Cortisol has earned the nickname the “stress hormone” because it is often connected to a stress response. However, cortisol is connected to more bodily functions than just your stress response. Understanding what role cortisol plays in maintaining your overall health as well as how it is connected to conditions such as adrenal dysfunction can help balance hormones and restore your sense of wellness.

What is Cortisol?

Cortisol is a steroid hormone produced in the adrenal glands, which are no bigger than a walnut and they sit on top of the kidneys.

Cortisol is involved in a wide range of metabolic processes like:

  • Mobilizing and increasing amino acids, the building blocks of protein, in the blood and liver.
  • Stimulating the liver to convert amino acids to glucose, the primary fuel for energy production.
  • Stimulating increased glycogen in the liver (the stored form of glucose).
  • Mobilizing and increasing fatty acids in the blood (from fat cells) to be used as fuel for energy production.
  • Counteracting inflammation and allergies.
  • Preventing the loss of sodium in urine and thus helps maintain blood volume and blood pressure.
  • Maintaining resistance to stress (e.g., infections, physical trauma, temperature extremes, emotional trauma, etc.).
  • Maintaining mood and emotional stability
  • Maintaining sleep-wake cycle (cortisol increases to wake us up in the mornings, then gradually declines throughout the day)

When we are stressed, our adrenals produce extra cortisol, which activates the body’s stress responses. When stress, which can be physical, mental, or emotional, continues over a long period of time, the adrenals become unable to keep up with the increased demand, and cortisol levels can drop.

What Happens When Cortisol Levels are Low?

Low cortisol levels can cause a variety of symptoms such as severe fatigue, hypoglycemia, muscle aches, sugar or salt cravings, and shakiness that is relieved by eating.

Low cortisol can also bring on symptoms such as moodiness, low blood pressure, allergies, recurrent infections, decreased ability to handle stress, brain fog, and swollen ankles that are worse at night. Patients often complain of muscle weakness, difficulty getting out of bed in the mornings, being wiped out and taking longer to recover from exercise, and being unable to tolerate thyroid hormone replacement.

When the adrenals continue to produce inadequate levels of cortisol, it is considered a form of adrenal dysfunction known as adrenal fatigue or burnout. This is actually incredibly common as many health experts estimate that upwards of 80% of the population suffers from some level of adrenal insufficiency.


Treating Adrenal Dysfunction with Cortisol

Under the right circumstances, hormone replacement can be of great benefit for people with adrenal dysfunction.

Some physicians, notably Dr. Jefferies in the mid-1980s, have advocated low-dose cortisol as safe for long-term use. Dr. Jefferies found that as long as the adrenal hormone level is kept within the normal range, the main toxicity that a patient might experience was a slight upset stomach, due to the body not being used to having the hormone come in through the stomach.

In an article published by Dr. Kent Holtorf in the Journal of Chronic Fatigue Syndrome about therapeutic doses of cortisol for patients with Fibromyalgia and chronic fatigue syndrome, he states: “Because treatment with low physiologic doses of cortisol (< 15 mg) has been shown to be safe and effective and routine dynamic ACTH testing does not appear to have significant diagnostic sensitivity, it is reasonable to give a therapeutic trial of physiologic doses of cortisol to the majority of patients with CFS and FM, especially to those who have symptoms that are consistent with adrenal dysfunction, have low blood pressure, or have baseline cortisol levels in the low or low-normal range. (…) Physiologic replacement of cortisol at doses of 5 mg to 15 mg a day is safe, with little or no associated risk. Such physiologic doses don’t carry the risk of adrenal and immune suppression or bone loss, which are well-known risks of pharmacological doses of corticosteroids. Cortisol treatment carries significantly less risk and a greater potential for benefit than standard treatments, such as antidepressants, muscle relaxants, anticonvulsants, and narcotics.”

Taking Care of Your Adrenals

The adrenals and proper production of cortisol are critical components of healthy bodily function. Adrenal fatigue can result in dramatic repercussions on your physical, emotional, and mental health. Treatment of adrenal fatigue should be tailored to you and your specific needs and can include low-dose cortisol, adrenal glandulars, vitamin C, Pantothenic acid, licorice, and chromium. Additionally, there are daily habits that you can incorporate into your routine to support adrenal health.

At Holtorf Medical Group, our team of experts can help address your concerns with the aid of highly-trained physicians that understand the adrenals and how to support them. If you are experiencing symptoms of burnout, contact us to see how we can help you!

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