Hormone Therapy Can Help Treat Cortisol Imbalance
Cortisol imbalance is becoming a more prevalent diagnosis as more and more people struggle to balance busy professional, family, and social lives. Our lives show no signs of slowing downand until were able to manage stress in a healthy way, we will continue to struggle with this significant hormone imbalance on a grand scale. If youve tried the steps explored above without seeing a significant change in your symptoms, it may be time to seek help from a qualified expert in hormone health.
The practitioners at BodyLogicMD are certified experts in integrative medicine and are focused on helping patients like you achieve optimal wellness through a combination of nutrition, lifestyle changes, and bioidentical hormone replacement therapy. When you partner with a BodyLogicMD practitioner, they perform a complete assessment to understand your symptoms, analyze your cortisol levels, and craft a treatment plan thats fully customized to your unique situation. Whether your cortisol levels are high or low, they can give you the treatment support you need to take back control of your wellbeing.
If youre struggling to figure out how to balance cortisol levels on your own, its time to consider a professional option. Theres no need to suffer with hormone imbalance. With modern holistic treatment, you can regain the health and vitality you once enjoyed, free from the symptoms of chronic stress.
What Happens When There Are Low Levels Of Cortisol
If there is an underproduction of cortisol, this means that there is an issue with either the pituitary or the adrenal gland. Not having the right levels in the bloodstream can result in a wide variety of problems that can be detrimental to healthy bodily functions.
Cortisol deficiency can be associated with Addisons disease that needs to be properly diagnosed by a doctor called an endocrinologist. After the right procedure and tests, they may prescribe Prednisone, a synthetic corticosteroid, as a treatment option.
Outlook And Prognosis For Individuals With Adrenal Insufficiency
If treated properly, individuals can live long, healthy, and active lives. As with any chronic condition, to avoid serious health complications, it is important to responsibly self-manage the condition, which involves taking medications as prescribed and working with physicians to adjust medications as needed. Proper treatment requires comprehensive care from adrenal experts. Seeking care for adrenal insufficiency in a multidisciplinary clinic provides significant advantages to patients.
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Is Stress To Blame For Low Cortisol
High cortisol is considered the stress hormone. People who have high cortisol levels usually have a number of emotional symptoms, including anxiety, anger, trouble sleeping, and depression. However, low cortisol isnt the same as high cortisol. Low cortisol is considered low because of how the brain responds to high levels of cortisol. In addition to low levels of cortisol, people with low cortisol may also have high levels of adrenaline and/or beta-endorphins. Its important to keep in mind that not all people with low cortisol levels will have emotional problems. People with low cortisol may be more likely to experience anxiety and depression, but they may also have higher levels of self-confidence. Furthermore, people with low cortisol may be more likely to have higher levels of adrenaline and beta-endorphins, which can benefit them in various ways.
Symptoms Of Addison’s Disease
The symptoms of Addison’s disease can include any or all of the following:
- loss of appetite and weight
- nausea, vomiting or diarrhoea
- hypoglycaemia low blood sugar levels
- increased pigmentation of the skin, particularly around scars and bony areas
- irregular or no menstrual periods in women
- mood swings, mental confusion or loss of consciousness.
These symptoms can develop quickly , or progress slowly over years. Many symptoms can mimic other diseases, so diagnosis can be delayed.
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Treatment Of Cushings Syndrome
Treatment of Cushings syndrome depends on the underlying cause of excess cortisol but may perhaps include surgery, radiation, chemotherapy or the use of cortisol-inhibiting drugs. If the cause is iatrogenic, from long-term use of glucocorticoid hormones to treat another disorder, the physician will gradually reduce the dose of the externally administered steroid to the lowest dose adequate for control of that disorder. Once control is established, the dose of glucocorticoid hormones may be given on alternate days to lessen side effects for the patient.
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How Does Cortisol Work
Before we move ahead and talk about the symptoms, lets take a step back and understand what exactly cortisol is and how it works in our bodies. Cortisol or hydrocortisone is a steroid hormone responsible for regulating many different vital processes in the human body. It is produced in the cortex of the adrenal gland and helps regulate the immune system, metabolism, and more.
The majority of the cells in the human body carry receptors for the hormone, which means that it performs different actions depending on which cell it interacts with. The hypothalamus and pituitary gland work to control how much cortisol should be released depending on the levels present in your blood. While usually the right response is produced, sometimes things go wrong, which leads to an under or overproduction of cortisol.
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How Is Addisons Disease Treated
Addisons disease is treated by replacing the missing hormones, cortisol and aldosterone, with synthetic versions of them.
Cortisol is replaced by the drug hydrocortisone, and aldosterone is replaced by the drug fludrocortisone. Addisons disease is a chronic condition, so youll need to take medication for the rest of your life.
The dosages of these medications are different for each person, and your healthcare provider may increase the dosage when youre experiencing an infection, trauma, surgery and other stressful situations to prevent an acute adrenal crisis.
If youre taking fludrocortisone, your provider might tell you to increase your salt intake, especially in hot and humid weather and after vigorous exercise.
What Causes Addisons Disease
The most common cause of Addisons disease is an autoimmune response, which occurs when your immune system attacks healthy tissues for an unknown reason. With Addisons disease, your immune system attacks the outer portion of your adrenal glands , where they make cortisol and aldosterone. Symptoms dont usually develop until 90% of the adrenal cortex has been damaged, which can take several months to years.
Approximately 75% of cases of Addisons disease are due to an autoimmune attack. Autoimmune Addisons disease may happen by itself or as part of a rare, inherited syndrome, specifically autoimmune polyendocrine syndromes I and II .
In the past, tuberculosis was a major cause of Addisons disease. It remains a prominent cause of the condition in developing countries.
Other less common causes of Addisons disease include:
- Repeated infections, including HIV/AIDS-related infections and fungal infections.
- When cancer cells from another part of your body invade your adrenal glands.
- Bleeding into your adrenal glands.
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Symptoms And Signs Of Secondary Adrenal Insufficiency
. Patients with confirmed secondary adrenal insufficiency should have CT or MRI of the brain to rule out a pituitary tumor or pituitary atrophy.
Adequacy of the hypothalamic-pituitary-adrenal axis Overview of the Endocrine System The endocrine system coordinates functioning between different organs through hormones, which are chemicals released into the bloodstream from specific types of cells within endocrine … read more during tapering or after stopping long-term corticosteroid treatment can be determined by injecting cosyntropin 250 mcg IV or IM. After 30 minutes, serum cortisol should be > 20 mcg/dL specific levels vary somewhat depending on the laboratory assay in use. An insulin stress test to induce hypoglycemia and a rise in cortisol is the standard for testing integrity of the hypothalamic-pituitary-adrenal axis in many centers but careful monitoring is required to avoid severe prolonged hypoglycemia.
The corticotropin-releasing hormone test can be used to distinguish between hypothalamic and pituitary causes but is rarely used in clinical practice. After administration of CRH 100 mcg IV, the normal response is a rise of plasma ACTH of 30 to 40 pg/mL patients with pituitary failure do not respond, whereas those with hypothalamic disease usually do.
Is Cortisol A Stress Hormone
Cortisol is widely known as the stress hormone. However, it has many important effects and functions throughout your body aside from regulating your bodys stress response.
Its also important to remember that, biologically speaking, there are multiple different kinds of stress, including:
- Acute stress: Acute stress happens when youre in sudden danger within a short period of time. For example, barely avoiding a car accident or being chased by an animal are situations that cause acute stress.
- Chronic stress: Chronic stress happens when you experience ongoing situations that cause frustration or anxiety. For example, having a difficult or frustrating job or having a chronic illness can cause chronic stress.
- Traumatic stress: Traumatic stress happens when you experience a life-threatening event that induces fear and a feeling of helplessness. For example, experiencing an extreme weather event, such as a tornado, or experiencing war or sexual assault can cause traumatic stress. In some cases, these events can lead to post-traumatic stress disorder .
Your body releases cortisol when you experience any of these types of stress.
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Snack On Licorice Or Sip Licorice Tea
Licorice raises urinary cortisol, Dr. Gottfried says, citing a study published in the Journal of Clinical Endocrinology and Metabolism. Its generally recommended that people with low cortisol try a small dose of root extract, 600 milligrams, she specifies. This is one instance where you want to go for the herb, not the candy. Otherwise, the added sugar in your licorice would cancel out the balance-restoring benefits.
Who Should Be Tested And How
1.1 We recommend diagnostic testing to exclude primary adrenal insufficiency in acutely ill patients with otherwise unexplained symptoms or signs suggestive of PAI .
1.2 We recommend confirmatory testing with the corticotropin stimulation test in patients with clinical symptoms or signs suggesting PAI when the patients condition and circumstance allow.
1.3 In patients with severe adrenal insufficiency symptoms or adrenal crisis, we recommend immediate therapy with iv hydrocortisone at an appropriate stress dose prior to the availability of the results of diagnostic tests.
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The 5 Primary Mechanisms Of Low Morning Cortisol Levels
At this point, we now know the following 3 key points that completely disprove the adrenal fatigue theory:
- Chronic stress does NOT generally lead to low cortisol levels.
- Low cortisol levels are generally NOT associated with Burnout Syndrome or Stress-Related Exhaustion Disorder.
- The vast majority of people with low morning cortisol levels typically do NOT actually have any problem with their adrenals being able to produce enough cortisol.
Now, even though we know that low cortisol levels is NOT actually the real cause of the symptoms associated with Burnout Syndrome and Stress-Related Exhaustion, some people are still skeptical and still want to believe in the adrenal fatigue theory, and say well then why did my test show that I do have low morning cortisol levels?
Indeed, the question now becomes
If its not chronic stress wearing out your adrenals, then what are the real factors responsible for low morning cortisol levels?
Were going to answer that definitively in this section and the following section, but first, there is something very important I need to remind you of
Since cortisol levels/adrenal function are NOT the cause of burnout/exhaustion/chronic fatigue symptoms, trying to fix the symptoms fixing your adrenals/cortisol is utterly misguided.
Trying to fix your symptoms by fixing something that wasnt actually causing your symptoms in the first place is not likely to result in much benefit.
High Levels Of Depression And/or Low Level Of Anxiety And/or High Perceived Suffering
Some studies show a link with higher levels of depression and lower morning cortisol levels. (Though these findings are very mixed, and many studies show normal cortisol levels or even high cortisol levels. And it depends on the specific subtype of depression. In contrast, higher anxiety levels are associated with elevated morning cortisol levels.
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Suppression Of Adrenal Function By Corticosteroids
In people who take large doses of corticosteroids, such as prednisone, the function of the adrenal glands can become suppressed. This suppression occurs because large doses of corticosteroids signal the hypothalamus and pituitary gland to stop producing the hormones that normally stimulate adrenal function.
If the person abruptly stops taking corticosteroids, the body cannot restore adrenal function quickly enough, and temporary adrenal insufficiency results. Also, when stress occurs, the body is not able to stimulate production of the additional corticosteroids that are needed.
Therefore, doctors never stop the use of corticosteroids abruptly if people have been taking them for more than 2 or 3 weeks. Instead, doctors gradually reduce the dose over weeks and sometimes months.
Also, the dose may need to be increased in people who become ill or otherwise severely stressed while taking corticosteroids. Corticosteroid use may need to be resumed in people who become ill or otherwise severely stressed within weeks of having the corticosteroid tapered and stopped.
How Long Should It Take To See Improvements
It can take some time to naturally heal your adrenal glands and start to feel more energetic, clear-headed, and in control of your hormones, weight and appetite. Everyone is different and reacts to lifestyle changes in unique ways. Some people will need to take medications to ultimately heal their problems, while others can feel drastically better by simply paying attention to their diets, stress levels and lifestyles. Either way, following the recommendations for natural remedies listed above is definitely still the way to speed up healing time and prevent the problem from worsening.
While there isnt necessarily one tried-and-true way to recover from adrenal problems, heres what you can expect in terms of timing:
- 69 months for minor adrenal issues
- 1218 months for moderate adrenal insufficiency
- Up to 24 months for severe adrenal insufficiency
If you visit a doctor about adrenal insufficiency , she or he might recommend you take medications to help speed up the healing process and reverse cortisol deficiency symptoms. Taking glucocorticoid medications like prednisone or hydrocortisone are the most common treatments, and the dosage of these depends on your level of stress, any present infections, medical history and injuries. The primary reason for taking hormonal replacement medications is to bring your cortisol and other hormone levels up to normal as quickly as possible.
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How Do You Increase Morning Cortisol
The number one thing that we want to do here is to ensure that we are not dealing with Addisons disease. Ideally, your doctor would take the time and take a look for that ruling it out once you gain the full picture.
Key Insight: Whether it is a blood test or a salivary test, a doctor should see if your pituitary gland is speaking properly to your adrenals. This is just like the TSH to your thyroid .
In almost all cases of this, it comes down more to your CAR pattern. In those cases, and upon testing, a doctor would see a:
- Low cortisol level, and
We would also see, once given ACTH, that your body would make more cortisol accordingly.
Doctors definitely need to distinguish a CAR problem from Addisons, because if you did have Addisons all of the treatments I am about to mention would not apply.
Bottom Line: Ensure that your diagnosis is determined before you start to treat what could be very different problems. If you know for sure that you do not have Addisons disease, what I am now going to tell you is what you can do to feel better and less fatigued!
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How To Fix Your Low Cortisol Levels
Now that weve covered the main causes of low morning cortisol levels, lets talk about how to fix it. In essence, this comes down to simply correcting the factors causing the low cortisol levels in the first place. In some of these cases this is very simple and quick, and in others, much more complex.
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When To Increase A Childs Hydrocortisone Dose
If a person with cortisol deficiency becomes very unwell, they are unable to increase the production of cortisol in their system, which is needed to help the body cope and which could be life threatening.
In these circumstances, the amount of hydrocortisone given needs to be increased quickly. This is done by, either:
- increasing the dose of oral hydrocortisone taken as tablets
- giving an injection into the childs thigh
It can be difficult to know when the child needs to increase their dose of hydrocortisone, but it may be necessary if they are ill, have an accident or injury or are going to have some medical treatments. Parents should follow the flow chart they have been provided to help them decide if this is required.
An extra dose will not do any harm, so if in doubt it is better to give it than not, and then contact the specialist treatment centre for advice about what to do next. If the child is unwell enough to require double dosing, an additional double normal morning dose of hydrocortisone should be given at 4am set an alarm to remind you.
If the child is given a hydrocortisone injection, they must be admitted to hospital afterwards to be monitored. You should insist that this is for a minimum of 12 hours. This is because the effects of injection only lasts about six to eight hours and it is important to check that the child is stable on their normal oral dose before going home.