The Cortisol Problem…

As I mentioned in my first post, I recently have been on a bit of a cortisol-reduction rampage (an ironically not-so-calm verb, I know).  This all started when I went to Dr. Pescatore to determine why my ability to go to sleep had come to a screeching halt and why I had to work so hard to maintain my muscle tone/ weight.  I’ve been eating *very* clean for a long time, working out diligently (and with true, hard effort,) and my results had stalled.

Much to my happy surprise, there were very clear-cut, obvious reasons for my issues.

Much to my dismay, however, there was a lot of work to be done.  My cortisol was SKY-HIGH, and stayed that way all day long, sticking stably high at the same level from 12 pm to 10 pm.  The result was a “cascade” of hormonal imbalances that made sleep and proper recovery impossible.  It also, not surprisingly, results in insulin resistance and makes it easier to store weight, thus my need to workout for hours upon hours to stay the same.

For those who don’t know, cortisol is a hormone that (according to wikipedia and, coincidentally, my doctor):

is released in response to stress. . . Its primary functions are to increase blood sugar through gluconeogenesis; suppress the immune system; and aid in fat, protein and carbohydrate metabolism. It also decreases bone formation.

There is a ton out there on stress hormones, so I won’t pretend to have more than a rudimentary understanding of all the harmful effects of cortisol.  But I will note: I didn’t think my life was stressful at all at the time I had the test done, and my levels were still super high.  My doctor said my history of eating disorders/cumulative “past stress” from school and work could easily explain my cortisol levels.

For many people, cortisol won’t be an issue.  But if you have a stressful life  and/or if you find yourself unable sleep or gain/lose weight, any of these issues could indicate that your cortisol levels are off.  Its easy enough to ask your doctor to do a salivary cortisol test (or if WellnessFX is available in your area, they can facilitate getting the test done).

When I got my out-of-whack results, I (much like the rule-loving, problem-solving fanatic that I am) immediately began researching ways to bring my cortisol down.  I am in no way an expert on how to calm down – even with a 10+-step process, I am generally amped up.  Part of it is general exuberance – I love my work, my friends, and my “extracurriculars” – so it is easy to be excited and pumped up all day.  The other part of it, though, is that sky-high cortisol pumping through my veins.  I’m trying to be patient (not a skill I really have) and give my body time to repair, since it has taken over a decade of not sleeping and overworking my body to get to this place.  I’ll let you know how it goes when we retest my cortisol in February (6 months after my last test).

My current cortisol reduction protocol includes:

(1) Planning on having 8 hours of sleep.  This one sounds simple, but with so many fabulous things that I have found to occupy my 21 hour days when I was only sleeping 3 hours a night, it is easy to make plans that involve staying up late (to see friends, go to a performance, workout, or for the ever-constant but not-necessarily-planned late night at the office) and/or waking up early (for work, for a workout, for an interesting breakfast talk, etc.)

As it turns out, even one night of bad sleep can throw off cortisol and leptin levels.  So making sleep a priority is the most important step towards normalizing cortisol levels.

I admit – it has been very difficult to adjust to saying no to things I want to do, or sleeping in a bit later and skipping a workout if I don’t get to bed early.  But, the results have been better than when I was waking up and downing a coffee to make it through a 6:45 am workout on 2 hours of sleep.  I’m lifting heavier and feeling better.

(2)  Speaking of downing a coffee….  I have given up coffee completely.  This is partly to do with cortisol, partly to facilitate a reduction in my caffeine intake, and mainly to avoid foods that have an inflammatory effect on my body (as determined by my ALCAT test.)  I do always have a “bulletproof” tea in the morning.  My blend is Numi Organic Pu-erh tea, 7 g ghee, 7 g coconut manna, 8 g MCT oil, Mexican cinnamon, and Alcohol-free Vanilla extract or pure vanilla beans.  Not only is it delicious, but it has energized me in the way coffee used to without any precipitous drops in energy later in the day.  After this one cup of tea, I only drink decaf tea or naturally caffeine free teas.

Note: some studies suggest that your body adjusts to caffeine intake, thereby reducing the impact of caffeine on cortisol levels.  This may be the case, but for me, I find it easier just to cut coffee out completely to get better sleep.  If you *have* to have your coffee, try to do it before 2 p.m. to avoid disrupting your sleep patterns.

(3) Meditation.  This can admittedly take many forms.  I like to walk through Central Park (as pictured from yesterday’s stroll) and/or listen to classical music to help clear my thoughts.

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I try to take 10 minutes (or more, if I have the time) when I get home to do a seated meditation (which for me just means sitting with nothing to do and–again–clear my thoughts, which are always racing).  I also do breathing exercises twice a day to teach myself to let go.

(4) Avoiding blue light after 10 pm.  This is the hardest.  Friends who know me know I try very hard to be responsive, and during my first 3 years as a lawyer, I lived with my blackberry attached to my ear to ensure I always responded as soon as possible.  Now, I still check my blackberry religiously while awake, but if I am not expecting anything urgent to come in after 10, I shut it off while I am sleeping and respond immediately in the morning if something came in after I got into bed.  Cut yourself some slack – work is an important part of life (especially if you love what you do), and sometimes, doing your best at work will mean that 8 hours of sleep with a turned-off blackberry == impossible.  In those instances, cut out any “extras” you’re doing to make time for sleep, but don’t be too hard on yourself if you can’t stick to your normal routine.  The flip side, though, is that no one needs to be woken up by the 3:50 am PLI email offering CLE credits or by a Law360 article (if you’re a lawyer, you know what I’m talking about.)  If you need to have your phone on at night to be able to wake up for urgent emails, set up rules in your email system to send those emails to another folder where you can check them in the morning.

BTW – This step has also meant the end of middle-of-the-week TV for me for the most part.  The shift has been a challenge, but it has markedly improved the quality of my sleep.

(5) Speaking of sleep quality, I track my sleep.  If I wake up and see that I had a low quality sleep, with frequent “light sleep” segments and several instances of waking up in the middle of the night, I try to sleep for extra hour and cut something out of my morning routine.

(6) To decrease cortisol, I’ve also had to drastically cut my cardio workouts down.  I focus on quality over quantity, and try to keep the total “work” time of any cardio workout under 30 minutes to avoid an adrenal response.  Because I love running and cycling, I sometimes bend the rules and go for 45 minutes or *gasp* an hour, but I try to make those the exception to the rule.

(7) Yoga.

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I’ve always loved yoga because it helps so many things – posture, alignment, recovery, etc.  The added bonus is that it is calming and strengthens muscles while your heart rate stays low (i.e., no cortisol spike).  My favorite NYC instructors are Melinda Abbott at Equinox and Evan Perry at YogaWorks.  When I can’t make it to class, David Swenson’s led Ashtanga video is amazing.

(8) Detox Baths – this one may not have the most profound or immediate effect, but let me be honest – it is probably my favorite.  I used Epsom salts, clays, and organic essential oils to relax, and keep the water pretty warm [read: hot].

(9) Supplements:  My doctor suggested a swath of things to aid in the reduction of my cortisol.  Foremost, we added 3mg melatonin, 50 g 5HTP, 200 mg L-Theanine, 1000mg GABA, [all Solgar] and 2 tsp of Magnesium (in the form of Natural Calm) every night, 30 min before bed.  Through experimentation on my own, I have added Krill Oil (I take one in the morning and one at night), 1 T MCT oil, an L-Arginine-L-Ornithine blend and Serrapeptase.

I know these supplements work because 30 minutes after drinking my cocktail, I have no choice but to fall asleep.  NOTE: these dosages were carefully prescribed by my doctor looking at my actual cortisol levels.  They may be way too high or low for other people, so research on your own and talk to your doctor before adding any of these to your routine.

(10) Massage:  Recovery and repair help the body relax, and relaxation helps stabilize cortisol levels.  Adding massages in when possible could also add in the additional bonus of speeding up recovery while you’re waiting for cortisol levels to come back down.

(11) Acupuncture:  I adore Mark Thompson Acupuncture.  Mark has done a TON to help break up knots I’ve developed from over-working my muscles, but he also offers “relaxation” acupuncture that targets adrenal overload.

Other than sleep, it’s unclear which of these techniques is the most efficacious.  The trick is to experiment and see what works for you. 🙂

One thought on “The Cortisol Problem…

  1. Pingback: natural sleep: Integrative Therapeutics Cortisol Manager, 90-Count - Anxiety Disorders and Treatments

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