8 cases out of 10, patients present to me with low cortisol levels. These are usually cases of burnout where we need to support the adrenals and bring balance to the hypothalamic-pituitary-adrenal (HPA) system that oversees your stress response.
Cortisol is released in a cyclical manner (in line with your circadian rhythms) such that you’ve got the highest production upon waking. 
This gets you out of bed.
Gives you focus and energy to start your day.
And primes your immune system for balance (protects against auto-immunity).
high Morning cortisol levels are therefore normal and essential (within healthy ranges).
Your cortisol cyclical rhythms can have various manifestations depending on what’s been going on for you and for how long. Initially when stress is really high, your cortisol spikes out of the normal ranges. In cases like this you’re on edge, anxious, hyper-vigilant and perhaps even bordering on ‘panic’. These are times when we need to use stress management techniques of exercise, deep breathing, nourishing foods, deep restful sleep and even herbs in some instances to help bring the body back into balance.
If the above is allowed to continue and become chronic, eventually your resources for hormone production diminish. The hormone DHEA begins to fall (will impact energy, focus, memory, repair) and your body may begin to deactivate the free active cortisol more readily to clear it out of your system. Leaving you fatigued and depleted. In situations like this, our goal is to raise DHEA, calm the nervous system (through acupuncture and stress management techniques) and if indicated either support the falling active free cortisol levels with herbs and lifestyle modifications.
If the above remains unaddressed even further, the cortisol levels diminish and your daily rhythm becomes flat with minimal cortisol production. This is when you’re feeling burnt out. Exhausted. Weak. Possibly tired but wired. And having difficulty with sleep (since you actually need a small bit of cortisol for good deep sleep). Irritable, achy and weak digestion are some other common symptoms at this stage. Your workouts become exhausting and are no longer rejuvenating. And your recovery time post exercise may slow down to a halt! In cases like this, I often have to ask patients to really consider an assessment of their life choices and consider a re-prioritization of the activities and the daily tasks they’re engaged in so that they can begin to schedule in some time for rest. Beyond that, adrenal support supplements are a must as well as acupuncture to regulate the extreme HPA-axis dysfunction. Many other treatments such as IV Nutrient therapy, hormonal therapy and glandular therapies are also available and become a significant part of the healing process. 
If you’re wondering how you’d know which stage of the HPA-axis dysregulation your body may be at, a saliva cortisol test is a great place to start. However an even better test for assessing adrenal function (as well as other hormones and neurotransmitter balance) is the DUTCH Hormone test (Precision Analytical). The Dutch hormone test will provide us with a very clear picture which stage of the Adrenal burnout (fatigue) your body may be at and how to halt the progression and reverse the downward spiral process.
If you’ve found this information helpful please share it with your friends and loved ones! Cortisol is an essential hormone and the adrenal glands (the glads responsible for its production along with the pituitary and hypothalamus) require protection. These 3 organs (HPA) take the brunt of our stress filled (the grind) lifestyle and it takes a toll on our body:
speeding the ageing process,
bringing about and aggravating auto-immune conditions
and contributing to system inflammation (the root cause of most chronic diseases in society today)!
- So love your adrenals and go for a nature walk today
- ♥ your adrenals and give yourself a 30 minute nap
- ♥ your adrenals & re-prioritize the rat race you may be on
- ♥ your adrenals and eat the rainbow, don’t skip out on proteins and load on the healthy fats
- ♥ your adrenals and invest in a DUTCH hormone test if you think you may heading down the HPA-axis dysregulation pathway
Yours in Health,
Dr. Negin
