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You Don't Know What You've Got 'til its Gone....

Low Cortisol States

You had just fallen back to sleep when your 6:00 o'clock alarm wakes you from your fitful five hour slumber. After hitting the snooze button three times, you reluctantly drag yourself to the shower. On the way, you yell at your two parasites (i.e. teenagers) to get their carcasses out of bed and get dressed for school. While you once prided yourself on preparing gluten free, dairy free, gourmet breakfasts for them, your exhaustion has forced you to choose the 30 minutes of sleep instead.

Your 45 minute morning drive to work during rush hour traffic offers you your only daily glimpse of humor. You pretend not to notice but can't help watch your fellow commuters singing, applying their make-up, text messaging, and picking their noses (like they think we can't really see them??) By noon, you've had four cups of coffee, answered at least 100 e-mails, and decided that at least four of your co-workers desperately need a prescription for Lithium...or maybe you do! Your typical lunch of diet soda and a handful of crackers is usually not enough to sustain you for the afternoon rat race, but you just don't have time to eat.

Finally, between 5 and 7 pm, you agonize your way through rush hour traffic (again), arrive at home, and start round three of your daily dinner, helping the parasites with their homework, and finishing up work from the office. Oh....your husband? He came home about an hour before you did and fell asleep on the couch, beer in hand, watching the nightly news. Some time between 10:30 and 11:00 pm, you crash. You have no trouble falling asleep, but you wake up every two hours because your husband is snoring, you have to go to the bathroom, or you are trying to remember why your friend, Susie, isn't speaking to you anymore. You finally fall back to sleep just in time for your alarm to scream at you at 6:00 am the following morning...Welcome to Einstein's definition of insanity!


For the past 20 or more years, the chaos called 'your life' is something you've just 'dealt with'. Stress multiplied by stress equals stress squared, but you could handle it. But now, in your third or fourth decade of the grind, your body is holding up the white flag of defeat. Even the mind is no longer willing even if the body will barely follow...Your fuse is so short, you will spontaneously combust at any time, you're constantly exhausted, and you can't remember where you put anything. How much longer do you think your body will cooperate?

Welcome to the number one cause of disease and death...STRESS. Stress is now a worldwide epidemic, and there is absolutely NO indication that this is going to change during our lifetimes. Although it's true that some degree of stress is necessary, and even healthy (EUSTRESS), for our survival, prolonged DISTRESS can cause widespread tissue destruction, cell damage, disease, and even premature death. Many different hormones are involved in the stress response. However, the most important one is the hormone cortisol.

Cortisol is the primary hormone of the chronic stress response. It is responsible for allowing your body to produce a 'fight or flight' response. The main job of cortisol is to provide your body with the fuel necessary resources to 'cave' or kick butt. When you are stressed, your cortisol goes up which causes your blood sugar and blood pressure to go up. Also, your bones, muscles, and other tissues are broken down to provide the fuel you need for the ongoing stress response. These changes are usually only temporary in the short term. However, long term exposure to cortisol can be disastrous. prevent your own self defense system from turning on you, your body has to make some radical changes, even if you feel like crap in the process.

Short term stress, which means less than 15 minutes (yeah, right!) normally causes a rise in cortisol and other hormones. But, chronic stress (i.e. your life) can eventually cause cortisol levels to nose dive. Most often, this happens because your brain tells your adrenal glands to turn down their cortisol production, not because the adrenals 'fatigue'! Once this happens, most people end up with all kinds of symptoms (but 'normal labs'). The most common symptoms are sensitivity to stress, chronic pain, and chronic fatigue. In addition, NOTHING in your body will work once you've gone from 'fight or flight' to 'barely surviving' mode. This means, forget about sex, sleep, weight loss, and any other bodily function that requires hormone balance.

It might interest you to know that low cortisol states have been found in 20 to 25 percent of patient with these stress-related bodily disorders: chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome, PTSD, burnout, atypical depression, and chronic pain (pelvic, back, headache). Other symptoms can include one or more of the following:

General: fatigue, fever, weakness, muscle pain, joint pain, sore throat, headaches, dizziness upon standing, chronic pain

Gastrointestinal: Lack of appetite, nausea, vomiting, diarrhea, abdominal or flank pain

Psychiatric: Depression, apathy, irritability, sleep disturbances, difficulty concentrating, difficulty with memory, confusion, stress sensitivity

Cardiovascular: Increased heart rate, abnormal regulation of blood pressure and heart rate with changes in body position, dehydration, depressed heart contractions

Laboratory: Low blood sugar, low sodium, high potassium, high calcium, increased numbers of white blood cells, low thyroid hormone levels

The symptoms and disease states associated with low cortisol CAN be treated once the underlying cause is identified and properly addressed. The key is to work with a health care provider with outstanding experience and knowledge of this very complicated medical condition.

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