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Cortisol Switcharoo (Part 2): How the Main Stress Hormone Robs Your Brain of Happy Chemicals and Sleep

I've written before about the "cortisol switch." Now, let's talk about how cortisol, the main stress hormone produced by your adrenal glands in your mid-back, brings you down and ramps up your risk of serious disease -- and more importantly, what you can do about it.
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2012-06-19-SGphoto2012195.jpgToday I want to dish on my Achilles' heel, which is the wayward, dysregulated hormone called cortisol. I wrote last time about the "cortisol switch" (described in part one -- click here for the definition), and now let's talk about how cortisol, the main stress hormone produced by your adrenal glands in your mid-back, brings you down and ramps up your risk of serious disease -- and more importantly, what you can do about it.

The Cortisol Diaries

Cortisol isn't a bad hormone, it just has a bad case of impulse control issues when your life is stress-crazed. When stress is not managed skillfully, and it becomes a chronic and repetitive part of your personal narrative, cortisol rises too high. Cortisol has three main jobs in your body: raise blood sugar (as fuel), raise blood pressure (so you can run from the tiger your body thinks is chasing you), and modulate your immune system.

Here are some of the problems linked with excess cortisol.

  • Diabetes/pre-diabetes. Cortisol's main job is to raise glucose levels, and even small bumps in cortisol, such as when drinking a cup of regular coffee, can raise blood sugar and increase insulin resistance (another major topic I'll tackle soon for you, and I promise to make it stunningly simple).

  • Sucky mood. Persistent stress causes your body to increase the production of brain chemicals, and initially you make too many "excitatory" neurotransmitters, such as epinephrine and norepinephrine. Over time your supply runs dry on feel-good brain chemicals such as serotonin, which regulate mood, sleep, and appetite. Then you find yourself mildly depressed, unable to focus, and wondering what happened to your battery charge. Maybe sleep and motivation start to worsen. Not pretty, but also not a good time to start a prescription antidepressant (unless, of course, symptoms are severe and you together with your doctor decide it's needed) -- you need to work on more effective stress management and correcting your cortisol (see prescriptions below), not crank up your serotonin with a happy pill! By the way, the "happy" pill was recently shown to increase breast and ovarian cancer by 11 percent, which you can now add to the list of side effects including weight gain, stroke, and libido hijack.[1]
  • More body fat. Too much cortisol makes you fat, especially at your belly. Hello, spare beach floaty? Unfortunately, the belly fat has four times the number of cortisol receptors, so you get into a vicious cycle of excess cortisol creating more body fat, which gets stimulated by persistently high cortisol levels.
  • Slow wound healing. When cortisol is high, it takes you longer to recover from injury, like a cut or even a sports injury. Your immune system is too jacked up to work effectively.
  • Lousy sleep. If you measure the cortisol levels of insomniacs, they are increased. High cortisol at night inhibits melatonin and disrupts your circadian clock.
  • Liver injury. Up to 20 percent of people with Cushing's syndrome, the clinical diagnosis conventional doctors make in people with cortisol levels that are inappropriately high and cause a particular batch of signs and symptoms, also have liver problems such as non -alcoholic fatty liver disease (NAFLD). Recently, the reverse was also found to be true: People with NAFLD show a switch in how the liver processes cortisol, leading to increased cortisol metabolism and clearance, perhaps to protect the liver from further damage from cortisol.[2]
  • Okay, Okay... Enough of the doom and gloom. Let's turn this ship around before it hits the iceberg.

    Now, for your prescriptions
    I have 250 prescriptions for right-sizing your cortisol. Here are three more.

    1. Get a massage. You're probably thinking, "Duh!" but there was just a small randomized study suggesting that massage may lower your cortisol. Now if we could just get our insurance to pay for it!

    2. Alternate nostril breathing. I do this three times per day. The Sanskrit term is "Nadi Shodhana," or channel-clearing breath. If you need to learn how to do it, click here for my YouTube video. This is not woo woo -- there's is science showing that when you breath in this way, your breath crosses the center line, builds synapses, leverages neuroplasticity, helps you see the bigger picture, and increases problem solving. And, by the way, it's shown in a randomized trial to lower blood pressure and heart rate, which means it reverses signs of stress.

    3. L-Theanine. Shown to calm down the sympathetic nervous system ("fight or flight"). The idea is that we need sacred balance between the sympathetic nervous system and parasympathetic nervous system ("rest and digest"). Dose of L-theanine is 250 to 400 mg per day.

    Now I'd like to hear from you...

    What are your favorite ways to lower cortisol when it's crazy high? Another prescription of mine is to leverage oxytocin with lingering touch (and orgasm), but that's a conversation for another time.

    Please leave me a comment and let me know what practices work best for you.

    Sara Gottfried, M.D., is a practicing integrative physician and author of the forthcoming book, The Hormone Cure (Scribner/Simon &Schuster, 2013). You can follow Dr. Sara on Twitter, connect with her on Facebook, watch her videos on Youtube, and subscribe to her newsletter.

    For more by Sara Gottfried, M.D., click here.

    For more on personal health, click here.


    1. Cosgrove L, Shi L, Creasey DE, Anaya-McKivergan M, Myers JA, Huybrechts KF. Antidepressants and breast and ovarian cancer risk: a review of the literature and researchers' financial associations with industry.
    PLoS One. 2011 Apr 6;6(4):e18210. Review.

    2. Ahmed A, Rabbitt E, Brady T, Brown C, Guest P, Bujalska IJ, Doig C, Newsome PN, Hubscher S, Elias E, Adams DH, Tomlinson JW, Stewart PM. A switch in hepatic cortisol metabolism across the spectrum of non alcoholic fatty liver disease. PLoS One. 2012;7(2):e29531. Epub 2012 Feb 20.

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