We live in a world of constant stress. Even when we think we might be living a low to moderate stress life, the truth is it’s probably much more than that. This is because stress comes in so many different forms, some of which we may not even be viewing as stressors. These can be anything from emails, texts and to-do lists to alcohol consumption, toxin & blue light exposure, lack of sleep, over exercising, gut imbalances and food sensitivities.
Stress and inflammation tend to be at the root cause of almost every chronic disease in our world today. This is because stress plays a large role in our immune system.
You see, our bodies are set up to handle acute stressors every now and then. In fact, small amounts of stress strengthen our immune system and small hits of cortisol are in fact anti-inflammatory. However, problems arise when we are dealing with chronic stress.
Chronic stress down regulates and suppresses immune function. This is why people with chronic stress tend to feel more worn down from their day to day and often tend to get sick more often than those who aren’t weighed down with as much stress.
When we are stressed, our adrenals produce cortisol - our “fight or flight” hormone. When this hormone is sent out, our body prioritizes survival (all stressors are life-threatening in our bodies view) over any bodily function that doesn’t necessarily contribute to our survival in the immediate moment. This is all fine if stress only occurs acutely, however when we are in a constant state of fight or flight these other processes never get the opportunity to be turned back on. This can be detrimental to our health in the long run.
The HPA axis (hypothalamic-pituitary-adrenal axis) is the system in our body that regulates stress. It is often thought that with too much stress and too much cortisol production, our adrenals begin to experience dysfunction or what may be referred to as “adrenal fatigue”. However, there can be more to the story than just this explanation. High cortisol level or cortisol depletion is not always the reason. Instead, cortisol resistance can often be the missing piece of the puzzle.
Evaluating if cortisol resistance is at play is very helpful when it comes to getting to the root cause of inflammation. This is because when the cells become resistant to cortisol, it makes it much more difficult for the body to shut off the inflammatory response.
So what is cortisol resistance?
Cortisol resistance is when the immune cells’ receptors stop listening or responding to the signal being sent from cortisol. This process can be thought of in a very similar manner as insulin resistance. It’s not a shortage of insulin, in fact the pancreas is doing a great job at manufacturing this hormone, but rather the cells have become unresponsive to the insulin knocking on their doors.
Usually and ideally, cortisol is produced when someone becomes sick, injured or acutely stressed, which signals the inflammatory response. In this ideal scenario, inflammation turns on and moves through its processes so that it can then turn on the anti-inflammatory pathways. Healing requires some degree of inflammation to fight off disease and infection. We must go through the inflammatory pathways before we can go through the anti-inflammatory pathways. However, when our cells become cortisol resistance, they are no longer able to move through the inflammation process the way they are supposed to. Rather our cells and tissues tend to get stuck in those inflammatory stages. When inflammation turns chronic, we suddenly are at a much higher risk of developing some form of degenerative disease.
So why is it important to understand if you might be cortisol resistant?
One of the key reasons is that oftentimes, when it comes to cortisol and adrenal testing, cortisol levels in the body are the main way of assessing hormone health. This could become misleading if your cortisol labs come back normal but you are still feeling the same effects as high cortisol levels. This is where it becomes confusing - just because your lab work appears normal doesn’t mean you are all cleared in the world of cortisol and inflammation. This is where it becomes so important to dig deeper to understand what is really going on.
So what causes cortisol resistance?
The most common cause is of course chronic stress (remember stress can come in so many different forms) and chronic elevated cortisol levels. However, insulin resistance and leptin resistance can also lead to cortisol resistance and vice versa. Our hormones are intricately and delicately connected. Imbalance in one hormone can and often will lead to imbalance in another.
Symptoms of cortisol resistance often mimic those of adrenal dysfunction. Some of these symptoms manifest themselves as gastrointestinal issues such as bloating, IBS and IBD, reproductive and hormone imbalance, weight gain, thyroid suppression, chronic fatigue, feeling “wired & tired”, taking a couple hours to “wake up”, poor sleep, acne, cravings and a general dysregulation in appetite. Another big sign of cortisol resistance is chronic soreness and a reduced ability to recover from workouts.
When it comes to preventing cortisol resistance, it is very important to take the appropriate measures to manage stress. Some of the best stress management techniques that I personally love for myself and clients are deep breathing, meditation, journaling, swapping out high intensity and cardio workouts for yoga, walking and strength training, time in nature, grounding and baths.
Diet changes are also very important for dealing with cortisol resistance. I recommend following a nutrient-dense whole foods diet rich in antioxidants, veggies, healthy fats and plenty of protein. It is also important to avoid inflammatory foods such as sugar, gluten, dairy, caffeine, alcohol and any foods you have a sensitivity to. I want to stress never to drink caffeine on an empty stomach when dealing with cortisol problems. This drives an increased secretion of stress hormones and only exacerbates symptoms.
Take time to properly manage stress, avoid intense exercise (at least while you heal) and manage other areas of your life that may need adjusting. Look at your relationships - who enriches your life and who depletes you? Look at your tasks throughout the day - what can you say no to? What can you change to make things less stressful? In order to reset and resensitize your receptor sites to cortisol, your body needs a period of time to feel at peace and void of stress.