Cortisol is one of the main steroid hormones produced in the adrenal glands. The primary action is to prevent hypoglycemia. Cortisol increases blood pressure and neutralizes inflammation. Some of the beneficial effects of cortisol are mood enhancement, dynamism, work capacity, stress resistance, immune system stimulation, anti-rheumatic action, and calming of the sympathetic or flight or fight part of the nervous system. When cortisol decreases, adrenaline actions predominate with emotional outbursts. This is why cortisol is a major part of our hormone replacement therapy.
Normal stimulators of cortisol are activity, standing, stress, emotions, and bright sunlight. At night, melatonin and growth hormone are secreted and help reduce levels, thereby improving sleep. If cortisol is high at night, insomnia results.
Cortisone is the natural precursor to cortisol and has 80% of cortisol’s activity. Prednisone, dexamethasone and others are synthetic derivatives of cortisol. Daily production is approximately 15-25mg/day in women and 25-35mg/day in men. Levels are highest around 6-8 am and lowest in late afternoon or evening. Cortisol production and utilization diminish with age.
Child: Thin, narrow face and body. Infections of ears, nose, and throat are common. Allergies, asthma, liver problems, colitis may predominate. Excessive emotional outbursts with anger/irritability, anorexia, difficulty eating except sweet cravings.
Adult: Larger face but may have become hollow. Thin body if lack of appetite or intestinal inflammation. Possible obesity if sweet cravings predominate.
Symptoms tend to worsen with stressful situations and when standing up. Physical signs such as joint inflammation tend to be localized to certain areas of the body (such as one hand). This is why hormone replacement therapy is important.
Signs and Symptoms of Cortisol Deficiency:
- Extreme moodiness with anxiety or depression in stressful situations.
- Excessive emotions, outbursts of anger/anxiety, panic. Frequent screaming or yelling. Sharp verbal retorts, use of strong, dramatized words. Excessive sensitivity to pain, intolerance to medications, prone to infections.
- Memory loss in stressful situations. Confusion, absentmindedness especially when stressed.
- Poor resistance to stress, difficulty functioning in stressful situations, paralyzed in stressful times.
- Irritability, negativism, feeling of being a victim, paranoia, accusatory, quarrelsome.
- Excessive thinness or overweight due to sugar or salt cravings.
- Hair loss, stress headaches, inflamed skin lesions, vitiligo, cheloids, irregular brown spots, easy suntan.
- Muscle pains, tendonitis, arthritis, predisposition to inflammatory diseases, allergies, asthma, food allergies, chronic inflammatory diseases such as rheumatoid arthritis.
- Fatigue-especially when stressed, burned out syndrome, lightheaded when standing.
- Longer sleep required, slight fever occasionally, intense hunger attacks, nausea or loss of appetite especially for meats. Sweet, salty cravings, colitis, bloating, abdominal pain, diarrhea.
Indications for hormone replacement therapy treatment: allergies, asthma, rheumatoid arthritis, GI tract inflammation, systemic infections, chronic sinusitis, other inflammatory diseases.