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Cortisol and Adrenal Fatigue

Cortisol is produced by our adrenal glands and is the main hormone in our body responsible for our tolerance of and response to prolonged stress. In our modern constantly connected world, ongoing 24/7 stress has become the norm for most people. This has resulted in an epidemic of stress-induced illness and cortisol imbalances.

Cortisol Production & Functions

Cortisol is a fascinating hormone with several major functions and interconnections with other hormones. A steroid glucocorticoid hormone, its production is controlled by the pituitary gland in the brain. Under prolonged stressful conditions, the pituitary produces a signalling hormone ACTH which stimulates the adrenal glands to produce more cortisol. Cortisol levels fluctuate in a daily circadian rhythm with peak levels around 8AM each day. Healthy levels of cortisol are required for the following:

  • optimal stress response
  • immune system balance
  • thyroid hormone conversion
  • blood sugar regulation
  • maintaining energy levels
  • healthy blood pressure

Consequences of Cortisol Imbalances

The effects of cortisol imbalances on the body are highly variable and can be difficult to recognize due to the hormone’s many functions. The term adrenal fatigue describes the situation where cortisol levels have decreased to consistently low levels. One of the first consequences is decreased stress tolerance, where smaller stressors trigger larger responses such as fatigue, insomnia, depression and anxiety. The immune system may become imbalanced leading to either recurrent infections or inflammatory conditions such as fibromyalgia or chronic pain. Thyroid hormone conversion and activation can be impaired, which will lead to low thyroid symptoms even though the thyroid gland is functioning normally. As cortisol is strongly connected to the hormone insulin, imbalances can lead to either hypoglycemia or elevated blood sugar which can contribute to excessive weight gain or loss.

Testing & Rebalancing Cortisol Levels

The most accurate and ideal way of measuring cortisol levels is through saliva testing, which is offered by many naturopathic physicians. The Adrenal Stress Index is a test where saliva cortisol samples are collected at 8AM, noon, 4PM and 10PM, which allows for a patient’s exact circadian cortisol rhythm to be determined. Based on these results, a treatment plan may be established including vitamins C and B5, adaptogenic herbs such as licorice, ashwaghanda, rhodiola and siberian ginseng and adrenal glandular extracts. A naturopathic doctor will also make recommendations regarding stress management, diet, exercise and sleep, as they all have an impact on adrenal function and recovery. A comprehensive naturopathic approach can greatly assist in and speed up recovery from stress-induced illness and cortisol imbalances.

Dr. Arjuna Veeravagu is a naturopathic physician, registered acupuncturist and founder of Sage Clinics in Yaletown and Victoria. More information about Sage Clinic can be found at To schedule a consultation with Dr. Veeravagu please email or call (604) 697-0397.