by Libby Weaver
It is important to understand how cortisol works, as it can be your friend or one of your worst nightmares! When made at optimum amounts, cortisol does numerous wonderful things for your health. It is one of the body’s primary anti-inflammatory mediators, meaning that wherever there is inflammation in the body, cortisol, having been converted into cortisone, dampens down the effect of that inflammation and stops your body from feeling stiff, rigid, or in pain. Many people, for example, will describe feeling that they have suddenly aged when they come out of difficult times. In the right amount, cortisol is not only an anti-inflammatory, it also buffers the effect of insulin, meaning that optimum amounts help you continue to burn body fat for energy while also maintaining stable—as opposed to rapidly fluctuating—blood glucose levels.
Cortisol levels change over the day and the right amount assists various bodily functions. Cortisol is designed to be high in the morning and, for the purpose of this discussion, let’s say that 25 units at around 6 a.m. are ideal. Cortisol is one of the mechanisms that wakes you up in the morning and helps you bounce out of bed full of energy and vitality. By midday, optimum cortisol will sit at around 15 units, and by 6 p.m. levels will ideally be at around four units. By 10 p.m. in the evening, optimum cortisol levels are around two units, a level at which they are designed to stay until around 2 a.m. when they slowly and very steadily begin to rise again.
Figure 6 below shows the changing amounts, and it is true what your mother told you: one hour of sleep before midnight is worth two after, because cortisol starts to rise around 2 a.m. and the waking up process gradually begins. Do you ever wake up around 2 a.m.? Continue reading, for it may be related to your adrenal glands, your liver… or both!
Figure 6: Optimal cortisol profile
Cortisol is nice and high in the morning and falls away again by the evening.
As a stress response continues, the effect on the body begins to change. In the early stages of stress, one of the first challenges cortisol presents is that the evening level of the hormone starts to spike again rather than continuing to decrease. At this stage, you still make optimum levels in the morning and are able to bounce out of bed and get on with your day with reasonable energy, but evening levels are creeping up. This is one mechanism through which good sleeping patterns can be challenged.
When cortisol levels become elevated above optimal, other changes in body chemistry begin to unfold. It has been suggested that elevated cortisol is the one common thread behind what we have come to describe as metabolic syndrome; that is elevated blood pressure, elevated cholesterol, and insulin resistance, the latter condition being a warning sign that if nothing changes in the near future, Type 2 diabetes is a likely consequence. If we remember that we are completely geared for survival and that cortisol tells every cell of the body that food is scarce, another of its roles is to slow down your metabolic rate. A slower metabolism leads you to burn body fat for energy far more slowly then you have in the past, as cortisol is designed to make sure that you survive this perceived period of famine.
Cortisol is “catabolic,” meaning that it breaks proteins down into its building blocks, known as amino acids. Your muscles are made from proteins, and cortisol signals them to break down, as the body’s perception is that fuel is needed. Additional amino acids are also needed in the blood to help repair tissues (even though you may be simply sitting in front of the TV, with your financial or relationship concerns mulling around your head!). The amino acids released as a result of the catabolic signaling of cortisol can be converted, through a process called “gluconeogenesis,” back into glucose (sugar), which your body thinks may be useful to assist you in your stress. Yet if you’re not active, this increase in blood glucose will not be utilized, and insulin will have to be secreted to return blood glucose levels to normal by returning the glucose in the blood to storage. Remember that glucose is stored as glycogen in the muscles and the liver.
But over time, the catabolic signaling of cortisol itself may have broken some of your muscles down, so now there is less space for glucose storage. As a result, some of the blood glucose returns to the remaining muscles while the leftovers are converted into body fat. Keeping the glucose level of the blood within the normal, safe range is of more importance to your body than whether you have wobbly bits around your middle! Essentially, too much cortisol can make you fat through dysregulated blood-sugar metabolism, not just fat metabolism itself. This is also a process through which long-term stress can lead to Type 2 diabetes.
Because cortisol is produced when stress has been going on for a while, your body (not knowing any better) thinks there is no more food left in your world, and it instinctively knows that it has a greater chance of survival if it holds on to some extra body fat to get you through the lean times. In modern times, when, for health reasons or vanity (or both), many people understand the importance of not carrying too much body fat, cortisol can provide a potential challenge to someone who believes that eating less is their only solution to body-fat loss.
Understanding the cortisol problem
If cortisol tells every cell of your body that food is scarce, and your metabolism slows down as a result, and you continue to eat and exercise in the same way you always have, your clothes will slowly get tighter. With cortisol telling every cell in your body to store fat, it is very difficult, if not impossible, to decrease body fat until the cortisol issue is resolved. We must get to the heart of the stress and either change the situation or change the perception.
Cortisol has a very distinct fat deposition pattern. You typically lay it on around your tummy, and, once again, the reason for fat placement here is governed by the body’s quest for survival. If food suddenly ran out, your major organs need protection and warmth, plus they have very easy access to fat (fuel) that will keep you alive. You also tend to lay fat down on the back of the arms, and you grow what I lovingly call a “back veranda.” To reiterate this important point: What do most people do when they notice that their clothes are getting tighter? They go on a diet, and, when you go on a diet, do you tend to eat more or less? You typically eat less (although some audience members call out “more” when I ask them this question at an event!), and in doing so you reaffirm to your body that food is scarce. But food is not scarce. It is abundant for you. If you want a chocolate bar at 3 a.m., you can get one. Eating less on your diet confirms to your body what it perceives to be true and that slows your metabolism even further.
Another challenge you face with elevated cortisol coursing through your body is that, since your body thinks that food is scarce, any time you see food, it’s very easy to overeat, no matter how firmly you intend to eat only three crackers when you get home from work! If that packet of crackers is open and in front of you, cortisol will scream at every cell of your body, “You are so lucky! There’s food there! Eat it!” and somehow, before you know it, the whole box of crackers is gone. Please don’t get me wrong… I am not saying that self-discipline and willpower have no place. My intention is simply to point out that we have very ancient hormonal mechanisms in action inside our bodies that believe they know better than you when it comes to your survival. Your body can be your biggest teacher if you learn how to decipher the messages it is communicating to you. And extra body fat is sometimes simply a vehicle of communication.
Silent stress
What about when the stress is silent? You might not be a drama queen running around, arms flailing all over the place, screeching, “I’m so stressed, I’m so stressed!” You may be a very private person and keep things mostly to yourself. You may be so private with your fears and concerns, only presenting a happy face to the world, that you don’t even realize that you’re worried about things or that you may have been in a stressed state for a very long time.
When you feel grateful for the life you have, it’s very easy to feel guilty if you complain about anything. A common internal phrase will be, “There are so many people worse off than me.” This thought immediately
makes you feel guilty and you stop focusing on your source of stress. Trouble is, although there are people worse off than you in this world, the minute you feel guilty, you change your focus so you don’t ever get the opportunity to identify what is really bothering you and, more importantly, why. These “whys” are explored in detail later in Puzzle Piece 9, Emotions. For now, I’ll share a common example, one that involves keeping the peace, to help you determine if cortisol, from an emotional source, is a likely piece we need to solve in your weight-loss puzzle.
Basic psychology teaches us that humans will do more to avoid pain than they will ever do to experience pleasure. Some people I meet will do anything, for example, to keep the peace and avoid conflict. Inwardly they become highly strung because they are always walking on eggshells around others, usually their intimate partner. “Hello, silent stress hormone production!” Others avoid feeling emotional pain by eating too much or making other poor food choices; perhaps by drinking bucketloads of wine or chain-smoking cigarettes. Alternatively, some people might write in a journal, go for a walk, a run, or a swim, while others will phone a friend and chat to deal with emotional pain. And all of these activities may take place with no conscious understanding of why.
Worrying can make you fat
You think you want to lose weight more than anything? You think you would do anything to be slimmer? You probably already have all of the information you need to do this. So what’s stopping you? Or what stops you once you’ve started?
Every day of my working life, I meet people who eat too much. They know they do, but they can’t seem to stop. Sometimes it is nutritious food, sometimes it’s not, but, whatever the case, they know they would be much better off if they ate less or chose better-quality food.
Often these people are seeing me because they want to lose weight and they are precious, intelligent people who don’t understand why they do what they do. These people know what to eat and what not to eat to lose weight, yet they don’t do it, even though they truly believe that they are desperate to lose weight.
There is a really big difference between eating two squares of chocolate and eating the entire block, between one cookie with a cup of tea in the evening and eating a dozen. We all know that eating too much makes us feel full and uncomfortable, but, worse, it usually drives us to say very unkind things to ourselves such as, “I’m so useless, I have no willpower,” and we go to bed feeling guilty and sad and believing we will never be able to change. The belief that things are permanent is very destructive.
So what might be going on for someone who, even with good intentions, just can’t stop eating? Besides elevated cortisol due to long-term stress, there may be other biochemical factors involved such as low progesterone, poor thyroid function, or blood sugar that surges and plummets. There are also likely to be emotional factors (explored in Puzzle Piece 9, Emotions) and core beliefs they probably aren’t even aware of, something I guide participants to explore thoroughly at my weekend events. Witnessing their “a-ha” moments is an honor.
One of the most wonderful and helpful statements my mother ever made was, “Don’t worry about something until it’s a problem.” If it becomes a problem, then you can face it, but worrying about something that truly may never happen only serves to hurt you. As we now know, stress, whether it is real or perceived, may promote the production of excess cortisol. The ripple effect of a worry can very slowly and subtly change your metabolism to one of fat storage and a headspace of sadness and withdrawal. And it’s the chemical signals of your body that are driving this. The beautiful piece of wisdom is useful to remember and act on, especially if you are a worrier:
‘God, grant me the serenity to accept the things I cannot change,
Courage to change the things I can,
And the wisdom to know the difference.’
THE SERENITY PRAYER BY REINHOLD NIEBUHR
Adrenal fatigue
The next biochemical stage of stress that can occur, especially if the stress has been prolonged, may involve cortisol falling low. If you have had a high level of cortisol output for many, many years, your adrenal glands may not be able to stand the tension, or have the resources to sustain such continual, high-level cortisol output and the metabolic consequences this drives. The adrenal glands were never designed to maintain this pattern of production and so cortisol output plummets. In general terms, you “burn out.” In more recent times, this has become known as adrenal fatigue, because the major symptom is a deep and unrelenting fatigue.
Cortisol is supposed to be high in the morning, and ideal amounts help you bounce out of bed. It plays a role in how vital you feel and helps the body combat any inflammatory processes that want to kick in. Stiffness is a key symptom of adrenal fatigue.
For those with chronic stress, morning cortisol levels tend to be low, and, if 25 units is the ideal, with adrenal stress you may only get to 10 units or fewer. It can be very difficult to get out of bed with such low levels. By mid-afternoon, it will be at an all-time low, and you feel you need something sweet, something containing caffeine, or a nap to get you through your afternoon (this can also be the result of low blood sugar, which is covered in detail in Puzzle Piece 7, Insulin, or poor thyroid function, which is also explored in Puzzle Piece 6, The Thyroid). For an adrenally fatigued person, cortisol may be nice and low in the evenings or for some it starts to rise again, interfering with restorative sleep. Furthermore, if you don’t go to bed before 10 p.m., an adrenally fatigued person will typically get a second wind, and it will be much harder for you to fall asleep if you’re still up at midnight. The following graph illustrates this.
When morning cortisol falls low, it is likely that prior to this it was high (although not always), and body fat may have increased during this time. But just because it is low does not mean easy access to body-fat burning, because of cortisol’s relationship to insulin, as well as the catabolic effects of cortisol, described earlier.
Figure 7: A typical cortisol profile of an adrenally fatigued person
Note particularly, the low waking cortisol and low midday reading.
Additionally, the fatigue you feel with this biochemical picture may make exercise the least appealing thing on the planet to you. You actually feel worse after exercise when you are adrenally fatigued, whereas exercise typically energizes us. Frustration mounts because you believe that exercising and eating less are the only solutions to weight loss, yet you can’t bring yourself to do either despite every good intention. Every time you eat something sweet, you eat too much, or another month goes past without much movement. When you reflect on this, you feel guilty, you might say mean things to yourself—and you may silently lose hope. You now think, “Who cares?” whenever you feel like eating something that won’t really nourish you, and the not-so-great eating continues, especially an excess consumption of carbohydrates as you desperately search for energy. Your clothes keep getting tighter and this just adds to your stress. The vicious cycle is self-perpetuating.
Humans were never designed to sustain long-term stress, and our individual bodies cope with it in different ways. For some, adrenalin remains the dominant stress hormone all of their lives, while others may flip over into what appears to be a more cortisol-dominant stress response. If the stress response doesn’t truly switch off, there is the potential that the adrenals will eventually crash, and cortisol output is no longer optimum or elevated. It will be negligible. At its extreme, this is a condition called Addison’s disease (and there may also be antibodies present), yet if a person’s cortisol level is extremely low but still falls just inside the “normal” range, that person will be told that they are fine. They feel lousy but all the tests they have always come back “normal.” They feel anything but normal, and people who know and love them will often comment that they are a shell of their former selves.
Cortisol can also be rather sinister in that it can interfere with your steroid (sex) hormone metabolism (explained in the next Puzzle Piece, Sex Hormones)
, your sleep patterns via its interference with melatonin, and also your mood via serotonin. Let’s look at them.
The serotonin-melatonin seesaw
Is this your typical day? Healthy breakfast, mid-morning coffee, salad or sandwich for lunch… with probably something sweet to follow lunch, but other than that, you are quite proud of yourself when you reflect on your food consumption so far for the day. But I predict that many of you then fall into one of three categories. Do you:
Hit mid-afternoon and eat anything and everything in sight and then spend the rest of the day berating yourself after such a great start?
Get so busy during the afternoon that food does not enter your head until you arrive home and a glass of wine and possibly some cheese and crackers allows you to let out a sigh of relief that the day is winding down?
Or is it neither of the above and the free-for-all starts after dinner, when you find yourself standing in front of the refrigerator or pantry saying to yourself, “I want something. I don’t know what it is that I want but I want something. And maybe it’s in here!”
