Saturday, September 17, 2016

Take Control of Your Cortisol Levels - Use These 5x Stress-Modulating Diet, Lifestyle & Supplementation Rules Wisely

Always remember: You want to control cortisol, not eradicate it if you want to melt away your belly fat, beat your personal bests and feel just great!
As a SuppVersity reader, you belong to the chosen few who know that cortisol is not the villain as which it is stigmatized in the fitness industry (obviously to sell supplements | learn more). Rather than being "bad" or "good", cortisol, a glucocorticoid, i.e. a hormone that keeps your blood glucose stable, and potent anti-inflammatory agent, is more vital than any "vitamin" - in spite of not having the magic "vita" in its name.

Whether the effects of this vital adrenal hormone are going to be "bad" or "good" for you, depends mostly on whether it rises and falls according to its natural 24-h rhythm or is chronically low (often labeled adrenal insufficiency) or chronically high.
If you want to mess with your cortisol rhythm overtraining is exactly what you "need"!

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Now your diet alone will probably not suffice to induce one or the other state of chronically messed up cortisol (unless you eat (a) almost nothing while training like a maniac for weeks ⇉ low cortisol; or (b) too much of a typically Western diet ⇉ high cortisol). And yet, it is still a good idea to know more about the diet ⇆ cortisol interaction(s) to be able to maintain hormonal homeostasis, and the SuppVersity is obviously the right place to learn all about it.
Figure 1: Overview of the three areas of your physiology that are directly affected by the levels and rhythm of cortisol.
With the ever-increasing number of "functional" foods boasting of being able to modify health-relevant parameters, including your cortisol level and thus your ability to, through its
multipronged action, stabilize or mess with your blood levels of glucose, to stimulate your tissue's
regenerative processes and to inhibit inflammation in each and every organ of your body.

Figure 2: This is how cortisol is "made" in your body (Stachowicz. 2016). In theory, you can influence its concentration by modifying this cascade at any point.
As Stachowicz, et al. point out in a recent review of the literature they published in the peer-reviewed journal Eur Food Res Technol (Stachowicz. 2016), diet is obviously not the only factor that influences our cortisol levels. Of at least as much importance are "[f]actors like stressful work, personal problems, [and] intensive training" , which "can lead to long-term sustained, excessive concentration of this hormone, affecting formation of metabolic disorders such as insulin resistance, increased blood pressure, abnormal bone regeneration and collagen synthesis or calcium deficiency in the organism" (ibid.). Against that background, it is hardly surprising that various groups of the society try to modulate their cortisol levels in ways they consider healthy (again: low is not healthy!) by supplementing or eating / avoiding certain foods that contain nutrients which regulate steroid hormones homeostasis.
In the short term, e.g. strategic overreaching, your body can cope with the exercise induced release of cortisol, but when over-reaching becomes over-training you run the risk of plumetting into the deep dark valley of unsurmountable fatigue.
Excursion - Exercise and cortisol: Athletes experience substantial increases of cortisol and adrenaline during intense workouts. That's normal and even necessary to (a) keep your blood glucose levels stable and (b) train at high(est) intensities. In fact, studies have shown that in athletes with higher motivation and orientation on the success, levels of these hormones were higher than those of other players. As Stachowicz, et al. point out "[t]hey also generally achieve better results" (Obmiński. 2009). On the other hand, studies show that people who experience mental fatigue experience limited activity of pituitary gland and sympathetic nervous system - in other words low cortisol levels (or rather the absence of appropriate spikes in response to e.g. exercise and other stressors).
And that rightly so! After all, Stachowicz et al. (2016) rightly point out, a "balanced diet with optional supplementation is one of the important factors determining the high physical and mental capacity of organism" (ibid) - and this goes for everyone from the frail elderly over the hobby- and pro-athletes to the stressed manager or teacher, who are all "particularly exposed to abnormal secretion, metabolism and transport of hormones, including cortisol" (ibid.) - people who will probably know about the effects of chronic stress:
"It was shown that in stressful situations appetite for sweet and fat meals rises, probably because of their high rewarding character (Zellner. 2005). Consumption of meals induces [an] increase in cortisol level. This response is strongly marked in men than in women. Influence of kind of macronutrients in taken food on cortisol concentration was investigated in many [types of research], but the results are not clear" (Stachowicz. 2016). 
One of the best known (and most logical) effectors of cortisol production is the content and type of carbohydrates in your diet - especially if you're not a sedentary slob; after all, cortisol's main function as a glucocorticoid is to counter hypoglycemia.
  • Rule #1 (esp. for easily fatigued athletes) - Eat enough (or no) carbs: Eat either no carbs at all (ketogenic diet) or enough carbs before, during and after training to prevent hypoglycemic conditions (click here to learn why this will also help to stay lean) and thus an abnormally high intra- and post-workout spike of hydrocortisone in blood while the consumption of liquids (studies show that this takes some carbs, i.e. 7% vs. just 1.5% in the intra-workout beverage | cf. Ihalainen, 2014 vs. Caris, 2014).
  • Rule #2 - Don't believe everything the supplement industry claims: As Stachowicz et al. rightly point out, the impact of around training protein, glutamine, arginine or branched-chain amino acids (BCAA), on the other hand, "is not clear and requires testing on large groups of athletes of various disciplines" (Stachowicz. 2016).

    What has been shown to work is tryptophan, which is a precursor of serotonin, that will effectively ameliorate the cortisol level increase, during and after workouts, but its potential side effects (esp. performance decrements) have not been well-studied, yet. The same must be said of phosphatidylserine and phosphatidic acid, which have been shown to (a) normalize the stress reactivity of hypothalamus-pituaryadrenal-axis in chronically stressed men and to reduce the cortisol response to exercise in a sponsored trial in which it was administered at dosages of 400 mg/day for 6 weeks - the total number of studies to support PS as a useful supplement for anyone from manager to athlete and from elderly to toddler, however is low; oftentimes, there's sponsorship involved and long-term studies or studies that would evaluate the effect of cortisol control on the adaptational response to exercise are missing.
  • Rule #3 - Don't overrate its benefits but get enough protein (1.6-2.2 g/kg per day): As explained in rule #2, there's no evidence that simply adding more protein to your diet is going to help you control cortisol. In fact, eating too much protein and too little fat and carbs may chronically elevate the glucocorticoid, because it has to keep the production of glucose from amino acids in the liver, i.e. gluconeogenesis, working. That adequate protein intakes are necessary, on the other hand, is a logical consequence of the role of serine, taurine, and other amino acids play in the control of the balance and optimal function of your hypothalamus-pituitary-adrenal-axis.
  • Rule #4 - Optimize your sleep by sleep hygiene and (optional) supplements: By optimizing your sleep you can restore a normal and healthy circadian rhythm and thus battle what makes cortisol a problem for so many in our society directly. How's that? Well, as previously highlighted, it's not the cortisol spikes you experience in the AM and during and after workouts, but chronically elevated (or depleted) levels of cortisol and spikes that occur untimely (e.g. the "2AM wake-up call", when your cortisol rises way too early and you cannot sleep longer than until 1-3 AM).
    Figure 3: Optimal sleep, melatonin and cortisol patterns are mutually dependent in health and disease - if you mess up one with the way you behave / live and/or supplements you mess up all (Glickman. 2010).
    Next to using earplugs, a blindfold (or curtains to make sure light doesn't disturb your sleep), reducing your (blue) light exposure in the evening, and using a non-stressing alarm to tell you that it's time to go to bed, a sleep tracker to access whether your intervention is successful, your circadian rhythm restoration program may involve: (1) no caffeine, coffee, or other stimulants in the 6h window before bed (some people will have to extend this window even further); (2) GABA at doses of 100-500mg before bed (don't take more or you may faint); if you cannot tolerate GABA, try taurine, instead, it will also enter the brain and act on the GABA receptor (Song. 2003); (3) melatonin at dosages you will have to figure out yourself (start with 1-3mg and ramp up until you sleep well and wake up refreshed, not groggy, which is usually a side effect of taking (a) too much or (b) the by no means recommendable time-released melatonin preparations).  
  • Rule #5 - Strategically supplement with... In contrast to the previous rules, rule #5 is "optional" or facilitative. There's mixed evidence for some vitamins, namely vitamin C (500-1000 mg), vitamin E (400 IU+), vitamin D (>2,000 IU), as well as high doses of vitamin B1, B2, and niacin, which are involved in metabolism and production of cortisol, can lower the glucocorticoid response to exercise. 
    Figure 4: Sign. associations between PWO hormone levels and lean mass, as well as fiber size, increases (West. 2012) - they exist, but the largest and best study to investigate them clearly shows: It's cortisol that predicts lean mass gains (left) and GH that predicts the growth of individual fibers. High post-workout testosterone, however, predicts ... nothing (learn more) .
    At least for the former (vitamin C and vitamin E), however, it has also been shown that it will impair the exercise-induced adaptational processes, i.e. improved conditioning, muscle strength, and size when taken chronically. No wonder, if you think about the previously outlined beneficial effects of your body's most potent anti-inflammatory homrone, cortisol, (see Figure 4, too) on the regenerative process after workouts.

    The beneficial effects of a natural (controlled) cortisol response to exercise are something you should also keep in mind when using magnesium supplements which have been shown to blunt the cortisol increase to physical exercise in Golf et al. (1984) 32 years ago. Since newer studies were not generally able to confirm Golf's findings, though, I wouldn't be too afraid of (or rely too much on) magnesium's ability to lower your cortisol levels in non-(mg)-deficiency situations. That's particularly true in view of the fact that Cinar et al. saw a sign. increase in cortisol in response to a similar combination of magnesium supplementation (10 mg/kg b.w.) and physical activity in 2008. Stachowicz, et al. are thus right to point out that "[t]he impact of magnesium supplementation on cortisol levels in athletes is not clear and needs further investigation" (Stachowicz. 2016).
    Figure 5: While we do have evidence that boron will have opposing effects (vs. magnesium or the previously mentioned vitamins on cortisol), the existing evidence is far from being conclusive (Naghii. 2011).
    The same must be said of the cortisol modulating effects of a former star on the bodybuilding supplement sky that has been largely forgotten today: boron. While Naghii et al. (2011) confirmed relatively recently that a daily morning use of preparation containing 11.6 mg of boron, just after 1 week, results in increase in cortisol and free testosterone, dihydrotestosterone (DHT) and vitamin D while decreasing estradiol levels, we are far from being able to call boron a proven ergogenic - also because its long-term benefits appeared to be zero in most exercise-related long-term studies with relevant outcome parameters (not hormones, but gainz in performance, size or strength). The same must be said of fish oil, which has been shown to reduce perceived stress, green tea (EGCG), which is supposed to inhibit the activity of 11β-hydroxysteroid dehydrogenase type 1 that converts cortisone to cortisol, and betaine with one study backing its anti-cortisol effect in trained individuals (Apicella. 2013).

    Long-term data assessing its safety, and potential detrimental effects on testosterone is also lacking on the effectiveness of licorice, one of the few supplements of which we have reliable evidence that it affects (increases) cortisol. 
Cardio - Only significantly "too much" can hurt your circadian cortisol rhythm, but if it does, it trigger muscle loss, fatique and (in a caloric surplus) even fat gain | learn more.
So what's the verdict? Get your ducks in a row by following rules #1-4. If you still feel (or even better have evidence from multiple cortisol swap tests in 24h) that you cortisol rhythm is messed up (see Figure 3 for what you should look out), try using supplements like magnesium, green tea or b-vitamins to lower and boron or licorice to increase it strategically.

Needless to say that the latter will require proper timing with the supplements that lower cortisol being taken at times when you want cortisol to decrease (PM) and supplements that increase the glucocorticoid being taken at times when you want it to increase.

Why the timing? If you'd read the whole article and not just the bottom line you wouldn't be asking that, because you'd should know by now that you want a natural cycle of peaks and troughs, not chronically high or low levels (don't use supplements that block your body's ability to activate / deactivate cortisone <> cortisol completely, unless you've good medical reasons, to) of this important adrenal glucoregulatory + anti-inflammatory hormone  | Comment!
  • Caris, Aline V., et al. "Carbohydrate and glutamine supplementation modulates the Th1/Th2 balance after exercise performed at a simulated altitude of 4500 m." Nutrition 30.11 (2014): 1331-1336.
  • Cinar, Vedat, et al. "Adrenocorticotropic hormone and cortisol levels in athletes and sedentary subjects at rest and exhaustion: effects of magnesium supplementation." Biological trace element research 121.3 (2008): 215-220.
  • Glickman, Gena. "Circadian rhythms and sleep in children with autism." Neuroscience & Biobehavioral Reviews 34.5 (2010): 755-768.
  • Golf, S. W., et al. "Plasma aldosterone, cortisol and electrolyte concentrations in physical exercise after magnesium supplementation." Clinical Chemistry and Laboratory Medicine 22.11 (1984): 717-722.
  • Hellhammer, Juliane, et al. "A soy-based phosphatidylserine/phosphatidic acid complex (PAS) normalizes the stress reactivity of hypothalamus-pituitary-adrenal-axis in chronically stressed male subjects: a randomized, placebo-controlled study." Lipids in health and disease 13.1 (2014): 1.
  • Ihalainen, Johanna K., et al. "Effects of Carbohydrate Ingestion on Acute Leukocyte, Cortisol, and Interleukin-6 Response in High-Intensity Long-Distance Running." The Journal of Strength & Conditioning Research 28.10 (2014): 2786-2792.
  • Naghii, Mohammad Reza, et al. "Comparative effects of daily and weekly boron supplementation on plasma steroid hormones and proinflammatory cytokines." Journal of Trace Elements in Medicine and Biology 25.1 (2011): 54-58.
  • Obmiński, Zbigniew. "Pre-And Post-Start Hormone Levels In Blood As An Indicator Of Psycho-Physiological Load With Junior Judo Competitors." Polish Journal of Sport & Tourism 16.3 (2009).
  • Stachowicz, Marta, and Anna Lebiedzińska. "The effect of diet components on the level of cortisol." European Food Research and Technology (2016): 1-9.
  • Song, Zhilin, and Glenn I. Hatton. "Taurine and the control of basal hormone release from rat neurohypophysis." Experimental neurology 183.2 (2003): 330-337.
  • Zellner, Debra A., et al. "Food selection changes under stress." Physiology & Behavior 87.4 (2006): 789-793.