As a naturopathic doctor, I look for the root cause of disease.

Unfortunately, chronic stress is one of the biggest culprits.

Stress seems to be an inevitable part of daily life. Whether it's due to work pressures, family responsibilities, financial concerns, constant exposure to political conflict, and troubling world events. Most people have experienced trauma in some capacity during their lives. Our bodies respond to stress by releasing cortisol, often referred to as the "stress hormone." While cortisol plays a crucial role in our body's response to stress, chronic elevation or an imbalance of cortisol levels can lead to various health issues. It’s helpful to understand the effects of cortisol on the body, the functional medicine testing used to assess cortisol levels, and review holistic approaches used to address these imbalances.

The Role and Impact of Cortisol

Cortisol is a hormone produced by the adrenal glands, which are small glands located on the top of each kidney. It serves several essential functions in the body, including regulating metabolism, reducing inflammation, controlling blood sugar levels, and assisting with memory formulation. When we encounter a stressful situation, whether physical or psychological, our bodies release cortisol as part of the fight-or-flight response. This response is crucial for survival, as it provides the energy needed to cope with the stressor.

However, problems arise when stress becomes chronic, leading to sustained high levels of cortisol.

Prolonged elevation of cortisol can have detrimental effects on various systems in the body, including:

1. Immune System Suppression: High cortisol levels can suppress the immune system, making individuals more susceptible to infections and illnesses.

2. Metabolic Effects: Cortisol influences glucose metabolism and can contribute to insulin resistance, weight gain, and increased abdominal fat deposition.

3. Fatigue and Sleep Issues: Cortisol is involved in the circadian rhythm and imbalances in normal daily rhythm can impact energy and sleep. Those with high cortisol levels typically feel “wired but tired”.

4. Cardiovascular Health: Chronic elevation of cortisol can contribute to hypertension, atherosclerosis, and an increased risk of heart disease.

5. Digestive Issues: Cortisol can disrupt digestion and nutrient absorption, leading to issues such as irritable bowel syndrome (IBS) and gastrointestinal discomfort.

6. Mental Health: Imbalances in cortisol levels are associated with mood disorders such as depression and anxiety.

It’s important to note that chronically high cortisol levels may result in low cortisol levels. This is not good either. I like to think about the Goldilocks analogy, not too hot, not too cold. Not too much cortisol, not too little.

Common symptoms of low cortisol include:

1. Weakness and fatigue: Low cortisol levels can lead to generalized weakness and a feeling of being physically depleted and not feeling relieved after rest. Low cortisol levels are common in those with chronic fatigue syndrome.

2. Dizziness and Lightheadedness: Cortisol helps regulate blood pressure, and insufficient levels can lead to orthostatic hypotension (low blood pressure), causing dizziness and lightheadedness upon standing up.

3. Hypoglycemia: Cortisol plays a role in maintaining stable blood sugar levels. Insufficient cortisol can lead to hypoglycemia (low blood sugar), resulting in symptoms such as shakiness, confusion, sweating, and irritability.

4. Digestive Issues: Cortisol helps regulate digestion, and low levels can lead to gastrointestinal symptoms such as nausea, vomiting, abdominal pain, and diarrhea.

5. Salt Cravings: Cortisol influences sodium retention in the body. Low cortisol levels may lead to salt cravings, as the body attempts to compensate for electrolyte imbalances.

6. Decreased Stress Tolerance: Cortisol is involved in the body's stress response. Low cortisol levels can impair the body's ability to cope with stressors, leading to increased susceptibility to emotional and physical stress, and illness.

7. Depression and Anxiety: Low cortisol levels may contribute to feelings of sadness, irritability, and anxiety.

Given the effects that cortisol has across all systems of the body, it’s important to assess levels accurately.

Functional Medicine Testing for Cortisol

1. DUTCH Test (Dried Urine Test for Comprehensive Hormones): The DUTCH test assesses cortisol and other hormone levels through dried urine samples collected at 4 different times of the day, offering a comprehensive view of a daily cortisol rhythm. I have been relying on this test for several years now. I prefer it because it’s possible to accurately measure sex hormones simultaneously which helps with a fuller picture of someone’s health.

2. Salivary Cortisol Testing: This test measures cortisol levels in saliva at different times throughout the day, providing valuable information about the body's natural cortisol rhythm. Saliva is an easy, noninvasive, and accurate way to test cortisol levels.

3. Blood Tests: Blood tests can measure cortisol levels at a specific point in time, but may not capture the diurnal rhythm of cortisol secretion as effectively as salivary or urine testing. I don’t find this method to be very helpful as it doesn’t reveal what cortisol changes are occurring throughout the day.

By utilizing these tests, naturopathic doctors in Tucson like myself or elsewhere can better understand a patient's cortisol levels and tailor treatment plans accordingly.

The other thing that I have found with testing is that it helps to validate what a person has been experiencing when other conventional testing hasn’t provided answers or solutions.

It’s not uncommon for my patients to share that they have been dismissed or have felt that like their issues are all in their head.

Addressing cortisol imbalances requires a multifaceted approach that considers the interconnectedness of the body's systems. Naturopathic doctors in Tucson and other holistic practitioners may recommend the following approaches to balance cortisol levels:

1. Stress Management Techniques: This is really essential for everyone. At a minimum, it’s important to incorporate some form of daily movement. Other commonly used tools are yoga, breathing exercises, meditation or even the use of an app to limit screen time use. These interventions help with relaxation and reducing cortisol levels.

1. Dietary Changes: A nutrient-dense diet rich in whole foods, fruits, vegetables, lean proteins, and healthy fats can support adrenal function and help stabilize blood sugar levels. Avoiding caffeine, refined sugars, and processed foods is also beneficial.

2. Herbal Remedies and Supplements: Certain herbs (termed adaptogens) and supplements, such as ashwagandha, rhodiola, holy basil, and phosphatidylserine, have been shown to help modulate cortisol levels and stress resilience.

3. Lifestyle Modifications: Adequate and good quality sleep, regular exercise, downtime and even playtime are essential for managing cortisol levels and overall well-being.

4. Body-Based Therapies: I usually incorporate body-up recommendations. Therapies such as acupuncture, massage therapy, and other types of body work can help reduce stress and promote relaxation, thereby supporting healthy cortisol levels. A relaxed body is a healthy body!

Cortisol plays a vital role in the body's stress response, but chronic elevation, imbalance, or deficiency can lead to various health issues. Functional medicine testing can provide valuable insights into cortisol levels, allowing for personalized naturopathic medicine treatment plans. By adopting a holistic approach that encompasses stress management techniques, dietary changes, herbal remedies, and lifestyle modifications, individuals can restore balance to their cortisol levels and optimize their overall health and well-being.

consider consulting with a naturopathic doctor like me who can provide comprehensive support for addressing cortisol imbalances and promoting long-term health.

It’s worth the investment!