Stress And The Cortisol Response

Have you ever had that sensation of being kicked in the gut following an upsetting phone call or situation with a friend or family member?

This sensation is caused by a sudden rise in our adrenal hormone, cortisol. Cortisol is a steroid hormone that regulates a wide range of vital processes that occur throughout the body- including blood sugar regulation, cognitive function, metabolism and immune response. When cortisol is appropriately triggered, it allows our blood sugar to rise commensurately, enhances our brain’s use of glucose, increases the availability of substrates needed for tissue repair, and lowers inflammation.

During a “fight or flight” episode, cortisol helps our liver make glucose from protein stores, a process called gluconeogenesis. This sudden energy surge can help us flee a saber-toothed tiger. However, most of us no longer encounter saber toothed tigers along our path today, as our early ancestors did. Instead, our fast -paced lifestyle and every day stressors pose even greater risks to our health due to their chronic nature.

When cortisol is chronically triggered, it will ultimately have deleterious effects on body weight, immune function, gut health, and overall chronic disease risk. When cortisol is high, it is very common for the sex hormones, such as estrogen, progesterone, and testosterone, to be low. It also decreases thyroid hormones. Common symptoms of elevated cortisol include irritability, “brain fog”, or difficulty concentrating, memory problems, sleep issues, fatigue, headaches, depression, and weight gain.

Weight Gain and Insulin Resistance

When cortisol remains elevated in our bloodstream, it drives our up our blood sugar level. This surge in blood sugar then triggers the release of insulin from our pancreas. If cortisol and insulin both remain high, this in turn results in storage of body fat, as it reduces the ability of the body to burn fat as fuel. This ultimately causes our skeletal muscle cells to become resistant to insulin, resulting in Insulin Resistance, or Pre- Diabetes.

Not only does insulin resistance place us at greater risk of diabetes, it also contributes to weight gain, especially around the middle. Abdominal fat, or visceral adiposity, is the most lethal type of fat. This type of fat leads to a greater risk of heart disease, stroke and cancer than fat accumulation around our hips or thighs. Insulin resistance is accompanied by loss of skeletal muscle tissue as well. Since muscle is our metabolic “engine”, our metabolism slows as a result. We gain fat, and continue to crave high calorie, high carbohydrates foods- the exact foods we should be eating less of.

Decreased Immunity

One of the functions of cortisol is to suppress inflammation. Due to lifestyle factors such as eating a high sugar, processed food diet, and an over exposure to environmental toxins, our bodies are chronically inflamed, and our cortisol levels soar. This wrecks havoc on our immune system.

There is a strong connection between high cortisol and a suppressed immune system. The suppressed immune system allows for a myriad of health problems, including an increased risk of infections, such as Covid- 19, an increased risk of cancer, and a greater tendency for food allergies and sensitivities. There is also a heightened risk of developing autoimmune conditions, such as Lupus, Rheumatoid Arthritis and Hashimoto’s Thyroiditis.

Gut Issues

In addition to that gut-wrenching feeling we get in our stomach when faced with a stressful situation, the high stress (high Cortisol) also affects our digestion, and the absorption of vital food and nutrients. When this happens, heartburn and indigestion often ensue. This may contribute to gut inflammation, causing holes or micro-tears in the mucosal lining of the intestine, known as leaky gut. This can lead to a whole array of gut issues, such as Irritable Bowel Syndrome, or Inflammatory Bowel Disease- i.e. Crohn’s or Ulcerative Colitis.

Cardiovascular Disease

During a “fight or flight” stress response, blood pressure and heart rate elevate, and arteries constrict to get oxygenated blood and vital nutrients to our heart, brain, and muscles. If we remain stressed-out over prolonged periods of time, our arteries are routinely constricted, leading to hypertension (high BP) and a greater propensity for plaque build -up (coronary artery disease) and thrombus formation (myocardial infarction, or heart attack). This is the reason why Type A personalities are known to have more heart problems than their relaxed, laid – back Type B peers.

Adrenal Fatigue

Because cortisol levels rise in times of physiological, mental, and emotional stress, and many of us remain “chronically stressed,” it follows that our adrenal glands might fail us over time. Adrenal fatigue occurs when the adrenal glands are overtaxed from excessive release of cortisol. They can’t keep up with the demands required for optimal body function. Symptoms of adrenal fatigue include extreme lethargy, as well depression, irritability, cognitive decline, compromised immune function, and cravings for sweet or salty foods.

The Cortisol Response

Cortisol levels are known to be naturally higher in the morning and decrease throughout the day. In our office, we check AM blood cortisol levels. If we recognize that adrenal regulation is an issue, we can also check a salivary cortisol response, where salivary cortisol levels are checked throughout the day. This helps us diagnose and optimally treat adrenal dysfunction.

What Can We Do to Support our Adrenals?

Unfortunately, we can’t always rid ourselves of an overwhelming job or a demanding partner, but there are important, effective strategies and supplements that can help keep cortisol levels in check.

Stress Management

It has been proven that certain lifestyle changes can help us better manage our stress, and therefore control our cortisol levels more effectively. We know that getting more, and better quality sleep is extremely helpful (check out our R3 Health natural sleep aids). A regular exercise program is also critical. Mindfulness, Meditation, Deep Breathing, Yoga and Tai Chi are valuable tools for effective stress management. It is also proven that laughing, doing enjoyable activities, and having meaningful social connections can reduce the stress burden and shift the neurochemical response away from cortisol and adrenaline toward the feel good neurochemicals like dopamine, oxytocin and serotonin.

In Unwinding Anxiety, Judson Brewer, MD, PhD, recommends that we try to become aware of and identify our negative thought habit loops. He suggests we witness the thoughts, emotions, and behaviors that we do habitually, but that result in negative consequences. He teaches that if we try to “think” ourselves out of a negative bodily sensation, or behavior, we typically make the situation worse. One of the approaches he recommends is a mindfulness practice known as RAIN. RAIN is an acronym, standing for the following sequential steps:

R- Recognize and Relax
A – Accept and Allow
I – Investigate
N- Note

The Anti- Inflammatory Diet

Systemic inflammation, as noted earlier, causes elevated cortisol levels. If we can naturally decrease inflammation in the body and diminish physiological stress, decreased cortisol levels should follow. This should in turn result in less chronic disease and improved wellness. Obviously, maximizing intake of anti-inflammatory foods, and minimizing intake of pro- inflammatory foods is an important step for controlling inflammation.

An anti-inflammatory diet is a plant-based diet that is full of fiber, antioxidants, and phytonutrients, such as those found in fruits, vegetables, beans, lentils, nut and seeds.
It is important to decrease sugar and high glycemic foods, drink alcohol and caffeine in moderation, and limit intake of saturated fats from animal products, as well as poly-unsaturated fats, found in processed foods and salad dressings. Increase intake of healthy fats such as fatty fish (salmon), avocado, olives, olive/ avocado oil, nut and seeds.

At R3 Health, we are privileged to have a functional medicine trained, licensed dietitian who can put together an individualized nutrition plan to help lower systemic inflammation, as well as help with all your nutritional/ wellness goals.

Important Supplements to Help with the Stress Response

L-theonine- a naturally occurring amino acid found in green tea leaves; can promote a sense of relaxation without causing drowsiness; has been found to reduce feelings of stress and anxiety.

CBD- Pure, medical grade CBD is a plant-based product, derived from the hemp plant, that contains powerful chemical substances, without the mind- altering properties of THC; has been found to help with sleep, anxiety, pain, and inflammation.

AdrenaMed – a powerful adaptogenic herbal and vitamin formula containing cordyceps, rhodiola, and gingeng- all designed to support the stress response. This formula also contains select B vitamins, which are known to support adrenal stress.

Ashwagandha- this plant matter originated in India, and it provides users with a calm feeling that helps soothe the nervous system. This plant compound can be found in several R3 Health products, such as CurcuPlus, Pro- female and Pro- Male.

Have you ever had that sensation of being kicked in the gut following an upsetting phone call or situation with a friend or family member?

This sensation is caused by a sudden rise in our adrenal hormone, cortisol. Cortisol is a steroid hormone that regulates a wide range of vital processes that occur throughout the body- including blood sugar regulation, cognitive function, metabolism and immune response. When cortisol is appropriately triggered, it allows our blood sugar to rise commensurately, enhances our brain’s use of glucose, increases the availability of substrates needed for tissue repair, and lowers inflammation.

During a “fight or flight” episode, cortisol helps our liver make glucose from protein stores, a process called gluconeogenesis. This sudden energy surge can help us flee a saber-toothed tiger. However, most of us no longer encounter saber toothed tigers along our path today, as our early ancestors did. Instead, our fast -paced lifestyle and every day stressors pose even greater risks to our health due to their chronic nature.

When cortisol is chronically triggered, it will ultimately have deleterious effects on body weight, immune function, gut health, and overall chronic disease risk. When cortisol is high, it is very common for the sex hormones, such as estrogen, progesterone, and testosterone, to be low. It also decreases thyroid hormones. Common symptoms of elevated cortisol include irritability, “brain fog”, or difficulty concentrating, memory problems, sleep issues, fatigue, headaches, depression, and weight gain.

Weight Gain and Insulin Resistance

When cortisol remains elevated in our bloodstream, it drives our up our blood sugar level. This surge in blood sugar then triggers the release of insulin from our pancreas. If cortisol and insulin both remain high, this in turn results in storage of body fat, as it reduces the ability of the body to burn fat as fuel. This ultimately causes our skeletal muscle cells to become resistant to insulin, resulting in Insulin Resistance, or Pre- Diabetes.

Not only does insulin resistance place us at greater risk of diabetes, it also contributes to weight gain, especially around the middle. Abdominal fat, or visceral adiposity, is the most lethal type of fat. This type of fat leads to a greater risk of heart disease, stroke and cancer than fat accumulation around our hips or thighs. Insulin resistance is accompanied by loss of skeletal muscle tissue as well. Since muscle is our metabolic “engine”, our metabolism slows as a result. We gain fat, and continue to crave high calorie, high carbohydrates foods- the exact foods we should be eating less of.

Decreased Immunity

One of the functions of cortisol is to suppress inflammation. Due to lifestyle factors such as eating a high sugar, processed food diet, and an over exposure to environmental toxins, our bodies are chronically inflamed, and our cortisol levels soar. This wrecks havoc on our immune system.

There is a strong connection between high cortisol and a suppressed immune system. The suppressed immune system allows for a myriad of health problems, including an increased risk of infections, such as Covid- 19, an increased risk of cancer, and a greater tendency for food allergies and sensitivities. There is also a heightened risk of developing autoimmune conditions, such as Lupus, Rheumatoid Arthritis and Hashimoto’s Thyroiditis.

Gut Issues

In addition to that gut-wrenching feeling we get in our stomach when faced with a stressful situation, the high stress (high Cortisol) also affects our digestion, and the absorption of vital food and nutrients. When this happens, heartburn and indigestion often ensue. This may contribute to gut inflammation, causing holes or micro-tears in the mucosal lining of the intestine, known as leaky gut. This can lead to a whole array of gut issues, such as Irritable Bowel Syndrome, or Inflammatory Bowel Disease- i.e. Crohn’s or Ulcerative Colitis.

Cardiovascular Disease

During a “fight or flight” stress response, blood pressure and heart rate elevate, and arteries constrict to get oxygenated blood and vital nutrients to our heart, brain, and muscles. If we remain stressed-out over prolonged periods of time, our arteries are routinely constricted, leading to hypertension (high BP) and a greater propensity for plaque build -up (coronary artery disease) and thrombus formation (myocardial infarction, or heart attack). This is the reason why Type A personalities are known to have more heart problems than their relaxed, laid – back Type B peers.

Adrenal Fatigue

Because cortisol levels rise in times of physiological, mental, and emotional stress, and many of us remain “chronically stressed,” it follows that our adrenal glands might fail us over time. Adrenal fatigue occurs when the adrenal glands are overtaxed from excessive release of cortisol. They can’t keep up with the demands required for optimal body function. Symptoms of adrenal fatigue include extreme lethargy, as well depression, irritability, cognitive decline, compromised immune function, and cravings for sweet or salty foods.

The Cortisol Response

Cortisol levels are known to be naturally higher in the morning and decrease throughout the day. In our office, we check AM blood cortisol levels. If we recognize that adrenal regulation is an issue, we can also check a salivary cortisol response, where salivary cortisol levels are checked throughout the day. This helps us diagnose and optimally treat adrenal dysfunction.

What Can We Do to Support our Adrenals?

Unfortunately, we can’t always rid ourselves of an overwhelming job or a demanding partner, but there are important, effective strategies and supplements that can help keep cortisol levels in check.

Stress Management

It has been proven that certain lifestyle changes can help us better manage our stress, and therefore control our cortisol levels more effectively. We know that getting more, and better quality sleep is extremely helpful (check out our R3 Health natural sleep aids). A regular exercise program is also critical. Mindfulness, Meditation, Deep Breathing, Yoga and Tai Chi are valuable tools for effective stress management. It is also proven that laughing, doing enjoyable activities, and having meaningful social connections can reduce the stress burden and shift the neurochemical response away from cortisol and adrenaline toward the feel good neurochemicals like dopamine, oxytocin and serotonin.

In Unwinding Anxiety, Judson Brewer, MD, PhD, recommends that we try to become aware of and identify our negative thought habit loops. He suggests we witness the thoughts, emotions, and behaviors that we do habitually, but that result in negative consequences. He teaches that if we try to “think” ourselves out of a negative bodily sensation, or behavior, we typically make the situation worse. One of the approaches he recommends is a mindfulness practice known as RAIN. RAIN is an acronym, standing for the following sequential steps:

R- Recognize and Relax
A – Accept and Allow
I – Investigate
N- Note

The Anti- Inflammatory Diet

Systemic inflammation, as noted earlier, causes elevated cortisol levels. If we can naturally decrease inflammation in the body and diminish physiological stress, decreased cortisol levels should follow. This should in turn result in less chronic disease and improved wellness. Obviously, maximizing intake of anti-inflammatory foods, and minimizing intake of pro- inflammatory foods is an important step for controlling inflammation.

An anti-inflammatory diet is a plant-based diet that is full of fiber, antioxidants, and phytonutrients, such as those found in fruits, vegetables, beans, lentils, nut and seeds.
It is important to decrease sugar and high glycemic foods, drink alcohol and caffeine in moderation, and limit intake of saturated fats from animal products, as well as poly-unsaturated fats, found in processed foods and salad dressings. Increase intake of healthy fats such as fatty fish (salmon), avocado, olives, olive/ avocado oil, nut and seeds.

At R3 Health, we are privileged to have a functional medicine trained, licensed dietitian who can put together an individualized nutrition plan to help lower systemic inflammation, as well as help with all your nutritional/ wellness goals.

Important Supplements to Help with the Stress Response

L-theonine- a naturally occurring amino acid found in green tea leaves; can promote a sense of relaxation without causing drowsiness; has been found to reduce feelings of stress and anxiety.

CBD- Pure, medical grade CBD is a plant-based product, derived from the hemp plant, that contains powerful chemical substances, without the mind- altering properties of THC; has been found to help with sleep, anxiety, pain, and inflammation.

AdrenaMed – a powerful adaptogenic herbal and vitamin formula containing cordyceps, rhodiola, and gingeng- all designed to support the stress response. This formula also contains select B vitamins, which are known to support adrenal stress.

Ashwagandha- this plant matter originated in India, and it provides users with a calm feeling that helps soothe the nervous system. This plant compound can be found in several R3 Health products, such as CurcuPlus, Pro- female and Pro- Male.

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Written by
Shay Geraghty, PA-C
Shay is a physician assistant at R3 Health™