Cortisol

What is cortisol?

Cortisone

Symptoms of excess cortisol (hypercortisolism)

Causes of excess cortisol

Prevention / remedies / cures / treatment for excess cortisol

Insufficient cortisol

References

What is cortisol?

Cortisol is the main hormone produced by stress and injury. Over short periods, it is a beneficial healing agent. However, over long periods excess cortisol can cause cortisol resistance (akin to insulin resistance). In this case more and more cortisol keeps getting produced, but its healing abilities become ineffective.

Corticosteroids are a class of steroid hormones that are produced by the adrenal glands. Corticosteroids are involved in a wide range of physiological processes, including stress response, immune response, regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels and behaviour.

Cortisol is the main corticosteroid hormone produced by the adrenal gland in most animals. It is released into the bloodstream mainly in response to stress, and to a lesser extent by a low blood-glucose level.

Cortisol's main functions are to suppress the immune response, to increase blood sugar through gluconeogenesis (glucose from non-carbohydrate sources like proteins and fats), and to aid in the metabolism of fat, protein and carbohydrates. (5)

Cortisol decreases bone formation. (1, 6)

In the 24 hour diurnal body cycle, cortisol is at its lowest level between midnight and 4am, and reaches its peak around 8 am to 9 am. (8)

Various synthetic pharmaceutical near-forms of cortisol which can be patented (cortisol look-alikes such as Prednisone) are used to treat a variety of diseases by conventional medical practitioners. They are used to suppress the immune system and reduce inflammation. Like any good pharmaceutical product they suppress the symptoms in the short term, but in the long term they have potent side-effects.

Cortisone

Cortisone is frequently confused with cortisol.

Cortisone is a steroid hormone. A synthetic look-alike (hydrocortisone) is used by the pharmaceutical industry as a pharmaceutical prodrug. A prodrug is a medication or compound that is metabolized (converted) into a pharmacologically active drug after taking it.

Cortisone is converted by the liver back to the active steroid cortisol by the action of an enzyme produced in the kidneys. If this enzyme is too high, just a little stress can cause way too much cortisol. If enzyme is too low, the stress will not receive the healing benefits of cortisol. (2, 3, 4, 5)

Symptoms of excess cortisol (hypercortisolism)

• Waking at 2 am or 3 am in the morning and not able to get back to sleep until normal get up time at 7 am or 8 am. Notice that this is the opposite of the normal and healthy circadian-cortisol cycle described above.
• Anxiety and depression. Stressed and not coping. (9, 10) This can raise the risk of dementia later in life.
• Heart rate variability, heart palpitation, arrhythmia.
• A high level of fear for an extended period (days, weeks, months) inhibing one's ability to reason and think clearly.
• Metabolic syndrome, insulin resistance, because glucose production is increased. Diabetes, type 2. (3)
• Cholesterol disrupted, with a worse blood fat profile (high triglycerides, decreased HDL, increased LDL, increased small dense cholesterol). Cardiovascular stress. High blood pressure. (8)
• Weight gain or obesity with fat concentrated around the belly. At the same time as gaining a paunch, you may lose muscle around the legs and buttocks.
• Osteoporosis, osteopenia. (1, 6)
• Inflammation. Initially, the immune system is suppressed, resulting in the outbreak of cold sores or being susceptible to infections. In the long term, chronic inflammation occurs.
• Detoxification by the liver is compromised. Bile salts are inhibited. Reduction in pancreatic enzymes. Reduced stomach acid.
• Copper deficiency. High levels of cortisol deplete copper. The classic early symptom of copper deficiency is grey hair.
• PCOS.
• Hypotonic urine. This is when an unusually low level of salts is expelled in the urine.
• Hair loss or balding.
• Cushing's Syndrome is caused by excess cortisol, including prolonged use of pharmaceutical steroids. Another frequent cause of Cushing's Syndrome is tumours on the adrenal or pituitary glands. Cushing's disease sufferers tend to have 'moon' faces and 'buffalo' humps (fat between the shoulders). Other symptoms include obesity, hypertension, diabetes, excessive body hair or baldness, weak immune system, cholesterol problems, muscle weakness, menstrual problems and sexual difficulties.

Causes of excess cortisol

• Prolonged stress, severe trauma, worry, burnout. This is usually self-generated. Watching news, TV, any media, advertisements and even movies and documentaries is mostly absorbing negative, fear-creating, loser-think. Hanging out with negative people achieves the same thing. They engender a negative attitude to life - a victim attitude, a lack of self-responsibility, a life full of complaint. (9, 10)
• Diet high in sugar, sweet food.
• Sleep deprivation.
• Caffeine excess.
• Estrogen excess, often caused by hormonal supplementation, xenoestrogens or menopausal problems.
• Vitamin D deficiency.
• Intense or prolonged physical exercise done too frequently.
• Chronic diseases, prolonged trauma pain or trauma.
• Excessive levels of potassium stimulate cortisol secretion. (7) However, this is unusual and the more common case is potassium deficiency which also causes excess cortisol.

Prevention / remedies / cures / treatment for excess cortisol

If you use any remedies from Grow Youthful, please come back next week (or whenever you have an outcome) and let us know about your experience. Please leave a comment as many people are interested.

See details of remedies recommended by Grow Youthful visitors, and their experience with them.

• Stress and attitude management. Look for what is good in your life, what is good right now. Can you see trees or plants outside? You are not starving, are you? There is much to be grateful for, all the time. Look for people who are truthful, who have others who love them, and who are both busy and generous.
  
  Attention. Moving your attention to doing something which uses different parts of your brain or requires your body to do something or be involved is a really effective way of stopping worrying. For example, a study found that just 45 minutes of art caused significantly lower levels of cortisol. (23)
• Diet. A non-toxic diet avoiding sugar and refined carbohydrates so you eat foods that starve rather than feed small-bacteria infections. Avoid using omega-6 polyunsaturated fats which cause systemic inflammation. Use probiotics.
• Sunlight and Vitamin D. Sunlight is a great de-stressor, and is the primary means by which we evolved to get vitamin D and other beneficial substances like nitric oxide.
• Green tea, which contains a compound named EGCG. This is a potent modulator of cortisol level in the blood, particularly if liver or kidney enzymes are not working properly. (2)
• Treating chronic diseases that are the root cause of the problem, prolonged trauma or pain.
• Exercise - comfortable, regular, enjoyable. Physical labour or work is also good, not only because of the exercise but also because it gets your mind off your worries.
• Curcumin in turmeric.
• Passionflower tea.
• Japanese nut weed.
• Ashwagandha. (11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21)
• Licorice.
• Vitamin B1, potassium, magnesium.
• Apple cider vinegar.

Insufficient cortisol (hypocortisolism)

Virtually the opposite symptoms to having excess cortisol - in other words, insufficient reaction to wounds and stress and low or slow healing response.

This is often associated with Addison's disease, Nelson's syndrome or Sheehan's syndrome.

Causes of insufficient cortisol may include the following. However, it depends on how long the disease has been established.

• Adrenal fatigue - initially.
• Chronic inflammation - long term.
• Autoimmune diseases.

References

1. Shengye Liu, Liyu Yang, Shuai Mu, Qin Fu. Epigallocatechin-3-Gallate Ameliorates Glucocorticoid-Induced Osteoporosis of Rats in Vivo and in Vitro. Pharmacol, 09 May 2018. Sec. Experimental Pharmacology and Drug Discovery. doi.org/10.3389/fphar.2018.00447.

2. Hintzpeter J, Stapelfeld C, Loerz C, Martin HJ, Maser E. Green tea and one of its constituents, Epigallocatechine-3-gallate, are potent inhibitors of human 11B-hydroxysteroid dehydrogenase type 1. PLoS One. 3 January 2014. 9(1):e84468. doi: 10.1371/journal.pone.0084468. PMID: 24404164; PMCID: PMC3880318.

3. Harun Patel, Kiran Dhangar, Yogesh Sonawane, Sanjay Surana, Rajshekhar Karpoormath, Neeta Thapliyal, Mahamadhanif Shaikh, Malleshappa Noolvi, Rakesh Jagtap. In search of selective 11B-HSD type 1 inhibitors without nephrotoxicity: An approach to resolve the metabolic syndrome by virtual based screening. Arabian Journal of Chemistry, Volume 11, Issue 2, 2018, Pages 221-232, ISSN 1878-5352, doi.org/10.1016/j.arabjc.2015.08.003.

4. Sun W, Chen X, Tong Q et al. Novel small molecule 11B-HSD1 inhibitor from the endophytic fungus Penicillium commune. Sci Rep 6, 26418 (2016). doi.org/10.1038/srep26418.

5. Hoehn K, Marieb EN. Human Anatomy & Physiology. 2010. San Francisco: Benjamin Cummings. ISBN 978-0-321-60261-9.

6. Chyun YS, Kream BE, Raisz LG. Cortisol decreases bone formation by inhibiting periosteal cell proliferation. February 1984. Endocrinology. 114 (2): 477-80. doi:10.1210/endo-114-2-477. PMID 6690287.

7. Mikosha AS, Pushkarov IS, Chelnakova IS, Remennikov GY. Potassium Aided Regulation of Hormone Biosynthesis in Adrenals of Guinea Pigs Under Action of Dihydropyridines: Possible Mechanisms of Changes in Steroidogenesis Induced by 1,4, Dihydropyridines in Dispersed Adrenocorticytes. 1991, Fiziol. 37: 60.

8. Mohd Azmi, Juliana N, Azmani S, Mohd Effendy N, Abu IF, Mohd Fahmi Teng NI, Das S. Cortisol on Circadian Rhythm and Its Effect on Cardiovascular System. Int J Environ Res Public Health. 2021 Jan 14;18(2):676. doi: 10.3390/ijerph18020676. PMID: 33466883; PMCID: PMC7830980.

9. Tsigos C, Chrousos GP. Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress. J Psychosom Res. 2002 Oct;53(4):865-71. doi: 10.1016/s0022-3999(02)00429-4. PMID: 12377295.

10. Hannibal KE, Bishop MD. Chronic stress, cortisol dysfunction, and pain: a psychoneuroendocrine rationale for stress management in pain rehabilitation. Phys Ther. 2014 Dec;94(12):1816-25. doi: 10.2522/ptj.20130597. Epub 2014 Jul 17. PMID: 25035267; PMCID: PMC4263906.

11. 15. Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019 Sep;98(37).

12. Andrade, C et al. A double-blind, placebo-controlled evaluation of the anxiolytic efficacy of an ethanolic extract of withania somnifera. Indian journal of psychiatry vol. 42,3 (2000): 295-301.

13. Choudhary D, et al. Body weight management in adults under chronic stress through treatment with ashwagandha root extract: a double-blind, randomized, placebo-controlled trial. J Evid Based Complementary Altern Med. 2017 Jan;22(1):96-106.<

14. Langade D, Kanchi S, Salve J, Debnath K, Ambegaokar D. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study. Cureus. 2019 Sep 28;11(9).

15. Salve, J. et al. Adaptogenic and Anxiolytic Effects of Ashwagandha Root Extract in Healthy Adults: A Double-blind, Randomized, Placebo-controlled Clinical Study. Cureus 2019.

16. Gannon JM, et al. Effects of a standard- ized extract of Withania somnifera (Ashwagandha) on depression and anxiety symptoms in persons with schizophrenia participating in a randomized, placebo-controlled clinical trial. Ann Clin Psychiatry 2019; 31(2): 123-9.

17. Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian J Psychol Med. 2012 Jul;34(3):255-62. doi: 10.4103/0253-7176.106022. PMID: 23439798; PMCID: PMC3573577.

18. Auddy B, et al. A standardized withania somnifera extract significantly reduces stress-related parameters in chronically stressed humans: a double-blind, randomized, placebo-controlled study. Journal of the American Neutraceu- tical Association 2008; 11(1): 50-6.

19. Khyati S, et al. A randomized double blind placebo controlled study of ashwagandha on generalized anxiety disorder. International Ayurvedic Medical Journal 2013; 1(5): 1-7.

20. Fuladi S, et al. Assessment of Withania somnifera root extract efficacy in patients with generalized anxiety disorder: A randomized double-blind placebo-controlled trial. Curr Clin Pharmacol 2020.

21. Auddy B, et al. A standardized withania somnifera extract significantly reduces stress-related parameters in chronically stressed humans: a double-blind, randomized, placebo-controlled study. Journal of the American Neutraceutical Association 2008; 11(1).

22. Larsson SC, Lee WH, Burgess S, Allara E. Plasma Cortisol and Risk of Atrial Fibrillation: A Mendelian Randomization Study. J Clin Endocrinol Metab. 2021 Jun 16;106(7):e2521-e2526. doi: 10.1210/clinem/dgab219. PMID: 33822969; PMCID: PMC8208666.

23. Kaimal G, Ray K, Muniz J. Reduction of Cortisol Levels and Participants' Responses Following Art Making. Art Ther (Alex). 2016 Apr 2;33(2):74-80. doi: 10.1080/07421656.2016.1166832. Epub 2016 May 23. PMID: 27695158; PMCID: PMC5004743.