More and more health practitioners are beginning to recognize how widespread adrenal fatigue is in the general population these days. Now they're starting to wonder if cortisol can help treat adrenal dysfunction effectively and safely.
Originally Posted November 2012
Updated October 2019
Many people report feeling under constant pressure and stress which causes them to feel sluggish, irritable and fatigued. They are desperately trying to clear up that mental fogginess with coffee or other stimulants, just to crash worse afterwards. Does this sound like you?
Although it’s been widely accepted as the “common way of living in a working, modern society”, it is not normal.
Understanding Adrenal Fatigue
The adrenals are small glands that sit on the kidneys. They regulate many bodily processes through the production of hormones. The hormones produced by the adrenal glands help regulate blood sugar, immune function, and stress response. A disruption in the excretion of these hormones can lead to malfunction in these bodily processes and others.
Adrenal fatigue is a chronic condition wherein the adrenals are incapable of supplying the hormones needed for healthy bodily function. There are a number of potential causes for this dysfunction including physical trauma, a stressful professional or personal life, hormone imbalances, chronic illnesses, chronic infections, and sleep deficits. These and other physiological stressors trigger adrenal activity. If the adrenals continue to experience an increased demand, they will eventually become exhausted and incapable of sustaining healthy function.
The Symptoms of Adrenal Fatigue
Low levels of adrenal hormones, specifically cortisol, can result in symptoms such as:
- Muscle aches
- Sugar or salt craving
- Shakiness relieved with eating
- Food sensitivities
- Recurrent infections
- Dizzy when standing
- Low blood pressure
- Decreased ability to handle stress
- “Brain fog”
- Swollen ankles that are worse at night
- Muscular weakness
- Difficulty getting out of bed
- Wiped out with exercise
- Inability to tolerate thyroid replacement
The Role of Cortisol in Adrenal Function
The most important anti-stress hormone in the body is cortisol. It protects the body from excessive adrenal fatigue by:
- normalizing blood sugar: cortisol increases the blood sugar level in the body, thus providing the energy needed for the body to physically escape threat or injury in order to survive. Cortisol works in tandem with insulin from the pancreas to provide adequate glucose for energy.
- anti-inflammatory response: cortisol is a powerful anti-inflammatory agent. It is secreted as part of the anti-inflammatory response. Its objective is to remove and prevent swelling and redness of nearly all tissues.
- immune system suppression: cortisol influences most cells that participate in the immune reaction, especially white blood cells. It suppresses white blood cells, natural killer cells, monocytes, macrophages and mast cells. It also suppresses adrenal fatigue.
- vaso-constriction: people with low cortisol have low blood pressure and reduced activity to other body agents that constrict blood vessels.
- physiology of stress: people with adrenal fatigue can not tolerate stress and will then succumb to severe stress. As their stress increases, progressively higher levels of cortisol are required. When the cortisol level cannot rise in response to stress, it is impossible to maintain the body in optimum stress response.
Cortisol sustains life via two opposite, but related, kinds of regulatory actions: releasing and activating the existing defense mechanisms of the body, while shutting down and modifying the same mechanisms to prevent them.
Using Cortisol to Safely and Effectively Treat Adrenal Fatigue
In the right situation and using the right dose, hormone replacement can be of great benefit for people with adrenal dysfunction. Medical science is just beginning to find out that a person can feel horrible and function poorly even with a minimal to moderate hormone deficiency that is clinically undetected by routine blood tests. This is evident in the case of adrenal fatigue.
Some physicians, notably Dr. Jefferies in the mid 1980s, have advocated low dose cortisol as safe for long-term use. Dr. Jefferies found that as long as the adrenal hormone level is kept within the normal range, the main toxicity that a patient might experience was a slight upset stomach, due to the body not being used to having the hormone come in through the stomach.
In an article published by Dr. Kent Holtorf in the Journal of Chronic Fatigue Syndrome about therapeutic doses of cortisol for patients with fibromyalgia and chronic fatigue syndrome, he states: “Because treatment with low physiologic doses of cortisol (< 15 mg) has been shown to be safe and effective and routine dynamic ACTH testing does not appear to have significant diagnostic sensitivity, it is reasonable to give a therapeutic trial of physiologic doses of cortisol to the majority of patients with CFS and FM, especially to those who have symptoms that are consistent with adrenal dysfunction, have low blood pressure, or have baseline cortisol levels in the low or low-normal range. (…) Physiologic replacement of cortisol at doses of 5 mg to 15 mg a day are safe, with little or no associated risk. Such physiologic doses don’t carry the risk of adrenal and immune suppression or bone loss, which are well known risks of pharmacological doses of corticosteroids. Cortisol treatment carries significantly less risk and a greater potential for benefit than standard treatments, such as antidepressants, muscle relaxants, anticonvulsants and narcotics.”
Finding a Doctor that Understands Adrenal Fatigue
The adrenals are a critical component of healthy bodily function. Adrenal fatigue result in dramatic repercussions on your physical, emotional, and mental health. Treatment of adrenal fatigue should be tailored to you and your specific needs and can include low dose cortisol, adrenal glandulars, vitamin C, Pantothenic acid, licorice, and chromium.
At Holtorf Medical Group, our physicians are trained to provide you with cutting-edge testing and innovative treatments to find the answers you deserve and a treatment plan that is personalized to you. If you are experiencing symptoms of adrenal fatigue, give us a call at 877-508-1177 to see how we can help you!
Resources1. Kent Holtorf, MD. “Diagnosis and Treatment of Hypothalamic-Pituitary-Adrenal (HPA) Axis Dysfunction in Patients with Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM).” https://www.holtorfmed.com/download/chronic-fatigue-syndrome-and-fibromyalgia/Diagnosis_and_Treatment_of_HPA_Axis_Dysfunction.pdf
2. Kent Holtorf, MD. “Adrenal Fatigue Testing.” https://www.holtorfmed.com/download/other/Adrenal-Testing.pdf
3. Kent Holtorf, MD. “Adrenal Fatigue Treatment Options.” https://www.holtorfmed.com/download/other/Adrenal-Treatments.pdf.
4. William McK. Jefferies. “Safe Uses of Cortisol.” Book.