A Time of Healing: My experience learning how elevated cortisol affects my life Remember the days when a bowl of Mom's (or maybe even Campbell's) chicken noodle soup was the panacea for everything from a runny nose to hard day at school? The world felt so much smaller then. And honestly, it was. While the comfort of a cozy meal will always serve me well, I've grown in a world that operates like a 'OPEN 24 hours' neon sign, constantly buzzing and lit. I never developed evolved coping strategies to shutter external stimulation and self-induced stress. For the better part of the last rolling 12 months, my day looked a lot like this: 4AM:WakeUp.Coffee.Writing.Workout.Breakfast.Email.Instagram.Errands.Cooking.Lunch.Housework.Email.Instagram.KidsNeeds.Dinner.6PMCRASH.Instagram.Writing.Husband.Snack.OutsideCommitments.Dogs.Email.Collapse9PM.AsleepInSeconds.IntermittentSleep1AM-4AMRise.Repeat.Repeat.Repeat.365DaysStrong. Look familiar? All the while, what you see above was on top of my 'healthy non-negotiables' of drinking all my water, hitting my protein target at maintenance calories, strength training 5 days/week and 10k steps a day. Oh and working on my budding business. ALSO: the constant barrage of news, politics, opinions, agendas, blue light, COVID and more, constantly flickering like lightening in the distance. A storm was brewing.
The response to my most recent post about "Normalizing Recovery" was overwhelming. It's clear we are aware that we have a stress-management issue, but so many of us are at a loss as to what may be the root cause. And worse, we have no idea how impactful simple (not easy) lifestyle changes can be to treat it. Dive a little deeper and you may find yourself living with side effects of high cortisol that you just thought were part of 'life' as a mom, a struggling student, a night-shift worker, a peri-menopausal woman. While I don't claim for a moment to have any of the answers to solve another person's symptoms, I can share the correlations I've encountered in my own self-discovery, that is entirely still underway. Cortisol is a critical stress-response hormone, produced by the adrenals and necessary to keep the wheels of life in motion. It’s what pumps through you during times of acute stress, allowing you to get to the other side! And there is a natural arc it should follow throughout the day, mimicking the rise and fall of the sun. But what goes up must come down. And if it doesn’t come down or it spikes at inopportune times… Well, there are a host of consequences that we must either endure or treat.
Whether your cortisol is chronically elevated or entirely inverse from the arc, your body is going to start lowering its ‘thermostat’ in order to move energy toward what it believes to be an imminent threat in your world. Unfortunately, we can’t tell our bodies that the stress we’re facing is completely self-induced to help us hit a deadline or achieve a goal. No, mission control in the center of our brain (the hypothalamus) never got the system upgrade to understand that in 2020 we are probably not being chased by a bear. But frankly, it doesn’t care. Either way it wants us to calm the hell down. So when cortisol is chronically elevated, it steals things; namely the operations that allow our bodies to function in synchronicity with hormonal and metabolic health. Cortisol is naturally catabolic (a break-down process), which is crucial in the right context - we NEED it, but not helpful when imbalanced to the point it hijacks functions like hunger management or the conversion of T4 to T3 in your thyroid (metabolic and hormonal implications). Because who needs muscles when you’re running from a bear? Those will just slow you down. Your body knows where prioritize things and in times of stress, and aesthetics or performance are NOT on the agenda.
To determine if high cortisol was contributing to my symptoms, I took a 4-Point Cortisol and Neurotransmitter Saliva test, as ordered by my naturopathic doctor. You collect saliva samples at four specific times of the day, and send to a lab for analysis. You can do this test without the neurotransmitter piece, but I am happy tested both because it became very clear to me that I needed to address low levels of serotonin and GABA in order to begin to right-set my cortisol. You see, balancing the inhibitory and excitatory neurotransmitters is a bit of a dance, as there are so many intertwined parts. Have you ever tried to pick up a hanger out of a pile, and 12 more pull up with it? Our chemical messengers are often the same; one's healthy range hinging on another. But once my serotonin and GABA are where they should be, this should have a natural effect on lowering cortisol. Once it is managed, I can then move on to supporting dopamine and the excitatory neurotransmitter imbalances that may or may not still remain, without worrying about over-stressing my system. So even though my dopamine is currently very low, supplementing that during a time of elevated cortisol would be like adding gasoline to a fire. It is this type of nuanced that approach that makes ‘I have high cortisol, what do I do?’ a situation that needs to be discussed with a doctor, and not consumed as a one size fits all approach. You may have the best experience with a Naturopathic or Functional Medicine doctor rather than one who practices western medicine. Generally our allopathic doctors will be most reactive when you present more diseased symptoms (I mean, who isn’t tired or wired all day long in 2020, right?)
You can see what lab work I had done in the last email I sent (Currently Shopping + Healing), which can also be found on the contact page of my website. Here's another blog with suggestions for good place to start. Here's what my test results showed: While my cortisol did follow the natural circadian arc and fall throughout the day, it was sky high at more than double the 'in range' metrics at the first specimen taken. This indicated that it spiked sometime in the middle of the night, and was not in alignment with the rise of the sun - triggering my insomnia and rush of energy to start the day 4 hours sooner than I should. And while it followed the arc downward throughout the day, it remained very elevated, until falling like a rock off a cliff at 6pm (corresponding with the time I was barely able to peel myself off a piece of furniture to find my way to bed). The million dollar question I was asked in my post...HOW is this at all related to waking up in the middle of the night to use the bathroom? When the adrenal hormone cortisol is elevated, your body is in fight or flight mode. That means no rest. Handy if it's 8am and you have a full day planned. Not so convenient if it spikes for the day at 2:30 in the morning, spurring you out of bed or causing you to toss and turn for hours. It's no wonder sleep is elusive; your brain is under the impression that it is time to hustle. And if you are stirring due to cortisol related-HPA axis dysfunction (read more here), these sleep disturbances will of course alert you to the fact that you need to use the bathroom. But there are other reasons you may wake to pee in the middle of the night unrelated to my circumstances, so please consume all of this in the context of your own health and biofeedback. If you would like to learn more, I recommend starting with this article from Natural Medicine Journal for another review of how, why and ways to support low cortisol. I also think Cody Boom Boom did a fantastic job explaining cortisol here on his blog. Aside from the supplementation that is tailored to my needs and should NOT be applied without the supervision of your doctor, here are some of the ways I am working to get better sleep and reduce cortisol:
I set boundaries - cutting way back on work hours/screen time.
I incorporate more breaks - 3 rest days, mediations, breathing, writing daily,
Brain dumps before bed - writing anything that comes to mind just before I pull down the sheets, in an effort to keep these thoughts at bay throughout the night.
Sipping on bone broth as part of my nightly wind down routine.
Reduction of anything that would amp me up throughout the day; reducing caffeine, ignoring family drama, the turning off the news, blue-light blocking glasses when I am behind a screen.
Enjoying a high carb breakfast every day (because of the inverse relationship between insulin - which is released when carbs are in the system - and cortisol).
Attempts to reduce acute cortisol spikes (which are good!) post workout with adequate and timely carbs and protein.
Ensure I’m out of a deficit, eating almost entirely unprocessed carbs, healthy fats and getting 90% of my protein from animal food sources rather than supplements.
Tracking my biofeedback and listening to what it is telling me, EVEN if I feel FINE.…(the Oura Ring has helped keep me accountable)
Phasing in these supplements under the guide of my doctor: 5HTP, Calm CP, Pharma GABA (not sharing details on timing or dosage)
So here I am, about 4 months into my goal to optimize health by balancing my hormones and heal my gut. I'll know I am there when I am sleeping through the night 6 days a week, eating a wide variety of foods and able to make recovery efforts feel as habitual as exercise. And the more I learn, the more I realize there is to learn. This journey is about self-discovery yes, but I am also madly and deeply passionate about the research and committing my energy to healing, while simultaneously understanding. I hope you'll click through some of the resources I linked and do the same! Thank you so much for taking the time to read this very lengthy post! Please share it with a friend if you think it may be helpful! Warmly, Katie