Cortisol, Insulin, & Stress…Oh My!
Prepare to run!
Picture it: you are going on a hike in the woods and you come across a bear. Immediately, your heart starts pumping, adrenaline kicks in, and you prepare yourself to fight or flight. While this is happening, your body begins to prepare for the need to have energy readily available for whatever may happen next.
A walnut-sized structure in the brain called the hypothalamus releases corticotropin-releasing hormone (CRH), causing your heart rate to increase.
Once CRH starts circulating in your body, the pituitary gland recognizes something is going on and starts releasing adrenocorticotropic hormone (ACTH) into the bloodstream to sound the alarm.
While working its way through your bloodstream, ACTH says hello to the adrenal glands that hang out on top of your kidneys and bind to a spot on the adrenal glands which triggers them to start producing cortisol and epinephrine (AKA adrenaline).
Cortisol and adrenaline trigger the body to send more blood to the muscles, increase your blood pressure, and decrease your sensitivity to insulin which leads to an increase in glucose in your blood. Increased blood pressure and more blood to the muscles prepare for you to fight or run. Increased glucose in your bloodstream gives you energy to escape the threat.
This stress response system is called the HPA (Hypothalamus-Pituitary-Adrenal) Axis.
What happens if the body is constantly stressed?
The HPA Axis is meant to be a short-acting system in the body - only to be needed in life-or-death situations. However, constant stress can lead to frequent activation of the HPA Axis and this frequent activation can cause ongoing health issues.
Persistent epinephrine spikes can damage blood vessels and arteries. This damage can cause increased cholesterol levels, high blood pressure, and a higher risk of heart attack or stroke.
Elevated cortisol levels decrease the body’s sensitivity to insulin which limits the ability to drive glucose (blood sugars) into the cells for use and creates high blood sugars. Over time, this can develop into diabetes.
Elevated cortisol triggers the body to store fat, particularly in the abdomen.
Elevated cortisol may contribute to the body’s need for high-energy foods (comfort foods) and cravings for highly caloric foods which can contribute to obesity.
Some studies have also shown a relationship between major depressive disorder and cortisol levels. The severity of depressive symptoms was proportionate to cortisol levels - those with more severe symptoms had higher levels of cortisol than those with less severe symptoms.
While not an accepted medical diagnosis, adrenal fatigue is a term applied to a collection of symptoms such as body aches, fatigue, sleep disturbances, and digestive problems. The theory is the adrenal glands cannot keep up with the constant state of flight-or-flight and cause slightly low levels of adrenal hormones. This is not to be confused with adrenal insufficiency which is an accepted diagnosis with blood tests showing low levels of adrenal hormones.
I’m constantly stressed, so what can I do?
Telling someone to stop stressing is easier said than done, right? In a life where most have to go to work, pay bills, and take care of kids, the stress is real. However, you can’t pour from an empty cup. So, let’s talk about techniques to counteract your stress response.
Just breathe. Before you roll your eyes, trust me. Belly breathing or diaphragmatic breathing helps control the nervous system and encourages the body to relax. When you feel stressed or anxious, taking a few minutes to deep breathe can have a bigger impact than you may think. There are plenty of videos out there, but this one is my go-to.
Be mindful. Mindfulness techniques have been around for centuries and for good reason. By being mindful of your thoughts, you can allow yourself to not take rash thoughts literally. You also become more aware of the needs of your body and give yourself more compassion. It is ok to not be ok, but recognize it and give yourself grace.
Meditation. This is a personal favorite stress reduction technique. Thankfully, meditation has become more popular in recent years and, of course, there’s an app for that. My favorite apps are Insight Timer, Calm, and Headspace. Insight Timer has meditations for anything you can think of - sleep, stress, depression, mindfulness, anxiety. You name it, they have it!
Exercise. I’m not talking about pumping iron at the gym (but if that’s your jam - get it!) Exercise doesn’t mean over-exertion. Just get your body moving. Go for a walk. Do some yoga. Take a tai chi class. Movement encourages deep breathing and relaxation of muscle tension.
Social support. Friends, spouses, relatives, co-workers, and confidants all provide a social net for times of stress and crisis. Good laughs also help boost those feel-good hormones and reduce the stress response.
Try not to let there be a bear in the woods moment every day of your life. Stress reduction is easier said than done, but like many things in life, it takes practice. Be kind to yourself. Also, recognize that there may be something else happening in your body aside from stress and it may take a visit to the doctor to rule out any other physical or mental health concerns.
-Kyra, RN
Sources:
Moyer, A. E., Rodin, J., Grilo, C. M., Cummings, N., Larson, L. M., & Rebuffé‐Scrive, M. (1994). Stress‐induced cortisol response and fat distribution in women. Obesity Research, 2(3), 255–262. https://doi.org/10.1002/j.1550-8528.1994.tb00055.x
Nandam, L. S., Brazel, M., Zhou, M., & Jhaveri, D. J. (2020). Cortisol and major depressive disorder—translating findings from humans to animal models and back. Frontiers in Psychiatry, 10. https://doi.org/10.3389/fpsyt.2019.00974
van der Valk, E. S., Savas, M., & van Rossum, E. F. (2018). Stress and obesity: Are there more susceptible individuals? Current Obesity Reports, 7(2), 193–203. https://doi.org/10.1007/s13679-018-0306-y
