Cortisol is one of our body’s natural anti-inflammatory chemicals. Without adequate cortisol we lose the ability to fight infection, control healthy organ function and maintain proper hormone levels. A recent post by Linda Cox about a new drug therapy for Multiple Sclerosis (MS) called Acthar which stimulates ACTH production highlights the importance of healthy cortisol production for controlling inflammation. ACTH stimulates the adrenal glands to produce cortisol. So, what are the adrenal glands and how do they assist in the promotion of natural levels of cortisol? Can adrenal hormone assessment be of assistance for people with MS? I believe that all individuals with MS should have functional adrenal hormone testing to evaluate this very important hormone system. The most effective way of evaluating functional adrenal hormone output is through salivary adrenal testing. This method of testing is easy to perform, very accurate, and gives a representation of cortisol output over a 24 hour period of time. Based on these results a doctor can then determine where in the day adrenal hormone assistance therapy, i.e. cortisol, nutritional supplementation, needs to be given.
Adrenal hormone assessment has become a popular avenue for health practitioners to evaluate hormone levels and imbalances, symptoms of fatigue, lethargy, and other issues of ill health. It is now recognized that many health conditions such as chronic fatigue, PMS, insomnia, frequent illness, and in part Multiple Sclerosis are related to imbalanced adrenal hormone output and reserve. What may cause some confusion about adrenal testing is the premise that adrenal hormone imbalance is the reason for an individual’s ill health, rather than a signal that other functions within a person’s body are declining. I liken it to the engine warning light in your automobile. If the light goes on, it indicates that there is a problem in your engine warranting diagnostic assessment to find the problem(s). This same logic needs to be applied to adrenal hormone assessment. It makes no sense to just treat the adrenal gland itself without finding the causative factor(s) for its imbalance.
The adrenal gland has many functions. It regulates sodium and potassium levels via our kidneys to help with electrolyte balance and blood pressure. It also produces many chemicals involved in energy production, immune system function, inflammation control, blood sugar balance, and sleep regulation. Cortisol is a major component of adrenal hormone output and its ability to impact the majority of body systems has made it an ideal hormone to measure as an indicator of adrenal gland function. Generally, high cortisol levels indicate an overactive adrenal gland while low cortisol levels are indicative of an underactive adrenal gland. I often find individuals with MS to have unhealthy adrenal gland function.
DHEA (dihydroepiandrosterone) is another adrenal hormone that serves as a precursor for the production of the sex hormones testosterone and the 3 estrogens. A balance between DHEA and the total output of cortisol is essential to maintain a balance of adrenal hormone production. This ratio is approximately 5:1 cortisol to DHEA, and deviations from this range are an indication that the body is compensating for underlying stress. This stress is not always emotional or mentally induced, but instead could indicate poor blood sugar control, digestive inflammation, chronic infections, poor diet and environmental toxins. Again, the deviation from normal is a warning that your body is not handling stress very effectively. In MS, many of these medical issues occur simultaneously which contributes to poor health.
For many people, the adrenal hormone imbalance can be quite severe. Examples of this are women with irregular menses, PMS, early menopause, infertility, or other female hormone related health issues. The reason for these problems is the lack of adequate sex hormone production, i.e. estrogen, testosterone, progesterone due to the need to keep up with the increased demand of adrenal hormones. The concepts surrounding this function are not difficult to understand, but the importance of its meaning can have a profound impact on your long-term health and well-being. The process is driven by stress and the body compensates by using hormone precursors for cortisol production rather than sex hormone production.
All sex, adrenal, and kidney hormone (aldosterone) production comes from cholesterol. Cholesterol, an essential chemical in our body, provides the necessary cofactors for a hormone called Pregnenolone. In a non-stressed individual, pregnenolone flows in a downward direction for the production of DHEA. DHEA is then converted to either testosterone, or the 3 different estrogens (estradiol, estriol, or estrone) depending on the body’s demand. Some of this pregnenolone is shunted to progesterone as well which, as needed, will convert to cortisol. Cortisol is then free to carry out its biological activities as discussed above. When estrogen, testosterone, and progesterone are being produced in normal amounts, this indicates a healthy and balanced hormonal system. However, in our fast-paced, stress filled society this normal scenario very rarely occurs leading the way for hormonal imbalances and a predisposition to ill health.
When the body is under stress, we tend to produce more and more cortisol. Over time we enter a phase called “pregnenolone steal” in which our body is stealing pregnenolone away from its normal hormone production pathways in preference of cortisol. Eventually the stimulus on our adrenal gland for stress hormone production (cortisol) is so great that our adrenal gland begins to weaken. Over time, this scenario leads to adrenal fatigue and eventually adrenal exhaustion setting the stage for poor inflammation control. In the adrenal exhaustion phase we have lost our ability to compensate for acute stressful events and we are left feeling fatigued, lethargic, and susceptible to chronic illness.
Chronic stress comes in many patterns and phases depending on an individual’s lifestyle, diet, sleeping patterns, genetic and hereditary factors. We all have stress, but the people that deal with stress in a positive emotional and mentally balanced way usually remain the healthiest with regards to their adrenal hormone function. However, stress is a multifactorial issue and its causes are a multitude of varying emotional, dietary, and lifestyle factors. Injuries, nutrient poor diets, chemical toxicity, disturbed sleeping patterns, drugs, infections, electromagnetic exposure, psychological stress such as doubt, lack of self-worth, fear, and anxiety all lead to demands on your adrenal reserves.
It is important to realize that normal adrenal hormone production is an indicator of overall normal body function. Any deviation from this balance is a signal of failing health. If the adrenals are weak and overstressed, then the cause(s) for this stress needs to be determined. Just like the engine warning light in your car, the adrenal glands and its corresponding hormonal production do not exist in isolation from the rest of our body. Its imbalanced function is a signal of deeper stress and maintaining normal output and production is imperative for a happy and healthy life.