Cortisol Imbalances May Cause Weight Gain, Depression, Anxiety, and Insomnia


Cortisol is widely known as a stress hormone produced by the human body’s adrenal glands. In popular culture, it’s reputed that elevated cortisol levels from stressful lifestyles contribute to weight gain, particularly in the abdominal area. Weight loss supplement vendors have developed many cortisol lowering supplements to help with these weight and stress problems. Authors including Shawn Talbott have developed diets for people gaining weight from high-stress/high-cortisol conditions. Some of these supplements and diets have good track records for working.

Unfortunately, if you attempt to treat the symptoms of a cortisol imbalance without knowing the actual cortisol levels, you can badly damage your health.

While some of these cortisol-affecting supplements and diets can help reduce or reverse high cortisol related weight gain and stress-related symptoms, it is potentially dangerous to assume you are suffering from high cortisol levels even if you are gaining weight while under a lot of stress with poor sleep, depression, and anxiety symptoms.

Why? Because most of the symptoms of high cortisol are also symptoms of low cortisol.

Common symptoms of both high and low cortisol levels include anxiety, insomnia, irritability, memory problems, confusion, depression, cravings for sugar, and body temperature regulation problems such as chills, hot flashes, and night sweats. Thus these symptoms alone cannot distinguish between these two related conditions.

This confusion is particularly worrisome because many treatments for imbalanced cortisol can severely worsen the condition if the patient is suffering from the low levels rather than high levels of cortisol. The reverse, treating somebody with high cortisol as if they have low cortisol, can also cause significant harm.

Cortisol Testing Is Essential

The only way you can know with reasonable certainty which cortisol imbalance condition applies to you is to get a series of four saliva cortisol tests spread throughout the day. A single blood test is not enough to get a clear understanding. One blood test alone may make it appear your adrenals have not totally failed and convince your doctor you don’t have Addison’s Disease, a total or near total failure of the adrenal glands. Yet in fact the adrenals could be nearing failure and cannot elevate the cortisol levels during the late stages of sleep as they should be able to do.

Below is an example of a ZRT Labs diurnal cortisol test graph from a patient with severe adrenal fatigue. This patient previously had cortisol blood tests performed in the afternoons that indicated the adrenal glands had not failed. Yet this graph clearly shows the cortisol levels are consistently below the normal range shown in green. They only approach the low end of normal ranges once during the day.

Adrenal fatigue causes low cortisol levels

Example of a cortisol test showing why four samples are needed

Properly functioning adrenals glands should pump out large amounts of cortisol not long before you wake up and less during the rest of the day. A series of four tests should show a curve that starts high at waking and drops throughout the day until a low level at bedtime. Often people who are getting a blood test in the late morning or afternoon will have seemingly normal cortisol levels when in fact most of the day they are suffering with either far too little or far too much cortisol.

It is critically important to your health to do a saliva cortisol test series before you try to treat symptoms that appear to be caused by stress and a change in your body’s cortisol levels. If you do not do so, you may worsen your health problems and land yourself in a hospital with the results of a cortisol deficiency crisis similar to what happens to people who have failed adrenal glands or Addison’s disease.

Often many of these symptoms can also be caused by neurotransmitter imbalances. It’s helpful to take a urine test to evaluate your levels of common neurotransmitters along with the set of four cortisol tests and a DHEA test to evaluate adrenal gland function.

I’ve previously written about how these tests are helpful in my article Depressed But Antidepressants Don’t Work? Adrenal Fatigue or Neurotransmitter Imbalances May Be Responsible. That article provides sources where you can obtain these tests even if your doctors are the typical mainstream GPs and psychiatrists who behave as if they know nothing about adrenal fatigue and neurotransmitter imbalances.

Mainstream doctors often dole out SSRI antidepressants such as Celexa, Zoloft, and Prozac and benzodiazipine anxiolytic medications including Xanax, Restoril, Valium, and Klonopin without doing any testing at all. This is a common path to developing drug dependencies that can take years to correct yet entirely fail to correct the underlying problems. Sometimes, patients become so sick from these drugs and/or the underlying problems that are not being fixed that they actually die. In many cases, it is my belief such deaths could be prevented if some more effort was put into identifying the root causes of their conditions via hormone and neurotransmitter testing. Such tests are often effective at identifying a cause, but unfortunately they are seldom used due to ignorance on the part of doctors and patients.

Prolonged Stress and High Cortisol Initiates Adrenal Fatigue

People who suffer from high cortisol levels are likely to experience increasing damage to their adrenal glands unless the stressful conditions stop. If they do not, these people are likely to go on to develop very low cortisol levels as their adrenal glands stop making significant levels of cortisol.

This is a remarkably common progression even though it may sound counter-intuitive. It is caused by the physiological strain on the adrenal glands from prolonged intense cortisol production as the adrenals battle to keep the body running under high stress. As the adrenal glands pump out high levels of cortisol for months or years, they start to wear out and eventually partially or totally collapse.


Changes In Symptoms During Late Stages of Adrenal Fatigue

As the adrenal glands collapse from exhaustion, you may find you develop a few new symptoms, some of your symptoms worsen, and others actually reverse. These are all clues as to the true nature of your problems. But most doctors will miss these clues as few are educated about them.

The symptomatic changes from the collapsing adrenal gland function often manifest via the development of chronic pain throughout the body. They are often accompanied by a drop in blood pressure and changes in blood glucose and triglycerides.

The increasing chronic pain is often the most obvious symptom. It can manifest as chronic dull aches, joint pains similar to arthritis, and muscle weakness seemingly everywhere. It sometimes increases to very intense pain, often around the kidneys, sides, and lower back near where the adrenal glands are located.

Chronic pain is often debilitating. Often these pains are worst at times when your cortisol levels are the lowest, frequently from around bedtime to waking time or a couple of hours later. This tends to severely worsen your sleep. Some people may try painkillers and antiflammatory medications and get little relief from them. The consequent inability to get restful sleep worsens the condition in a rapidly destructive cycle that impacts your mental and emotional well-being.

You may find yourself unable to get up in the mornings, needing frequent naps, having panic attacks, being more moody, or unable to focus and concentrate. Your coworkers (if you can still work) and even your friends and family may accuse you of being paranoid, irrational, angry, and unpleasant. Those are all symptoms that most people cannot help but notice.

Cortisol helps the body deal with pain, inflammation and stress. When the adrenal glands can no longer make sufficient quantities, you therefore lose much or all of your ability to handle pain and stress. Chronic pain and low cortisol therefore go hand in hand for many long-suffering patients.

Other Tests Provide Hints of Cortisol Levels

There are often many changes in your blood chemistry that may go unnoticed as your cortisol levels change from high to low as your adrenal glands burn out. From the common tests many doctors run, you may even think your health is improving a bit in the area of blood triglycerides and glucose. But in fact, your health has taken a dramatic turn for the worse due to your adrenal collapse.

Please be aware that these tests are no substitute for the saliva cortisol tests for those suffering adrenal fatigue. They should be considered helpful mainly when used in conjunction with cortisol testing.

Blood pressure and body temperature are two things you can test rather easily that can provide some insights that might help motivate a doctor to order a series of cortisol tests. They can also help you monitor whether you are making progress at recovering from your condition and might also suggest when another round of saliva cortisol tests might be appropriate to monitor for changes in your condition and to adjust therapy.

High cortisol levels often cause elevated body temperatures. Low and variable body temperature is common with adrenal fatigue that has progressed to result in low cortisol levels.

Low body temperature without variability is also a common symptom of low thyroid function. It is very common for thyroid function to be impaired by adrenal gland problems and for one person to have both adrenal fatigue and hypothyroid symptoms. In such cases, it is often difficult to correct the thyroid problems without fixing the adrenal gland dysfunction. Attempts to increase thyroid hormone output without supporting and repairing the adrenal glands can further damage the adrenals and fail to correct the symptoms doctors often associate with hypothyroidism without even considering the possible connection to adrenal gland dysfunction.

You’ll need to measure your temperature a few times per day as there is some variability in body temperature for even a healthy person. Try to measure your temperature based upon consistent times after waking. Measure it apart from meals or physical activity that may cause larger than usual variations in temperature. Measure it at waking, a couple of hours after waking, four hours after that, another four hours later, and again just before bedtime. For instance, if you wake at 8am, then try 8am, 10am, 2pm, and 6pm (just before dinner), and just before going to sleep at 10pm.

If you see a lot of variability in temperature from the average or the temperatures are often high or low versus the common 98.6 degrees F body temperature, it is likely you have an adrenal fatigue problem. Generally speaking, higher temperatures mean you are catching the problems while the adrenals are still able to pump out a lot of cortisol. For lower temperatures, lower and more variable temperatures correspond to later stages of adrenal collapse. Temperatures in the low to mid-90s F are not unusual for such people who have not begun appropriate treatment.

Take your blood pressure lying down or sitting down and then again immediately after standing up. Healthy people or those with early adrenal fatigue are likely to see their systolic blood pressure increase a bit when they stand to help maintain the overall diastolic blood pressure. People who are suffering from high cortisol levels will often have higher blood pressure than before their cortisol levels rose from stress. Those with late stage adrenal fatigue and low cortisol will see their systolic blood pressure drop, sometimes by 5 or even 10 mmHg after standing. This is because the adrenal glands cannot pump out enough hormones to help the body quickly regulate blood pressure. Often these people will experience dizziness from standing, too. There of course could be other reasons for these symptoms, but they are a solid clue suggesting that you need some more definitive testing to better understand your adrenal function.

Treating Adrenal Fatigue Successfully Requires Knowing Your Cortisol Levels

As adrenal fatigue is a progessively worsening condition causing severe changes in cortisol and other hormones produced by the adrenal glands, knowing what treatment is appropriate requires an understanding of the stage of the illness. The best way to do that is via the saliva cortisol tests. Although there are a few supplements and medicines that can help people with both high and low cortisol levels recover, many are actually specific to a subset of the progression of the illness. Therefore it is critical that you and your medical care providers understand your cortisol levels before you embark on trying to correct the condition.

Cortisol abnormalities are common in people diagnosed with chronic fatigue syndrome (CFS), fibromyalgia (FM), hypothyroidism, multiple sclerosis, and many other conditions connected with long-term chronic stress. It is very possible that all of these conditions are connected by the adverse impact on the adrenal glands due to chronic stressors including a mix of root causes such as intense emotional stress, infections, and autoimmune reactions. The popular culture saying “stress kills” rings very true for people with adrenal dysfunction and abnormal cortisol levels. Chronic stress causes adrenal gland collapse which can result in severe adrenal insufficiency or even Addison’s Disease which may result in death.

If you are suffering symptoms or related conditions discussed in this article and are aware of chronic conditions putting a great deal of stress on you, please get your cortisol levels tested as soon as possible. It could make the difference between eventual recovery and worsening health leading to a lingering in this miserable state for decades.

Related Books

Further Reading

Carbohydrate Binge Eating and Weight Gain May Indicate Tryptophan and Serotonin Deficiencies

Abnormal Cortisol Levels, Depression, Anxiety, and PTSD Are Signs of Long-Term Abuse and Psychological Trauma

Reducing Sedative and Addictive Side Effects of Anti-Anxiety Drugs Benzodiazepines (Xanax, Valium, etc.) with L-Theanine, Pregnenolone, and DHEA

Chronic Stress Kills: High Cortisol Levels Damage the Brain, May Lead to Shorter Life and Neurodegenerative Diseases Such As Alzheimer’s and Parkinson’s

Depressed But Antidepressants Don’t Work? Adrenal Fatigue or Neurotransmitter Imbalances May Be Responsible

Low Cortisol, Low CoQ10, and Mitochondrial Dysfunction Often Found in Adrenal Fatigue, Chronic Fatigue Syndrome, Fibromyalgia, and Myalgic Encephalomyelitis Patients

40% of US Population May Have Hypothyroidism

Adrenal Disease

The Physiological Effects of Stress on the Body

Adrenal Fatigue: Do You Have It?

Adrenal Fatigue and How to Beat It

Stress and Cortisol: The Plague of the 21st Century

Association between stressful life events and exacerbation in multiple sclerosis: a meta-analysis


These statements have not been evaluated by the Food and Drug Administration. The products mentioned in this post and on this website are not intended to diagnose, treat, cure or prevent any disease. The information presented here is for educational purposes and does not constitute medical advice. Please obtain medical advice from qualified healthcare providers.


Comments

Cortisol Imbalances May Cause Weight Gain, Depression, Anxiety, and Insomnia — 13 Comments

  1. Pingback: Depressed But Antidepressants Don’t Work? Adrenal Fatigue or Neurotransmitter Imbalances May Be Responsible. | EmediaHealth

  2. Pingback: Low Cortisol, Low CoQ10, and Mitochondrial Dysfunction Often Found in Adrenal Fatigue, Chronic Fatigue Syndrome, Fibromyalgia, and Myalgic Encephalomyelitis Patients | EmediaHealth

  3. Pingback: L-Theanine for Anxiety, Insomnia, and Depression | EmediaHealth

  4. Pingback: Chronic Stress Kills: High Cortisol Levels Damage the Brain, May Lead to Shorter Life and Neurodegenerative Diseases Such As Alzheimer’s and Parkinson’s | EmediaHealth

  5. I had a saliva Cortisol test about 4 years ago. My Primary care physician, psychologist, and Urologist all blow me off when I show them the test results. Very low Cortisol upon waking and off the map by 9PM at night. Been under extreme stress for 4 years now. I am worried about overloading my adrenal glands. SSRI antidepressants, benzodiazipine meds, not working. Don’t sleep, weight gain, sweats, hard to get up in the morning, need naps, panic attacks, moodiness, trouble concentrating. Family says I anger easily, and I’m unpleasant to be around.

    Who do I see, what kind of Dr.? Endocrinologist, Holistic, Chinese Medicine? I’m at a loss but I want my life back.

    • Art,

      Can you share the numerical results from the test? I’d like to understand the curve better.

      It’s a challenge to deal with backwards cortisol levels. It is much easier to deal with consistently high or low levels.

      You could try to boost your cortisol levels in the morning with a small dose of IsoCort and licorice root. Only take these the first thing in the morning when you wake up as you have to watch out for boosting your nighttime cortisol higher. I would also suggest adaptogenics such as rhodiola rosea, ashwagandha, and eleuthero as they are all supposed to help normalize cortisol.

      Cortisol imbalances often come along with other symptoms of stress and fatigue and energy problems. Depressive symptoms and anxiety are common, no wonder because it is depressing and anxiety-inducing when you feel you can’t function normally.

      I really do not like SSRI antidepressants as a first line of attack against depressive symptoms. If you have the funds, I would suggest getting a neurotransmitter saliva tests to see if you have low serotonin levels. My guess is that you do and that this can be corrected by supplementing with tryptophan, L-lysine, St. John’s Wort, 5HTP, and melatonin at bedtime. The thinking here is that you need enough tryptophan in the brain to make adequate serotonin. L-lysine helps gets the tryptophan through the blood brain barrier. 5HTP at low doses can help, also, but you want to keep the dosages low because it may too rapidly convert to serotonin outside the brain and that is part of the cause for serotonin syndrome. St. John’s Wort helps boost serotonin levels, but it can cause photosensitivity reactions so it is best to take it at night at least for starters. Serotonin converts to melatonin, so if you take supplemental melatonin then it seems likely that your body will use less serotonin for making melatonin and you’ll have better levels of this sleep-inducing hormone, too. Low serotonin and tryptophan also contribute to weight gain.

      If you can’t afford a neurotransmitter test, I still think it is likely that moderate supplementation with tryptophan, lysine, and melatonin is a good idea as you’re unlikely to cause any big problems other than possibly morning grogginess.

      You need to address the anxiety issues, too. L-theanine, glycine, and phenibut all seem to be good at helping with mild to moderate anxiety levels. It’s my observation that benzodiazipines are a bad choice for chronic usage, but they can be OK for sporadic usage under extreme anxiety conditions. You just don’t want to be taking these for longer than a few days without a break of a week or more as they will cause physiological dependence in nearly everybody.

      Have you been tested for DHEA, pregnenolone, testosterone, and estradiol levels? These are often severely disturbed with people who have adrenal gland problems. Often supplemental pregnenolone (which can convert to cortisol) and DHEA (which can convert to testosterone) are very helpful. But I really recommend you have baseline blood test results so you can understand if you may have to watch out for conversion to too much estradiol which is very common in guys over 40. If that’s a problem, you may need a medication such as Arimidex to help fight that. You could also use 7KETO DHEA instead of regular DHEA as it is supposed to be incapable of conversion to testosterone and then estradiol.

      Do you have insurance coverage? If so, I’d suggest you try an endocrinologist for starters as they should also be familiar with other hormone problems, too. They seems to take hormone problems much more seriously than most GPs. Try to find who cites experience treating people with chronic fatigue and fibromyalgia types of symptoms as they are almost certainly going to be very familiar with cortisol problems.

      Some holistic and Chinese medicine practitioners can be very good and inexpensive compared to doctors. But they may not have the predisposition to run some of the tests the endocrinologists are likely to run. Given how adrenal gland problems often are accompanied by many other hormone problems, I think it’s important to get a comprehensive set of hormone tests and insurance is likely to cover them if an endocrinologist orders them.

      Hope this helps.

      Alison

    • Art,

      I’ve been thinking some more about your low in the morning and high at night cortisol imbalance.

      One problem with treating this out-of-sync imbalance is that you can’t afford the time and expense to get your cortisol levels checked via saliva test multiple times per month as you change supplements and behaviors trying to aid in your recovery.

      Two things you can realistically watch to help monitor cortisol levels are body temperature and blood pressure. When cortisol is low, your body temperature tends to be low and unstable. Note that low thyroid hormones also tend to push body temperatures low, but if you have normal cortisol then you will often see low but stable temperatures. With low cortisol or varying cortisol and normal thyroid hormones, you could for instance see temperatures of something like 94 to 95 degrees F in the morning and 98 or 99 at night given your cortisol pattern.

      When cortisol is low, your blood pressure generally will be lower. When it is high, your blood pressure tends to go up. So if you get yourself a thermometer and blood pressure tester, you can try checking these two measurements at various times of the time and note how they change versus what you saw in your saliva cortisol test.

      Also, you can time taking certain cortisol-lowering supplements for the afternoon and night. Phosphatidylserine (often abbreviated PS) is reputed to have cortisol lowering affects. You could try taking 100 mg of this in the afternoon and another 100 mg at night to see if that helps. Unfortunately PS is rather expensive compared to some other supplements.

      Are there behavioral things that you do in the afternoon, evenings, and night that may produce aggravation and/or fear? These may be raising your cortisol levels, too. For instance, if you are working in a stressful job then that may be raising your cortisol levels so that by night they are high. It’s possible that your body tries to compensate for this by producing too much of the enzymes that break down cortisol at night, and then you have low cortisol in the mornings. But this is guess as figuring this out with certainty is not an easy thing to do.

      I think you could also experiment with timing of adaptogens such as rhodiola rosea that are known for helping to normalize cortisol levels. One Life Extension article Reducing the Risks of High Cortisol discusses rhodiola rosea at length and cites how it helps avoid elevated cortisol from stressful circumstances. Perhaps you could time taking rhodiola rosea once before lunch and once before dinner and see if that helps get your night-time cortisol levels to come down some.

      You should also read a Life Extension article on stress management discusses several herbal and nutritional options. I’ve already mentioned a few of them to you and in my articles, but there are some others mentioned in there, too.

      Alison

  6. I took the spit test. corisol levels as follows: moring-2.7
    noon-9.2, evening-3.5, night-.7
    I went to internal med dr who prescribed p-100, and something for am to bring levels up and the former for bringing them down again. I have suffered all the symptoms for 3 years, I am in menapause, last period oct. 2010. I lost my job in 2010 due to aggresive and paranoid personality problems. I have lost everything since then, job, home, insurance, no unemployment insurance. I live with boyfriend who tries to help but is tired of it all. can you recommend any help for me.

    • Lori,

      If you shifted the numbers in time so that the noon numbers were in the morning, they actually don’t look nearly as bad then.

      This makes me think that perhaps a sleep phasing problem has something to do with it. What is your sleep schedule like most nights (in bed to out of bed)?

      How would you describe your sleep?

      Specifically, how long does it take to fall asleep, how many times do you wake up, how long does it take to fall back to sleep after each waking?

      Just a guess, but if you are having a lot of problems falling asleep then maybe the focus should be on that first and perhaps the out-of-phase cortisol would be partially or entirely fixed.

      Alison

    • Lori,

      Did you get any other hormone test results? Often people with adrenal or cortisol problems also have low pregnenolone and DHEA.

      Pregnenolone can convert to cortisol. You may want to try taking a small starting amount of pregnenolone and DHEA, around 50 mg to 100 mg of each, in the mornings to see if that helps your symptoms.

      It’s possible that you might be able to help elevate your morning cortisol levels by taking some supplemental pregnenolone and licorice root at bedtime. The licorice root may help to keep what cortisol you have from being enzymatically degraded and the pregnenolone might provide raw ingrediants to make more cortisol.

      There’s a chance that this may help raise your waking cortisol levels some. There’s also a chance that it may raise the sleeping cortisol levels too high and could interfere with sleep. Which it will do, if either, you may not be able to know without trying it.

      Ashwagandha and rhodiola rosea are adaptogens that may help stabilize the cortisol levels in normal ranges. You can try taking these in the morning and afternoon.

      During the time your cortisol levels are too high, you might try taking phosphatidylserine complexed with something like omega 3 fatty acids and lecithin. Sharp PS Gold is one ingredient that is made like this, you can find it in a few products.

      Alison

  7. Pingback: Treatment of Depression and Anxiety from Divorce and Child Custody Battles Using Antidepressants and Benzodiazipines Is Risky | angiEmedia

  8. My wife has been struggling with high cortisol at night (about 2:00 am) for about a year life factors include the lose of family members, premenepause age 53, she is getting couseling she has had test after test takes zanax has tried lexapro and is using some herbs. balancing seratonin is a problem also ….. any help would be great…. Victor

    • I would suggest trying to avoid the Xanax and any benzodiazepines whenever possible. Save them for extreme anxiety situations. If they are used too much, they will not work and most people will develop a physiological dependency on them requiring higher and higher dosages.

      There are reports that low-dosage DHEA, pregnenolone, and L-theanine can help reduce the side effects of benzodiazepines and possibly reduce the need for them in the first place.

      Can you describe her general mood and anxiety levels and how they change during the day?

      How is her sleep? How long does it take to fall asleep? How often does she wake? How long does it take to fall back to sleep? How does she feel after a typical 8 hour night in bed?

      Taking phosphatidylserine after dinner may help lower the 2 AM levels of cortisol. Ashwagandha a couple of times during the day is also worth a try.

      Glycine around 3g to 5g at bedtime seems to help with moderate anxiety.

      Phenibut around 300mg to 900mg can help with higher levels of anxiety.

      You can combine glycine and Phenibut.

      Valerian root extracts can also help.

      I recommend that people try to avoid SSRI antidepressants like Lexapro. Be sure to change dosages of these medications very slowly because rapid dosage changes are likely to cause worsened depression even leading to suicide. Such side effects are particularly likely within the first few weeks of initiating these medications.

      SSRI antidepressants are believed to work by allowing existing serotonin to be used more effectively.

      An alternative is to try to boost serontonin levels using nutraceuticals such as L-tryptophan supplementation. By combining lysine with L-tryptophan, you can often drive more tryptophan into the brain where it can be used to produce serotonin. You should also consider supplementing with B complex vitamins, particularly B6, B12, and folate, to improve neurotransmitter production.

      There’s a prescription drug call Metanx which is essentially a prescription vitamin as its active ingredients are bioactive forms of B6, B12, and folate. It is often prescribed for diabetes patients, but many psychiatrists are also using it for depression. You can get P5P, methylcobalamin, and methylfolate supplements that are the active ingredients in Metanx without a prescription.

      5HTP can help similarly to tryptophan, but a problem with it is that it may convert to serontonin before it crosses the blood-brain barrier.

      Fish oil supplementation is believed to help with depression by helping to repair cell membranes and improve neurotransmitter levels.

      Some people benefit from taking melatonin before bed. This can help spare serotonin which may otherwise be used to make more melatonin. Sometimes high dosages of melatonin (particularly those over 10mg) may increase grogginess upon waking, so I would suggest trying a smaller dosage such as 3mg immediate release for starters and see how that works. There are products that combine immediate release and timed release melatonin that may also be good choices, especially if repeated waking during the night is a problem.

      Alison

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