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Cortisol and Adrenal Function


August 21, 2009 | Published by

adrenal gland illustrationThe hormones secreted by your adrenals influence all the major physiological processes in your body. They closely affect the utilization of carbohydrates and fats, the conversion of fats and proteins into energy, the distribution of stored fat (especially around your waist and at the sides of your face), normal blood sugar regulation, and proper cardiovascular and gastrointestinal function.

Essential to the maintenance of homeostasis, cortisol is a life-sustaining hormone. Cortisol is called “the stress hormone” because it influences, regulates or modulates many of the changes that occur in the body in response to stress, including:

  • Blood sugar (glucose) levels
  • Fat, protein and carbohydrate metabolism to maintain blood glucose (gluconeogenesis)
  • Immune responses
  • Anti-inflammatory actions
  • Blood pressure
  • Heart and blood vessel tone and contraction
  • Central nervous system activation

Cortisol can be viewed as sustaining life through two opposite but related types of regulatory actions: releasing and activating existing defense mechanisms of the body, and shutting down and modifying the same mechanisms to prevent them from overshooting and causing damage or cell death.

Cortisol levels normally fluctuate throughout the day and night in a circadian rhythm that peaks at about 8 AM and reaches it lowest around 4 AM. While it is vital to health for the adrenals to secret more cortisol in response to stress, it is also very important that bodily functions and cortisol levels return to normal following a stressful event. Unfortunately, in our current high-stress culture, the stress response is activated so often that the body does not always have a chance to return to normal. This can lead to health problems resulting from too much circulating cortisol and/or from too little cortisol if the adrenal glands become chronically fatigued (adrenal fatigue).

Higher and more prolonged levels of circulating cortisol (like those associated with chronic stress) have been shown to have negative effects, such as:

  • Impaired cognitive performance
  • Dampened thyroid function
  • Blood sugar imbalances, such as hyperglycemia
  • Decreased bone density
  • Sleep disruption
  • Decreased muscle mass
  • Elevated blood pressure
  • Lowered immune function
  • Slow wound healing
  • Increased abdominal fat, which has a stronger correlation to certain health problems than fat deposited in other areas of the body. Some of the health problems associated with increased stomach fat are heart attacks, strokes, higher levels of “bad” cholesterol (LDL) and lower levels of “good” cholesterol (HDL), which can lead to other health problems.

saliva testing vialsChronically lower levels of circulating cortisol (as in adrenal fatigue) have been associated with negative effects, such as:

  • Brain fog, cloudy-headedness and mild depression
  • Low thyroid function
  • Blood sugar imbalances, such as hypoglycemia
  • Fatigue – especially morning and mid-afternoon fatigue
  • Sleep disruption
  • Low blood pressure
  • Lowered immune function
  • Inflammation

The best way to determine your particular cortisol levels is to use the saliva test that measures your cortisol levels several times per day. Because saliva hormone levels correlate well with the amount of hormone inside the cells (tissue levels), saliva testing is often more useful than blood or urine testing of hormone levels. By measuring your saliva hormone levels at least four times per day, you will be able to see for yourself where your cortisol levels are compared to the norms. You can see whether low cortisol levels are responsible for the feelings of fatigue that you experience during particular times of day.

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  • I’m currently attempting recovery from extreme adrenal fatigue / reactive hypoglycemia and the many accompanying symptoms. I have recently taken a cortisol test of a 24hr urine. How will this test inform me of my cortisol levels, and how can I use this test to understand/monitor my recovery of adrenal fatigue? Also, how does the 24hr urine test compare to a saliva test?

    Last, I’m wondering if when I recover from adrenal exhaustion, if I will still have to continue the strict reactive hypoglycemia diet I’m on. That is, if I am able to correct my adrenal issue, is it presumable that my reactive hypoglycemia state (ie. symptom) may become resistant to fluctuation / stable as well?

  • lisa says:

    have u been tested for addisons disease? because im told thats what i have and that you never recover from it , its a chronic condition requiring steroid treatment. if you dont get it treated you are playing russian roulette with your life ! dont mess about with this see your doctor immediately and ask for a referal to a endochrinologist

  • Jenny says:


    I recently got saliva testing for my cortisol levels and I have very low cortisol levels. I am currently taking Dr. Wilson’s supplement protocol. Is there a way to find out which protocol (mild, intermediate, severe) I should be on based on my cortisol levels rather than the quiz? Thank you.

    • Adrenal Fatigue Team says:

      Hi Jenny,

      Great question – as of now we do not have protocol recommendations based on cortisol levels. Sometimes health practitioners will recommend a protocol based on test levels, if they review the results with you. Otherwise you can do what we generally recommend to all taking the protocol, which is start at the mild (basic) and build up as needed. You can use the basic protocol for 2 weeks, then increase to the intermediate if needed. The intermediate protocol can be followed for another 2 weeks before moving up to the maximum (severe) protocol if necessary. We hope that helps – please let us know if we can answer any further questions. You can also call us at 800-357-5027 with any questions.

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