In the mists of time the acute stress response protected our survival. For example, it readied us for fight or flight from a saber tooth tiger. Our blood pressure went up, our heart and respirations were quickened; and our non-essential functions (hormones,digestive system) were stopped since one does not need them to fight or flight. All the previous adrenal-cortisol stress reactions are to get more blood, sugar and oxygen to the needed leg and arm muscles and brain for the flight or fight response. All this took minutes and then all went back to normal. One either escaped or not. If it was the latter then there was never stress again. The exact same cortisol stress-response occurs today but now it is a continuous stress response,7days a week, 24 hours/day. The stress response depends on the adrenal glands putting out cortisol for the flight -fight response to occur. Though we have evolved in many ways there is no stress distinction between an acute or chronic stress response. The adrenal-cortisol reaction is the same for both!
When we have the adrenal glands working overtime due to chronic stress situations at first the cortisol output is high. When high the cortisol depresses the output of many of the hormones and the digestive system since these are not necessary for flight or fight. The adrenal glands eventually wear out like any machine that is continuously abused. Therefore, the hormones of the adrenal glands, cortisol, adrenaline, and DHEA cannot be produced. This is similar to when the pancreas is forced to put out insulin all the time due to an high output of blood sugar for fuel for the flight-fight response. Cortisol stimulates the liver to utilize the liver’s glucose stores by putting the sugar into the blood for fuel.
Cortisol is a hormone that normally is secreted from the adrenal glands between 6-10 AM. The secretion time span depends on the person’s genetics and habits of time of rising. Theoretically it is put out to help the person awaken by stimulating an energy burst of glucose (sugar). Cortisol has many functions but here we are concerned with stress.
If he/she remains in stress and the adrenal glands persistently secrete cortisol we get into a potentially pathological state. At first the cortisol stays high all the time in order to stimulate the liver to put out sugar for fuel so the person can “fight or flight.” The high sugar levels stimulate the pancreas to put out insulin constantly to push the sugar into the cells via the cells receptors, which let the sugar enter the cells. There are a few sequels to this scenario. First the cells cannot use all the sugar that the cortisol-liver (sugar)-insulin axis delivers continuously, so it pushes it into storage as fat [triglycerides]. This gets deposited in women in the thighs and buttocks and then the abdomen. In men it is usually first deposited in the abdomen and then the other areas. Another thing that can happen to some people is the insulin surge may drop the blood sugar too much so they get what is called a reactive hypoglycemia ( This is not a true hypoglycemia). This makes the person hungry, lethargic, angry-aggressive and sleepy. This hypoglycemia is an added stress to the already ongoing stress. More stress! If stress continues to stimulate the adrenal glands and therefore high cortisol levels the adrenal gland fatigues out and produces low levels of cortisol or none. Now we have true adrenal fatigue. Also the receptors on the cells for insulin get tired of being consistently hit with insulin and develop a resistance to the insulin. The sugar stays in the blood causing high blood sugar. So the pancreas puts out more insulin to push the perceived needed sugar into the cells. This vicious cycle continues causing more cell receptor resistance evolving which we call Insulin Resistance. This is the first step to diabetes melitus (Diabetes II) and the Metabolic Syndrome [once called Syndrome X]. This fact is so important that I wrote a chapter in my book dedicated to diabetes and the metabolic syndrome.
This constant outpouring of cortisol can lead to numerous other problems that are not being addressed in the conventional medical world. One is the problem of osteopenia and osteoporosis. It is known that high night cortisol levels lead to bone absorption. For example, there is a warning that is posted on corticosteroid medications [ex. Prednisone]. It states that people on cortisol-like medications producing high cortisol levels can develop osteopenia, osteoporosis and stomach-intestinal ulcers. Instead of investigating a stress causation and therefore high cortisol levels for why the person has osteopenia or osteoporosis the physician puts them on calcium, vitamin D and sometimes synthetic hormones.
If he/she does nothing to alleviate the stress situation eventually more breakdowns in the body occur. First the pancreas cannot keep putting out insulin constantly so it just runs dry and one has full-blown diabetes II. Similarly, the adrenal gland cannot keep putting out cortisol and it runs dry, so no more cortisol. And not mentioned yet is that while the adrenal gland is putting out cortisol it cannot at the same time put out DHEA (dihydroepiandrosterone) which cells need as an anabolic [building] hormone. Cortisol is a catabolic [breaking down] hormone. DHEA hormone is also a backup for making testosterone and estrogen when a person cannot produce it due to other problems such as aging. This lack of production of DHEA is very important as another body builder and energy stimulant. It is also an adjunct in the production of testosterone and estrogen especially in peri-menopausal and menopausal females.
In summary: cortisol when being abnormally secreted from the adrenal gland constantly due to stress is known as the death hormone. This is because it was created for the periodic fleeting flight or fight encounter. To enhance this response a lot of the other hormones are diminished by the cortisol since they are not needed to run or fight. These hormones include, estrogen, testosterone, progesterone, aldosterone (BP control) and thyroid hormone. Cortisol also shuts down the non-essential digestive system, raises blood pressure and heart rate. Prescription corticosteroids are used for allergies since they block the immune response. Well so does high cortisol levels do to stress leaving the person without a good immune system and therefore illnesses to microbe infections. Just think of the illnesses that can occur without well functioning hormones, digestive system and immune system. Another blog coming will soon give more functions and the symptoms and signs of Adrenal Fatigue Syndrome.
No wonder a person feels terrible and starts getting different illnesses when under stress. All these hormones are necessary for ones well being and anti-aging and they need to be in a state of homeostasis (balanced). In fact, sometimes the person believes that the prescribed hormone by the physician is not working; in reality it is, but it is the person that is still not doing anything about their stress. Therefore, they are counteracting a lot of the good affects of the prescribed hormone solution whether it is one of the sex hormones or thyroid or insulin by resisting seeing a counselor for stress. (See the blog on “Stress and your well-being”).
I believe in testing ones cortisol levels by a saliva test. Testing this way is for several reasons. Cortisol by nature changes its day-night production output (diurnal production). It is high in the AM and then by noon it is dropping and by evening it is down and even lower at midnight. It starts to go up again about 5-6 AM so that it can wake one up with a sugar spurt. A blood test would tell you the cortisol level at one particular time and not give the healer the knowledge of this diurnal trend which is needed in the diagnosis of one of the two stages of adrenal fatigue- too high or too low. Having blood drawn for some people is a stress and theoretically can cause an elevation of the cortisol level. Also with the right saliva test you get a calculation of the DHEA levels which is important in the adrenal fatigue diagnosis. It is important to know the DHEA level and compare this to the cortisol in order to really help the client.