Cortisol has hit the social media airwaves with a bad reputation, especially about weight loss.  As usual, social media took something right and made it wrong.

Before I can comment about cortisol’s relationship to weight gain, it is important to understand cortisol.

Cortisol is a glucocorticoid hormone secreted from the adrenal glands and is a vital hormone for the stress response system. Cortisol helps increase blood sugar and blood pressure during stress events.

Without an adequate amount of cortisol, the body is unable to respond to stress and results in numerous symptoms, including:

• Fatigue
• Dizziness, fainting
• Low blood pressure
• Low blood sugar
• Digestive upset such as vomiting, diarrhea
• Muscle pain, cramping, fatigue
• Joint pain
• Depression
• Loss of body hair
• Salt cravings
• Abdominal weight gain
• Inappropriate responses to stress

Severe depletion of cortisol may lead to coma or death, but this occurs when the adrenal glands are damaged, such as with Addison’s disease.  Most people do not suffer from Addison’s disease, but it highlights the importance of cortisol.  

Much more common is cortisol insufficiency resulting from a living a lifestyle colloquially known as “burning the candle at both ends.” In this scenario, cortisol levels initially rise, to address stress, but over time may become depleted. Fatigue, abdominal weight gain, poor ability to manage stress, salt/sugar/fat cravings, repetitive colds, and an inability to respond to stress with grace are common symptoms of insufficient cortisol levels.

For many, regular consumption of sugary foods will result in cortisol depletion.  This occurs due to the following (simplified) mechanism:

• Blood sugars rise steeply after eating sugar.
• Insulin takes the sugar out of the blood stream and puts it into the cells.
• Subsequently, there is a lack of blood sugar to support the next need for cellular energy. This is felt like a blood sugar “crash.”
• Cortisol rises to raise blood sugar. I call this inappropriate release of cortisol due to dietary choices. Remember, cortisol is a stress hormone, so stress responses also occur with the rise of cortisol, including a rise in blood pressure.
• If this blood sugar is not needed immediately by cells, it is converted into fat.   

Blood sugar yo-yo-ing may result in weight gain, fatigue, and insufficient cortisol.

The adrenal glands also produce other hormones, including:

• Sex hormones: Progesterone, DHEA, Testosterone, Estrogens
• Mineralocorticoids: Aldosterone (a blood pressure regulator)
• Catecholamines: epinephrine, norepinephrine (adrenalins).

In order to maintain cortisol levels, the adrenal glands may preferentially support cortisol production over these over hormones. For peri/menopausal women, hot flashes and night sweats may worsen if hormone production needs to favor cortisol production rather than sex hormones.

So, yes, cortisol is a contributor to belly fat due to blood sugar dysregulation, but cortisol is not the culprit. Lifestyle, diet, nutritional insufficiencies, and a lack of allowing oneself to relax is path to cortisol insufficiency. It is possible to regain cortisol balance with lifestyle,  nutritional changes, and if needed, targeted nutraceutical therapy. Weight loss is also only possible when cortisol and other hormones are balanced.

Not sure if cortisol insufficiency contributes to your symptoms?  Dr. Rodgers offers testing for cortisol and sex hormone levels.  She can also counsel you on how to maintain healthy blood sugars to preserve your cortisol stores.