All About Cortisol

Cortisol is your “fight or flight” hormone that helps your body in times of stress. It also helps with other processes that occur in your body, like regulating blood pressure, controls sleep/wake cycle, manages how your body uses carbohydrates, and more. Keep reading to learn more about cortisol.

about cortisol

All About Cortisol

Your adrenal glands are responsible for producing cortisol. The adrenals sit on top of your kidneys. During times of extreme stress, your brain will send signals to your adrenals to produce more cortisol. This will temporarily shut off or alter other functions like your digestive or immune system. When the danger passes, stress levels should return to normal along with blood pressures and other bodily systems.

Sometimes, though, your brain might think you are under constant stress and your adrenal glands will produce too much cortisol. This can lead to numerous health problems.

HPA-Axis Dysfunction

The “HPA-Axis Dysfunction”, which stands for hypothalamic-pituitary-adrenal axis (although if you want to be even more comprehensive, there is the term hypothalamic-pituitary-thyroid-adrenal-gonadal axis), is the hormone axis that needs to be in symphony in order to feel optimal health.  

HPA-axis dysfunction is a cause of many common symptoms, and is often either unknown or overlooked by physicians.  Chronic fatigue, insomnia, hot flashes, and mid-section weight gain, to name a few, can all be caused by HPA-axis dysfunction.

If you go to your regular doctor and convince them to test for adrenal function (and they actually do it!) they will likely order a morning serum cortisol.  The issues with this though is that it is a snap shot as to what your cortisol is at that moment. Hormones, however, work on a diurnal rhythm, and the hormone levels fluctuate throughout the day.  That is why the gold standard for adrenal testing in functional medicine is a 4-Point Salivary Cortisol. With this test, you collect saliva samples in the privacy of your own home, on a “typical” stress day, first thing in the morning, noon, early evening, and before bed.  This gives a much more accurate and detailed picture as to your typical adrenal response, and can be used to help tailor treatment. ZRT Labs is one of my favorite salivary hormone lab companies, and patients can directly order kits from their website.


Treatment for HPA-axis dysfunction is a step-wise approach and should be personalized with the help of a practitioner to your symptoms, comorbid conditions, and your adrenal testing. 

Lifestyle treatments are the foundation.  Stress reduction techniques like meditation, yoga, massage, as well as a whole foods diet and adequate sleep are necessary for adrenal health.

Adaptogens:  These are herbs that are used to help support adrenal function. Ashwagandha, rhodiola, Schisandra, licorice, and Siberian ginseng are some of the more commonly used herbs.

Glandulars:  These are dried, ground up animal (usually bovine) glandular tissue.  These are used as supplement in profound fatigue while the lifestyle modifications and adaptogens are take effect.  

Cortisone: This is a prescription cortisol replacement.  It is a last resort and only used for a very short period of time, in low dose, for extremely low cortisol levels. (We are not talking about Addison’s disease, which is low cortisol from adrenal destruction).  

It is important to remember that adrenal function takes time to improve, often six months or longer.  So be patient, and keep meditating!   

Please speak with your doctor before starting any treatment plan.

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