Balancing Cortisol for Short & Long Term Survival

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Highlights
Cortisol is a hormone involved in several vital physiological mechanisms critical to our short- and long-term survival. Cortisol secretion is paramount in responding to life-threatening situations, but it also carries a series of adverse metabolic effects that will affect longevity. Through a series of mechanisms, cortisol promotes muscle breakdown and fat accumulation, thereby distorting a healthy body's composition.

In the first blog of the Hormones series, we explore one of the most discussed hormones of the human body: cortisol. Cortisol plays a central role in our ability to function, respond to stressful situations, and shift our fuel utilization to enable survival under life-threatening conditions. However, like most physiological mechanisms in our body designed for short-term survival, it also carries a cascade of adverse effects that will affect our metabolism, ability to maintain healthy body composition (i.e., maintain muscle and keep fat off), and longevity. To understand how all of this comes into play, let’s first look at the main functions of cortisol.

What is Cortisol, and is it all bad?
Cortisol is a steroid hormone produced by the adrenal glands, located on top of the kidneys. It plays a critical role in the body’s response to stress, often called the “stress hormone.” When the brain perceives a threat, the hypothalamus signals the pituitary gland to release adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to produce cortisol. This hormone helps mobilize energy by increasing glucose availability, providing the body with the necessary fuel to cope with the stressor. Cortisol also has anti-inflammatory effects, regulating the immune system’s response to ensure it doesn't overreact.
Additionally, it influences various bodily functions such as metabolism, blood pressure regulation, and maintaining cardiovascular function. While cortisol is essential for survival, chronic stress can lead to prolonged high levels of cortisol, which may contribute to adverse health effects like impaired cognitive function, weight gain, and a weakened immune system. It follows a daily rhythm, peaking in the morning and declining throughout the day, which helps regulate the sleep-wake cycle. Overall, cortisol is vital for maintaining homeostasis, especially during stress, but its balance is crucial for long-term health.

The Metabolic Effects of Cortisol
The most prominent ways through which cortisol impacts metabolism and fuel utilization are the following:

1. Energy Mobilization: Cortisol increases glucose availability in the bloodstream by promoting gluconeogenesis (the production of glucose from non-carbohydrate sources such as proteins). This helps provide energy during stress, leading to a short-term boost in metabolic rate.
2. Fat Storage and Redistribution: In chronic stress conditions or prolonged cortisol exposure, the hormone encourages fat storage, particularly in the abdominal region. It does so by increasing insulin resistance, which reduces glucose uptake by cells and leads to more fat being stored.
3. Muscle Breakdown: Cortisol promotes the breakdown of muscle tissue to release amino acids, which can be converted into glucose. This process can slow the metabolic rate because muscle tissue is metabolically active and burns more calories at rest than fat tissue.
4. Impact on Thyroid Hormones: Cortisol can suppress the production and activity of thyroid hormones, which are critical metabolic rate regulators. Reduced thyroid activity can slow metabolism, leading to weight gain or difficulty losing weight.
5. Impact on Appetite: Cortisol can stimulate appetite and cravings for high-calorie, sugary, and fatty foods, further affecting metabolism by promoting weight gain and influencing energy expenditure.

Overall, while cortisol can temporarily increase metabolic rate during acute stress, chronic elevation tends to slow metabolism by promoting fat storage, muscle breakdown, and suppressed thyroid function.

Cortisol -> Insulin Resistance -> Fat Accumulation
Cortisol is a hormone secreted during times of stress, and as a result, it primes our body to respond accordingly. Under such conditions, our physiology is optimized to provide glucose to the areas that need it most to effectively address the stressful situation, including our brain and nervous system. To achieve this, cortisol increases glucose availability and promotes insulin resistance to specific cells, prioritizing glucose supply to high-priority areas. Here’s how it works:

1. Cortisol Increases Glucose Availability:
   • Gluconeogenesis: Cortisol promotes gluconeogenesis, which produces glucose from non-carbohydrate sources (like amino acids) in the liver. This increases the overall glucose concentration in the blood.
   • Glucose Production by the Liver: The liver remains sensitive to cortisol's effects, producing glucose even with elevated insulin levels.
2. Cortisol Promotes Insulin Resistance:
   Cortisol decreases cells' sensitivity to insulin, particularly in muscle and fat tissues. Insulin is a hormone that facilitates glucose uptake from the blood into cells. When cells become insulin resistant, they do not respond to insulin effectively, reducing the amount of glucose they absorb from the blood. Even though cortisol raises blood glucose levels by promoting gluconeogenesis, it makes cells less sensitive to insulin. This leads to a situation where glucose remains in the bloodstream rather than being absorbed by tissues, except for specific cells that don't rely on insulin for glucose uptake (like brain cells).
3. Different Tissue Responses:
   Cells across our body respond differently to cortisol regarding their insulin sensitivity. Active tissue like our muscles, which typically account for most of the glucose uptake, becomes less sensitive to insulin. In contrast, fat retains a significant portion of its insulin sensitivity. As a result, in a high cortisol-level state, muscles cannot absorb as much glucose, leaving a substantial part of it to be absorbed by fat tissue. When glucose is absorbed by fat tissue, it’s converted into more fat through lipogenesis. The increased absorption of glucose by adipose tissue instead of active muscle is a side effect of our body’s primary objective of maintaining greater glucose levels in the bloodstream and thus ensuring critical organs such as the brain have the energy needed to respond to a stressful situation.

Copper Rock Clinic's Approach
At Copper Rock Clinic, we understand the vital role hormones like cortisol play in your overall health and well-being. Specializing in bio-identical hormone replacement therapy (BHRT), we tailor our treatment plans to address hormonal imbalances, including those related to stress and cortisol levels. Whether it's managing weight, enhancing energy, or optimizing metabolic health, our personalized approach ensures long-term vitality and balance. We also offer a range of complementary therapies, from metabolic analysis to peptide treatments, to help you regain control of your health. Come visit us at Copper Rock Clinic to start your journey toward better health today.

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