Insulin resistance and its implications play a considerable role in a variety of disease models we see in the present day. Naturally addressing insulin resistance is often done through food, which, although powerful, is not the whole story. Today we explore one of the major pillars that can blunt insulin sensitivity: the connection between cortisol and insulin resistance.

Good Health and Insulin Sensitivity

There are many factors to look at (outside of the diet) when it comes to finding good health:

• Environmental toxins
• Stress levels
• Sleep
• Relationships: support network
• Spirituality
• Sexual health
• Quality of drinking water
• Sun exposure
• …and many many more.

In this piece, we will be focusing on insulin sensitivity, and primarily focus on the role that cortisol plays in generating this healthy relationship between glucose and insulin.

Insulin is the hormone produced by the body that stabilizes blood sugar. Insulin sensitivity refers to the ability for your body to efficiently and effectively metabolize and store glucose (sugar). Healthy insulin response is referred to as ‘sensitive,’ while an inadequate response is referred to as ‘resistant.’ [1]

The higher your insulin and glucose, the more at risk you are for metabolic issues and the inability to make progress on any particular way of eating. Insulin sensitivity determines your body’s ability to process and store glucose. Failure to do so means more glucose in the blood, which can result in a host of illnesses and symptoms ranging from weight gain and brain fog all the way to type 2 diabetes and even death. [2]

 

What is Cortisol?

Cortisol is known as the “stress hormone,” is a steroid hormone synthesized from cholesterol. Cortisol is involved in many functions in the human body, such as mediating the stress response, regulating metabolism, the inflammatory response, and immune function. Even though it may have a bad reputation, we do need cortisol to maintain many areas of health. [3]

In healthy quantities, cortisol helps control blood pressure, reduce inflammation, and plays a crucial role in controlling the body’s glucose metabolization as well as inducing the waking in the sleep/ wake cycle. Problems, however, occur when cortisol levels are chronically elevated.

Like anything, it’s about balance. Modern lifestyles promote underlying chronic low (to high) levels of cortisol, which means that the body is in “fight or flight” all day and night. Some signs that you have a cortisol imbalance (aka constantly going) include: [4]

• Quick to overreact (like road rage)
• Wake up feeling tired (poor quality sleep)
• Over reliant on caffeine or sugar to get through the day
• Low libido
• Anxiety
• Depression
• Unmotivated
• Over or under eating
• Cardiac problems

The Cortisol Insulin Link

Stress has a direct impact on your body’s ability to regulate and store the sugar in your blood. By promoting fight or flight, stress induces the release of stress hormones cortisol and glucagon. [5]

To give you rapid access to sugars (to assist with the fight or the flight), these two hormones break down glycogen in the blood into glucose, providing you with quick access to energy. This is extremely useful in case of a life or death situation but becomes problematic when the stress is chronic. [6]

When the body experiences chronic stress, the body is continuously tapping into this process of glycogen breakdown, and chronically releasing glucose into the blood. You may have an extremely low glycemic diet, but if you are under constant stress your body is continually releasing glucose either way. [7]

Various studies highlight the impact that stress hormones have on dulling insulin sensitivity over time. [8, 9] stress is ancestrally an isolated experience, followed by periods of relaxation. So managing stress, and ensuring your lifestyle is not promoting chronic levels of underlying stress, is imperative to proper glucose storage and metabolism, and overall whole-body health.

How to Lower Cortisol Levels Naturally

Luckily, many of the factors that cause cortisol to release are things we can monitor and control. Reducing cortisol levels is naturally twofold: removing the stressors, and implementing relaxation/ mindfulness techniques.

Removing the Bad

Stress comes in chemical, physical, and emotional forms. When It comes to chemical stress, you want to be mindful of the toxins that you expose your body to, both internally and externally (topically, or the air that you breathe). Opting for non-toxic body care and home cleaning products is major because these are the kinds of things you interact with daily. Another primary source of chemical stress is water and food quality. Opt for filtered or pure spring water, as well as organically grown foods (without herbicides and pesticides) whenever possible.

Overhauling all your diet, home, and body items can be daunting, so instead, you can opt to replace items with non-toxic versions when the current item runs out. But if you are facing major chronic health issues, perhaps consider a significant overhaul in the time-sensitive nature of preserving your health.

Physical stress can occur from moving too little or too much. Although people tend to focus on sedentary lifestyles (too little movement), there is also an increasing amount of people doing too much. Monitor physical stress is especially imperative for women in their reproductive years; that can induce more harm than good by doing “too much” movement. Hormonally, the menstrual cycle is a fantastic metric to check-in with your stress levels since stress delays ovulation. If you have a painful or abnormally long cycle (35+ days), consider addressing the possibility of over-exercising as a potential cause of chronic stress.

Finally, the last type of stress is emotional stress. Despite not having a physical input, emotional stress can be the most insidious form of stress because of this very reason. Since we cannot see it, most people diminish the value placed on emotions as a form of stress– when in reality it generates the same hormonal (cortisol stress) response that physical inputs do. Managing emotional stress permeates all types of relationships: at work, with friends, at home, and perhaps most importantly, the relationship we have with ourselves.

Managing emotional stress requires doing internal work to address traumas, fears, patterns that may be destructive to our wellbeing (addictions), all of which are rooted in the ability to set boundaries with people, places, and habits that are not serving our highest good. Having a community of trustworthy friends and a trusted healthcare provider (like a functional medicine practitioner or therapist) is invaluable in helping us cultivate self-worth and emotional wellbeing.

Putting in the Good

After addressing some of the significant factors contributing to daily stress, you can then start to incorporate techniques that help promote relaxation, often called ‘mindfulness’ techniques. There are many ways to bring you back to the moment and support the rest and digest mode known as the ‘parasympathetic’ mode. They include: [10-12]

• Breathwork
• Meditation
• Walking
• Mantras
• Journalling
• Tai Chi/ Qi Gong
• Yoga
• Essential oil/ aromatherapy
• Calming music

The key when choosing which relaxation/ mindfulness technique is right for you is ultimately whichever habit you can implement into your life regularly. Ideally, you want to start and finish your day with mindfulness practices. Setting your day up from a relaxed place and unwinding with relaxation to help promote deeper sleep.

Some methods can also be used throughout the day to help keep your cortisol levels low in unthreatening situations that cause unnecessary stress. For example, you could practice breath or mantra work before a big presentation, to calm your nerves and drop cortisol levels.

Summary

Keeping cortisol levels balanced throughout the day is a crucial aspect of health for many reasons. One of these reasons is that chronically elevated cortisol leads to weak insulin response and ultimately can lead to insulin resistance. To avoid a wide range of symptoms and diseases linked to insulin resistance, managing stress is vital. Avoiding physical, emotional, and chemical stressors are paramount in reducing overall stress. Keeping cortisol levels low naturally can also be promoted by implementing mindfulness tools, including breathwork, meditation, walking, and mantras.

References

[1] White, M. F. “Insulin Signaling in Health and Disease.” Science, vol. 302, no. 5651, 2003, pp. 1710–1711., doi:10.1126/science.1092952.

[2] Reaven, G. M. “Role of Insulin Resistance in Human Disease.” Diabetes, vol. 37, no. 12, 1988, pp. 1595–1607., doi:10.2337/diab.37.12.1595.

[3] Thau L, Gandhi J, Sharma S. Physiology, Cortisol. [Updated 2020 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538239/

[4] Melamed, Samuel, et al. “Chronic Burnout, Somatic Arousal, and Elevated Salivary Cortisol Levels.” Journal of Psychosomatic Research, vol. 46, no. 6, 1999, pp. 591–598., doi:10.1016/s0022-3999(99)00007-0.

[5] Kadmiel M, Cidlowski JA. Glucocorticoid receptor signaling in health and disease. Trends Pharmacol. Sci. 2013 Sep;34(9):518-30.

[6] Geer, Eliza B., et al. “Mechanisms of Glucocorticoid-Induced Insulin Resistance.” Endocrinology and Metabolism Clinics of North America, vol. 43, no. 1, 2014, pp. 75–102., doi:10.1016/j.ecl.2013.10.005.

[7] Institute of Medicine (US) Committee on Military Nutrition Research; Marriott BM, editor. Food Components to Enhance Performance: An Evaluation of Potential Performance-Enhancing Food Components for Operational Rations. Washington (DC): National Academies Press (US); 1994. 11. The Metabolic Responses to Stress and Physical Activity. Available from: https://www.ncbi.nlm.nih.gov/books/NBK209038/