This will be part 1 of our 4-part series in how hormones affect the immune system and autoimmune diseases.
Cortisol is a major hormone in our body. It is the hormone that is responsible for waking us up in the morning, and it is the major hormone associated with stress. Because of this, it is commonly called the “fight or flight” hormone.
When cortisol is high, it’s effect is to help us in stressful situations. Think: Running from a bear. When you are in survival mode, you need a lot of things to work for you. You need your muscles to contract so that you can run fast. You need your blood sugar to be higher so that you have more energy in your cells. You need your vision to be focused, and you need better blood flow.
Alternatively, apart from stimulating certain things, high cortisol levels can also help suppress certain things. For example, constipation is commonly associated with high levels of cortisol. This makes sense because the last thing you want to do when running from a bear is poop yourself. High levels also suppress the immune system. For similar reasons, you don’t want to have to fight an infection when running from a bear.
It is this effect on the immune system that we will discuss here.
Cortisol’s Effect on the Immune System
Like I said above, when cortisol levels are high, it suppresses our immune system. It’s because of this reaction that we have steroid medications like Prednisone. Prednisone is a steroid hormone derived from our body’s natural cortisol. In fact, all steroids are initially derived from cortisol. So when levels are high, they are helpful in reducing symptoms of autoimmunity. And when they are low, they are likely to aggravate autoimmune diseases.
So, if high cortisol levels are likely to help reduce autoimmune flares, then why does stress usually trigger autoimmune diseases? There are many reasons for this.
In periods of acute stress (meaning stress that lasts less than a few weeks), autoimmune diseases are generally suppressed. When people have relatively stress-free lives and they go through a period of acute stress, cortisol levels temporarily increase during that period of stress. After this period of stress, if the person has a relatively normal stress response, those levels will go back to normal.
The problem generally occurs in people who have prolonged periods of stress. This can cause a low hormone reserve. Meaning that when the acute stress happens, they can produce high levels of cortisol, but when the stress is gone, levels will plummet way below normal. This leads to overall low cortisol levels. These people will usually notice their autoimmune disease has flared in periods after a major stress event like the death of a loved one, or a sudden change in a life circumstance.
There are also issues with people that have chronic low-grade stress for a long period of time. This can lead to overall low levels of cortisol. This is because the adrenal glad has a hard time keeping up with the demand and the cortisol levels deplete over time. These people will notice that their autoimmune diseases start to get worse slowly over periods of long, persistent stress, or that they are more likely to get sick when viral infections spread.
Stress and Cortisol Production
So if stress can cause acute elevations in cortisol and burn it out over time, what kind of stress are we talking about? There are many different ways that stress can change cortisol levels. This is usually through physical, emotional or mental stress.
Physical stress can be anything from working a job that is physically demanding on a regular basis, to over exercising on a regular basis. Physical demands on our body require cortisol levels to increase to help things like our muscles contract.
Emotional stress is usually from life events or circumstances. Periods of emotional stress from family, work or relationship events can cause levels to spike or depleted over time.
Mental stress is often seen in students or in people required to do sustained levels of mental work over time. The brain requires large amounts of blood sugar to process mental tasks. Cortisol helps increase blood sugar to increase the brain functioning.
How to Treat Cortisol Levels
If you think that stress or changes in cortisol levels are affecting your immune function or autoimmune disease, there are several ways you can go about working on this. The first is to consider cortisol testing. This can be done through blood tests, but saliva tests that look at cortisol throughout the course of the day are better. These tests can tell you what your cortisol levels are doing in the morning (when they are supposed to be high) vs in the evening (when they are supposed to be low).
If you find that your cortisol levels are too low, there are several ways to help bring them into balance. The best way is to try to eliminate the stress that caused them to be low in the first place. If you can’t change the situation causing the stress, implementing things like meditation or biofeedback can help. Exercise in short periods can help increase cortisol levels.
If cortisol levels are extremely low, you can work with a provider that can help you increase levels without stimulating anxiety. There are many herbal therapies that can help improve the adrenal glands production of hormones. There are also therapies that give precursors to cortisol like pregnenolone, to help cortisol production.
In any rate, you should always work with a provider that is well versed in understanding the effects of hormones on the immune system. If you have questions about therapies that our providers use, or if you are wondering how stress is impacting your autoimmune disease, you can contact our office to schedule a free phone consult with one of physicians today.