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Cortisol - Please 'Weigh In'

bluess

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bluess
Joined
Oct 22, 2001
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I cast a cry out to the wonderful people on board - what is the scoop on stress/cortisol/weight? I am not a scientist or doctor, and really cannot tell whether the information I am finding on the web is worth anything. The basic tune on the web is that stress tells the body to release cortisol, and that cortisol tells your body that you may experience a famine any minute, and that results in your body storing calories right around the old tummy.

I am not considering taking any of the lovely diet pills out there, and am reducing the stress in my life for a variety of other reasons, but would be interested in any comments.

Thanks!

Bluess
 
I think that it can raise your blood sugar if enough of it is in your system (cause it messes with your body's natural insulin somehow )... Which technically can make you gain weight.

I would say that this effect is probably very minimal compared to things such as the amount of calories you consume daily.

I do not know of any other effects that it would cause to make you store fat in specific areas of the body, that sounds like hogwash.

Edit: I am no professional, I just looked it up a while back when I saw a commercial about a weight loss pill also.
 
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I don't know how reliable this article is (I only glanced at it) but it seems to cover the area you are talking about. Note, I am not vouching for the contents, you will have to determine for yourself whether the information in it is reliable.

http://thyroid.about.com/od/loseweightsuccessfully/a/cortisol.htm

Anecdotally, my mam has Addison's disease, so doesn't produce any cortisol herself and she has to take medication to replace it. Before she was diagnosed, she did lose an awful lot of weight , so it may be that cortisol plays some role in weight, but I doubt that it is a simple relationship. She also completely lost her appetite and ate like a sparrow, so the relationship may be mediated via appetite - a lot of people overeat when they are stressed.
 
The theory may be good, but in vivo, cortisol levels high enough to cause problems are quite rare. Day to day stress will not raise your cortisol high enough to cause you any grief, but it sure is a good hook to get you to buy into yet another spurious weigh loss program.

I've got type II diabetes. Plus an adrenal 'incidentaloma', a benign growth on an adrenal gland. Been through all those tests, lots of times. If MY cortisol is normal, so is yours.

A friends golden retriever had Cushing's. Boy, was she bloated. Like a water bed mattress. If a human had that, treatment would commense lots earlier.
 
Cortisol is basically a catabolic hormone. This means it will increase when your body senses a need for providing increased fuel. Such conditions include dieting and emotional stress. What elevated cortisol will do, among other things, is that it will increase the production of glucose via various pathways, including muscle and fat catabolism. Evolutionary speaking, this would help you deal with an emergency situation. And that emergency situation shouldn't last too long because you can't be fighting for your life for too much time. Interestingly, the initial, short-term effect of increased cortisol is elevated awareness and readiness.

But what happens today is that emotional stress due to the rhythms of modern life often will prolong the stress periods. Cortisol will sometimes remain "chronically" elevated and the original short stress reflex will become chronic. This means that via various complex mechanisms certain neurotransmitters will be depleted and certain receptors will be downregulated. Soon, the net result of increased cortisol will shift from lipolytic to lipogenic. And while the evolutionary reason for the stress could be the lack of food, now it is more probable that the stress will co-exist with abundance of food. Muscle will keep being catabolized and the glucose synthesized from the muscle protein will be turning into fat since the diet is not hypocaloric.
 
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Cortisol is involved in responses to stress and we find elevated levels with acute stress. What is less clear is what happens under conditions of chronic stress (cortisol levels are lower, rather than higher in a number of studies). And it is also unclear whether elevated cortisol levels associated with obesity are the cause of or are caused by obesity.

I looked around a bit for a decent review online. The introduction to this paper talks a bit about the issues and provides references.

The typical alt-med response to take a pill seems unwarranted. It makes more sense to me to attempt to modify your stress levels and follow sensible diet/exercise advice (which is what all of us should be doing anyway, right? :)).

Linda
 
At the prices I've seen the infomercials set for these pills I have to wonder why it's not being prescribed. I know my doctor isn't afraid of making money and these pills have to be a cash cow with all the overweight people, including me, there are in the world.
 
Leftus said:
At the prices I've seen the infomercials set for these pills I have to wonder why it's not being prescribed. I know my doctor isn't afraid of making money and these pills have to be a cash cow with all the overweight people, including me, there are in the world.
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How would your doctor be able to make money by prescribing these pills?

Linda
(hoping that I can get in on the action)
 
As always, the JRef rocks. Thank you all for your responses. They have pretty much borne out my immediate response to all of the 'info' floating around.
 
casebro said:
A friends golden retriever had Cushing's. Boy, was she bloated. Like a water bed mattress. If a human had that, treatment would commense lots earlier.
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So should the dog's. However, I've a feeling that the preferred treatment (trilostane) is not licensed for canine use in the USA.

Rolfe.
 
Rolfe said:
So should the dog's. However, I've a feeling that the preferred treatment (trilostane) is not licensed for canine use in the USA.

Rolfe.
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I thought that if the dog wasn't eleven years old, they might have removed the adrenals? But that is assumtion that something else in the HPTA system is not the real culprit.

I'll have to look into the trilostane as a medical treatment, in case I ever get that bad.
 
No, you don't remove the adrenals. That's because the adrenal medulla would be removed as well, the source of catecholamines, and this would be a Bad Thing. However, if the cause of the Cushing's is an adrenal tumour, this is probably unilateral, so removing the diseased adrenal only is a practical course of action - like kidneys, you can get by on one.

Most Cushing's cases however are pituitary in origin. In man, one of the preferred treatments is removal of the pituitary lesion. The original Cushing was a brain surgeon! This is not done in dogs.

There are two drugs (well three but we can forget ketoconazole because it's not a good idea) which will affect the adrenal cortex.

Mitotane is the older drug. It's never had any sort of product licence because it's not very safe (its effect is irreversible), but it can be used two ways. You can use a moderate dose to get adrenocortical activity down to acceptable levels, and then usually stay on maintenance treatment and this was done quite successfully for many years. Or else you can use a high dose to obliterate the adrenal cortex entirely and then maintain your patient on Addison's maintenance therapy. This latter was used more in Europe, and I've seen some good survival rates, but there were a lot of problems getting the right dose in the first place.

Trilostane is the newer drug. It is reversible in action (if you stop the drug the adrenals recover), and so safer, and so it is licensed. It can only be used for long term maintenance, as you can't completely nix the adrenals with it. Because of these factors it got a product licence, and now vets have to use it as first line treatment in all cases. If you feel a patient needs mitotane you have to go through a lot of regulatory hoops to get authorisation to import it as an unlicensed medicine. However, published survival rates are just about the same as moderate long-term mitotane maintenance in fact.

Last I heard of it, trilostane didn't have a produce licence in the USA, and there was a thriving black market.

Rolfe.
 
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