Cortisol - Please 'Weigh In'

bluess · 20th February 2008, 06:48 PM

I cast a cry out to the wonderful people on board - what is the scoop on stress/cortisol/weight? I am not a scientist or doctor, and really cannot tell whether the information I am finding on the web is worth anything. The basic tune on the web is that stress tells the body to release cortisol, and that cortisol tells your body that you may experience a famine any minute, and that results in your body storing calories right around the old tummy.

I am not considering taking any of the lovely diet pills out there, and am reducing the stress in my life for a variety of other reasons, but would be interested in any comments.

Thanks!

Bluess

Gate2501 · 20th February 2008, 06:56 PM

I think that it can raise your blood sugar if enough of it is in your system (cause it messes with your body's natural insulin somehow )... Which technically can make you gain weight.

I would say that this effect is probably very minimal compared to things such as the amount of calories you consume daily.

I do not know of any other effects that it would cause to make you store fat in specific areas of the body, that sounds like hogwash.

Edit: I am no professional, I just looked it up a while back when I saw a commercial about a weight loss pill also.

Rolfe · 21st February 2008, 03:50 AM

Excuse please, nonsense post.

Professor Yaffle · 21st February 2008, 04:13 AM

I don't know how reliable this article is (I only glanced at it) but it seems to cover the area you are talking about. Note, I am not vouching for the contents, you will have to determine for yourself whether the information in it is reliable.

http://thyroid.about.com/od/loseweig...a/cortisol.htm

Anecdotally, my mam has Addison's disease, so doesn't produce any cortisol herself and she has to take medication to replace it. Before she was diagnosed, she did lose an awful lot of weight , so it may be that cortisol plays some role in weight, but I doubt that it is a simple relationship. She also completely lost her appetite and ate like a sparrow, so the relationship may be mediated via appetite - a lot of people overeat when they are stressed.

casebro · 21st February 2008, 06:45 AM

The theory may be good, but in vivo, cortisol levels high enough to cause problems are quite rare. Day to day stress will not raise your cortisol high enough to cause you any grief, but it sure is a good hook to get you to buy into yet another spurious weigh loss program.

I've got type II diabetes. Plus an adrenal 'incidentaloma', a benign growth on an adrenal gland. Been through all those tests, lots of times. If MY cortisol is normal, so is yours.

A friends golden retriever had Cushing's. Boy, was she bloated. Like a water bed mattress. If a human had that, treatment would commense lots earlier.

El Greco · 21st February 2008, 06:58 AM

Cortisol is basically a catabolic hormone. This means it will increase when your body senses a need for providing increased fuel. Such conditions include dieting and emotional stress. What elevated cortisol will do, among other things, is that it will increase the production of glucose via various pathways, including muscle and fat catabolism. Evolutionary speaking, this would help you deal with an emergency situation. And that emergency situation shouldn't last too long because you can't be fighting for your life for too much time. Interestingly, the initial, short-term effect of increased cortisol is elevated awareness and readiness.

But what happens today is that emotional stress due to the rhythms of modern life often will prolong the stress periods. Cortisol will sometimes remain "chronically" elevated and the original short stress reflex will become chronic. This means that via various complex mechanisms certain neurotransmitters will be depleted and certain receptors will be downregulated. Soon, the net result of increased cortisol will shift from lipolytic to lipogenic. And while the evolutionary reason for the stress could be the lack of food, now it is more probable that the stress will co-exist with abundance of food. Muscle will keep being catabolized and the glucose synthesized from the muscle protein will be turning into fat since the diet is not hypocaloric.

fls · 21st February 2008, 08:22 AM

Cortisol is involved in responses to stress and we find elevated levels with acute stress. What is less clear is what happens under conditions of chronic stress (cortisol levels are lower, rather than higher in a number of studies). And it is also unclear whether elevated cortisol levels associated with obesity are the cause of or are caused by obesity.

I looked around a bit for a decent review online. The introduction to this paper talks a bit about the issues and provides references.

The typical alt-med response to take a pill seems unwarranted. It makes more sense to me to attempt to modify your stress levels and follow sensible diet/exercise advice (which is what all of us should be doing anyway, right?

).

Linda

Leftus · 21st February 2008, 10:27 AM

At the prices I've seen the infomercials set for these pills I have to wonder why it's not being prescribed. I know my doctor isn't afraid of making money and these pills have to be a cash cow with all the overweight people, including me, there are in the world.

fls · 21st February 2008, 11:16 AM

Originally Posted by Leftus

At the prices I've seen the infomercials set for these pills I have to wonder why it's not being prescribed. I know my doctor isn't afraid of making money and these pills have to be a cash cow with all the overweight people, including me, there are in the world.

How would your doctor be able to make money by prescribing these pills?

Linda
(hoping that I can get in on the action)

bluess · 21st February 2008, 12:19 PM

As always, the JRef rocks. Thank you all for your responses. They have pretty much borne out my immediate response to all of the 'info' floating around.

Rolfe · 21st February 2008, 03:27 PM

Originally Posted by casebro

A friends golden retriever had Cushing's. Boy, was she bloated. Like a water bed mattress. If a human had that, treatment would commense lots earlier.

So should the dog's. However, I've a feeling that the preferred treatment (trilostane) is not licensed for canine use in the USA.

Rolfe.

casebro · 21st February 2008, 08:16 PM

Originally Posted by Rolfe

So should the dog's. However, I've a feeling that the preferred treatment (trilostane) is not licensed for canine use in the USA.

Rolfe.

I thought that if the dog wasn't eleven years old, they might have removed the adrenals? But that is assumtion that something else in the HPTA system is not the real culprit.

I'll have to look into the trilostane as a medical treatment, in case I ever get that bad.

Rolfe · 22nd February 2008, 03:24 AM

No, you don't remove the adrenals. That's because the adrenal medulla would be removed as well, the source of catecholamines, and this would be a Bad Thing. However, if the cause of the Cushing's is an adrenal tumour, this is probably unilateral, so removing the diseased adrenal only is a practical course of action - like kidneys, you can get by on one.

Most Cushing's cases however are pituitary in origin. In man, one of the preferred treatments is removal of the pituitary lesion. The original Cushing was a brain surgeon! This is not done in dogs.

There are two drugs (well three but we can forget ketoconazole because it's not a good idea) which will affect the adrenal cortex.

Mitotane is the older drug. It's never had any sort of product licence because it's not very safe (its effect is irreversible), but it can be used two ways. You can use a moderate dose to get adrenocortical activity down to acceptable levels, and then usually stay on maintenance treatment and this was done quite successfully for many years. Or else you can use a high dose to obliterate the adrenal cortex entirely and then maintain your patient on Addison's maintenance therapy. This latter was used more in Europe, and I've seen some good survival rates, but there were a lot of problems getting the right dose in the first place.

Trilostane is the newer drug. It is reversible in action (if you stop the drug the adrenals recover), and so safer, and so it is licensed. It can only be used for long term maintenance, as you can't completely nix the adrenals with it. Because of these factors it got a product licence, and now vets have to use it as first line treatment in all cases. If you feel a patient needs mitotane you have to go through a lot of regulatory hoops to get authorisation to import it as an unlicensed medicine. However, published survival rates are just about the same as moderate long-term mitotane maintenance in fact.

Last I heard of it, trilostane didn't have a produce licence in the USA, and there was a thriving black market.

Rolfe.

20th February 2008, 06:48 PM	#1
bluess Illuminator Join Date: Oct 2001 Location: Dithering between book choices in a shop somewhere. Posts: 3,431	Cortisol - Please 'Weigh In' I cast a cry out to the wonderful people on board - what is the scoop on stress/cortisol/weight? I am not a scientist or doctor, and really cannot tell whether the information I am finding on the web is worth anything. The basic tune on the web is that stress tells the body to release cortisol, and that cortisol tells your body that you may experience a famine any minute, and that results in your body storing calories right around the old tummy. I am not considering taking any of the lovely diet pills out there, and am reducing the stress in my life for a variety of other reasons, but would be interested in any comments. Thanks! Bluess
	__________________ 'Lord Emsworth, that amiable but bone-headed peer, stood at the window drooping like a wet sock.' -PG Wodehouse, The Crime Wave at Blandings

20th February 2008, 06:56 PM	#2
Gate2501 Graduate Poster Join Date: Jan 2008 Posts: 1,377	I think that it can raise your blood sugar if enough of it is in your system (cause it messes with your body's natural insulin somehow )... Which technically can make you gain weight. I would say that this effect is probably very minimal compared to things such as the amount of calories you consume daily. I do not know of any other effects that it would cause to make you store fat in specific areas of the body, that sounds like hogwash. Edit: I am no professional, I just looked it up a while back when I saw a commercial about a weight loss pill also.
	Last edited by Gate2501; 20th February 2008 at 07:00 PM.

21st February 2008, 03:50 AM	#3
Rolfe Anti-homeopathy illuminati member Join Date: Sep 2003 Location: NT 150 511 Posts: 34,320	Excuse please, nonsense post.
	__________________ "The way we vote will depend, ultimately, on whether we are persuaded to hope or to fear." - Aonghas MacNeacail, June 2012. Last edited by Rolfe; 21st February 2008 at 03:50 AM.

21st February 2008, 04:13 AM	#4
Professor Yaffle Butterbeans and Breadcrumbs Join Date: Jan 2007 Location: Emily's shop Posts: 15,337	I don't know how reliable this article is (I only glanced at it) but it seems to cover the area you are talking about. Note, I am not vouching for the contents, you will have to determine for yourself whether the information in it is reliable. http://thyroid.about.com/od/loseweig...a/cortisol.htm Anecdotally, my mam has Addison's disease, so doesn't produce any cortisol herself and she has to take medication to replace it. Before she was diagnosed, she did lose an awful lot of weight , so it may be that cortisol plays some role in weight, but I doubt that it is a simple relationship. She also completely lost her appetite and ate like a sparrow, so the relationship may be mediated via appetite - a lot of people overeat when they are stressed.
	__________________ I think you'll find it's a little bit more complicated than that. My blog "Well I think I've made it abundantly clear in this thread I have no idea what I'm talking about..." - truethat

21st February 2008, 06:45 AM	#5
casebro Philosopher Join Date: Jun 2005 Posts: 6,790	The theory may be good, but in vivo, cortisol levels high enough to cause problems are quite rare. Day to day stress will not raise your cortisol high enough to cause you any grief, but it sure is a good hook to get you to buy into yet another spurious weigh loss program. I've got type II diabetes. Plus an adrenal 'incidentaloma', a benign growth on an adrenal gland. Been through all those tests, lots of times. If MY cortisol is normal, so is yours. A friends golden retriever had Cushing's. Boy, was she bloated. Like a water bed mattress. If a human had that, treatment would commense lots earlier.
casebro Philosopher Join Date: Jun 2005 Posts: 6,790	__________________ Please pardon me for having ideas, not facts. Some have called me cynical, but I don't believe them. It's not how many breaths you take. It's how many times you have been breathless that counts.

21st February 2008, 06:58 AM	#6
El Greco Summer worshipper Join Date: Nov 2003 Location: Παρά θιν'αλός Posts: 14,267	Cortisol is basically a catabolic hormone. This means it will increase when your body senses a need for providing increased fuel. Such conditions include dieting and emotional stress. What elevated cortisol will do, among other things, is that it will increase the production of glucose via various pathways, including muscle and fat catabolism. Evolutionary speaking, this would help you deal with an emergency situation. And that emergency situation shouldn't last too long because you can't be fighting for your life for too much time. Interestingly, the initial, short-term effect of increased cortisol is elevated awareness and readiness. But what happens today is that emotional stress due to the rhythms of modern life often will prolong the stress periods. Cortisol will sometimes remain "chronically" elevated and the original short stress reflex will become chronic. This means that via various complex mechanisms certain neurotransmitters will be depleted and certain receptors will be downregulated. Soon, the net result of increased cortisol will shift from lipolytic to lipogenic. And while the evolutionary reason for the stress could be the lack of food, now it is more probable that the stress will co-exist with abundance of food. Muscle will keep being catabolized and the glucose synthesized from the muscle protein will be turning into fat since the diet is not hypocaloric.
	__________________ "Robbing a bank is no crime compared to owning one" - Bertolt Brecht "Let it go and come to bed already, El Greco" - MoeFaux Last edited by El Greco; 21st February 2008 at 07:00 AM.

21st February 2008, 08:22 AM	#7
fls Penultimate Amazing Join Date: Jan 2005 Posts: 10,236	Cortisol is involved in responses to stress and we find elevated levels with acute stress. What is less clear is what happens under conditions of chronic stress (cortisol levels are lower, rather than higher in a number of studies). And it is also unclear whether elevated cortisol levels associated with obesity are the cause of or are caused by obesity. I looked around a bit for a decent review online. The introduction to this paper talks a bit about the issues and provides references. The typical alt-med response to take a pill seems unwarranted. It makes more sense to me to attempt to modify your stress levels and follow sensible diet/exercise advice (which is what all of us should be doing anyway, right? ). Linda
	__________________ God:a capricious creative or controlling force said to be the subject of a religion. Evidence is anything that tends to make a proposition more or less true.-Loss Leader SCAM will now be referred to as DIM (Demonstrably Ineffective Medicine) Look how nicely I'm not reminding you you're dumb.-Happy Bunny When I give an example, do not assume I am excluding every other possible example. Thank you.

21st February 2008, 10:27 AM	#8
Leftus Thinker Join Date: Sep 2007 Posts: 156	At the prices I've seen the infomercials set for these pills I have to wonder why it's not being prescribed. I know my doctor isn't afraid of making money and these pills have to be a cash cow with all the overweight people, including me, there are in the world.
Leftus Thinker Join Date: Sep 2007 Posts: 156

21st February 2008, 11:16 AM	#9
fls Penultimate Amazing Join Date: Jan 2005 Posts: 10,236	Originally Posted by Leftus At the prices I've seen the infomercials set for these pills I have to wonder why it's not being prescribed. I know my doctor isn't afraid of making money and these pills have to be a cash cow with all the overweight people, including me, there are in the world. How would your doctor be able to make money by prescribing these pills? Linda (hoping that I can get in on the action)
	__________________ God:a capricious creative or controlling force said to be the subject of a religion. Evidence is anything that tends to make a proposition more or less true.-Loss Leader SCAM will now be referred to as DIM (Demonstrably Ineffective Medicine) Look how nicely I'm not reminding you you're dumb.-Happy Bunny When I give an example, do not assume I am excluding every other possible example. Thank you.

21st February 2008, 12:19 PM	#10
bluess Illuminator Join Date: Oct 2001 Location: Dithering between book choices in a shop somewhere. Posts: 3,431	As always, the JRef rocks. Thank you all for your responses. They have pretty much borne out my immediate response to all of the 'info' floating around.
	__________________ 'Lord Emsworth, that amiable but bone-headed peer, stood at the window drooping like a wet sock.' -PG Wodehouse, The Crime Wave at Blandings

21st February 2008, 03:27 PM	#11
Rolfe Anti-homeopathy illuminati member Join Date: Sep 2003 Location: NT 150 511 Posts: 34,320	Originally Posted by casebro A friends golden retriever had Cushing's. Boy, was she bloated. Like a water bed mattress. If a human had that, treatment would commense lots earlier. So should the dog's. However, I've a feeling that the preferred treatment (trilostane) is not licensed for canine use in the USA. Rolfe.
	__________________ "The way we vote will depend, ultimately, on whether we are persuaded to hope or to fear." - Aonghas MacNeacail, June 2012.

21st February 2008, 08:16 PM	#12
casebro Philosopher Join Date: Jun 2005 Posts: 6,790	Originally Posted by Rolfe So should the dog's. However, I've a feeling that the preferred treatment (trilostane) is not licensed for canine use in the USA. Rolfe. I thought that if the dog wasn't eleven years old, they might have removed the adrenals? But that is assumtion that something else in the HPTA system is not the real culprit. I'll have to look into the trilostane as a medical treatment, in case I ever get that bad.
casebro Philosopher Join Date: Jun 2005 Posts: 6,790	__________________ Please pardon me for having ideas, not facts. Some have called me cynical, but I don't believe them. It's not how many breaths you take. It's how many times you have been breathless that counts.

22nd February 2008, 03:24 AM	#13
Rolfe Anti-homeopathy illuminati member Join Date: Sep 2003 Location: NT 150 511 Posts: 34,320	No, you don't remove the adrenals. That's because the adrenal medulla would be removed as well, the source of catecholamines, and this would be a Bad Thing. However, if the cause of the Cushing's is an adrenal tumour, this is probably unilateral, so removing the diseased adrenal only is a practical course of action - like kidneys, you can get by on one. Most Cushing's cases however are pituitary in origin. In man, one of the preferred treatments is removal of the pituitary lesion. The original Cushing was a brain surgeon! This is not done in dogs. There are two drugs (well three but we can forget ketoconazole because it's not a good idea) which will affect the adrenal cortex. Mitotane is the older drug. It's never had any sort of product licence because it's not very safe (its effect is irreversible), but it can be used two ways. You can use a moderate dose to get adrenocortical activity down to acceptable levels, and then usually stay on maintenance treatment and this was done quite successfully for many years. Or else you can use a high dose to obliterate the adrenal cortex entirely and then maintain your patient on Addison's maintenance therapy. This latter was used more in Europe, and I've seen some good survival rates, but there were a lot of problems getting the right dose in the first place. Trilostane is the newer drug. It is reversible in action (if you stop the drug the adrenals recover), and so safer, and so it is licensed. It can only be used for long term maintenance, as you can't completely nix the adrenals with it. Because of these factors it got a product licence, and now vets have to use it as first line treatment in all cases. If you feel a patient needs mitotane you have to go through a lot of regulatory hoops to get authorisation to import it as an unlicensed medicine. However, published survival rates are just about the same as moderate long-term mitotane maintenance in fact. Last I heard of it, trilostane didn't have a produce licence in the USA, and there was a thriving black market. Rolfe.
	__________________ "The way we vote will depend, ultimately, on whether we are persuaded to hope or to fear." - Aonghas MacNeacail, June 2012.