STRESS - What is Cortisol?

Hey, it's Dr. A. I want to answer a question that came as a follow-up to our other, uh, YouTube about the adrenal glands and what are they and why would I care. This one is specifically about the stress hormones and most particularly around cortisol, although as we talked about, the adrenal glands come in 2 parts. There's the medulla that makes the adrenaline-related hormones, and then the cortex that makes cortisol and aldosterone and testosterone precursors. But I kind of want to focus on cortisol because it gets a lot of press and there's a lot of confusion around it. And so the questions, there's a few of them, but they all basically were, you know, I've heard that cortisol is, you know, made naturally in my body, and I've heard that it can be either elevated or low, and I've heard I can have some disease problems from that, and what's the deal with cortisol? So The bottom line is there are, uh, 2 primary— there's a few others, but there's 2 primary disease states where cortisol production is an issue. You can have Cushing's, where you're making way too much cortisol— that's not good— or Addison's disease, where you're not making enough cortisol, and that is not good either. If you don't have enough cortisol, you actually can die, so it must be pretty important. Well, If you look at the other video, we go into this a little bit more, but what is the adrenal cortex makes cortisol and related compounds? It is very active in the morning naturally, so it's a circadian output. And so in the morning you have the most cortisol being produced, and then it tapers off through the day and you have very little at night. If you have too much cortisol at night, it's like taking steroids at night. You won't sleep well. If you have too many steroids, people can get agitated. People can go into psychotic episodes with too much cortisol. All sorts of stuff can happen that you don't want. So the cortisol in your body is tightly controlled. Your brain has a messenger that it sends out through the pituitary that tells the adrenal glands to either keep making cortisol or shut it down. So under normal circumstances, think of it like a slide. It's high in the morning and low at night. Now cortisol in your body can be produced at very high levels for stress reasons. This is good because if, for example, you're under a lot of stress, running from bears or other types of stressors, your body is assuming it's going to need more resources to burn up for energy, etc. So cortisol, in addition to waking us up in the morning, if we get under stress and it rises, it's called a glucocorticoid because it's going to increase the amount of glucose that's in the blood, which if we're running away or fighting bears or whatever is great. But what do I do if I have too much glucose in my blood but I'm not running away from bears? I'm not going to burn it up. This is where we talked about in the other video where chronic stress can trigger chronic adrenal overacting, not like Not like Cushing's, but just overreacting. And so it can throw off a lot of things. Our blood sugar is one thing. So chronic stress, especially when it's not met with enough physical activity, will increase your blood sugar. Now, over time, that chronic stress can increase your blood sugar and increase, you know, your hemoglobin A1c and all sorts of things, especially if you're diabetic. You don't need that. So that's why I'll talk a lot about stress control. So you think, well, okay, if it's not Addison's too low or Cushing's too high, how does the cortisol be, you know, made in excess even though it's not Cushing's? Well, your body is naturally able to make more if you have a real stress. Now, what's another thing that happens though with too much cortisol? Too much cortisol long term will mess with your calcium and bone metabolism. So specifically, it will tend to trend your calcium levels a little bit down because it slows down your absorption of calcium in the gut and stuff. And then it also slows down the cell signaling in your bone for bone turnover. So long-term chronic stress is also known to be unhealthy for the bones. The other thing that's critically important, especially if you're listening to this in 2021, uh, and we all have, you know, COVID on our minds and other infections and stuff, what you want to keep in mind is, um, if you have a lot of stress hormone going out, it slows your immune system down. And you think, uh, well, that wouldn't be very good. No, it's not. So I don't know if you've ever, you know, if you've ever been given large doses of steroids because you had a disease state or something went wrong and you need them, they're always very careful with you getting infections when you have high amounts of steroid in your system because it's suppressing your immunity. Well, the same thing happens with stress, whether it's actually running from bears or whatever, or you're just stressed because your work, you know, your workplace is stressful, you have maybe a living situation that's stressful, whatever, That can create extra cortisol and that actually will, will slow your immune system down. Now, the whole thing with cortisol slowing your immune system down can actually set you up to more illness, especially infections. Now you think, well, cortisol is really needed. If I don't have it, I can die. There's all these good things that cortisol does. What about this thing about, you know, muting my immune system and stuff? There are times where naturally with— if you're going through an infectious process where your immune system has these change points, and we talked about this a little bit in the B and T cell immunity question that I got, and so in these change points sometimes your body will actually produce a little bit more cortisol to help tell the immune system it's time to calm down. So there is a reason biologically for cortisol and other chemistry to slow your immune system down. But if it's caused because you're under so much stress and you have this high stress level going on all the time, all that does is slow your immunity down, slow your immune response down, and make you more of a target for bugs, you know, to infections and things. So just to summarize, cortisol is very necessary. You die without it. If it's too high as a disease, we call it Cushing's. If it's too low, we call it Addison's. But in between there, there is a variable bracket that it operates in every day of your life, hopefully. And it's supposed to be higher in the morning and lower at night. In the morning, it helps wake your brain up. It's part of your waking up hormone system. And you sort of live off it all day long. And at night, you want it nice and low so that you go to sleep easily. We know that if it's above those levels, the normal levels, we might actually then have higher blood sugar, lower calcium, and other problems going on, and then immune suppression. The thing with the adrenals is they're made to react to stressors because we've got to have something if bears are going to be chasing us. And so what we want to remember is that if we're making the adrenals react when there's no bears around, we need to either deal with that stress in whatever way we can. And in the meantime, physical activity is very good because then at least you're burning up the resources that the stress hormones are putting out there. So that's what cortisol is, that's why it's so important, and it's why you don't either want to have too little or too much. But it's also why your body is beautifully set up to be able to raise it when it needs to and then tone it down when it needs to. Well, I'm Dr. A. Thank you so much, all you new subscribers. Thanks for the questions. Please like, share, Subscribe, notifications, all that good stuff. It really, really helps us here at the channel, and I'll keep answering your questions.