03 Mar Cortisol 101
Hormones are your body’s chemical messengers that tell your organs and tissue how to function. Whether it is fat loss, sleep, metabolism, muscle synthesis, (there are many more roles/actions that take place!), hormones play a critical role in reaching your goals.
What is Cortisol?
Cortisol is primarily a stress hormone because it is well known during during the fight or flight response. However, it is very important for other functions, as almost every cell has a receptor site for cortisol. Cortisol can act as an anti-inflammatory, control blood sugar, regulate metabolism, assist with memory function, and supports the developing fetus during pregnancy. The goal is not to strive for zero cortisol, in fact we want cortisol to be high in the morning so we wake up, and then taper off during the day. By tapering off and having lowered cortisol in the evening allows melatonin to rise to allow the body to fall asleep.
Diurnal Cortisol Patterns
Ever heard of “tired but wired”? When cortisol is higher due to prolonged stress, symptoms include food cravings, insomnia, and anxiety. Chronic fatigue results in higher than normal cortisol patterns. This is recognized by cortisol elevation in the morning, followed by a rapid drop. Symptoms include a mid-day energy drop, drowsiness, and poor exercise recovery. Low overall cortisol is associated with burnout, shown with day long fatigue, cravings for food, insomnia, and exhaustion. Ideally cortisol is highest 30 minutes upon waking, then follows a gradual decline throughout the day. One of the best ways to restore optimal biorhythm is to go to bed earlier and wake up earlier…see the post on “What is great sleep”. *Disclaimer: this should not be taken as a diagnosis or medical advice in lieu of your physician’s diagnosis. This is meant for education so the appropriate conversations can be conducted with your health care provider.
Cortisol is not the bad guy! During a fast cortisol gives the body energy through gluconeogenesis and releases free fatty acids for energy during the “fight or flight” response. However, prolonged elevated cortisol has deleterious health effects. For example, cortisol directly affects fat storage and weight gain in stressed populations. Obese individuals, there is an enzyme that converts inactive cortisone to active cortisol that is expressed more and visceral fat cells have more of these enzymes than subcutaneous fat cells. What does that mean? Abdominal fat and fat that surrounds organs has greater blood flow and 4x more cortisol receptors thus increasing fat accumulation versus fat that is located just under the skin.
Subjects with higher cortisol secretions has been shown to consume more high fat and high sugar foods. Stress indirectly controls our appetite by regulating other hormones like corticotropin releasing hormone (CRH), Leptin (our satiety hormone), and Neuropeptide Y (NPY). High palatable foods are associated with higher calories and lower satiety, leading to a calorie surplus and the fat deposited deep in the abdomen. Health effects of stress induced obesity are hypertension, hyperlipidemia, hyperglycemia, and a high waist-to-hip ratio (WHR). A high waist-to-hip ratio increases the risk for cardiovascular disease, type 2 diabetes, and cerebrovascular disease. To check your WHR, simply measure the smallest portion of your waist then divide by the circumference of your hips at the widest point. Men at high risk are > 0.96 or 39 inch waist. Women at high risk > 0.84 or 35 inch waist.
Elevated cortisol wrecks havoc on the immune system by suppressing its function. Again, in appropriate doses, cortisol reduces inflammation which boost immunity, but long term cortisol elevation increases susceptibility to colds, food allergies, gastrointestinal issues, and the risk of autoimmune disease. Digestion of food is done by the parasympathetic nervous system (think “rest and digest’), however when cortisol is elevated the sympathetic nervous system is activated which leads to compromised digestion and absorption, indigestion, and inflamed mucosal lining which leads to an increased production of cortisol.
- Prioritize sleep.
- Eat a healthy diet prioritizing lean proteins and vegetables at regular intervals to control hunger pangs. Intermittent fasting is not the magic bullet for fat loss; it is a tool that can be applied to the right person to assist in fat loss and blood sugar management.
- Exercise the right amount. Strength training (45 min session) and low volume interval training (20 – 30 min sessions) are going to be your best bet to aid in blood sugar regulation and balance stress hormones. If the thought of sprint intervals makes you exhausted, go for a walk instead.
- Supplement with Vitamin C and Magnesium. A magnesium deficiency shows an up regulation in the HPA axis, responsible for secreting cortisol, as well as reduced serotonin levels. A study by Peters et al., 2001 showed 1500mg of Vitamin C showed a reduction in cortisol and inflammation after a 90km race.
The weight loss solution is not calories in / calories out, anymore. Managing hormones combined with the right type of exercise will produce the fastest results. Stress affects both health and aesthetics; if you prioritize your health, aesthics will follow!