Here's what happens: When there is a stress signal sent through the sympathetic nervous system, a stimulus package is initiated in the hypothalamus and the pituitary gland releasing ACTH which then produces cortisol, and DHEA through the adrenal cortex. This cascade is intended to provide anti-inflammatory help, and shuttle glucose to the brain, heart, lungs, and skeletal muscle. This is required by our body to help us make a quick getaway. More energy is needed right? Have you ever heard of those amazing stories where people lift a car or tree off of someone? That's stress on steroids. Literally!!
Cortisol works with the liver to provide the glucose, but prevents fat breakdown elsewhere in the body to conserve energy stores. That can be a major reason why someone is holding fat in their midsection. Stress! Cortisol levels are usually their highest in the morning and decline throughout the day. However in acute stress, there will be very high cortisol levels all throughout the day. If that goes on and one for a long season of time (stress, stress, stress,) then there will be a low cortisol in the morning. Often people will complain that they are extremely tired, but wired. They couldn't get sleep if they wanted to. This person will literally be running on Cortisol empty and things will seem to be falling apart..... or in this fun comic strip, your stripes will feel like they are falling off.
DHEA is another prohormone that is forced into action with a stress response. I have tons of patients who test their DHEA levels and they are low, low, low. DHEA stimulates our immune system. When there is not enough DHEA in our body, it's not a good thing. I promise that you will feel the effects. (I'm raising my own hand here. I treated myself for some adrenal fatigue years ago) DHEA maintains tissue strength and repair, supports bone, is neuroprotective, and promotes a sense of well-being. If you don't have enough, guess what you are going to feel like? Crummy, blah, pitiful, fatigued, feeling sick, irritable, frumpy, and dumpy. DHEA levels peak somewhere between 20-30 years old and after 40 the levels tend to decline markedly. Many studies provide evidence that low DHEA levels result in depression, forgetfulness, brain fog, lack of vitality, and poor immune status.
Sometimes the body has to decide what to do because Cortisol and DHEA are derived from the same precursors. The body says, should I produce one, or the other, or both? In normal circumstances, the body does a great job at providing both, and in good balance. But, when we have a lot of stress in our lives, there is a preferential drive toward production of cortisol. This is referred to as cortisol steal. This person will have higher cortisol levels, and lower levels of DHEA and all the other hormones downstream. Long term cortisol production is associated with immune suppression, high blood sugar, insulin resistance, abdominal fat, high blood pressure, memory impairment, high cholesterol, and impaired thyroid function. Not a good thing! This can only go on so long and then the adrenal glands take a vacation without giving you notice. You are left to go about your stressful daily business without the hormones you need. And the coffee pot and chocolate bars will become your best friends.
It is important not to make assumptions when a person may have hormonal imbalance. Fatigue and hot flashes might make you think of estrogen deficiency but there's so much more that has to be considered. By testing the adrenals along with the sex hormones, I've seen over and over that the imbalance can rest on the premise of stress and cortisol steal. The body will steal progesterone, and DHEA to get the steroid high that it needs. If you don't address this contributor, the estrogen you might put on board for hot flashes will only benefit a person so much. Then the other hormones needs to be balanced as well. If pregnenolone and progesterone are low because of the 'cortisol steal', then the other hormones will not be synthesized either. It's a downhill snowball effect on your other hormones. Test it and address it!
Hopefully you realize after reading this that living on stress is not the best. I understand that we can't excuse ourselves from our stressful jobs, family needs, and life events, but we can manage our physical "self" to help us weather the storms of life much better. It's important to get to a professional that can identify the root cause of the fatigue, hot flashes, irritability, poor sleep, poor healing, poor immunity, and so on. Each person is unique in their daily activities, stress levels, age, and adaptability to the juggling act of life. Knowing what your levels are and how to treat them appropriately is significant in your efforts to live happy and healthy. In the majority of those suffering with this, it's just a simple and manageable regimen that needs to be implemented. Core supplements and vitamins are essential and beneficial in combatting this along with custom therapies to restore the lacking hormones. ~That's years of experience talking here.
Call my office and I can tell you how to get tested in a convenient and affordable way.
To your good health,
Dr. Sonja
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