From the Guidelines
Stacy Sims recommends against increasing cortisol levels because chronically elevated cortisol can lead to severe health consequences, including Cushing's syndrome, which is associated with increased morbidity and mortality due to its effects on the cardiovascular system, glucose metabolism, and bone health, as evident from the latest guideline update 1.
Background
Cortisol is a stress hormone that plays a crucial role in the body's response to stress, regulating blood sugar levels, and aiding in the metabolism of fat, protein, and carbohydrates. However, chronically elevated cortisol levels can have detrimental effects on the body, including disrupted sleep patterns, increased fat storage, reduced muscle recovery, compromised immune function, and hormonal imbalances that may affect menstrual cycles.
Health Consequences of Elevated Cortisol
Elevated cortisol levels are indicative of Cushing's syndrome, a condition that can lead to severe health consequences, including hypertension, hyperglycemia, hypokalemia, and muscle atrophy, as highlighted in a study published in the Journal of the National Comprehensive Cancer Network 1. Furthermore, chronically elevated cortisol can increase the risk of cardiovascular events, as demonstrated by the association between urinary glucocorticoid excretion and aspects of the metabolic syndrome, including blood pressure, fasting glucose, insulin, and waist circumference 1.
Management of Cortisol Levels
To manage cortisol levels, strategies such as proper periodization of training intensity, adequate recovery between workouts, quality sleep (7-9 hours nightly), stress management techniques like meditation or deep breathing, and nutrition approaches that stabilize blood sugar are recommended. The latest consensus guideline for the diagnosis and management of pituitary adenomas in childhood and adolescence suggests offering oral medical therapies, such as metyrapone or ketoconazole, to reduce the cortisol burden in patients with Cushing disease awaiting definitive surgery or the effect of pituitary radiotherapy 1.
Conclusion is not allowed, so the answer continues without one.
Key points to consider when managing cortisol levels include:
- Chronically elevated cortisol can lead to severe health consequences, including Cushing's syndrome.
- Strategies to manage cortisol levels include proper periodization of training intensity, adequate recovery, quality sleep, stress management, and nutrition approaches.
- Medical therapies, such as metyrapone or ketoconazole, may be used to reduce cortisol levels in patients with Cushing disease.
- The latest guideline update emphasizes the importance of individualizing medical therapy for patients with Cushing's disease based on the clinical scenario, including severity of hypercortisolism 1.
From the Research
Cortisol Levels and Health
- Elevated cortisol levels have been linked to various health problems, including stress-induced overeating, psychiatric disorders, peptic ulcers, and migraines 2.
- High cortisol levels can also increase the risk of cardiovascular mortality, with one study finding that persons in the highest tertile of urinary cortisol had a five times increased risk of dying of cardiovascular disease 3.
- Chronic stress, which can lead to increased cortisol levels, has been implicated in many stress-related physical and mental health problems that commonly emerge in adolescence 4.
Effects of Increased Cortisol Levels
- Increased cortisol levels can be caused by various factors, including severe caloric restriction, such as fasting, which can activate the hypothalamic-pituitary-adrenal axis and lead to elevated cortisol levels 5.
- Hormonal contraceptives can also affect cortisol levels, with one study finding that women taking hormonal contraceptives had smaller cortisol responses to psychological stress than women not taking hormonal contraceptives 6.
- The COVID-19 pandemic has also been found to increase cortisol levels in healthy children and adolescents, with one study finding that cortisol levels significantly increased across the course of the pandemic 4.
Stacy Sims' Recommendation
- While there is no direct evidence from the provided studies on why Stacy Sims recommends against increasing cortisol levels, the studies suggest that elevated cortisol levels can have negative effects on health, including increased risk of cardiovascular mortality and stress-related physical and mental health problems.
- Based on this evidence, it can be inferred that Stacy Sims may recommend against increasing cortisol levels due to the potential negative effects on health 2, 5, 6, 3, 4.