How do you end up with high cortisol?
If you are under any form of stress, this can be emotional stress, physical stress, the body responds with releasing more cortisol and adrenaline. The fight or flight reaction. The body’s reason for doing this is to change amino acids into glucose (gluconeogenesis). The extra glucose gives the body energy to cope with the stress on it. Intense exercise has the same effect.
In those with Hypothyroidism or Hashimotos, cortisol tends to rise when we are not diagnosed, or have been treated with T4 only medications, like Synthroid or Levothyroxine, these cause stress to our body. Hashimotos tends to cause inflammation which also raises cortisol (another stress on the body). Inflammation can come from the actual attack on the thyroid, or those who are consuming gluten, and have a sensitivity to it, they are unaware of. Even those without Hashimotos who are not diagnosed or treated with T4 only medications can see their cortisol raise due to inflammation.
Some other causes of high cortisol are high doses of Progesterone, re-activated viruses, chronic illness, Lyme disease, current and chronic life stress. This is not a complete list, but some of the more common ones. These and your hypothyroid state will need to be addressed.
This is not Cushing’s disease we are talking about, that is often caused by a tumor, usually benign, on the adrenal glands that cause the high cortisol. This is something to work with a Doctor on and not something we really cover here.
Although cortisol rising to help us serves a good purpose, it is when it remains high too long that we run into issues. High cortisol encourages T4 to convert to the inactive hormone Reverse T3 instead of the active hormone, T3. Uncontrolled high cortisol will lead to weight gain, with much of it in the stomach, difficulty falling asleep, or waking in the wee morning hours fully awake, high heart rate, depression when the Reverse T3 goes to high (it leaves you hypo), blood pressure issues, cortisol resistance and in some, anxiety due to adrenaline rising as cortisol does.
How do I find out if I have high cortisol?
It is never suggested to guess if you have high cortisol! The symptoms of high and low cortisol are so often the same for many. Blood tests are not accurate to diagnose high cortisol in an HPA Axis Dysregulation. Blood cortisol testing measures both bound (not usable) and unbound (usable) cortisol. Blood cortisol measures at least 85% of bound cortisol, we want to see what is available for use. This means your blood test could show high cortisol when in fact it is optimal or low! We suggest testing with a 4 point in the day saliva cortisol test. Saliva testing only measures unbound (usable) cortisol.
A saliva cortisol test done four times in the day (the lab you choose needs to have full lab ranges with a bottom and top of range all four times, ZRT and Labrix are two we like).
You are looking for optimal results to look like this:
Waking – about the VERY top of the range
4 hours later – about top ¼ of the range
4-5 hours later – about mid-range
Bedtime – the EXACT bottom of the range
What kind of symptoms does high cortisol have?
High and low cortisol often have such similar symptoms (and this is why you will need to test to VERIFY what you indeed do have!). Insomnia, or falling asleep just fine, then waking an hour or a few hours later and unable to fall back to sleep, some have anxiety, some feel exhausted, high Reverse T3 labs, some feel weak, less common in high cortisol is nausea in stress. Because the high cortisol encourages T4 to convert to the inactive hormone, Reverse T3, you begin to see hypo symptoms return, low body temperature, exhausted, hair may be falling out, weight gain, body aches etc.
Will my high cortisol fix itself if I reduce my stress?
Highly unlikely, and low cortisol is likely in your future if you leave this untreated. Your poor adrenal glands are working overtime to keep pumping out high amounts of cortisol, eventually they too become exhausted, and simply cannot produce cortisol at that rate. In the beginning of the adrenals inability to produce at that rate we often see, low, high, low, high…or even low, low, high, high, or low, low, low high. That bedtime high cortisol seems to be the most stubborn in its ability to keep producing high amounts of cortisol, much longer than any other time in the day.
What can high bedtime cortisol do?
High bedtime cortisol often causes a difficult time falling to sleep, or you fall asleep fine and are awake in an hour, or 2-3 hours and wide awake or, you have all of the above! A major disruption in your sleep. The body’s natural Circadian Rhythm has your cortisol at the highest at waking, gradually dropping down to the lowest at bedtime, so that you can rest your body and your mind in sleep. Having high bedtime cortisol often causes low waking cortisol.
Can I treat my high cortisol?
Health food stores and internet sites all carry herbs that lower cortisol. Below are examples of some supplements that patients have found success with in lowering their cortisol. These are taken one hour before you tested the high cortisol on a saliva cortisol test. Some are able to lower high cortisol quickly, others can take months to years. You know you have the high cortisol under control, once you have no more symptoms. At this point you can see if reducing your dose still keeps you at no symptoms, if the symptoms come back, simply add in what you reduced the next day. If they don’t come back, go ahead and continue reducing. Many seem to have more success taking a combo of the supplements listed below, but if you take enough of just one, others have had success with that as well.
- Phosphatidylserine (PS) is an amino acid derivative that is highly prevalent in the neural tissue of humans. In the brain, PS is essential for the creation of the phospholipid bilayer, which acts as a “gatekeeper” that regulates what goes in and out of your cells. It helps to lower cortisol as it curbs and manages cortisol. When looking for one to buy, you want the simple, and not the complex. The complex contains Phosphatidyl Choline, and patients have said it gives them an out of it kind of feeling. Recommended doses range from 300 mg to 1,000 mg. Many found starting at 300 mg and if needed, raising by 100 mg every 3-5 days to no symptoms worked best for them. Many of the Phosphatidylserine’s out there contain soy, the amount is small if you have no other soy your diet, it should be fine for your thyroid. Jarrow makes a soy free formula called PS-100 that also works.
- Seriphos by Interplexus is another good alternative, it contains 1000 mg PS per capsule. Many have had great success using this to lower cortisol.
- Zinc can be added to any of these for a high bedtime cortisol if you have tested low in Zinc. It does not appear to lower optimal levels or low levels of cortisol, and also seems to work best on a high bedtime cortisol level. 25-75 mg of Zinc seems to work best. Some people do get stomach upset with Zinc; this can be avoided taking it on a full stomach and starting on low doses and working up. Zinc is the antagonist of Copper, and it can lower Copper levels. If you test Zinc and it comes back low, you may consider testing Copper as well before taking Zinc, to see if your levels are high. If they are high, you will want to look at our high Copper page on how to detox the Copper (taking just the Zinc can cause an unnecessarily painful detox)! If your Copper is not high, you will want to add in some Copper with your Zinc to maintain your levels. 2-4 mg of Copper with your Zinc seems to be enough to maintain Copper levels according to some experts.
- Holy Basil is a member of the mint family and an adaptogenic herb that has been shown to lower cortisol. (Most adaptogens do not raise or lower cortisol, this is an exception). Patients found that beginning with one pill an hour before each high was tested and raising by one pill at each high every 3-5 days to no symptoms worked best for them.
- Zizyphus/Jujube is an herbal supplement, also called Jujube, is used in Chinese medicine and known for its sedative qualities in the treatment of Insomnia. Because of this sedation, it could help lower high cortisol. It is often used in combination with Magnolia extracts, which may have direct correlation in lowering cortisol. (Zizyphus/Jujube is taken with Relora as ONE supplement)
- Relora is also an herbal supplement containing extracts of phellodenron and magnolia. It has been shown to lower high cortisol levels by attaching to your cortisol receptors, which the body takes to mean it doesn’t need to produce more cortisol. (Relora is taken with Zizyphus/Jujube as ONE supplement