Diane was a middle-aged financial consultant who had been in relatively good health. She had undergone a hysterectomy 24 months prior and used only bio-identical hormones. She ate a healthy diet, worked out regularly, took the proper supplements, and slept well. You may picture Diane as a fit, happy, and healthy person. However, Diane was forty-five pounds overweight, losing her hair, exhausted all day, depressed, perpetually cold, and having digestive problems. She was doing all the right things, so why did she still feel like gum on the bottom of a shoe? The important missing tidbit was that Diane and her spouse of twenty years divorced one year prior. How is it possible for just one stressful circumstance to wreak such havoc? The answer is cortisol induced hormonal chaos.
Hormones are chemical messengers released by our bodily organs is response to orders received from two key areas in the brain, the hypothalamus and the pituitary gland. These two ‘parental figures’ tightly regulate the functions and behaviors of the body’s ‘hormone children’ so the family lives harmoniously. The sibling hormone cortisol is the most disruptive of them all, and because it is the most influential bodily hormone, it alone can dictate the whole hormone family dynamic in a detrimental way. Cortisol is the body’s main stress hormone and is released by the adrenal glands in response to stress. As the primary ‘fight or flight’ hormone, cortisol is the only hormone we could not survive without. We are designed to mount a ‘healthy’ fight or flight response for short periods of time. However, if we defy the rules of nature and subject ourselves to persistent stress in its many forms, the body does what it can to protect your life but not your health, peace of mind, and longevity.
Cortisol is the body’s primary ‘wear and tear’ hormone. Its task is to provide cells with the fuel necessary to mount a stress response. Various other hormones including estrogen, testosterone, progesterone, and growth hormone are ‘growth and repair’ hormones. In order for your body to function optimally, there must be balance between all of these hormones. If chronic stress tips the balance in cortisol’s favor, ‘non-essential’ functions (i.e. digestion, sleep, and reproduction) take a back seat on the long trip to poor health. Exploring the influence cortisol exerts on other hormones may provide a better understanding for why so many bodily functions go awry when we are ‘stressed out’.
Cortisol and Estrogen
Estrogen has in excess of four hundred functions within the body which include maintaining a healthy cardiovascular system, building bone tissue, protecting brain function, and promoting reproduction. When cortisol is elevated, the release of estrogen declines. Furthermore, the sensitivity of tissues to estrogen is absent even if it is present. As a result, delayed puberty, infertility, absence of menses, and miscarriage may occur. In aging women, cortisol frequently rises, and it is believed this could be responsible for postmenopausal women’s propensity towards developing weight gain, mood problems, inflammation and autoimmune disease, insulin resistance, and greater risk for heart disease.
Cortisol and Progesterone
Not only is progesterone a reproductive hormone, it also functions as an anti-inflammatory, anti-muscle spasm, anti-anxiety, and anti-uterine cancer and anti- breast cancer hormone. Its capacity to also serve as a neuroprotective hormone (preserving and sustaining the brain) enhances thought processes, focus, and recall. Since the body normally uses progesterone to make cortisol, during times of acute and chronic stress, a unique phenomenon identified as “the progesterone steal syndrome” may occur. The result is a decrease in levels of progesterone as it funnels into cortisol production to meet the body’s increased cortisol requirement. This can cause premenopausal females to have PMS symptoms and postmenopausal women to suffer from worsening signs and symptoms of estrogen dominance (i.e. irritability, sleep disturbances, an increase in weight, bowel disturbances, breast cancer, and uterine cancer)
Cortisol and Testosterone
Testosterone plays as essential a role in men as estrogen does in women. Studies have revealed testosterone to be crucial in instrumental in maintaining heart health, optimizing blood glucose control, improving sexual function, and improving bone health. Testosterone is essential in women too serving to maintain energy levels, sex drive, mood, bone strength, and mental function. As is the case with other ‘feel good’ hormones, levels of testosterone plummet in the face of cortisol dominance.
Cortisol and DHEA
DHEA is the other primary adrenal gland hormone and it rises with cortisol during an acute stress response. Just as progesterone is the body’s natural ‘anti-estrogen’ hormone, DHEA is the body’s natural ‘anti-cortisol’ hormone. Its appearance during acute stress helps prevent cortisol from causing extensive injury to otherwise healthy tissues. Chronic stress leads to a decrease in DHEA. Since DHEA is essential for immune system function, heart health, bone building, and brain function, cortisol induced reductions in DHEA can bring about a myriad of signs and symptoms involving many different bodily systems. One unique hint that DHEA could be low is loss of hair in the armpits, on the legs, and in the pubic area.
Cortisol and Thyroid Hormone
Thyroid hormone is a key player in the metabolism of protein, carbohydrates, and fats, advising cells how to handle each type of energy form. Thyroid hormone is also crucial in maintaining the health of tissues, stimulating bone growth, and boosting brain cell development. Like cortisol, thyroid hormone is actually a ‘wear and tear’ hormone. To protect itself from stress induced spontaneous combustion, the body can put the brakes on thyroid hormone production and action. Common symptoms of low thyroid hormone levels include lethargy, cold intolerance, constipation, depression symptoms, memory problems, and an increase in weight. Considering that stress induced alterations in thyroid hormone occur in an indirect manner, test results may fall ‘within the normal range’, and therein lies the challenge.
Reestablishing Hormone Family Harmony It may be more obvious why Diane’s hormone balance was disturbed soon after she experienced a tremendously stressful ordeal. Since cortisol effectively negates the beneficial effects of other hormones, every organ system can be harmed by perpetual cortisol excess. It is important for your health care provider to check the integrity of your stress response system, including cortisol levels, before initiating any kind of hormone replacement therapies. Bear in mind, sibling rivalry is intense between cortisol and all the other hormones. Just as a cortisol lowers other hormones, replacing other hormones in the presence of low cortisol can cause and equal and opposite problem. Estrogen, progesterone, testosterone, DHEA, and thyroid hormone, especially when given simultaneously, can lead to signs and symptoms of worsening fatigue, weight gain, depression, and chronic pain since these hormones will tip the balance out of cortisol’s favor (remember hypocortisolism?)
I call stress ‘The Great Equalizer’ for good reason. Only in the company of a happy stress response system will the body function at optimal levels.