Take control over the body-shaping hormone cortisol: Part I

From ZRT Lab

Conventional approaches to weight loss focus exclusively on losing weight by reducing stored fat. Despite being the prevailing norm for many years, this approach is flawed because it fails to target the most problematic fat “depot” of all, abdominal visceral fat, fat that drives insulin resistance and inflammation and thereby underlies numerous human diseases.

Conventional methods of weight loss also result in dramatic loss of muscle, typically 25% of total weight lost, a crippling loss. The loss of muscle poses long-term threats to health by permanently reducing basal metabolic rate that guarantees weight regain as fat. It means that conventional approaches to weight loss yield limited benefits that are only temporary. Loss of muscle also leads to a future of falls, fractures, frailty, loss of independence, and early death—yes: early death. That nice weight loss program you paid a lot of money for, or the smartphone app identifying your stress eating triggers, or the GLP-1 agonist that your doctor declared a “breakthrough” all shorten your life by several years because they failed to factor in the full range of consequences of weight loss achieved by simply reducing calories. Don’t take my word for it; take a look at the huge databases that have tracked tens of thousands of people who have engaged in calorie-cutting weight loss programs demonstrating that people who lose weight by reducing calories die younger: the NIH’s NHANES database of >16,000 participants, the European EPIC Norfolk database of more than 12,000 participants, the ASPREE database of >19,000 participants are among the several large data sets showing us that people who intentionally (not inadvertently, as in cancer) lose weight die several years before others who don’t lose weight.

A better approach is to therefore manage shape and body composition, the location and quantity of fat and muscle, an approach that I shall be discussing at length here in anticipation of the deeper conversations I will be introducing in my Super Body book coming our in December, 2025. The sooner you adopt these new strategies, the more likely you are to avoid all the dangerous pitfalls of conventional weight loss and enjoy superior shape and body composition. It is a new paradigm that should cause you to discard all previous notions of weight loss.

A number of factors enter into the equation that determines how much fat and muscle you have and where they are distributed. Some factors are hormonal, some are dietary, some involve the microbiome that, in turn, exerts effects on shape and body composition through a number of mechanisms including the very powerful gut-brain axis. In this WilliamDavisMD.com blog post, let’s focus specifically on the effects of the hormone, cortisol.

Cortisol, of course, is a hormone produced in the adrenal glands as well as liver, visceral and subcutaneous fat. Cortisol release increases in response to stress, both physical and emotional. Cortisol levels are normally highest in the morning upon arising, decline throughout the day, reaching its lowest point at bedtime, thereby a major player in circadian rhythm (a pattern illustrated by the 4-sample salivary cortisol curve, as shown in typical ZRT Lab measurements, shown above). The morning surge provokes hunger, energy, and increased alertness, properties required for arousal to forage or hunt for food, Such acute daily effects are therefore necessary and beneficial. But cortisol also has a dark side that is brought out when surges are excessive or abnormally sustained, when circadian mistiming occurs, or when levels are abnormally low.

Paradoxically, improved physical performance is associated with a greater afternoon and evening drop in cortisol (though more severe drops are associated with fatigue and impaired functioning). In other words, the ideal circadian cortisol release pattern involves a morning surge followed by sharp drop later in the day. Higher levels of evening cortisol can especially be a problem, as it has been associated with increased development of frailty, weight gain, and all the health and social problems that accompany these situations. The severe loss of muscle that occurs in Cushing’s disease from very high levels of cortisol is a vivid illustration of the effects of excessive cortisol on muscle.

Common emotionally stressful situations increase cortisol, e.g., a heated argument, taking care of a debilitated parent, loneliness, enduring an unhappy marriage. It also rises if a physical threat is perceived or with chronic pain. Lack of sleep or disrupted sleep patterns trigger higher levels or disturbed timing of cortisol commonly seen, for instance, in people who work night shifts. Another source of abnormally high cortisol levels is deprivation of exposure to nature: people who spend more time in natural settings such as fields or forests have lower cortisol levels than someone who spends their entire day in an office or other artificial setting. Exposure to sunlight or other intensive light sources in morning can help reset mis-timed cortisol surges, as well as reducing blue wavelength exposure later in the day. When repetitive over a long time period, excessive and mis-timed surges in cortisol can have health consequences involving impaired immune responses, increased inflammation and insulin resistance, even adding to risk for dementia. And it can add to negative distortions of shape and body composition.

Higher levels of cortisol:

• Increase accumulation of abdominal fat—i.e., inflammatory fat that also increases insulin levels and Inflammation, indirect effects that impair muscle structure and function: more abdominal fat, less muscle,
• Erodes muscle mass—High cortisol levels can directly cause muscle loss. Recall that aging alone is accompanied by 30% loss of youthful muscle. Factors associated with higher levels of cortisol accelerate loss of muscle.
• Increases myosteatosis—Abdominal visceral fat encourages parallel infiltration of muscle by fat, myosteatosis. This becomes an almost universal phenomenon as we age, adding to age-related loss of muscle mass and strength, worsens insulin resistance, and has even been associated with increased mortality.

In short, addressing factors influencing cortisol should be a part of your efforts to optimize shape and body composition: allow loss of abdominal visceral fat while preserving, or even increasing, muscle mass. Understanding the many causes of high or mis-timed cortisol can help you correct such phenomena: making sleep a priority, ensuring regular physical activity, spending time in natural settings especially in the morning, addressing common nutrient deficiencies and, the topic of Part II of this series: purposeful and intelligent management of the GI microbiome. I shall also be discussing cortisol management in an upcoming InnerCircle.DrDavisInfiniteHealth Virtual Meetup Zoom meeting near future including the interpretation of salivary cortisol curves.

Super Body is available for pre-order:

The original IHB post is currently found on the: ⎆Infinite Health Blog, but accessing it there can require an unnecessary separate blog membership. The copy of it above is complete, and has been re-curated and enhanced for the Inner Circle membership.