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Posted on December 23, 2011 By
Maybe you’ve heard the word “cortisol” thrown around a few times, and maybe it means nothing to you. If you’ve ever been remotely into body-building, it’s a term that you would be very familiar with.
Before we get into the “What About Cortisol?” topic, I want to talk a little about the author of the article I’m going to recommend to you here. Dr. Jack Kruse isn’t your average neurosurgeon. Based out of Nashville Tennessee, Dr. Kruse works out of a facility called Nashville Neurosurgery, but he actually started out his medical career as a dentist. This wide scope of medical knowledge definitely gives Jack an edge the field, but what really sets him apart from the rest, is that he personally practices the Paleo diet lifestyle, and uses those principles in the treatment of his patients. Jack’s blog, “Living An Optimized Life”, can be found at . I recommend you go and take a look at the articles on Jack’s blog, because you’ll quickly see that he has a very unique writing style, and an immense amount of knowledge to share.
So anyway….what IS cortisol?
“Cortisol (hydrocortisone) is a , more specifically a , produced by the . It is released in response to and a low level of blood glucocorticoids. Its primary functions are to increase through ; suppress the immune system; and aid in fat, protein and carbohydrate metabolism. It also decreases bone formation. During pregnancy, increased production of cortisol between weeks 30-32 initiates production of fetal lung surfactant to promote maturation of the lungs. Various synthetic forms of cortisol are used to treat a variety of diseases.” – Wikipedia.org
Dr. Kruse posted an article to his blog on December 8th 2011, entitled “”, that just happens to be all about cortisol from an ancestral perspective. After a brief introduction, which was written in a way that cannot possibly be considered “layman’s terms”, Dr. Kruse sets the stage fro his article with this statement,
“Most of the readers of this blog should already understand that the most common cause of elevated cortisol in the USA is from obesity, so weight loss garners a lot of attention as a key treatment modality to lower cortisol levels. Today we are going to talk about cortisol more in depth in how we managed it clinically.”
After that, Jack gets into the nitty-gritty of the issue.
“WHAT TO DO WHEN CORTISOL IS LOW LIKE IN ADRENAL FATIGUE? Many believe that one can solve lowered cortisol levels by just eating more carbs. This sounds great on the surface but no one should be dogmatic about this without a proper biologic context. Lets talk about why this is the case. Cortisol production can best be enhanced by correcting most of the other hormone deficiencies that influence the biochemical pathways used by the adrenal glands first. Rarely is cortisol insufficiency a hormone problem in isolation. It usually occurs with several other deficiencies present. These further complicate its diagnosis and treatment correctly in my view. The best way to repair the lowered cortisol deficit is to optimize hormonal function and allow the body to re adjust to circadian cycles. Often, patients symptoms become so severe that waiting for allostasis is clinically not an ideal choice.” “In the blogosphere, many default to recommend eating more carbs to elevate cortisol inadrenal fatigue cases. They seem to think that the carbs are somehow the “magic bullet” for this condition. They are not the best choice in my view, but eating them will might help a person temporarily. Consumption of carbs will stimulate the ultradian cycle of cortisol production. This occurs because presence of carbohydrates are associated with the longer light cycles seasons from an evolutionary timeline. Light is the most effective way to alter your cortisol levels because of its dramatic effects on the circadian cycle. If you don’t believe it try eating carbs in the winter for adrenal fatigue. This is usually an epic failure for patients clinically because the light cycles are stronger stimulus to allostatic control of cortisol levels than carbs are. Why does this occur, you ask? Because sunlight or bright artificial light are potent effectors of the cortisol pathways. The cortisol awakening response is highest at sunrise due to release of cortisol from the hippocampusin the brain. It is the hormone that wakes us up daily. It is lowest at night when light ends. Bright light diminishes cortisol if the dose of light is high while darkness seems to lower it as time increases in it. The cortisol awakening response is larger when people wake up in light rather than darkness. Therefore light is the most effective means of controlling our cortisol production that we can use clinically.”
How interesting is that!? I’ve never thought about it that way before, but it makes a lot of sense.
“Night time artificial light also raises cortisol levels because our pineal-thyroid circuits have not evolved an off switch for artificial light as yet. Global control of gluconeogenesis is mediated by . Glucagon is released when our blood glucose is low and is unaffected by the light cycle. Glucagon generally is released from the human GI tract at night when we are sleeping to maintain our blood glucose while we sleep and not feeding. Many patients report anecdotally that a small amount of carbs help them sleep at bedtime. This is impossible if one’s liver is working correctly because gluconeogenesis is turned off when glucose is present in our blood usually. When I hear this I immediately know this person is compensating for another hormonal deficit. Only when we are in ketosis is gluconeogenesis stimulated! A small amount of dietary carbs should not be stimulatory to sleep, much less, the hepatic pathway of gluconeogenesis; low levels of carbs are instead required for itto occur. Glucagon augments ketosis further, and it is the failure of glucagon to act that actually promotes the adrenal pathways which might lead to adrenal fatigue if not enough carbs are eaten. In my experience, people with highest risk of adrenal fatigue are generally those with poor hepatic gluconeogenesis, and not from a lack of a dietary carbohydrates. One would be wise to adjust or tighten their light cycles first, then fix their liver problems next, before they consider eating a lot of carbs to fix their adrenal fatigue first. Most people choose the carb pathway because it is most convenient in our current neolithic world. There is nothing special biochemically about those people who are not at risk for adrenal fatigue. People most at risk for adrenal fatigue are those with and they usually are LR or have low HDL’s on lab testing. I covered this in previous blog .”
Okay great Dr. Kruse, so carbs aren’t the answer…this most of us already know, for the most part…. but what can we do to optimize cortisol?
Note: this is just a summary. You’ll need to read the to get all of the details.
“1. Increase your exposure to sunlight, especially in the morning and maximize darkness at night by sleeping with an eye mask at night and try to avoid all artificial light after dusk. New electronics put out unreal amounts of light and completely destroy our normal circadian cortisol cycles more than any other behavior we engage in including obesity.” “2. At each meal, blood levels of cortisol NORMALLY temporarily triple regardless of macronutrients in the meal! Many people think that only dietary carbs do this but this is not true. Dietary saturated fat (LDL levels) is necessary for the production of cortisol as saturated fat cholesterol is the first building block for cortisol synthesis. Carbs do not form the building blocks of cortisol production at all.” “3. Beverages with caffeine (coffee, tea, cola) and alcohol should be avoided before bedtime as caffeine can increase cortisol and considerably reduce night-time secretion of melatonin. Melatonin is a hormone that tends toreduce any cortisol production at night. Remember that cortisol is supposed to be very low at night when melatonin is high. Melatonin production is increased by a photochemical mediated pathway that converts serotonin to melatonin in the pineal gland after 4 hours of complete darkness.” “4. Excessive and prolonged stress of any kind, exhausts the adrenal glands. This renders them less efficient to produce adequate amounts of cortisol and might lead to adrenal fatigue. Testing the cortisol to sex steroid hormones ratio easily tells us if this is a clinical problem.”
In one of the closing paragraphs, Jack points out this rather impactful observation:
“Often a lack of clinical response is most often attributed to a poor diet. This is a diet usually high in carbs and PUFAs in unison, and low in all fats, classically described as the SAD. Therefore, the patient should be encouraged to migrate to a primal palate as a way of accelerating progress of healing.”
It’s often important to remember that not only does a poor diet (or the Standard American Diet, as Dr. Kruse points out), cause issues of this kind, but it can also foil any treatments that would seek to “repair” the problem. It seems that the cause, can perpetuate the dysfunction.
If we maximize our sun exposure, increase our fat intake, avoid alcohol and caffeinated beverages before bedtime, and avoid stress, we can effectively alleviate some of the cortisol issues that so many people struggle with in our neolithic way of life. It seems that Dr. Kruse’s bottom line here, is that if we eat, sleep and drink in accordance with our bodies natural rhythm, and our ancestral diet, we will be much healthier on the whole. By eating a poor diet, cortisol which is designed to work to our benefit, often becomes turned in the opposite direction to work in our detriment.
I believe the question “What About Cortisol?” can be answered or negated by my favorite mantra…..GO PALEO, OR GO HOME! What do you think?
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Barry Cripps is a Paleo-based Nutrition and Wellness Consultant, who operates out of Bowling Green, Kentucky.
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