Latest / hol+ with Dr. Taz MD | The Future of Medicine is Holistic / Chronically Stressed? The Truth About Cortisol, Adrenal Fatigue & Healing Holistically
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- Chronically Stressed? The Truth About Cortisol, Adrenal Fatigue & Healing Holistically === We are actually living in one of the most stressful times in human history, and there are a number of really basic reasons why we have the studies now, guys that show processed foods, sugar, alcohol, all of these things, caffeine, they all increase cortisol production if the family is overly scheduled throughout the week. Seven different activities. Three different schools, meals all over the place. That is a hum of high cortisol that really kind of reverberates through the entire family. Now in conventional medicine, you tell a provider you're stressed. What do you typically leave with 90% of the time you leave with the medication for anxiety? Or for depression without much of an explanation as to why you may have cortisol dysfunction, what your cortisol levels are, or what they might be doing to the rest of your biochemistry. This is a problem because although you may be anxious and depressed, the root of your cortisol dysfunction could be coming from somewhere else. I don't think it's a secret that we are in the midst of a cortisol crisis. Everywhere we go, we're talking to somebody about stress, trying to help them manage stress, and I promise you, this is exactly what I'm seeing in my exam rooms. This is not limited. To adults. By the way, even our children today are using the word stress and feeling stressed, and it looks different depending on who you're talking to. At the root of this, stress is a hormone called cortisol and cortisol. It's been shown in a 2018 study increases nine times above average in a stressful situation. So we've gotta understand what's going on here and break it down because stress is impacting. Every single thing in our life is raising cortisol levels, which in turn impact our biochemistry and our physiology, but more importantly, impact the way we interact with one another in the world. When a child is stressed, they may not be able to tell you that, but what you see instead is maybe. Anything from bedwetting, trouble sleeping, a lot of crying and irritability, and as they get older it can present as full on anxiety, depression, eating disorders, and more. When adults are stressed, same thing. They ignore it. They try to power through, is what I hear over and over again, rather than digging in and trying to understand what's going on. But when adults are stressed, it can show up in so many different ways. There are absolutely the emotional ways, right, of getting irritable and snappy and angry men, by the way, express stress through anger more so than women often, or they're not sleeping, they're not eating. We could go on forever, but at the root of this word stress that we all throw around over and over again, and we all understand it's relative to each one of us. We each have our own bandwidth for stress. Is the hormone cortisol. And without really knowing what cortisol is doing, the lifestyle and the stress of you, the individual or of your family may be undoing your life. And this is something we need to really get ahold of and understand. There are many different signs and symptoms of a cortisol imbalance, but before we get into that. Let's talk about what cortisol is. It's a hormone at the end of the day. It's a messenger that goes to the rest of the body, kind of telling it what to do, but it's actually secreted from the adrenal gland with direction from the pituitary, and the pituitary sits right next to the hypothalamus. Both of which are lodged right here in your brain. I've talked about this analogy before, but I love it so much, so I'm gonna bring it up again. Essentially, the hypothalamus, this organ that sits right behind this pineal gland that's taking in light is our shark fin kind of sensing and feeling our environment, and really helping us respond to all the stimuli that we are exposed to in any given day. So if we're scared, if we're happy, if we're joyful, if we're fearful that hypothalamus is taking all of that in, as is taking that information in, it's communicating with its sister organ, sitting right next to it, the pituitary gland. And that pituitary gland is regulating the HPA axis and all of us men, women, and children. When cortisol levels go high, or actually, let's take it a step back when you are severely stressed, right? The hypothalamus is sensing that cortisol levels, again, 2018 studies had nine times more cortisol. Cortisol starts to pour out with direction from the pituitary gland and starts to communicate. With the rest of the body. So what does that mean? What does that look like? Well, with high cortisol, the first thing that can often happen is your heart rate goes up. So those are the palpitations you may feel. Now, a little bit of stress is not so bad, right? It makes us get up in the morning. It makes us accomplish things, makes us maybe do incredible things in the world, right? Keeps us motivated. But that chronic state of high cortisol affects the heart leading to palpitations, then moves on and can impact your blood pressure. So many times, high blood pressure is connected to high cortisol, and high cortisol can impact your blood sugar. So what if I just spelled out here? If you've been watching and listening to Whole Plus for a little while, you know what I have just done. High blood pressure, high blood sugar, heart palpitations. All of that is a recipe for insulin resistance. As blood sugar gets higher and higher, it can't move into the cells, the insulin gets more stubborn, delivers it back to the liver. The liver doesn't want it. We start to store fat. So the next thing you know, a symptom of cortisol dysregulation is weight gain specifically. Belly fat. That's the first place you can see that your body is responding to a lot of the stress around you. So everything from palpitations, blood pressure, weight gain, high blood sugar, which by the way, anytime blood sugar levels start to get higher and higher, you start to experience more blood sugar instability, so you're suddenly ravenous. Or you eat a carbohydrate rich meal or a high sugar meal and you're passing out and you don't know why, again, your cortisol levels are getting higher. That's the root of why this is happening to you. Now, moving on, as cortisol levels continue to rise or continue to stay dysregulated because they can go up and down and create havoc in the body. The more long-term consequences of cortisol dysfunction start to show up. And this is where we get into everything from the more cognitive issues where you have brain fog memory in the most severe cases, dementia, or you have emotional issues like anxiety and depression. But I have even seen in practice where exaggerated cortisol levels. Can bring about a schizophrenic or psychotic episode in our younger teenage patients or patients in their twenties and a bipolar episode in women, especially in their thirties, forties, and fifties. So again, this, this hum of cortisol is super powerful. But there's more. It can also trigger chronic inflammation. And while we're in a cortisol crisis, we're also in an epidemic of inflammation. Inflammation, depending on who you are, can show up in lots of different ways. For some, it's joint pain and joint swelling. For others, it's hair loss. For somebody else, it's rashes. There's so many different ways that inflammation can present in the body. But high cortisol is one of those tipping points for the expression of inflammation within you. So again, not to beat the drum too much, but here's what it means from a diagnostic standpoint. I find myself diagnosing everything from autoimmune diseases to hormone imbalances, even early cancers. More so cortisol has a important and lasting impact on the body in its sweet spot, which I keep talking about over and over again. It does what it's supposed to do, gets us motivated, gets us going, makes us do the things we need to do to be present in the world, but as it continues to dysregulate. Because the stress in your life may be too high or you may not have the tools to manage what's going on in your life. Then it does start to turn into physiologic changes that result in disease conventional medicine has us managing right. Each and every one of those symptoms I just listed out, or maybe each and every one of those diagnoses I just listed out. But we wanna think about cortisol in a different way, something that's preventable and actionable and really brings a whole health picture, a healing picture, and a healing journey for you. This cortisol crisis that I'm talking about, remember I'm talking about the entire family. I'm not just talking about men and women, but I'm also including our children. 'cause I do think it's impacting the family unit. So as we talk over the next few minutes, I want you to be thinking about not only yourself. But maybe whoever is in your family, that could be your parental family. It could be your childhood home, it could be your current family, it could be your friend, family, it doesn't matter. Family really sustains us and keeps us whole, and we hear that over and over again from all the different guests that have come on the show. But that family unit has to be healthy and having cortisol in the right place individually and within a family are two concepts that are so deeply intertwined and. Impact our biochemical and physical health along with our emotional health as well. So why are we now in a cortisol crisis? Wasn't there a crisis before when people couldn't get food or water or when they couldn't work or when they had to farm their own food? Wasn't there a crisis then? The answer is actually no. While people have always been stressed to some capacity, we are actually living in one of the most stressful times in human history, and there are a number of really basic reasons why, and the first actually starts with your circadian rhythm, the light dark cycles that we so naturally take for granted. Here's what the science says. When we wake up in the morning, we have high cortisol levels and we're supposed to, that's when cortisol levels are supposed to spike. When we look at a bright sun or a lamp or any type of bright light, that cortisol level increases, which is still a good thing. In fact, blue light, our phones, our iPads, all the devices within our home also increases cortisol levels. Now, all of that is great. If we limited that exposure to the early hours of the morning, six, 7:00 AM to maybe 9:00 AM or so in the morning. But what is the reality? For most of us, we are on our phones all day long. We are disrupting our dark light cycles all the time. We communicate globally, different time zones. We're flying, we're shifting. So when to wake up and when to go to bed has now lost the clear boundaries. It once had this, in turn, sends the entire cortisol and hormonal rhythm. Outta whack cortisol now because it's seeing all this light and it's getting stimulated over and over again. The light's coming through this pineal gland right here. Cortisol now is chronically elevated all throughout the day. It's not going down naturally like it's supposed to. In fact, right around two or three o'clock or so, cortisol levels, if you looked at a graph, should gradually be coming down. So as you're winding down and getting ready for bed. Your cortisol levels are lowering, and that's great 'cause you're going to fall asleep. But instead, what's happening with the constant exposure of light blue light, in particular, cortisol levels are staying elevated and they're impacting your melatonin production. Remember, melatonin is the sleep hormone helps us to fall asleep. Now it's being disrupted, so you are wide awake. So we start getting into the different stages of cortisol dysregulation and the very first stage happens because of light exposure, honestly, and disruption of your sleep wake cycle. That first stage is when cortisol is high during the day, and it does not come down after that two or 3:00 PM it just stays elevated. But it still hasn't yet flipped at night. I experienced all this personally with my ER shifts and the sleep wake cycles were all over the place. We go from seven A to seven p, seven P to seven a 11 8 11 p. I really honestly did not have a bedtime and did not have a wake up time. So my solution in my twenties was just to get by with maybe three hours of sleep. I wore that like a badge of honor and thought I was. Powering through only surely to pay the price a few years later. So we have to be in touch with what we are doing and what behaviors may be triggering this cortisol crisis. Now, take that same example I just gave you, but think about our kids. That light exposure is a hundred fold compared to what we are getting in terms of their surface area and their body chemistry. So why are we surprised when our children whose cortisol levels are high, their melatonin is low, they're not getting deep sleep and proper sleep wake cycles again, because of the technology and devices that surround them. Why are we surprised that they might have anxiety or depression or sensory issues or learning issues or difficulty focusing? So much of it is just in what we've done. Light, but that's certainly not the only part of the story. We have to move on to another big category of why we have cortisol dysregulation today across the board and the other, honestly, and you're, I know you're so tired of hearing me and others say this, but it's true. So we have to say it again. It's food quality. We have the studies now, guys that show processed foods, sugar, alcohol, all of these things, caffeine. They all increase cortisol production, and they keep us on this wave of high cortisol, elevated cortisol until it finally crashes out permanently. So if you're in a stressful state, what do we all do when we're stressed, by the way, right when we're stressed, it's like, oh my gosh, I gotta stay up late and get this deadline. I gotta do this thing, I gotta do this paper. We drink more caffeine, raise our cortisol levels up again, don't sleep again. Raise cortisol levels up again and it just compounds and compounds and compounds, and the body will try to take care of it for a period of time until it no longer can. So we've already touched upon the role of technology in cortisol. I don't wanna. Belabor that one too much, but it's real. And I think the most frustrating part as a parent is our children are learning on technology, writing on technology. They don't get technology breaks when it comes to their education. And I think that's a problem that we are gonna be dealing with and reckoning with in the years to come. But beyond that, the blue light from everything in our homes is impacting, obviously. Sleep and the light dark cycles and the circadian rhythms and all of these different aspects that tie right back to cortisol production. But let's touch on maybe one or two more reasons why we're in a cortisol crisis. The others, again, may be connected to technology, but it's the. Simple fact that we're not in nature anymore. We live in clustered conditions in cities or towns or communities. Most of our outdoor activity is maybe to exercise or maybe there's a sporting event that we may partake in, but being outside is not a natural part of the rhythm of our day any longer. We're in cars, we're not walking, so we don't touch the ground. We don't feel the earth and we don't see the sun, and all of those things when we think about how we are wired and how we are built is important in regulating cortisol. Our children often don't have outdoor activity anymore, right? PE has been taken away in so many school systems across the country, even across the globe, to a certain extent. Another reason why our kids are suffering from cortisol dysfunction, finally. The structure of family is impacting cortisol and cortisol regulation. More and more people are choosing to live alone or to live isolated from their original family, or are spread out across the globe. And while they try to connect and create families of their own, we can't get away from the simple fact that we heal in community and we heal in family. And that actually at the end of the day, brings cortisol down. I hear more and more young people tell me that they don't wanna get married. They don't want, you know, to be in a relationship. They prefer to be alone. They prefer alone time. Many, it's, it's shocking to me, and I sound like the old person here now, but it's shocking to me to hear couples needing dedicated time alone to scroll on their phones because we've started to develop a relationship with our technology that sometimes competes with the relationships that we have. With the people right in front of us, but the isolation of families from their extended family and then of individual family members from each other contributes to this cortisol crisis. So those are probably the biggest categories. There's so many more. We could talk about each individual toxin. We could talk about parabens and phthalates and you know, the chemical exposure that we have today just in our body care products, in our houses, the way our houses are made so much that we could talk about. But those to me, are probably the most tactical categories around why we are in a season, a generation of a cortisol crisis. And why stress today? It's such a big deal because it's impacting us biochemically. Now in conventional medicine, when you walk in and tell somebody you're stressed, right? You tell a provider, you're stressed. What do you typically leave with? I'm gonna wager, 'cause I've been through this personally, and I hear it from my patients all the time, that 90% of the time you leave with the medication for anxiety or for depression. Without much of an explanation as to why you may have cortisol dysfunction, what your cortisol levels are, or what they might be doing to the rest of your biochemistry. This is a problem because although you may be anxious and depressed, the root of your cortisol dysfunction could be coming from somewhere else. So when we now apply the whole plus way of doing things or take a holistic path. To balancing cortisol, we dig in a little bit deeper. First off, we want to identify where the cortisol dysfunction is coming from. Which means a couple of things. Let's first start with identifying where you are in the spectrum of cortisol dysregulation. You will know this term when I say it, adrenal fatigue, which conventional doctors often dismiss. In fact, before this episode, I was just looking to see if anything's changed maybe over 15 to 20 years. And guess what? Shocker, it's not adrenal fatigue is not a recognized term in conventional medicine. But we all know it's real, and all it is talking about is what is happening with cortisol. There are about four stages of adrenal fatigue. I want you guys to know, and I want you to take notes because hopefully you're able to identify where you are and then we can build a treatment plan based off that. Stage one is what I was talking about earlier. Your cortisol levels are high. They stay elevated after two or three o'clock in the afternoon. This is stage one adrenal fatigue, totally reversible. You can change it. A few lifestyle tweaks here and there. You're good to go. As long as you make the changes stage two. Now things start to get a little dicey. You have the elevated cortisol levels for sure, but now your cortisol levels are starting to climb towards the evening, maybe even into the night. So this means you're gradually moving into the state. Where you're just wired all the time. You can't slow down, you can't get rest. So typically you can't fall asleep and you're starting to cheat on your sleep hours because you're up longer and longer at night. Stage two moves right into stage three. Now, in stage three, you are tired all day long and you're wired all night. So now what's happening? The patterns flipped. Your cortisol levels are high now all night. They're low during the day and you simply cannot function. This is where we see about stage three or so. Is where we really do start to see the cognitive decline, the emotional sort of fallout of cortisol dysfunction. We start to see the early signs of inflammation and insulin resistance as well. We start to see the weight gain as you guys enter into stage three of this adrenal fatigue, and we start to put those pieces together, understanding that we've gotta reverse this and hopefully reverse it fairly quickly and easily. And the final stage is a big one. This is where disease absolutely happens. You are crashed out. Cortisol levels have now completely depleted. You are low at night. You're low during the day. You can barely get outta bed. You can barely move. You're fatigued after a workout and everything feels like a big deal. Chinese medicine would describe the stage four adrenal fatigue as low QA depleted person, low constitutional energy, and work to rebuild that energy and move them up. So you go from four to three to two to one, and hopefully restore your cortisol balance. The first place I would begin in rebuilding cortisol. Into a regular rhythm that really honors the sleep wake cycle and helps your body heal regardless of what stage you're in, is to first begin with correcting your sleep cycle. So that means for any of you that might be. You know, doing shift work or might be telling me you're a night owl. You guys do that all the time. It's not good for you, or whatever the reason may be. Or maybe you're just in a season, you're a new mom, or you have toddlers or something's going on, you still need a plan to compensate for this outpouring of cortisol that's happening because you're in this phase of life. So I recommend the following. First of all, correct the sleep cycle. Have a routine that forces you to wind down at night and something that forces you to wake up in the morning. That could look like so many different things. We're not gonna go through the entire list 'cause the list is long, but it. Definitely includes moving your devices outta your bedroom, maybe making sure you're maximizing melatonin production. I love magnesium too, by the way. It really does help to calm the nervous system down and then deciding what do you wanna add to that sleep toolbox. Is it yoga? Right before you go to bed, a sound bath, is it stretching? Is it reading? Is it just having a conversation with somebody in your family? Then as you get into a good night routine, the morning routine, if you're still feeling tired, because that cortisol level is still not really rising to where it should be, maybe looking into a sun lamp first thing in the morning, or getting outside and being in nature. These are ways to gradually increase your cortisol, but more importantly, to reset this cortisol dysfunction. Moving on from there, we wanna get back to the principles of managing blood sugar, having a healthy gut and optimizing nutrients. Unfortunately, you have to remove inflammatory foods like gluten. I know everyone's rolling their eyes. Gluten, dairy, sugar, alcohol. Try to choose cleaner options when you can. And definitely, you know, all the preservatives, fast foods, processed foods, those are going to impact cortisol function too. So I would say sleep cycle first, food quality second. And with food and diet, remember one other thing because the blood sugar level gets thrown off so terribly. With cortisol dysfunction at any of those stages that we just talked about. I think it's really important to eat consistently. You cannot fast. You have to eat every four hours. You can keep maybe a 12 hour fast at the most, but until that cortisol level stabilizes again, it's super important, super critical to eat at regular intervals and focus on protein and healthy fats to keep those cortisol levels balanced. With children, same thing. We want them eating consistently. Trying to get protein and fat in at the end of the day, that really does help improve cortisol dysfunction. So those are kind of the pillars I would say. Good sleep cycle, good diet, and then we keep building from there. Many people with cortisol dysfunction deplete their nutrients. They're low in B, they're low in magnesium, they're low in amino acids, they're low in essential nutrients, and as those deficiencies sort of intensify, they experience hormone imbalances as well. So in men it looks like low testosterone and women often will see low estrogen. Low progesterone or thyroid dysfunction. So testing a lot of this is helpful too, to know kinda where to begin. If, for example, somebody is very low in B vitamins, I would add a good quality B vitamin for the period of time that they are dealing with cortisol dysfunction. That's one that I've seen in practice over and over again if testosterone or progesterone or estrogen are low, then having that discussion on, do you need a baby dose of some of these hormones? While we're trying to reestablish cortisol dysfunction, will that be helpful? And oftentimes we find it is, in fact, when women are stressed and cortisol levels go up, progesterone is the first hormone to crash out causing even more insomnia, blood sugar instability, early periods, heavy periods, and all the hormonal symptoms that you often hear and read about. So hormones play a role in a good cortisol balancing plan. But what may be even more important is structuring your life. What is your self care? What does your mind body toolbox look like? If you run a stressful life in a stressful job, that's okay. Not telling anyone to quit their job or to stop doing something that they love. You do have to have some guardrails in place where there's some recovery time, so maybe you're powering through three or four days a week, but a couple of days a week, it's turning that intensity down and you're maybe going outside for a hike, getting acupuncture or a massage, spending time with family. And all of these principles are true of the family as well, right? If the family is overly scheduled throughout the week. Seven different activities, three different schools, right? Meals all over the place. That is a hum of high cortisol that really kind of reverberates through the entire family. Then what are the days? Or the schedule days where the family can tone it down. Not every day has to be planned with 50,000 things to do. Some days need to be about just hanging out together and connecting and reconnecting or seeing elders of the family or other family members because again, when we separate ourselves from the family, even though sometimes families are hard, we actually at the end of the day hurt ourselves. So family time, community time. This is a part of a cortisol management plan, and it's really important for starting to reverse many of the symptoms of cortisol dysfunction. Now, if you've been listening to me over the last few minutes and you're like, wait, is this me? Do I have cortisol dysfunction? How do I know? What do I do? Well, here's what I recommend. The good news is that there's so much testing available now that you can actually diagnose yourself and on the Whole Plus website, we actually have some quizzes that help you to understand as well where you may be in this journey of high cortisol and high stress. I. But from a laboratory standpoint, here are the things to know. You can check your cortisol levels and blood, but it has to be a first morning draw. Otherwise, you're gonna get inaccurate or hard to interpret results if you do it later throughout the day. My favorite is doing a four point saliva cortisol test. It's a way of understanding what your cortisol levels are doing all throughout the day, and again, understanding which of those stages you're in that we were just talking about. In addition to that, I would understand where your nutrients are. Some of the ones that I just mentioned, like BD and magnesium in particular, I would get a sense of where your other hormones are, where's progesterone, estrogen, testosterone, thyroid. It's also helpful to look at blood sugar numbers. You could wear a glucometer and understand where your blood sugar is. Are you going super high and then suddenly dropping really low? Are you chronically low or chronically high? All of that gives you a lot of valuable information when you're trying to understand how to turn this cortisol faucet off. But remember one thing conventional medicine thinks of managing cortisol dysfunction only when they find cortisol secreted. From something like a tumor or as some sort of cancer associated issue. Otherwise, there's really not a medication or treatment for cortisol dysfunction or stage one, stage two, stage three, stage four, adrenal fatigue instead, you know, it's sort of like. Here's an anxiety, here's a depression medication, or an A DHD medication, right? Or something for dementia. All the different medications, all the pharmaceutical options. But when we take the holistic approach, again, we're building, we're building the body back to being stronger and better than it was before the cortisol hits came into place. So it means building it back from a sleep, first light, dark cycle second, nutrition and gut. Third and fourth hormones are probably fifth. And walking through that, adding on the self-care, making time for family and nature, bringing that whole puzzle together, which at the end of the day helps to keep cortisol in the correct place and pull you out of a cortisol crisis. Now one thing I've been wrestling with and challenging myself with for a really long period of time, I'm gonna try it here today, but hopefully it kind of makes sense. We can all do that individually, right? You can build your cortisol regulation plan. Maybe your partner can build his, we can help our children build, build theirs. Whether we do the testing or not, we can start to put some of these things into effect. But when you have a family unit, whether it's two people, three people, four people, or 10 people, and everybody is not doing that work and understanding where they are in this journey, in this sort of epidemic of cortisol and overproduction of cortisol, then the unit has the hum of high cortisol. So even though you're doing your part, if somebody else is not doing their part, you are absorbing that high cortisol or that same energy from them and you're helping yourself, but you would help yourself more if that person would also step into the step, into the chat, as my children say. So it's important as a family to have these conversations. Where are we with stress? Are we overscheduled? Are we not connecting and spending time together? Is everybody on their devices and their phones at meal times, or at times it should be about family bonding. Do you have any boundaries in place with how long you're supposed to be on a device within the home? And then are you getting outside and are you having fun as a family? And when you bring that hum of cortisol down within the family unit, when you hit conflict, it's easier to manage conflict 'cause everybody's not coming in and a three alarm kind of state of mind trying to deal with conflict. Some conflicts are very minor, but go out of control because the person or the people involved in a particular conflict are so stressed out and are so not in the right mental space. So as we think about. Families, and we think about mental health and we think about our physical health. We know it's all connected. And we read headlines every day about the mental health epidemic, right? The cancer epidemic in younger and younger people. You know, our brains are dying because we're not able to focus or remember things anymore. At the end of the day, we need to be thinking about cortisol and how do we reset and rewire our brains to start to turn the dial of cortisol down and get us all out of this cortisol crisis. All right. I hope this has all made sense, and I hope that you're able to implement any of these steps. Remember, healing is a journey and it's hard to bring all the pieces together all at one time. Just start somewhere. There's never a wrong place to start, but jumping in with yourself and your family will change the course of your lives. Thanks for watching and listening to this episode of Whole Plus. I can't wait to see you guys next time. Thank you so much for listening and watching today's episode of Whole Plus, be sure to share this episode with your friends and family. And if you have it already, please take a moment to subscribe to this podcast on YouTube, or click the follow button on Apple, Spotify, or wherever it is that you get your podcast. Don't forget to follow me on all social channels at Dr. Taz md. Until next time, stay healthy and stay whole.