When I last discussed cortisol, and my feeling that I may have excess amounts of it, I overlooked mentioning the insomnia issue as a reason I suspect high cortisol. Lack of sleep causes higher cortisol. Higher cortisol also in turn leads to poorer sleep, or lack of sleep. Kind of a vicious cycle, and one I’ve been trapped in. Increased cortisol thus seems like it’s been both a result of my sleep problems, and possibly a factor hurting my sleep, too.
Lately, partly due to focusing on improving my sleep (also by working on actively reducing cortisol), I have had some success. Happily! I even had two good nights’ sleep in a row, last night and the night before. This is big for me! I feel like I am on the right path, for sleep.
Another symptom of high cortisol is storage of body fat on the upper body (called dyslipidemia). I didn’t mention here, in my prior cortisol post, that this may relate to my not-receding armpit fat. Yes, fat in my armpits. I had very high stress for many years, which no doubt contributed to storing fat there and in fact broadly across my upper body. Now, much of that fat has dissolved but a noticeable amount of armpit fat remains; I wonder if it will ever all go away. Anyway, I’m just mentioning it as another factor I failed to mention here that makes me suspect lingering high cortisol for myself.
So, back in my initial cortisol post, one of my links was to a post on Chris Kresser’s blog, which said that low-carb/keto may increase cortisol for (some) women. To support that point, that blog post referenced a study of 21 participants. My bloggy friend Siobhan commented that perhaps this study shouldn’t carry much weight due to its small size. Fair enough, so I investigated it a little more, and found that Peter Attia also discussed the same study (if you don’t know Attia, he’s a brilliant MD and athlete who has spent a lot of time and effort personally and professionally studying low-carb and ketogenic diets, and who understands the science on what seems like a genius level). Attia promised a future post to discuss both the raised cortisol findings in that study, and impact on thyroid hormones, TSH and T4. He even refused to comment on the cortisol and thyroid findings until that later, promised post, but unfortunately, he never wrote that promised post. So, we don’t have his thoughts on the higher cortisol findings (and lower thyroid activity found) in that study. But, Attia seemed to actually like and actually champion other results of this study, and I don’t see him saying anything remotely like, “study too small, ignore.” He even titles his post, “Good Science, Bad Interpretation,” suggesting he actually thinks its a good study. Check out his post here.
So, there’s a voice I trust (Attia’s) saying that this study is good, along with Chris Kresser’s vote of approval, that this study has credibility.
Siobhan’s other criticism of the study was that its description of the diets as “very low-carb” was inaccurate because they were 2,000 calories/day and 10% carb. This means 200 calories of carb, which is 50 g carb, which is what I did for basically a year (though for some periods for that year my carb intake was even lower). I think Siobhan was implying that true “very low carb” should be LESS carbs than this. But, for me, 50g carb/day matches my own diet pretty precisely. And, if eating “only” 50 g carb/day can increase cortisol, then surely eating even lower carb than this must also increase cortisol, too.
The Paleo Mom says that cortisol “necessarily” rises on keto/low-carb because that’s the mechanism by which your body makes its own glucose – and of course, making your own glucose internally is necessary when your body isn’t getting the glucose it needs to function from the diet. No one, not even in LC and keto communities, disputes that your body and brain need at least about 135 g of glucose/day, the only dispute is whether you need to *eat food* for that glucose (what the high-carbers claim) or whether your body makes that glucose itself through gluceneogenesis (what low carbers claim, and which I believe the biochemistry is actually very well-established on). To my mind, there is no real dispute: eat low to no carb and you’ll find immediately that you do NOT drop dead, which means that your body does indeed make its own glucose. We can all prove this ourselves inside of 2 days. But, I never really understand the pathway or mechanism by which the glucose-making process occurred. Now, it looks like that process involves cortisol. Check out The Paleo Mom’s explanation why here. And/or, Amy Berger at Tuit Nutrition, a nutritionist who I highly respect, also points out that yes, it’s cortisol that stimulates gluconeogenesis.
I also found a T-nation article about managing cortisol in the low-carb context, and it explains that exercise-induced cortisol increases are higher when low-carbing, which would of course apply directly to me. This article suggests managing this by eating carbs around workouts and replacing many/most lost carbs with protein (not just fat).
The article also:
- Posits that long-term low-carb depletes glycogen and depleted glycogen naturally leads to increased cortisol, as it’s the relevant mechanism to raise blood glucose (echoing what Paleo Mom and Amy Berger say above about cortisol being the trigger for the body making it’s own glucose)
- Mentions that excess cortisol blocks conversion of T4 to T3, creating thyroid deficiency (something I tested positive for a little over a year ago for the first time in my life).
- This parallels another reference I found saying that low-carb, being suppressive of insulin, can also suppress thyroid activity because the body needs insulin to convert T4 to T3. So, there may be a double whammy on the thyroid here, at least for susceptible populations?
- This particular article describes “low carb” as getting 25-30% of one’s calories from carbs. So for a 2,000 calorie diet, this would be 600 carb calories or 150 g carbs.
I located a study that showed that people that more prone to stress (as I am) tend to have a lower cortisol response to stress when eating higher-carb.
I also found a study showing that, people secrete different amounts of cortisol in response to stress. I suspect my body is an over-achiever on this front🙂
People prone to gain weight around the abdomen (versus the hips and thighs) tend to secrete more cortisol than others. Yup, that’s me again! I’ve substantially changed my body shape over the past 2+ years of LCHF and regular exercise, but still the belly fat remains (some of which surely is loose skin but a good bit of it is just plain ole fat).
(This somewhat parallels Dr Joseph Kraft’s findings that different people secrete different amounts of insulin in response to a glucose challenge. This was true even in young, healthy populations! See a rundown of his findings here. So, some people can by hyper-secretors of one or more hormones. This suggests that people can be hypo-secretors, too? And that secretion of hormones is, like many things, a spectrum of possible outcomes. This might explain part of differences in metabolic responses – varying levels of secretion of varying hormones.)
I’ve read (IIRC) Dr Barbara Berkeley of Refuse to Regain mention in her blog posts (though I can’t find the reference now) that those of us with histories of obesity tend to be hyper-secretors of insulin, which is why we must be so careful with going off-plan and why weight re-gain occurs so easily.
I suspect myself of being a hyper-secretor of cortisol, and possibly insulin, given my long history of obesity.
So, in light of all this, I’ve revised how I eat, at least to try it out. I considered Paleo Mom’s advice for what carbs can be added: for those with history of metabolic dysfunction (like me), she recommends continued to permanent avoidance of fructose. This resonates for me, since I had my most dramatic success with changing how I eat, just in the first 3 months, where I wasn’t even very low-carb, I just cut most (not even all!) added sugar from my diet, and just cut back (not cut out!) carbs, to 1 serving or portion per meal. In fact, in those days, I was still having a teaspoon of sugar in my daily coffee! For me this is shocking, at this stage, to consider putting a spoon of *straight sugar* basically straight into my mouth. But even doing so, cutting back fructose nearly totally was transformative. This means I need to consider being careful with fruit going forward, or at least try this approach – more carbs, but maybe not from fruit.
I’ve also tried the T-Nation advice, to add the extra carbs in around workouts, either before, during and/or after. I have added some fruit around workouts, partly because I just believe that it’s better to eat an unprocessed, whole food than some manufactured “bar” and if those are the choices, I will be choosing fruit at least sometimes.
It’s been tougher to add carbs back than I expected. I still end up some days around 50 g carbs, but most days, I’m more like 75-85, and some days I even hit 125-135. These are total carbs, not “net” where fiber has been subtracted. I initially tried to get these in around workouts, but I also read that carbs at night can help sleep, so that’s empowered me to just have them whenever. And the results so far? As I mentioned above, my sleep is improving. My weight is improving, having gone down a bit. I can’t report honestly on what that is today, being TOM, but my Happy Scale daily average is down to 177.2, the lowest (or nearly so) that it’s been since I started using it. I feel like I am hitting a metabolic “zone”, like I am slimmer, and like I am stronger in my workouts. I expect the “slimmer” part to show up on the scale any day.
I do expect it to take weeks to months to alter hormonal levels and patterns, so I expect my cortisol-reducing action plan to continue. And, for now, so far, so good.
I’ve read in several places people saying, calories matter, but hormones matter more. Isn’t this what Gary Taubes has essentially been saying all along? He really focused on the hormone insulin but obviously there are lot of hormones flowing in all our bodies, and more hormones than just insulin affect body weight. For me, focusing on cortisol – and reducing it – seems to be helping.