May 27, 2025 • 28 mins
In this episode, Dr. Alfred Alessi and Matt Tack begin by introducing the Health Foundations and the Alessi Total Care Program. They delve into the critical hormone cortisol, exploring its functions, the effects of stress, and the impact of imbalances. The discussion highlights cortisol's role in immune function, supported by case study insights. Effective methods for cortisol testing and stress assessment are examined, followed by a comprehensive guide to natural cortisol management. The episode emphasizes lifestyle interventions and personalized health planning with Alessi Functional Health. It concludes with a final call to action and closing remarks, offering listeners practical approaches to managing cortisol and stress effectively.
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Episode Transcript
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(00:00):
It's all about getting back to the basics.
(00:02):
And so, you don't have to be at the mercy ofstress, right?
Your body's not broken, it's actually extremelyadaptive.
And when you can support the foundations, whichare sleep, food, rhythm, and recovery, you're
gonna give your body that permission to heal.
Welcome to Health Decode, your number onesource for real health information, with your
hosts, doctor Alessi and Matt Tack.
(00:27):
Hey, Health Decoded listeners.
Doctor Alessi here.
Let me ask you a serious question.
Are you tired of waiting until something goeswrong to finally see a doctor?
At Alessi Functional Health, we take adifferent approach, the right approach.
We believe true health care isn't about chasingsymptoms.
It's about preventing them in the first place.
(00:48):
That's why we created the Alessi Total CareProgram.
This is a functional medicine based membershipthat gives you proactive, personalized care
year round.
You'll get access to comprehensive blood workand functional testing, custom doctor grade
nutraceuticals, deep discounts on labs,protocols, and follow ups, as well as twenty
(01:11):
four seven direct access to your doctor, notjust a ten minute checkup that ends with
another prescription.
And here's the best part.
As a Health Decoded listener, you'll get yourfirst three months completely free when you
sign up for an annual membership.
That's on top of hundreds in savings alreadybuilt into the program.
(01:31):
This is your chance to take responsibility foryour health and join a movement that's
redefining what primary care should look like.
Head on over to alessifunctionalhealth.com,click on our services tab, and go to Total
Care.
Learn more about this program and claim yourexclusive podcast listener offer.
Your health is your greatest asset.
(01:52):
Let's protect it proactively.
Welcome back to another episode of HealthDecoded.
I am your host, doctor Alessi, and I'm excitedto have you guys back today.
Really great topic that we have for you andreally excited to get into this.
This is something that I believe is verymisunderstood in health in general and
(02:14):
something that a lot of doctors really don'tknow how to test for or how to look for.
And ultimately, patients end up getting andpeople end up getting kind of bad advice in
this topic.
So, what we're going to talk about today iscortisol, and realistically how elevated
cortisol can hijack your health in the longterm.
(02:34):
And so, you know, what I want to make sure Iclear up right away is that cortisol is not
your enemy.
People throw it around as if it's a negativething.
In fact, you wouldn't survive without it.
Cortisol is a steroid hormone.
It's produced by your adrenal glands, which sitlike little hats on top of your kidneys, and
it's part of a very finely tuned system calledthe HPA axis, the hypothalamic pituitary
(02:57):
adrenal axis.
This system is essentially your body's stresscommand center.
It decides when to mobilize resources, when torest and how to respond to everything from a
physical threat to emotional tension.
Now, here's what cortisol is supposed to do ina healthy system.
It helps regulate blood sugar so that you canhave stable energy, reduce inflammation when
(03:20):
appropriate.
It controls and manages your sleep wake cycle,your circadian rhythm.
It supports metabolism and the conversion offood into energy.
It manages blood pressure and it mobilizes yourbody's fight or flight response in times of
danger.
So, picture this, you're hiking in the woodsand suddenly you come across a bear.
(03:41):
Your brain immediately signals your adrenalglands to release cortisol and adrenaline.
Cortisol is going to increase your blood sugarso that your muscles will have energy, narrow
your blood vessels to raise blood pressure, itsharpens your focus and reaction time, and it
tells your immune system, Hold on, we have morepressing matters at hand.
So, it's going to also halt digestion andreproduction to conserve resources.
(04:07):
In that moment, cortisol could be a lifesavingally.
But the problem is that we're not always inthat position, right?
But your brain doesn't differentiate between abear and your boss who just sent you a rude
email at 9PM.
Or maybe a toxic relationship or financialstruggles or maybe doom scrolling on Instagram
(04:28):
for two hours before bed.
All of those micro stressors when experienceddaily are going to trigger the same cortisol
release as if you were in that situation.
So, it's like your body thinks you're beingchased by a bear 20 fourseven and it never gets
the signal to stand down.
When cortisol stays elevated for too long, thatacute survival response becomes a chronic
(04:50):
health disaster.
So, here's a quick study spotlight from PsychoNeuroendocrinology in 2016.
Chronic psychological stress is associated withsustained elevations in cortisol, contributing
to metabolic dysfunction and immunesuppression.
That means that high cortisol, when elevatedfor a long time, can disrupt your immune system
(05:13):
making you more vulnerable to infections.
It can also increase belly fat because cortisoltells your body to store fat in the abdomen for
fuel.
It'll cause insulin resistance, unstable bloodsugar, it can wreck your energy and your sleep
and literally blunt your brain's ability tofunction.
And over time, your adrenals are going to burnout leading to low cortisol, exhaustion and
(05:37):
then ultimately complete burnout.
So, this episode isn't just about feelingstressed and that biochemical process, we're
talking about how do we maintain and managecortisol long term to then ultimately avoid
this kind of thing in the first place.
And so, isn't bad, but chronically elevatedcortisol is.
(05:57):
So, in this episode, we're going to fix that.
We're going to unpack how cortisol affects yourweight, sleep, mood, metabolism, hormones, and
more.
And then, I'll show you how to take backcontrol naturally.
So, how does cortisol wreck your body?
Alright, now that you understand what cortisolis, and why it matters, let's talk about what
happens when it's out of balance, especiallywhen it's chronically elevated or eventually
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bottoms out.
Because when your cortisol rhythm is off, yourentire system will suffer.
So, let's break it down and let's go symptom bysymptom of what happens.
So, the first one on the list here is weightgain, right?
Especially belly fat, abdominal adipose tissue.
Cortisol raises blood sugar to fuel yourmuscles in a crisis, but when the crisis never
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ends, that sugar isn't burned, it's stored.
Especially as visceral fat around the abdomenand organs.
This belly fat isn't just cosmetic, it ismetabolically active and inflammatory, which
can feed the cortisol cycle even more.
Even worse, chronically high cortisol willcrank up your cravings for sugar and carbs,
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pushing you more towards an emotional bingetype of eating.
The next one on the list is insomnia.
The thought of being tired but then wired atnight.
Cortisol is supposed to follow a diurnalrhythm.
It should spike in the morning when you wake upand it should taper down to let melatonin rise
towards the end of the day so you can sleep.
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When cortisol is too high at night, you'regoing to feel wired but you're exhausted.
Lying in bed, maybe scrolling on your phone,your mind is racing and you can't fall asleep.
Eventually, you're not going to wake uprefreshed anymore, you're going to start the
day already behind because your diurnal rhythmhas now been flipped.
The next thing that we can experience is brainfog.
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I've experienced this before.
Chronic cortisol can impair your hippocampus,which is the part of your brain responsible for
memory, focus and learning.
So, you might feel like you can't rememberbasic things, you can't stay on task or you
feel just mentally sluggish all day.
It's not a motivation issue, it's aneurochemical imbalance.
(08:08):
Chronically elevated cortisol can also impairhormone balance and cause low libido.
Cortisol and your sex hormones share the sameraw materials, primarily pregnenolone.
When your body is under stress, it prioritizessurvival over reproduction, a phenomenon called
the pregnenolone steal.
This can lead to low testosterone or estrogen,PMS, irregular periods or fertility issues, or
(08:35):
total loss of libido or sexual energy.
Another one is blood sugar spikes and insulinresistance.
Chronically elevated cortisol raises bloodsugar to help you survive, but if that sugar is
not used, it creates insulin resistance overtime.
Go back two episodes and listen to our episodeon blood sugar, that will make more sense.
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This can then lead to blood sugar crashes, moodswings, sugar cravings, and eventually this
becomes prediabetes or even full blown type twodiabetes.
Another thing cortisol can do is suppress thethyroid gland.
So, high cortisol can inhibit your conversionof T4 to T3, basically your active thyroid
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hormone.
It can also increase reverse T3, which thenblocks your receptors from using thyroid
hormone effectively.
So, what does this mean?
Even if your thyroid labs are looking normal,you could still have slow metabolism, the cold
hand and feet symptoms, constipation, thinninghair and chronic fatigue.
(09:37):
And then, next, last on the list here is immunedysfunction.
We touched on this for a second.
Cortisol has an immunosuppressive effect, whichis great for short term inflammation control,
but it's a disaster when this is sustained longterm.
So, you might find yourself getting sick moreoften, experiencing long recovery from colds,
or developing or worsening autoimmune flareslike Hashimoto's, rheumatoid arthritis or
(10:01):
eczema.
And now, here's the kicker, the longer you stayin this stress state, the more depleted your
adrenal glands become.
And eventually, your body cannot sustain theoutput anymore and your cortisol production
crashes.
This is where people move from the wired andtired to just plain exhausted and the body
totally burns out.
(10:23):
They wake up fatigued, no motivation, they feelemotionally numb, depressed, physically heavy.
That's not just burnout, it's what we call HPAaxis dysfunction, or adrenal exhaustion.
And it is a serious thing.
So, here's a real case study, and this is apatient we worked with.
I'm not going to say any names, but we workedwith a 42 year old entrepreneur type A, high
(10:47):
performer, early riser, late night emails untilreally he started breaking down and noticing
about over the span of six months to a year.
He noticed he was gaining weight, even thoughhe was working out like crazy and eating clean.
He couldn't sleep.
He lost all drive, libido, sex drive with hispartner, and even his creativity.
(11:08):
Event everything eventually felt kind of like achore to him, even just getting out of bed.
So, we ran his labs, we looked at a fullhormone panel, thyroid panel, inflammation, and
his cortisol was basically flat lined in themorning, when it should have been at its
highest.
And it was spiked at night when it should havebeen at its lowest.
So, this is what we just alluded to, this wasthat adrenal dysfunction.
(11:30):
Classic HPA axis dysfunction.
His stress response system had burned out fromchronic overuse.
But the cool thing here was that we implementeda strategy with lifestyle, supplements, and
nutritional interventions.
And he put in the work and eventually werebuilt his body's HPA axis to be functional
again.
(11:52):
Now, the takeaway here is chronic cortisolimbalance is really a silent saboteur of modern
health.
And again, this is something not a lot ofdoctors talk about, because not a lot of
doctors know about.
So, if you're struggling with weight, energy,mood, or sleep, or hormones, it's time to start
asking yourself, what is my cortisol rhythmactually doing?
(12:12):
And start getting some answers.
And that's exactly what I want to get into nowin this next segment.
Labs, testing, what to look for, and ultimatelywhat most doctors are gonna miss.
But before we do that, here's a quick word fromone of our sponsors.
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Now back to the episode.
Okay.
Welcome back.
Now let's get into testing the stress responseand what your labs can ultimately reveal and
what most doctors are ultimately missing whenit comes to testing this.
So, say you're dealing with symptoms, you'vegot brain fog, fatigue, cravings, maybe even
(14:07):
hormone issues.
Here's the truth, if you don't test thesethings, you're just guessing.
And if you test the wrong things, you're stillguessing.
So, let's talk about how do you properly assesscortisol and the overall stress response, and
why average blood tests and your CBC are reallynot going to cut it.
The problem with conventional testing is youwalk into your doctor's office feeling off,
(14:31):
fatigued, overwhelmed, not yourself.
If they run anything, it's going to be a singleblood cortisol level and maybe they take that
at 8AM.
And they say, Oh, you're in range.
First off, what does in range actually mean?
Right?
Are you on the higher end of reference range?
The lower end, but you're still within range?
Those are two different things.
That one number doesn't give us enough of apicture of how cortisol is flowing throughout
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the day or how it's affecting your hormones,thyroid, immune system, or brain.
So, think of it like this, you wouldn't judgean entire movie by one still frame, right?
So, why would you judge your entire stresssystem by one number?
So, the functional medicine approach, what wetest and why is that, you know, we want to see
(15:16):
a full picture of what this is doing and whatyour body is doing throughout a daily basis.
So, the number one thing we're going to look atis what's called a cortisol awakening response
or a CAR.
This is a saliva test taken multiple times inthe first thirty to sixty minutes after waking,
as well as throughout the day.
This is going to measure how quickly yourcortisol spikes start, as well as what that
(15:41):
rhythm looks like midday, end of the day and atnight.
And so, a spiked CAR may mean chronic anxietyor inflammation.
Another test we often use is a Dutch test.
This is a dried urine test for comprehensivehormones.
This is going to give us cortisol and cortisonepatterns, both the free and the metabolized.
(16:03):
This is going to give us estrogen,progesterone, testosterone, and how your body
is processing them.
Melatonin levels, as well as the organic acidmarkers for how your body is metabolizing
vitamins, glutathione and more.
And so, you get an hour by hour map of yourhormones and your stress response.
This is not something that a basic blood testwill show.
(16:25):
The other things we need to see is fastinginsulin and glucose and your hemoglobin A1C,
because these are tightly linked to cortisol.
So, cortisol is often going to lead to insulinresistance even if your glucose looks normal.
We discussed this back in the blood sugarepisode as well.
Go back and listen to that.
So, these tests are going to show us how wellyou're handling sugar and stress.
(16:50):
Next, what we look at is a full thyroid panel.
We want to see not just TSH, we want to seefree T3, free T4, reverse T3, as well as
antibodies.
Remember, discussed there's a link betweenimmune suppression and worsening of autoimmune
conditions.
So, we want to see those thyroid antibodies.
Because chronic cortisol will slow thyroidconversion, increase reverse T3 and even mask
(17:15):
hypothyroid symptoms.
Another thing that we want to see that this isnot 100% necessary but is beneficial is looking
at key nutrients.
So, key nutrients for adrenal and stresssupport are going to be B12, zinc, magnesium,
vitamin D, ferritin and selenium.
These are the raw materials that your adrenalglands and nervous system use to function.
(17:38):
And so, people are walking around withborderline or even deficient levels, especially
magnesium and B12 and they don't even know it.
And the worst part is most doctors are going tomiss this because they consider within range to
be okay.
So, some of the red flags that get overlookedevery single day is normal cortisol on a blood
(18:00):
test but a reverse daily rhythm, flat in themorning, high at night.
Low free T3, so even if TSH is normal, this cansignify early thyroid dysfunction.
Estrogen dominance in both men and women.
Low DHEA, which is a key adrenal hormone thatoften crashes with chronic stress.
(18:21):
And then B12 in range, but functionally low,especially if you have fatigue or brain fog.
So, here's a quick study spotlight from theJournal of Psycho Neuroendocrinology in 2018.
Salivary cortisol patterns often offer a moreprecise insight into HPA axis dysfunction and
(18:43):
psychological stress than single serum values.
Now, that's exactly what we just talked about,that snapshot versus looking at the whole
picture.
So, the takeaway here is if you've been toldthat everything looks normal, but you feel
anything but, your labs may be incomplete ormisinterpreted.
And it's time to take a functional approach.
(19:03):
You need to look at rhythms, patterns, and thefull hormone landscape, not just a snapshot of
numbers.
Now, that brings us to the fun part.
In the next segment, I want to talk through howto actually fix it naturally without jumping
straight to medications or hormone replacement.
So, how do we restore and balance our stresssystem naturally?
(19:27):
Now that we've uncovered what cortisol is, howit becomes dysregulated, and how to properly
test it, let's get into the solution.
So, good news that I want you to take away fromthis is that your body wants to heal.
You just need to give it the right input.
This isn't about suppressing cortisol, it'sabout restoring rhythm, resetting stress
(19:48):
system, and ultimately your HPA axis.
So, step one, this is takeaways that I wantyou, if you need to write it down, things that
you can integrate and start doing today.
Step one, reset your nervous system.
Chronic stress is not just in your head, it'shardwired into your autonomic nervous system.
(20:09):
And we need to shift from fight or flight intorest and repair.
So, here's how you do it.
Daily breath work.
Commit five to ten minutes.
Start with an exercise like box breathing.
This is where you do a four inhale, four secondhold, four second exhale, four second hold,
repeat.
Or focusing on more of an extended exhale whereyou do four seconds in and then six to eight
(20:33):
seconds out.
This has been proven to lower cortisol andactivate the parasympathetic system.
You could also use things like cold exposure.
Try for two to three days a week.
It doesn't have to be a plunge or an ice bath.
Just start with a cold shower for thirtyseconds to two minutes a day.
This will help build resilience to stress andretrain your cortisol reactivity.
(20:57):
Also, practice grounding or nature therapy.
Being barefoot on the grass and walking outsidewith the sun on your face can work numbers for
lowering inflammation and modulating yourcortisol naturally.
Now, step two is you need to stabilize yourblood sugar.
Cortisol rises when blood sugar crashes.
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So, to heal your adrenals, we need to stabilizeyour energy supply.
We talked about this as well in a previousepisode, but protein with every meal.
20 to 30 grams minimum.
Healthy fats like avocados, olive oil or nuts,these are going to help stabilize that insulin
response and blood sugar spike.
And then using complex slow digesting carbslike sweet potatoes or berries or quinoa, This
(21:41):
is gonna provide you with not such an elevatedquick spike in blood sugar.
And then, the constant snacking.
Try not to graze every two hours.
Let your body feel hungry, let your blood sugarget back to normal.
Another thing you can try is consideringintermittent fasting.
But only if cortisol is stable.
You don't want to fast if you're alreadytanked.
(22:02):
Now, you're adding more stress to an alreadystressed state.
We discussed fasting and how to implement it afew episodes back as well.
Go back and listen to that one if you've nevertried fasting and you're interested.
Step number three, heal your gut.
Your gut and brain are in constant conversationwith each other and inflammation in the gut
drives stress signals to the brain and viceversa.
(22:25):
So, start by removing the inflammatorytriggers: gluten, dairy, processed sugars,
alcohol.
Then, rebuild the gut with L glutamine, zinccarnosine, probiotics, bone broth and collagen.
For a deep dive on this, go revisit episode 16on gut health where we gave you a whole game
(22:45):
plan for that.
And now step four, you have to, have to, haveto rebalance your circadian rhythm.
Cortisol is supposed to rise in the morning andfall at night.
But a lot of people have this backwards.
So, here's how you reset it.
Your morning routine should look like brightlight within thirty minutes of waking.
Ideally, natural sunlight or a high lux lamp,10,000 amps.
(23:11):
Movement, so walking, stretching, mobilitywork, and a protein rich breakfast.
Get rid of the sugary cereals and the sugarycoffee in the mornings, which is only going to
spike your cortisol anyway.
And then the night routine, which is basicallysetting you up for this, no screens one hour
before bed, I prefer two.
And then using some kind of blue light blockerif you are going to be on your screen.
(23:35):
You need those glasses that can help filter theblue light because the blue light stimulates
the optic nerve which stimulates cortisol.
Dim the lights after sunset, let your body kindof understand that now it's starting to get
time for bed.
Use things like magnesium glycinate or LTheanine if needed at night.
And then the biggest thing I think you can dothat makes the biggest impact is going to bed
(23:59):
and waking up at the same time every day, evenon the weekends.
Even if your schedule changes, try to do it atthe same time.
Because sleep is your most powerful hormonetherapy.
And then, step five, you can supplement withthings like adaptogens.
These are not magic pills, they're not going toreplace anything we just talked about, but they
(24:21):
can support the rebuilding process when you usethem strategically.
A fantastic one is Ashwagandha.
This helps to lower those elevated cortisollevels, get you back towards a normal balance.
Rhodiola, phosphatidylserine, magnesium andthen a vitamin C and B complex.
These are essential co factors for adrenalhormone production.
(24:42):
If you don't know where to start, work with apractitioner or functional medicine doctor to
make sure you're dosing these properly based onyour labs.
And then step six, as always, move.
Move your body.
But don't burn it out.
Exercise is a stressor and so when you'realready fried, intense exercises can push you
(25:02):
further off the cliff.
So, start with walking.
10,000 steps a day is a great goal.
Get into some zone two cardio.
Lower heart rate but longer duration.
And then practice strength training, two tothree days a week, but keeping the intensity
more moderate at first until you can handle it.
If you feel worse after working out, you'reoverdoing it.
(25:23):
This is a great, great warning sign.
So, you know, in cadence here, lifestyle winsbefore pills, right?
So, me be clear, there's a time and a place forhormone replacement therapy or medications.
I'm not knocking them completely.
I just think they're overused when there'sother things we can do fundamentally first.
(25:44):
So, if you skip over the lifestyle foundationswe just covered, you're basically building on
sand.
Supplements aren't going to work, prescriptionsaren't going to hold, and you're putting the
cart before the horse essentially.
And so, here's a real great quote from theAmerican Journal of Lifestyle Medicine in 2021.
It said, Lifestyle interventions should be thefirst step in addressing HPA axis dysfunction
(26:07):
and cortisol related disorders.
This is one of the most popular journals forlifestyle medicine that exists.
And so, that should just tell you that there'sit's all about getting back to the basics.
And so, don't have to be for a final takeawayhere, you don't have to be at the mercy of
stress, right?
Your body's not broken, it's actually extremelyadaptive.
(26:27):
And when you can support the foundations, whichare sleep, food, rhythm, and recovery, you're
going to give your body that permission toheal.
Now, if you want to take this a step further,and you want to learn more about how we help
people to diagnose, reverse, and heal adrenalfatigue and hormone imbalances within our
functional medicine programs, go toAlessiFunctionalHealth.com, schedule a
(26:51):
consultation where you can meet with me or oneof my teammates, and let's create a
personalized plan for lifelong health.
If you're a listener of the podcast, you'realways going to get exclusive discounts and
price reductions on all of our lab protocolsand testing.
As always, if you found any value in today'sshow, I just ask you please like, subscribe,
and then share this with someone who you thinkwould need to hear it.
(27:13):
That's the only way we're gonna get to growthis message.
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If you wanna get in touch with us, if you everwanna be featured on an episode, share your
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(27:34):
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resources page.
You're gonna learn more about our approach tonutrition and cutting edge therapies.
I wanna thank you again for being a part ofthis and for joining us on today's episode.
Thanks for tuning in, where we break down thescience, we bust the myths, and we help you
take control of your health naturally.
(27:56):
So until next time, I'm doctor Alessi.
Stay curious, stay empowered, and remember thatyour health is in your hands.
Thank you for tuning in to Health Decoded,where we break down the truth about all things
health and empower you to take charge of yourwell-being.
If you found value in today's episode, pleasesubscribe, leave a review, and share it with
(28:18):
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To hear your questions answered live on theshow, send them to ask@AlessiFXHealth.com.
That's ask@alessifxhealth.com.
(28:38):
Until next time, stay curious, stay empowered,and remember, your health is in your hands.
It's all about getting back to the basics.
(00:02):
And so, you don't have to be at the mercy ofstress, right?
Your body's not broken, it's actually extremelyadaptive.
And when you can support the foundations, whichare sleep, food, rhythm, and recovery, you're
gonna give your body that permission to heal.
Welcome to Health Decode, your number onesource for real health information, with your
hosts, doctor Alessi and Matt Tack.
(00:27):
Hey, Health Decoded listeners.
Doctor Alessi here.
Let me ask you a serious question.
Are you tired of waiting until something goeswrong to finally see a doctor?
At Alessi Functional Health, we take adifferent approach, the right approach.
We believe true health care isn't about chasingsymptoms.
It's about preventing them in the first place.
(00:48):
That's why we created the Alessi Total CareProgram.
This is a functional medicine based membershipthat gives you proactive, personalized care
year round.
You'll get access to comprehensive blood workand functional testing, custom doctor grade
nutraceuticals, deep discounts on labs,protocols, and follow ups, as well as twenty
(01:11):
four seven direct access to your doctor, notjust a ten minute checkup that ends with
another prescription.
And here's the best part.
As a Health Decoded listener, you'll get yourfirst three months completely free when you
sign up for an annual membership.
That's on top of hundreds in savings alreadybuilt into the program.
(01:31):
This is your chance to take responsibility foryour health and join a movement that's
redefining what primary care should look like.
Head on over to alessifunctionalhealth.com,click on our services tab, and go to Total
Care.
Learn more about this program and claim yourexclusive podcast listener offer.
Your health is your greatest asset.
(01:52):
Let's protect it proactively.
Welcome back to another episode of HealthDecoded.
I am your host, doctor Alessi, and I'm excitedto have you guys back today.
Really great topic that we have for you andreally excited to get into this.
This is something that I believe is verymisunderstood in health in general and
(02:14):
something that a lot of doctors really don'tknow how to test for or how to look for.
And ultimately, patients end up getting andpeople end up getting kind of bad advice in
this topic.
So, what we're going to talk about today iscortisol, and realistically how elevated
cortisol can hijack your health in the longterm.
(02:34):
And so, you know, what I want to make sure Iclear up right away is that cortisol is not
your enemy.
People throw it around as if it's a negativething.
In fact, you wouldn't survive without it.
Cortisol is a steroid hormone.
It's produced by your adrenal glands, which sitlike little hats on top of your kidneys, and
it's part of a very finely tuned system calledthe HPA axis, the hypothalamic pituitary
(02:57):
adrenal axis.
This system is essentially your body's stresscommand center.
It decides when to mobilize resources, when torest and how to respond to everything from a
physical threat to emotional tension.
Now, here's what cortisol is supposed to do ina healthy system.
It helps regulate blood sugar so that you canhave stable energy, reduce inflammation when
(03:20):
appropriate.
It controls and manages your sleep wake cycle,your circadian rhythm.
It supports metabolism and the conversion offood into energy.
It manages blood pressure and it mobilizes yourbody's fight or flight response in times of
danger.
So, picture this, you're hiking in the woodsand suddenly you come across a bear.
(03:41):
Your brain immediately signals your adrenalglands to release cortisol and adrenaline.
Cortisol is going to increase your blood sugarso that your muscles will have energy, narrow
your blood vessels to raise blood pressure, itsharpens your focus and reaction time, and it
tells your immune system, Hold on, we have morepressing matters at hand.
So, it's going to also halt digestion andreproduction to conserve resources.
(04:07):
In that moment, cortisol could be a lifesavingally.
But the problem is that we're not always inthat position, right?
But your brain doesn't differentiate between abear and your boss who just sent you a rude
email at 9PM.
Or maybe a toxic relationship or financialstruggles or maybe doom scrolling on Instagram
(04:28):
for two hours before bed.
All of those micro stressors when experienceddaily are going to trigger the same cortisol
release as if you were in that situation.
So, it's like your body thinks you're beingchased by a bear 20 fourseven and it never gets
the signal to stand down.
When cortisol stays elevated for too long, thatacute survival response becomes a chronic
(04:50):
health disaster.
So, here's a quick study spotlight from PsychoNeuroendocrinology in 2016.
Chronic psychological stress is associated withsustained elevations in cortisol, contributing
to metabolic dysfunction and immunesuppression.
That means that high cortisol, when elevatedfor a long time, can disrupt your immune system
(05:13):
making you more vulnerable to infections.
It can also increase belly fat because cortisoltells your body to store fat in the abdomen for
fuel.
It'll cause insulin resistance, unstable bloodsugar, it can wreck your energy and your sleep
and literally blunt your brain's ability tofunction.
And over time, your adrenals are going to burnout leading to low cortisol, exhaustion and
(05:37):
then ultimately complete burnout.
So, this episode isn't just about feelingstressed and that biochemical process, we're
talking about how do we maintain and managecortisol long term to then ultimately avoid
this kind of thing in the first place.
And so, isn't bad, but chronically elevatedcortisol is.
(05:57):
So, in this episode, we're going to fix that.
We're going to unpack how cortisol affects yourweight, sleep, mood, metabolism, hormones, and
more.
And then, I'll show you how to take backcontrol naturally.
So, how does cortisol wreck your body?
Alright, now that you understand what cortisolis, and why it matters, let's talk about what
happens when it's out of balance, especiallywhen it's chronically elevated or eventually
(06:22):
bottoms out.
Because when your cortisol rhythm is off, yourentire system will suffer.
So, let's break it down and let's go symptom bysymptom of what happens.
So, the first one on the list here is weightgain, right?
Especially belly fat, abdominal adipose tissue.
Cortisol raises blood sugar to fuel yourmuscles in a crisis, but when the crisis never
(06:46):
ends, that sugar isn't burned, it's stored.
Especially as visceral fat around the abdomenand organs.
This belly fat isn't just cosmetic, it ismetabolically active and inflammatory, which
can feed the cortisol cycle even more.
Even worse, chronically high cortisol willcrank up your cravings for sugar and carbs,
(07:07):
pushing you more towards an emotional bingetype of eating.
The next one on the list is insomnia.
The thought of being tired but then wired atnight.
Cortisol is supposed to follow a diurnalrhythm.
It should spike in the morning when you wake upand it should taper down to let melatonin rise
towards the end of the day so you can sleep.
(07:28):
When cortisol is too high at night, you'regoing to feel wired but you're exhausted.
Lying in bed, maybe scrolling on your phone,your mind is racing and you can't fall asleep.
Eventually, you're not going to wake uprefreshed anymore, you're going to start the
day already behind because your diurnal rhythmhas now been flipped.
The next thing that we can experience is brainfog.
(07:48):
I've experienced this before.
Chronic cortisol can impair your hippocampus,which is the part of your brain responsible for
memory, focus and learning.
So, you might feel like you can't rememberbasic things, you can't stay on task or you
feel just mentally sluggish all day.
It's not a motivation issue, it's aneurochemical imbalance.
(08:08):
Chronically elevated cortisol can also impairhormone balance and cause low libido.
Cortisol and your sex hormones share the sameraw materials, primarily pregnenolone.
When your body is under stress, it prioritizessurvival over reproduction, a phenomenon called
the pregnenolone steal.
This can lead to low testosterone or estrogen,PMS, irregular periods or fertility issues, or
(08:35):
total loss of libido or sexual energy.
Another one is blood sugar spikes and insulinresistance.
Chronically elevated cortisol raises bloodsugar to help you survive, but if that sugar is
not used, it creates insulin resistance overtime.
Go back two episodes and listen to our episodeon blood sugar, that will make more sense.
(08:56):
This can then lead to blood sugar crashes, moodswings, sugar cravings, and eventually this
becomes prediabetes or even full blown type twodiabetes.
Another thing cortisol can do is suppress thethyroid gland.
So, high cortisol can inhibit your conversionof T4 to T3, basically your active thyroid
(09:16):
hormone.
It can also increase reverse T3, which thenblocks your receptors from using thyroid
hormone effectively.
So, what does this mean?
Even if your thyroid labs are looking normal,you could still have slow metabolism, the cold
hand and feet symptoms, constipation, thinninghair and chronic fatigue.
(09:37):
And then, next, last on the list here is immunedysfunction.
We touched on this for a second.
Cortisol has an immunosuppressive effect, whichis great for short term inflammation control,
but it's a disaster when this is sustained longterm.
So, you might find yourself getting sick moreoften, experiencing long recovery from colds,
or developing or worsening autoimmune flareslike Hashimoto's, rheumatoid arthritis or
(10:01):
eczema.
And now, here's the kicker, the longer you stayin this stress state, the more depleted your
adrenal glands become.
And eventually, your body cannot sustain theoutput anymore and your cortisol production
crashes.
This is where people move from the wired andtired to just plain exhausted and the body
totally burns out.
(10:23):
They wake up fatigued, no motivation, they feelemotionally numb, depressed, physically heavy.
That's not just burnout, it's what we call HPAaxis dysfunction, or adrenal exhaustion.
And it is a serious thing.
So, here's a real case study, and this is apatient we worked with.
I'm not going to say any names, but we workedwith a 42 year old entrepreneur type A, high
(10:47):
performer, early riser, late night emails untilreally he started breaking down and noticing
about over the span of six months to a year.
He noticed he was gaining weight, even thoughhe was working out like crazy and eating clean.
He couldn't sleep.
He lost all drive, libido, sex drive with hispartner, and even his creativity.
(11:08):
Event everything eventually felt kind of like achore to him, even just getting out of bed.
So, we ran his labs, we looked at a fullhormone panel, thyroid panel, inflammation, and
his cortisol was basically flat lined in themorning, when it should have been at its
highest.
And it was spiked at night when it should havebeen at its lowest.
So, this is what we just alluded to, this wasthat adrenal dysfunction.
(11:30):
Classic HPA axis dysfunction.
His stress response system had burned out fromchronic overuse.
But the cool thing here was that we implementeda strategy with lifestyle, supplements, and
nutritional interventions.
And he put in the work and eventually werebuilt his body's HPA axis to be functional
again.
(11:52):
Now, the takeaway here is chronic cortisolimbalance is really a silent saboteur of modern
health.
And again, this is something not a lot ofdoctors talk about, because not a lot of
doctors know about.
So, if you're struggling with weight, energy,mood, or sleep, or hormones, it's time to start
asking yourself, what is my cortisol rhythmactually doing?
(12:12):
And start getting some answers.
And that's exactly what I want to get into nowin this next segment.
Labs, testing, what to look for, and ultimatelywhat most doctors are gonna miss.
But before we do that, here's a quick word fromone of our sponsors.
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Now back to the episode.
Okay.
Welcome back.
Now let's get into testing the stress responseand what your labs can ultimately reveal and
what most doctors are ultimately missing whenit comes to testing this.
So, say you're dealing with symptoms, you'vegot brain fog, fatigue, cravings, maybe even
(14:07):
hormone issues.
Here's the truth, if you don't test thesethings, you're just guessing.
And if you test the wrong things, you're stillguessing.
So, let's talk about how do you properly assesscortisol and the overall stress response, and
why average blood tests and your CBC are reallynot going to cut it.
The problem with conventional testing is youwalk into your doctor's office feeling off,
(14:31):
fatigued, overwhelmed, not yourself.
If they run anything, it's going to be a singleblood cortisol level and maybe they take that
at 8AM.
And they say, Oh, you're in range.
First off, what does in range actually mean?
Right?
Are you on the higher end of reference range?
The lower end, but you're still within range?
Those are two different things.
That one number doesn't give us enough of apicture of how cortisol is flowing throughout
(14:56):
the day or how it's affecting your hormones,thyroid, immune system, or brain.
So, think of it like this, you wouldn't judgean entire movie by one still frame, right?
So, why would you judge your entire stresssystem by one number?
So, the functional medicine approach, what wetest and why is that, you know, we want to see
(15:16):
a full picture of what this is doing and whatyour body is doing throughout a daily basis.
So, the number one thing we're going to look atis what's called a cortisol awakening response
or a CAR.
This is a saliva test taken multiple times inthe first thirty to sixty minutes after waking,
as well as throughout the day.
This is going to measure how quickly yourcortisol spikes start, as well as what that
(15:41):
rhythm looks like midday, end of the day and atnight.
And so, a spiked CAR may mean chronic anxietyor inflammation.
Another test we often use is a Dutch test.
This is a dried urine test for comprehensivehormones.
This is going to give us cortisol and cortisonepatterns, both the free and the metabolized.
(16:03):
This is going to give us estrogen,progesterone, testosterone, and how your body
is processing them.
Melatonin levels, as well as the organic acidmarkers for how your body is metabolizing
vitamins, glutathione and more.
And so, you get an hour by hour map of yourhormones and your stress response.
This is not something that a basic blood testwill show.
(16:25):
The other things we need to see is fastinginsulin and glucose and your hemoglobin A1C,
because these are tightly linked to cortisol.
So, cortisol is often going to lead to insulinresistance even if your glucose looks normal.
We discussed this back in the blood sugarepisode as well.
Go back and listen to that.
So, these tests are going to show us how wellyou're handling sugar and stress.
(16:50):
Next, what we look at is a full thyroid panel.
We want to see not just TSH, we want to seefree T3, free T4, reverse T3, as well as
antibodies.
Remember, discussed there's a link betweenimmune suppression and worsening of autoimmune
conditions.
So, we want to see those thyroid antibodies.
Because chronic cortisol will slow thyroidconversion, increase reverse T3 and even mask
(17:15):
hypothyroid symptoms.
Another thing that we want to see that this isnot 100% necessary but is beneficial is looking
at key nutrients.
So, key nutrients for adrenal and stresssupport are going to be B12, zinc, magnesium,
vitamin D, ferritin and selenium.
These are the raw materials that your adrenalglands and nervous system use to function.
(17:38):
And so, people are walking around withborderline or even deficient levels, especially
magnesium and B12 and they don't even know it.
And the worst part is most doctors are going tomiss this because they consider within range to
be okay.
So, some of the red flags that get overlookedevery single day is normal cortisol on a blood
(18:00):
test but a reverse daily rhythm, flat in themorning, high at night.
Low free T3, so even if TSH is normal, this cansignify early thyroid dysfunction.
Estrogen dominance in both men and women.
Low DHEA, which is a key adrenal hormone thatoften crashes with chronic stress.
(18:21):
And then B12 in range, but functionally low,especially if you have fatigue or brain fog.
So, here's a quick study spotlight from theJournal of Psycho Neuroendocrinology in 2018.
Salivary cortisol patterns often offer a moreprecise insight into HPA axis dysfunction and
(18:43):
psychological stress than single serum values.
Now, that's exactly what we just talked about,that snapshot versus looking at the whole
picture.
So, the takeaway here is if you've been toldthat everything looks normal, but you feel
anything but, your labs may be incomplete ormisinterpreted.
And it's time to take a functional approach.
(19:03):
You need to look at rhythms, patterns, and thefull hormone landscape, not just a snapshot of
numbers.
Now, that brings us to the fun part.
In the next segment, I want to talk through howto actually fix it naturally without jumping
straight to medications or hormone replacement.
So, how do we restore and balance our stresssystem naturally?
(19:27):
Now that we've uncovered what cortisol is, howit becomes dysregulated, and how to properly
test it, let's get into the solution.
So, good news that I want you to take away fromthis is that your body wants to heal.
You just need to give it the right input.
This isn't about suppressing cortisol, it'sabout restoring rhythm, resetting stress
(19:48):
system, and ultimately your HPA axis.
So, step one, this is takeaways that I wantyou, if you need to write it down, things that
you can integrate and start doing today.
Step one, reset your nervous system.
Chronic stress is not just in your head, it'shardwired into your autonomic nervous system.
(20:09):
And we need to shift from fight or flight intorest and repair.
So, here's how you do it.
Daily breath work.
Commit five to ten minutes.
Start with an exercise like box breathing.
This is where you do a four inhale, four secondhold, four second exhale, four second hold,
repeat.
Or focusing on more of an extended exhale whereyou do four seconds in and then six to eight
(20:33):
seconds out.
This has been proven to lower cortisol andactivate the parasympathetic system.
You could also use things like cold exposure.
Try for two to three days a week.
It doesn't have to be a plunge or an ice bath.
Just start with a cold shower for thirtyseconds to two minutes a day.
This will help build resilience to stress andretrain your cortisol reactivity.
(20:57):
Also, practice grounding or nature therapy.
Being barefoot on the grass and walking outsidewith the sun on your face can work numbers for
lowering inflammation and modulating yourcortisol naturally.
Now, step two is you need to stabilize yourblood sugar.
Cortisol rises when blood sugar crashes.
(21:17):
So, to heal your adrenals, we need to stabilizeyour energy supply.
We talked about this as well in a previousepisode, but protein with every meal.
20 to 30 grams minimum.
Healthy fats like avocados, olive oil or nuts,these are going to help stabilize that insulin
response and blood sugar spike.
And then using complex slow digesting carbslike sweet potatoes or berries or quinoa, This
(21:41):
is gonna provide you with not such an elevatedquick spike in blood sugar.
And then, the constant snacking.
Try not to graze every two hours.
Let your body feel hungry, let your blood sugarget back to normal.
Another thing you can try is consideringintermittent fasting.
But only if cortisol is stable.
You don't want to fast if you're alreadytanked.
(22:02):
Now, you're adding more stress to an alreadystressed state.
We discussed fasting and how to implement it afew episodes back as well.
Go back and listen to that one if you've nevertried fasting and you're interested.
Step number three, heal your gut.
Your gut and brain are in constant conversationwith each other and inflammation in the gut
drives stress signals to the brain and viceversa.
(22:25):
So, start by removing the inflammatorytriggers: gluten, dairy, processed sugars,
alcohol.
Then, rebuild the gut with L glutamine, zinccarnosine, probiotics, bone broth and collagen.
For a deep dive on this, go revisit episode 16on gut health where we gave you a whole game
(22:45):
plan for that.
And now step four, you have to, have to, haveto rebalance your circadian rhythm.
Cortisol is supposed to rise in the morning andfall at night.
But a lot of people have this backwards.
So, here's how you reset it.
Your morning routine should look like brightlight within thirty minutes of waking.
Ideally, natural sunlight or a high lux lamp,10,000 amps.
(23:11):
Movement, so walking, stretching, mobilitywork, and a protein rich breakfast.
Get rid of the sugary cereals and the sugarycoffee in the mornings, which is only going to
spike your cortisol anyway.
And then the night routine, which is basicallysetting you up for this, no screens one hour
before bed, I prefer two.
And then using some kind of blue light blockerif you are going to be on your screen.
(23:35):
You need those glasses that can help filter theblue light because the blue light stimulates
the optic nerve which stimulates cortisol.
Dim the lights after sunset, let your body kindof understand that now it's starting to get
time for bed.
Use things like magnesium glycinate or LTheanine if needed at night.
And then the biggest thing I think you can dothat makes the biggest impact is going to bed
(23:59):
and waking up at the same time every day, evenon the weekends.
Even if your schedule changes, try to do it atthe same time.
Because sleep is your most powerful hormonetherapy.
And then, step five, you can supplement withthings like adaptogens.
These are not magic pills, they're not going toreplace anything we just talked about, but they
(24:21):
can support the rebuilding process when you usethem strategically.
A fantastic one is Ashwagandha.
This helps to lower those elevated cortisollevels, get you back towards a normal balance.
Rhodiola, phosphatidylserine, magnesium andthen a vitamin C and B complex.
These are essential co factors for adrenalhormone production.
(24:42):
If you don't know where to start, work with apractitioner or functional medicine doctor to
make sure you're dosing these properly based onyour labs.
And then step six, as always, move.
Move your body.
But don't burn it out.
Exercise is a stressor and so when you'realready fried, intense exercises can push you
(25:02):
further off the cliff.
So, start with walking.
10,000 steps a day is a great goal.
Get into some zone two cardio.
Lower heart rate but longer duration.
And then practice strength training, two tothree days a week, but keeping the intensity
more moderate at first until you can handle it.
If you feel worse after working out, you'reoverdoing it.
(25:23):
This is a great, great warning sign.
So, you know, in cadence here, lifestyle winsbefore pills, right?
So, me be clear, there's a time and a place forhormone replacement therapy or medications.
I'm not knocking them completely.
I just think they're overused when there'sother things we can do fundamentally first.
(25:44):
So, if you skip over the lifestyle foundationswe just covered, you're basically building on
sand.
Supplements aren't going to work, prescriptionsaren't going to hold, and you're putting the
cart before the horse essentially.
And so, here's a real great quote from theAmerican Journal of Lifestyle Medicine in 2021.
It said, Lifestyle interventions should be thefirst step in addressing HPA axis dysfunction
(26:07):
and cortisol related disorders.
This is one of the most popular journals forlifestyle medicine that exists.
And so, that should just tell you that there'sit's all about getting back to the basics.
And so, don't have to be for a final takeawayhere, you don't have to be at the mercy of
stress, right?
Your body's not broken, it's actually extremelyadaptive.
(26:27):
And when you can support the foundations, whichare sleep, food, rhythm, and recovery, you're
going to give your body that permission toheal.
Now, if you want to take this a step further,and you want to learn more about how we help
people to diagnose, reverse, and heal adrenalfatigue and hormone imbalances within our
functional medicine programs, go toAlessiFunctionalHealth.com, schedule a
(26:51):
consultation where you can meet with me or oneof my teammates, and let's create a
personalized plan for lifelong health.
If you're a listener of the podcast, you'realways going to get exclusive discounts and
price reductions on all of our lab protocolsand testing.
As always, if you found any value in today'sshow, I just ask you please like, subscribe,
and then share this with someone who you thinkwould need to hear it.
(27:13):
That's the only way we're gonna get to growthis message.
We don't spend and take money to do anymarketing for this.
We just wanna provide value and we just askthat you share in return.
If you wanna get in touch with us, if you everwanna be featured on an episode, share your
story or get a question answered, email it tous at ask@AlessiFXHealth.com.
(27:34):
You can also visit AlessiFunctionalHealth.com,sign up for our newsletter, and check out our
resources page.
You're gonna learn more about our approach tonutrition and cutting edge therapies.
I wanna thank you again for being a part ofthis and for joining us on today's episode.
Thanks for tuning in, where we break down thescience, we bust the myths, and we help you
take control of your health naturally.
(27:56):
So until next time, I'm doctor Alessi.
Stay curious, stay empowered, and remember thatyour health is in your hands.
Thank you for tuning in to Health Decoded,where we break down the truth about all things
health and empower you to take charge of yourwell-being.
If you found value in today's episode, pleasesubscribe, leave a review, and share it with
(28:18):
someone who needs to hear this.
For more resources and personalized support,visit us at AlessiFunctionalHealth.com and sign
up for our newsletter.
To hear your questions answered live on theshow, send them to ask@AlessiFXHealth.com.
That's ask@alessifxhealth.com.
(28:38):
Until next time, stay curious, stay empowered,and remember, your health is in your hands.
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