Small But Mighty: Understanding Cortisol, Stress & Adrenal Fatigue

Nowadays, “busy” easily spills over into “stress”.

Our adrenal glands keep us going under stress, and they can get tired. There are entire books written about adrenal fatigue, so here I will focus on cortisol, a.k.a. the stress hormone.

The adrenal glands are small but mighty. Each one is about the size of a walnut, and sits on top of a kidney. They make many steroid hormones, including adrenaline, androgens and corticosteroids. Cortisol is the active form of the corticosteroid group of adrenal hormones.

Cortisol is anti-inflammatory and regulates metabolism. When we are under stress, our adrenals make more cortisol.

Cortisol causes the release of sugar into the bloodstream, in preparation for the “fight or flight” that might have to happen next. The problem is that nowadays many people’s bodies are in a constant state of “fight or flight” readiness.

Many people are aware of the effect of too much cortisol causing weight gain. However, in my practice I see so many people under chronic stress; they have trouble with their metabolism even if their cortisol level is not elevated. This is where we start to see adrenal fatigue.

We measure cortisol as a fasting blood level first thing in the morning. Another way to measure cortisol is with saliva testing; a saliva cortisol testing kit can allow a person to measure their cortisol four times throughout the day – early morning, noon, afternoon and late evening. Because medical insurance usually does not cover the saliva testing, I don’t order it that often. Many times my patients will have had it done elsewhere, and I will see a clear correlation between their results and the symptoms they describe to me.

Cortisol is at its highest level when we wake up, and steadily decreases throughout the day. This means that while we are sleeping, our adrenals are busy in the early hours of the morning making cortisol and getting us ready to have energy for our day.

If someone has early morning waking, or feeling sweaty in the early hours of the morning, they might be making too much cortisol. This is often the case if they are under particular stress. In this situation, the adrenal glands can benefit from support from herbal “adaptogens” – ingredients that improve adrenal function over time. There are also over-the-counter ingredients such as phosphotidylserine (often called “PS”) and L-theanine that can help calm that excess early morning production of cortisol.

With our busy stressful lives, it’s good to use some kind of adrenal support supplement. Some boost energy and some have a more calming effect. It is perfectly safe and acceptable to use these kinds of supplements on an as-needed basis. I take an adrenal boosting supplement on a regular basis, and I keep an adrenal-calming supplement handy for periods of time when I am under more stress than usual, which is disrupting my sleep in the pattern described above.

Nowadays we live under continuous physiologic stress. Traffic, email, constant connectedness with cell phones. Even if we handle stress well, our bodies, especially our adrenals, can use some support.

Life is long.

Our adrenal glands are small but mighty. Don’t forget to show them some love so they stay in good shape for the long run of life.