Feeling tired? - Cortisol has a strong influence on health
By Dr. Martin Gleixner, MSc, ND
Last month's column was dedicated to stress.
It examined the various ways in which stress can appear in our lives, at times in ways that we are not even aware of.
After a brief definition of stress, I explained how: 1) feeling out of control; 2) loneliness; 3) poor eating habits; 4) over-exercising; and 5) chronic disease are at the top of the list in disrupting our health. This month we will look at different physical stressors that can offset our hormones, with special emphasis on cortisol.
Cortisol stands out because it has such as strong influence on our health. It is manufactured and secreted by our adrenal glands and people can experience high levels of cortisol, inappropriate ups and downs, or over time, lower than optimal levels.
At its extreme highs and lows, one can be diagnosed with Cushing's or Addison's disease, respectively. These serious conditions are best diagnosed via blood serum levels.
Hormone saliva testing conducted by naturopathic doctors is a useful tool for diagnosing abnormal cortisol patterns that may be missed by conventional blood tests. Imbalanced cortisol levels can contribute to a host of different symptoms. Under normal health conditions, cortisol is highest in the morning giving the pick-up and go that is needed and should be lowest in the evening when it is time to relax before bed. When its 24-hour rhythm is offset, common symptoms can include feeling tired upon waking and feeling 'wired' in the evening before bed.
Three physical stressors common in many chronic health conditions are often hidden causes of cortisol disruption: tissue damage, imbalanced blood sugar levels and allergies.
* Tissue damage:
When inflammation occurs in the body for long enough, it starts to injure cells. In turn, tissues (groupings of unique cell types found in organ or body parts) can become damaged. At this stage it is often called a pathological (versus functional) process in the body.
Examples include hepatitis (liver inflammation), atherosclerosis (or hardening of the arteries) which often leads to hypertension, angina or heart attacks, loss of cartilage in arthritis, the breakdown of blood vessel walls commonly seen in diabetes, and the breakdown of the gut lining as in Crohn's disease or ulcerative colitis, among many others.
Generally speaking, most chronic health conditions involve a certain degree of inflammatory process. Examples include reflux (GERD), irritable bowel syndrome, eczema and chronic sinusitis, to name a few.
One of ways our body attempts to mitigate the damage is by secreting cortisol. Its potent anti-inflammation action quells the fire wherever it may be needed in the body. If the disease is not treated, the inflammatory process is ongoing. The adrenal glands are called on 24-hours a day to secrete cortisol, giving our glands little time to recuperate.
Work with your medical doctor or naturopathic doctor to find effective ways of treating your chronic disease. Use inflammatory markers tested in the blood such as sedimentation rate (ESR) and c-reactive protein (CRP) to evaluate treatment progress. Most importantly, look at ways that prevent chronic disease in the first place via pro-active lifestyle choices and explore treatment options that address the root cause of inflammation in the body rather than its end-result.
* Blood sugar imbalances:
Our blood sugar (glucose) is normally well regulated in the body because it fuels the body. Certain organs such as the brain depend entirely on glucose to operate efficiently. Keeping a tight control on glucose levels is equally important because excess amounts can harm organs and blood vessels as commonly occurs in advanced diabetes.
Dietary choices and lacking a daily eating routine such as skipping breakfast or missing other meals can contribute to suboptimal blood sugar levels and can lead to higher than normal cortisol levels. Many people, for example, can experience a hypoglycemic episode after they eat excess carbohydrates without protein or fats.
The initial rise in blood glucose levels is quickly followed by a sharp drop in glucose levels leading to fatigue.
Insulin and cortisol work in opposing ways to maintain blood glucose levels. Insulin aims to decrease blood sugar levels by helping our liver and muscles to put glucose into storage. Cortisol, on the other hand, helps to maintain glucose levels mainly by stimulating the liver to use amino acids and fats to make glucose (a process called gluconeogenesis).
Aim to have more routine in your eating habits. Most importantly, never skip breakfast. If your body is unaccustomed to eating breakfast, your digestive system may be shut down and you may lack hunger signals. Start slowly. Start off with a handful of blueberries and a few nuts. Stimulate your morning hunger by eating less the evening before and include exercise to kick-start your metabolism. Aim to include quality protein and good fats with every meal.
Not only is cortisol anti-inflammatory, it is also anti-allergenic. It helps the body adapt when our immune system begins to over-react to common allergens. I believe that gluten intolerance and celiac disease are two of the most important (and often unrecognized) causes of elevated cortisol levels in the body.
Gluten is a protein found in wheat, barley, rye, and spelt. It's never been easy for people to digest, but gluten is becoming more accessible due to its widespread use in food products. Our modern food industry has also found ways to bio-engineer a higher concentration of gluten in a given grain thereby increasing its risk of becoming problematic.
Celiac disease is an auto-immune condition triggered by the ingestion of gluten. The immune system attacks the toxic gluten molecule by producing antibodies. These same antibodies actually attack the lining of the small intestine as well, causing widespread damage. The incidence of celiac disease is on the rise around the world.
Although statistics are not available in Canada, we are likely experiencing similar rates than those in the United States where it affects 1 out of 133 persons.
People with gluten intolerance also produce antibodies to gluten, but these antibodies, however, do not attack the lining of the intestine (the hallmark of celiac disease). The immune response is still generated thereby causing a great deal of inflammation and physical distress.
Many people have gluten intolerance and celiac disease but remain undiagnosed. Many symptoms can also mimic other conditions. To adapt to the inflammatory response in the body, once again cortisol is secreted in large amounts. Since many people are consuming gluten up to 3 to 6 times per day, the stress on the adrenal glands can be significant.
Being aware of the types of stress that can impact our health is important. Inflammatory responses in the body due to chronic health conditions and related cortisol imbalances are complicated and should be evaluated based on the greater context of your care. Work with your medical doctor or naturopathic doctor to assess the effect of stress on your health. The use of specific vitamins in medicinal doses and individualized herbal combinations that target inflammatory responses in the body and balance the hormonal system are also very helpful.
Published by Dr. Gleixner on Wednesday September 1st, 2010 in Times & Transcript.
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