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The Consequences of Hypocortisolism

What is Hypocortisolism?

Hypocortisolism is when levels of cortisol itself switch from being chronically elevated to being too low.

Hypocortisolism has been found to occur in a number of different situations, all of which share the commonality of being related to or caused by chronically high levels of stress. One of these is burnout, due to work stress, which is characterised by physical exhaustion, depression and chronic inflammation. The risk of autoimmune disease may also increase. Burnout has also been related to an increased risk of heart disease, depression and immune system dysfunction.

Possibly related to burnout are diseases such as Post-Traumatic Stress Disorder (PTSD), fibromyalgia and chronic fatigue syndrome (CFS), all of which can be related to chronic stress and all of which show markedly similar symptoms of fatigue and exhaustion during the day. This fatigue is often coupled with sleep impairment, most likely due to the elevations in catecholamine levels (people are exhausted but overstimulated).

This sets up a vicious cycle, difficult to break, where stress leads to poor sleep which leads to an inability to cope with stress.

While not studied in the context of dieting itself, athletes may experience similar types of changes which are referred to as overtraining, the consequence of a long-term imbalance between the training being done and overall recovery (i.e. sufficient food intake, sleep, days off). A chronic stress situation, the earliest stages of this imbalance can cause performance to begin to decrease and here another vicious cycle occurs as athletes begin training harder, worsening the problem.

If this continues for extended periods, eventually overtraining will occur, marked by lethargy, a depressed immune system, a lack of motivation to train and mood changes such as depression. Muscles may feel chronically heavy or inflamed and athletes in some sports find it impossible to raise their heart rate or perform and this is a clear indication that the body is no longer able to mount a stress response.

The specific cause of overtraining is currently unknown but it is clearly a response to chronic stress and represents a type of adrenal insufficiency.

At the extremes of true overtraining, athletes may take months to fully recover completely.

In the aftermath, fatigue, lethargy, depression, chronic inflammation, impaired immune system function and a host of others all occur and this comes along with low morning cortisol, low levels of overall cortisol and a general inability to increase cortisol in response to stress.

Coach HB

The above information is taken from the The Woman's Book by Lyle Mcdonald with Eric Elms

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