Cortisol: The Good, the Bad, and The Chronically Stressed

Cortisol 101

Cortisol is truly the Goldilock’s hormone. These days, it tends to get a bad rap as most people blame it as the cause of their stubborn weight gain (which is important to consider, along with other thyroid, estrogen, nutrition, and lifestyle).

But the truth is that cortisol is absolutely necessary for life. We all need cortisol, but too much or too little can be bad. As with many hormones, optimization lies in finding balance.

Cortisol is a steroid hormone released by the adrenal glands. It’s considered part of the glucocorticoid family, meaning one of its primary functions is to increase blood glucose (sugar).

There are two main disease states related to cortisol imbalance: Addison’s and Cushing’s.

Cortisol excess is known as Cushing’s. It can be primary or secondary, depending on whether the excess is being made in your body or coming from an outside source (like pharmaceuticals).

Cortisol deficiency is known as Addison’s disease. People on this end of the spectrum get sick a lot and have little ability to adapt to stress.

But most of us fall somewhere in the middle of these categories. It’s all about balance.

The Delicate Dance of Cortisol Production

Cortisol is primarily produced under situations of high stress. Ideally, it should rise and fall fairly quickly, as the person is able to respond to and resolve the stressor.

But today, many of us fall into the category of “chronically stressed”, which means that cortisol levels never entirely go back to baseline.

Chronic stress is where cortisol goes wrong. In a chronically stressed patient, we see all the “good” things about cortisol turn into “bad”. Much of the work we do with these patients revolves around reducing the stress response and treating the negative impacts that high cortisol has had on the body.

10 Ways Cortisol is Good… Or Bad

The following are 10 primary functions of cortisol and circumstances where cortisol production is helpful or harmful.

• Cortisol promotes the release of glycogen from the liver as glucose and stimulates the liver to make more glucose

  • Good when: you need quick energy to your muscles to run away

  • Bad when: you’re under chronic stress and your liver is constantly releasing glucose, leading to chronic high blood sugar, insulin resistance, and diabetes

• Cortisol releases amino acids from the liver to be converted into glucose

  • Good when: again, more fuel for fight or flight

  • Bad when: another blow to insulin sensitivity and possible insulin resistance

• Cortisol creates fat deposits in the abdomen

  • Good when: we need extra fat to survive a famine

  • Bad when: there isn’t actually any famine

• Cortisol increases breakdown of bone to release calcium into the bloodstream

  • Good when: you need extra minerals for your muscles to function

  • Bad when: it weakens the bones over time

• Cortisol excites your nervous system

  • Good when: you need heightened perceptual abilities

  • Bad when: can create anxiety, irritability, and other unfavorable moods

• Cortisol increases antibody production

  • Good when: ready for infection if you are injured during a fight

  • Bad when: over time, the ability to produce antibodies reduces, and your immune system response drops

• Cortisol increases levels of circulating neutrophils

  • Good when: you need to fight an active infection

  • Bad when: increases the chance of developing ulcers

• Cortisol suppresses the immune system

  • Good when: you need those resources for “fight or flight"

  • Bad when: immune system function is decreased because of the lower number of immune cells

• Cortisol inhibits the conversion of thyroid hormone T4 to the more active version, T3

  • Good when: you lower levels of thyroid hormone to slow down metabolism and maintain homeostasis

  • Bad when: thyroid becomes sluggish, leading to weight gain, fatigue, and hair loss

• Cortisol blunts secretory IgA throughout mucosal tissues (gut, sinuses, eyes, vagina, etc)

  • Good when: important energy needs to be redirected to deal directly with a threat

  • Bad when: the barrier protecting you from bacteria, viruses, and other toxins is now weakened

Where Does Chronic Stress Fit In?

But the story doesn’t end here. In patients who have been chronically stressed for a long enough time period, we see an initial increase in cortisol, followed by a sharp decline. This is what some people call “adrenal fatigue” but is more accurately known as HPA Axis Dysfunction or Adrenal Insufficiency.

Curious where you might fall? Here are some signs.

High cortisol:

• weight gain around the belly and face

• flushed face

• mood changes, especially anxiety and depressed mood

• low libido

• osteoporosis or osteopenia

• high blood pressure

• increased bruising or stretch marks

• increased thirst or urination

• muscle weakness

• difficulty falling or staying asleep

• waking in the middle of the night

Low cortisol:

• decreased stress resilience (things make you stressed more easily)

• fatigue

• skin rashes

• prone to infections and allergies

• intense cravings, especially for salt and sweet

• low blood pressure

• GI complaints - indigestion, gas, bloating, SIBO

• muscle pain

• hair loss

How To Move Forward

Evaluating cortisol with a simple 4 point saliva test can help us to determine where your body is on the stress response cycle, and how much damage cortisol has actually had.

Our doctors at EmpowerMed Clinic look for the root cause of cortisol imbalance and help to rebalance your body at a foundational level.

Every patient is carefully evaluated with comprehensive bloodwork and functional lab work looking for sources of imbalance within the body that can lead to cortisol imbalance.

If you are ready to get to the root cause of your stress, reach out to the EmpowerMed team of naturopathic doctors today. We take a collaborative approach to natural medicine, partnering with patients to help them achieve their unique health and wellness goals.

Contact us today at 760-456-7501 or use our booking link to schedule.

EmpowerMed Clinic is located just off the I-15 and Carroll Canyon within the Fitness Quest 10 Wellness Center of Scripps Ranch, San Diego County, CA. We serve the communities of North County San Diego, Poway, Rancho Bernardo, 4S Ranch, Mira Mesa, Ramona, Scripps Ranch, Santee, and more.

Written by Dr. Carleigh Golightly