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.
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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.
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.
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