WHAT IS LOW CORTISOL? – Hypocortisolism
Normally, the stress hormone cortisol is released in a typical ‘diurnal’ or circadian pattern. It peaks in the early morning hours, gradually declines throughout the day, and reaches its lowest levels during the first few hours of sleep. Low cortisol, medically known as ‘hypocortisolism’ is defined as either an abnormally low (or ‘blunted’) daytime cortisol levels, an inappropriate rise in cortisol after exposure to a stressor, or both.
Hypocortisolism and Chronic Fatigue Syndrome
Hypocortisolism has been found in up to 25% of patients with chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome, posttraumatic stress disorder, ‘burn-out’ and chronic pain syndromes.
Low Cortisol and Adrenal Fatigue
Is low cortisol the same thing as adrenal fatigue? Yes and no. Proponents of adrenal fatigue claim that low cortisol occurs because the adrenal glands cannot keep up with the ongoing demand placed upon them by chronic stress. The end result is low cortisol and the symptoms thereof (fatigue, depressed mood, etc).
There is unequivocal evidence that low cortisol states occur and are clinically relevant. However, no medical evidence exists confirming that low cortisol states occur as a consequence of failing adrenal glands or ‘adrenal exhaustion’. Rather, most evidence points to a breakdown in the sophisticated communication circuits between areas in the brain (the hypothalamus and the pituitary gland) and the adrenal glands. Some other reasons include:
• The cortisol message is there but the cells of the body do not respond.
• The adrenal glands cannot make cortisol because they are damaged (i.e. heavy metal toxicity), diseased (i.e. autoimmune disease) or lack an important factor in cortisol production (i.e. vitamin C deficiency)
It is important to understand that low cortisol states are an indication of other underlying problems which must be identified and treated. Assuming the adrenals simply ‘no longer work’ is inaccurate and potentially dangerous if the true underlying cause is not determined.