerance or sensitivity, work with a healthcare professional to help eliminate it. -Remember, high stress causes your body to burn through these nutrients, so you may need more than normal, especially if you have already gotten your body to a place of deficiency.
-Don’t be afraid to go to therapy or counseling. Talking with someone can help you to acknowledge your feelings and emotions, and channel them into energy to help you accomplish your life goals instead of holding you back.
-Focus on sleep and your cortisol rhythms. Start each day with getting into the sunlight as soon as possible, even try taking a walk or using a happy light if you don’t have light upon waking -Don’t skip meals and avoid the use of blue light at least two hours before bed that can block your body’s ability to produce the melatonin you need to go to sleep. Blue light blockers can be excellent to help with this, whether they are glasses or a setting on your phone laptop (or blue light blocking screen for your TV)
-If you suspect adrenal imbalance- test, don’t guess! (the author is a huge fan of the DUTCH Salivary cortisol test or ZRT salivary four point cortisol test).
-Don’t try to self-medicate with adaptogens or CBD oil alone. Be smart and invest in your health and yourself by doing proper testing. You want to make sure your testing involves four points to assess cortisol fluctuations throughout the day, and not just use a single cortisol level via blood test (like many conventional doctors will use to assess). These single blood markers can be helpful in assessing adrenal diseases of Cushing’s and Addison’s, but they will most likely not catch adaptive cortisol or cortisol dysregulation.
-Use adaptogens in a smart way. Again, you need to be using what will help you.
-Practice gratitude. Starting your day with a grateful mindset can set the tone for a positive outlook on the day. Not only that, but your thoughts can either help or hinder your healing. Negative thinking can increase inflammation in your body, preventing you from healing both emotionally and physically. Start your day by journaling, praying, practicing yoga, or going for a walk. Drink a cup of tea (or coffee if your adrenals are able to handle it), and cuddle with your pet (which I hope is a cat- just saying). Journal down your thoughts so that you can recognize, release, and respond to them and your emotions.
-Have an orgasm. Yes, girl- do it. Orgasms can lower your cortisol levels and flood your brain with the happy neurotransmitter oxytocin. Help your brain choose pleasure over stress.
-Learn how to “sloth mode.” Slothing means doing nothing. Being a pure sloth. Slow, relaxed, and recharging. Slothing isn’t just physical- it is also mental and emotional. Silence your phone, sit or lay on your couch, and watch a funny or happy movie. Learn to sloth when you need it and it will become a superpower.
-Detox your social media. If following someone increases stress, self-hatred, or causes comparison to yourself or your body, kindly unfollow or mute the person. You need to do what is best for YOU. If Sometimes a social media detox for a week is enough, other times it may be time to cut it out for good.
-Laugh, cuddle, hug people, and have sex (get that orgasm girlfriend!). Then do it again. Seriously though, this boosts levels of oxytocin in your brain, which leads to feelings of happiness, as well as relaxation. Plus, who needs an excuse to have an orgasm?
-Limit consumption of refined sugars and carbohydrates to help balance your blood sugar. -Focus on smart snacks- always pairing two macronutrient components together.
-Track your heart rate variability (HRV). As previously discussed, this can help you when you may need more rest, relaxation, and recovery.
-Limit your caffeine intake, especially if you are a slow caffeine metabolizer (CYP1A2-1F are slow, while CYPA2-1A are fast). Having caffeine too late in the day can keep you wired at night, affecting your sleep. It can also increase cortisol in your body, which you don’t want when your cortisol levels and adrenals need some love. You don’t need to cut out caffeine cold turkey, but think of weaning yourself down bit by bit. A great goal is keeping your caffeine under 400 mg per day, if possible. If caffeine makes you jittery or causes low blood sugar, it’s a great sign caffeine is not for you.
Supplements for overall adrenal health include: B-vitamin Complex (don’t add to a multivitamin) Magnesium biglycinate: 400 mg/day Vitamin C: 1-2 g/day Omega-3s: 1-2 g/day Vitamin D: 1000-5,000 IU/day, depending on labs (deficiency may need up to 10,000 IU) Zinc: 10-50 mg based on needs, deficiencies, and copper levels, Reishi mushroom: 300-2000 mg/day
