Obesity and Cortisol:Controlling Stress Hormones to Limit Fat
Karen Kaufman, MS, CCN
While watching shoppers stroll through
the malls during the Christmas holiday season, I was struck with
just how serious obesity is becoming. Since 1994 when the
Department of Agriculture issued the New Food Pyramid (a low
fat, grain-based diet), the number of overweight and obese
people in this country has continued to increase. Try as they
might, the medical profession has yet to come up with a
successful strategy for long-term weight loss. In fact,
depending upon how one reads the medical literature,
conventional medical diet strategies have a success rate of
between 3 and 7%.
Doing the math, this means that conventional weight loss
strategies have a FAILURE rate of between 93 and 97 percent.
Surely, there is something more complex to
obesity than simply eating too much, or not exercising enough.
One clue to the obesity puzzle recently hit the medical news
headlines. The September/October issue of Psychosomatic Medicine
published a fascinating article that reported that stress might
cause excess abdominal fat, even in otherwise slender women.
There have been numerous studies that have examined the release
of cortisol during acute and chronic stress, and the physiologic
effects that this hormone has on the body. This is the first
study to find that even in non-overweight women, this excess
cortisol contributes to the deposition of visceral fat
particularly in the abdominal region. Central obesity sets the
stage for a host of health concerns such as heart disease and
diabetes. This study was conducted on women, but as the studys
author Dr. Epel states: These relationships are likely to apply
to men as well.
Fight or Flight Response
It is important to understand that the stress response, or the
fight-or-flight response, played a critical role in the
evolution of man. The first descriptions of this response can be
traced to the work of a Harvard physiologist, Walter Cannon, who
described the human brain as hard-wired to protect us from
bodily harm. This wiring exists in the hypothalamus, which, when
stimulated, sets in motion a sequence of events that begins with
nerve cell firings that result in the release of chemicals to
prepare the body for running or fighting.
Lets say early man is suddenly confronted by a saber-tooth
tiger. The fight-or-flight response activates and the body
releases adrenaline, noradrenaline and cortisol. These hormones
shunt blood away from the center of the body and toward muscles
and limbs to prepare in the event this man is attacked.
Additional physiologic responses ensure a rapid response to the
threat: pupils dilate, awareness intensifies, and impulses
quicken. When the perceived threat disappears the body reverts
to its physiologic homeostasis, shutting down the release of the
hormones, until the next threat appears.
This finely tuned mechanism was fine for our ancestors, and in
fact they depended on it for their very survival. But in our
modern world, this same stress response
kicks in rather indiscriminately, whether someone simply steals
our parking space or we are facing true danger in the back alley
of a city street with a mugger on our trail.
General Adaptation Syndrome
Numerous issues of this publication, most notably Dr. Ward Deans
discussions of the Neuroendocrine Theory of Aging Part II,
Adaptive Homeostat Dysfunction (April 1999 Vitamin Research
News), have addressed the negative effects of this
hyperadaptosis that has become part of the price we pay living
in this stressful, fast-paced society.
What once was a critical component for survival in a hostile and
volatile environment has become a source of many potential
health problems. The bodys response to stress in the modern
world has been characterized as the General Adaptation Syndrome
(GAS). The GAS is a three-stage process.
The first GAS stage has already been described above. The second
stage is that of resistance, where we learn (to our own
detriment) to efficiently cope with the stressor. During this
stage, hypothalamic cortisol receptors become less sensitive to
feedback inhibition, resulting in increased cortisol production
(Fig. 1.). Excess cortisol production is associated with a
number of metabolic disorders of the Hypothalamic Pituitary
Adrenal Axis (HPA) which include insulin resistance, central
increased blood pressure, suppressed immune function and
impaired wound healing. In fact, prolonged excessive cortisol
elevation can lead to signs and symptoms resembling Cushings
Disease. The third and final stage of the GAS is total adrenal
exhaustion which involves a depletion of energy reserves and a
loss of resilience leading to fatigue, immune system burnout,
and a host of other systemic symptoms that may include brain
pathologies such as Alzheimers disease and depression.
Although the stress response has been part of our genetic wiring
since the beginning of time, this hyperadaptosis is a phenomenon
that has only been recognized in the
last three decades. Since the syndrome described involves a
complex interplay of hormones and neurotransmitters, there is
not going to be one quick fix that will solve this problem for
One of the best known and most effective ways to lower excess
cortisol levels is with the nutrient Phosphatidylserine (PS).
Almost all readers are by now familiar with the benefits of PS
in preventing short-term memory loss, age-related dementia, and
Alzheimers Disease. The ability to blunt the effects of excess
cortisol may be PSs most important function. A recent
double-blind crossover study conducted at California State
University by Thomas D. Fahey, Ed.D., established that serum
cortisol levels were significantly lower in weight training
athletes who took PS when compared to those who took the
placebo. This is an important finding not only for weight
training athletes who are trying to blunt the catabolic (or
muscle breakdown) effects of the cortisol released during their
vigorous workouts, but to all of us who suffer under the daily
stressors of modern life. PS can be taken in dosages from one to
three 100 mg capsules per day based, upon individual needs.
An entire category of herbs called adaptogens assist the body in
coping with stress by restoring hypothalamic cortisol receptor
sensitivity. Increased cortisol receptor
sensitivity to negative feedback inhibition results in a rapid
restoration of the stress response to normal, with a reduction
in cortisol levels. AdaptaPhase I is one such blend of
adaptogenic herbs. It is a combination of Siberian ginseng,
Manchurian Thorn Tree extract, Hawthorn extract, Echinopanax
elatum and Schisandra. This blend of adaptogenic herbs was
developed for people under increased stress. Some people will
get relief from one ml per day, while others will benefit from
as many as four mls. AdaptaPhase I may work alone or in
conjunction with its anti-catabolic counterpart, AdaptaPhase II.
Daily the body engages in a tug of war between two types of
metabolism, anabolic metabolism and catabolic metabolism. During
the anabolic phase the body accumulates
energy to build up new cells and lean muscle. Catabolism occurs
when the body exhausts its energy reserves and breaks down lean
muscle tissue. This often occurs when the body is subjected to
extreme stress, such as the intense physical demands faced by
athletes, the high pressure experienced by dot com executives as
the NASDAQ loses 50% of its value, or a personal trauma such as
the death of a loved one. AdaptaPhase II is synergistic blend of
ingredients designed to help the body overcome that exhausted or
tired feeling that is experienced by people under such extreme
stress. The formula includes soy protein isolate, Rhaponticum
Terrestris, and Adjuga turkistanica. These ingredients exert
profound energizing, anabolic, muscle-building effects. This
product is best used in cycles, with each cycle lasting 10 days
with a break of two to three weeks between each 10 day cycle.
Dosages range from 4-10 capsules per day depending upon the
individuals weight and the amount of physical or psychological
stress that individual is undergoing.
The third stage of the GAS, adrenal exhaustion, is often more
difficult to resolve. Adrenal exhaustion involves a depletion of
energy reserves and a loss of resilience. Symptomatic signs of
adrenal exhaustion can be as diverse as fatigue, nervousness,
anxiety, severe PMS, depression, brain fog, carbohydrate
cravings, allergies, muscular pain and tenderness, joint pain
and irritable bowel syndrome. The goal of nutritional therapy in
this situation is to restore the natural, diurnal release of
normal levels of cortisol. The theory is if you provide the body
with a small amount of a cortisol-like substance, the adrenal
glands can take a rest and have an opportunity to regenerate.
Then normal cortisol production will be restored.
CortiTrophin is a combination of adrenal concentrate and
glycyrrhizinate. Glycyrrhizinate is a natural cortisol-mimicking
extract from licorice. Taking a small amount
of CortiTrophin 25-100 mgs/day can be beneficial in treating
symptoms of adrenal exhaustion and can provide significant
relief from the symptoms of chronic fatigue and fibromyalgia. To
best mimic the bodys own physiology, CortiTrophin should be
taken on an empty stomach, first thing in the morning. If a
second dose is required, it should be taken before lunch. Since
CortiTrophin mimics the action of cortisol, one should be very
judicious in using it. It should only be used intermittently and
if any adverse effects occur, such as water retention or
elevated blood pressure, use should be discontinued imwww.ely.
As cortisol rises with age, another adrenal hormone, DHEA, drops
precipitously. Convenient salivary testing of both DHEA and
cortisol can provide a road map for balancing these two critical
hormones. However, DHEA can also be used empirically to
alleviate the symptoms of excess cortisol or hyperadaptosis.
DHEA can improve glucose tolerance, convert excess body fat to
lean muscle mass, alleviate depression, increase energy and
decrease pain in chronic fatigue and fibromyalgia patients,
decrease joint pain and fatigue in inflammatory and autoimmune
diseases, improve mental clarity and enhance overall immune
Nutritional strategies are only one component, albeit an
important one, of a rational approach to attack the problem of
excess cortisol. This discussion would be incomplete
without mentioning an optimal integrative approach to reducing
excess cortisol levels which would include nutritional
supplement strategies, stress reduction through exercise, and
stress reduction through meditation. In a study published in the
Journal of Sport and Exercise Psychology, Edward McAuley, a
professor of kinesiology at
the University of Illinois, found that aerobic exercise had a
significant impact on anxiety as compared with subjects asked
merely to sit still. Herbert Benson, MD, author of the
Relaxation Response has dedicated a lifetime to the notion that
the regular practice of meditation can reduce the negative
effects of stress and reduce cortisol levels.
Another dedicated researcher in this field has been Jon
Kabat-Zinn, Ph.D., of the University of Massachusetts. He is the
author of Full Catastrophe Living, which provides an excellent
guide to those of you who want to include the meditation
approach in your plan for optimal health. When it comes to
stress, I learned long ago not to sweat the
small stuff. And in the end, its all small stuff.
source of nutrients and supplements.
did we qualify them ?
1. Bjorntorp P, Rosmond R, Neuroendocrine abnormalities in
visceral obesity. Int J Obes Relat Metab Disord 2000 Jun; 24
2. Pasquali R, Vicennati V, Activity of the
hypothalamic-pituitary-adrenal axis in different phenotypes. Int
J Obes Relat Metab Disord 2000 Jun;24 Suppl 2:S47-9.
3. Bjorntorp P, Rosmond R, The metabolic syndrome: a
neuroendocrine disorder? Br J Nutr 2000 Mar;83 Suppl 1:S49-57.
4. Raber J, Detrimental effects of chronic
hypothalamic-pituitary-adrenal axis activation. From obesity to
memory deficits. Mol Neurobiol 1998 Aug;(1):1-22.
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