We left of in part 2 of this mini series talking about how levels of growth hormone and IGF-1 in particular influence our metabolism, and diabetes as well, and some of the things that cause these hormones to be too low.
So things like obesity and high body fat percentage, and the resulting high levels of free fatty acids that accompany this, and in type 2 diabetics, the increased fatty acid levels that excess insulin causes, all contribute to lower growth hormone secretion, and in turn, lower IGF-1 levels, which among other things, lead to reduced glucose uptake by our cells which leads to higher blood sugar levels.
Finally, Dr. Walsh brings up cortisol, the third hormone on this metabolic panel, and like all hormones, you don't want to be too low or too high. So we have the low risk range, 2.3 to 19.5, which is quite a wide range, and below or above this is high risk for disorders.
Cortisol is of course secreted by the adrenal glands, and cortisol by the way plays a huge role in diabetes, especially higher levels which cause high blood sugar directly, since cortisol is a glucocorticoid, ad the gluco part does mean glucose, and it's primary function is actually to raise blood sugar, although it does other things as well, most notably control excess inflammation.
So the idea here is for cortisol to keep your blood sugar from going too low, and that's a big deal because we tend to eat on irregular schedules and historically have undergone significant periods of famine, so if our body wasn't good at keeping our blood sugar up we would not have survived as a species.
However, excessive cortisol levels definitely produce excessively high blood sugar, especially in diabetics, whose defenses are broken down by insulin resistance caused by too high insulin levels over time, leaving us particularly ill equipped to deal with the blood sugar excursions of excess cortisol.
Generally, when we measure serum levels of cortisol, it's done in the morning when its levels tend to be at their highest. Cortisol levels do fluctuate throughout the day though, and this is why it's more helpful to test it at various times with saliva testing or do a 24 hour urinary cortisol test to get a better picture of what is going on with this hormone overall.
So there is a cascade effect that happens with high cortisol, which increases glucose, and that increases insulin levels as well, so it's particularly important to diabetics to not have cortisol levels excessively high.
Since cortisol is particularly released during times of stress, it's a stress hormone after all, managing chronic stress is very important to keeping cortisol levels under control. Chronic stress in itself is more than sufficient to keep the levels of cortisol very high and continuously too high.
People that complain of the so called dawn phenomenon experience the effects of cortisol on blood sugar, and many think that cortisol only does its dirty work on blood sugar in the morning, but this can put us up too much all day and night, it's just that it has more of an effect in the morning because that's when corisol levels tend to be highest with a lot of people anyway.
High cortisol, since it indirectly causes higher levels of insulin, also can be a big stumbling block to people losing weight, even if they follow the proper diet, because as we know, insulin is the hormone that controls weight, and if it's too high, you just aren't going to lose much weight.
Diabetics often notice poor wound healing, and high cortisol is behind this actually, it's a catabolic hormone and makes it harder for the body to repair itself overall. This is because it's preparing us for battle and we want to muster our resources for that and the healing can come later. If we're in a constant battle from stress though, the later part might not come.
Of particular note to diabetics is that cortisol also promotes the breakdown of amino acids and other substances in the process of gluconeogenesis, the creation of glucose from non glucose sources. Excessive gluconeogenesis is a primary defect in diabetes and is why our blood sugar can be very high in spite of not consuming a lot of glucose sources in our diet, and in a great many diabetics is the primary cause of high blood sugar.
Poor memory, both long and short term, is another feature of high cortisol, and many diabetics have memory problems. This is due to the effect of high cortisol on the brain, and once again, if you are in battle then memory is going to be less important, and when the body acts like it's in battle all the time from chronic stress, well our bodies simply aren't designed for this.
Cortisol can also be too low as well, and there are many symptoms that are associated with this, and Brian mentions a few, higher sensation of pain, and of course fatigue. The tendency here is toward hypoglycemia though, something we don't see a lot of without medication.
Poor sleep is another feature of low cortisol, although it's just one cause of that, and this actually is associated with low blood sugar in the middle of the night, causing a cortisol spike which often is associated with an awakening. This is just one of the causes of poor sleep by the way and if you don't wake up with low blood sugar than it probably isn't low cortisol.
Low cortisol can also cause dehydration from not retaining sodium properly and therefore not retaining enough water.
Type 2 diabetics tend to have high cortisol though, and managing this is certainly an important facet of treatment, although conventional medicine isn't interested in even looking at this, other than in extreme cases such as Addison's or Cushing's disease, and that's because these conditions require medications, and if they don't have a prescription for it, they don't care about it.
Overall, this is an outstanding and readily understandable discussion of these three important metabolic hormones, and you really have to educate yourself on this because your doctor isn't going to be educating you, and this stuff is really outside the scope of their practice actually, since their practice is limited to prescribing drugs, and they certainly don't take the holistic view of health that we require.