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Recent Longevity News for the seven days ending 10/19/11.  You should consult your doctor if you are taking any medications.

Omega-3 fatty acids shown to prevent or slow progression of osteoarthritis - Science Daily, 10/17/11 - "New research has shown for the first time that omega-3 in fish oil could "substantially and significantly" reduce the signs and symptoms of osteoarthritis ... omega-3-rich diets fed to guinea pigs, which naturally develop osteoarthritis, reduced disease by 50 per cent compared to a standard diet ... Furthermore, there was strong evidence that omega-3 influences the biochemistry of the disease, and therefore not only helps prevent disease, but also slows its progression, potentially controlling established osteoarthritis ... The only way of being certain that the effects of omega-3 are as applicable to humans as demonstrated in guinea pigs is to apply omega-3 to humans. However, osteoarthritis in guinea pigs is perhaps the most appropriate model for spontaneous, naturally occurring osteoarthritis, and all of the evidence supports the use of omega-3 in human disease ... Most diets in the developed world are lacking in omega-3, with modern diets having up to 30 times too much omega-6 and too little omega-3. Taking omega-3 will help redress this imbalance and may positively contribute to a range of other health problems such as heart disease and colitis" - See Mega Twin EPA at Amazon.com and Jarrow Max DHA at Amazon.com.

Musical aptitude relates to reading ability - Science Daily, 10/16/11 - "poor readers had reduced neural response (auditory brainstem activity) to rhythmic rather than random sounds compared to good readers. In fact the level of neural enhancement to acoustic regularities correlated with reading ability as well as musical aptitude. The musical ability test, specifically the rhythm aspect, was also related to reading ability. Similarly a good score on the auditory working memory related to better reading and to the rhythm aspect of musical ability" - Note:  I'm a karaoke fan so I found it interesting even if no one else does.

Multivitamins and mortality: ‘Seeing-what-you-want’ science - Nutra USA, 10/14/11 - "The problem with these studies is that they don't show cause-and-effect. The researchers could not surmise any mechanism for the increased deaths related to vitamin E use. The problem is that men with prostate cancer take more supplements and in higher doses. They may have also been wearing tennis shoes. But obviously these are only associated factors, not causal factors ... So what to make of all this? It’s a high profile journal with a reputation of only publishing damning studies about supplements – look to the likes of the American Journal of Clinical Nutrition or the Journal of Nutrition and you will see tens, even hundreds of studies reporting benefits of good nutrition, of which supplements play a role. JAMA has a better PR department, it would seem, and the medical community looks to it with reverence – don’t get me wrong, it is a great journal… for medical research" - Note:  I nearly have a Fred Sanford coronary when I visit someone's house and see the supplements they are taking.  They obviously hadn't done any research.  Things like taking huge quantities of the alpha form of vitamin E that they bought in some half gallon container at Wal-Mart when doing that has been shown to cause a deficiency of the other forms of vitamin E.  Same for carotenoids, the wrong form of vitamin d, selenium, magnesium, etc.

Gut bacteria may affect whether a statin drug lowers cholesterol - Science Daily, 10/13/11 - "Among the group who had a strong response to the drug, three bile acids appeared to play a role. The bile acids are produced by certain gut bacteria, which are increasingly understood as factories for chemicals that can contribute to a state of health. Among the people who responded poorly to the statin, five different bile acids were commonly evident ... new strategies could be developed to manipulate the gut microbiome using probiotics to spur different gut bacteria, which could then give the drugs a boost" - See probiotics at Amazon.com.

Eating green veggies improves immune defenses - Science Daily, 10/13/11 - "green vegetables -- from bok choy to broccoli -- are the source of a chemical signal that is important to a fully functioning immune system. They do this by ensuring that immune cells in the gut and the skin known as intra-epithelial lymphocytes (IELs) function properly ... After feeding otherwise healthy mice a vegetable-poor diet for two to three weeks, I was amazed to see 70 to 80 percent of these protective cells disappeared"

The Impact of Current BPH Treatment on Sexual Function - Medscape, 10/13/11 - See table one.  Some of those medications were less than the placebo.  For example, Alfuzosin had a 3% ED rate but the placebo was 4%.  The article didn't cover gynecomastia which can be a problem with BPH treatments.  Some studies support letrozole to prevent gynecomastia.  I take a quarter tablet every other day.

  • Prostate Drug May Not Dim Sex - WebMD, 6/26/07 - "Six months after the men started taking their assigned drugs, the survey scores were about three points higher for the men taking Proscar. By the end of the study, that gap narrowed to about two points"

Watching Your Protein May Be Key to Weight Control - WebMD, 10/12/11 - "men and women fed a 10% protein diet ate 12% more calories over four days than they did on a 15% protein diet ... When protein in the diet goes too low, ''We keep eating in an attempt to attain our target level of protein," ... As the protein declined to 10%, the men and women tended to eat more carbohydrates and fat-containing food, boosting the risk for weight gain. But Gosby found that increasing the protein from 15% to 25% didn't seem to make any difference in total calories eaten ... Aiming at 15%-25% of total energy intake as protein seems about right for a moderately active person" - [Science Daily]

Secrets to squashing hidden household germs - MSNBC, 10/12/11 - 4:08 video.

Folic acid supplements in early pregnancy may reduce the risk of severe language delay in children - Science Daily, 10/12/11 - "mothers who took folic acid supplements from 4 weeks before to 8 weeks after conception reported a significantly lower prevalence of severe language delay in their children at age 3 ... Unlike the United States, Norway does not fortify foods with folic acid -- a fact that increases the contrast between women who do and do not take folic acid supplements and makes Norway a good place to study this effect"

Vitamin D crucial in human immune response to tuberculosis, scientists find - Science Daily, 10/12/11 - "The team found that T cells, which are white blood cells that play a central role in immunity, release a protein called interferon-g that triggers communication between cells and directs infected immune cells to attack the invading tuberculosis bacteria. However, this activation requires sufficient levels of vitamin D to be effective ... Researchers next tested serum taken from blood samples in healthy humans, both with and without sufficient levels of vitamin D. They found that the immune response was not triggered in the serum with lower vitamin D levels, as is found in many African Americans. But, when adequate vitamin D was added to this deficient serum, the immune response was effectively activated ... vitamin D may help both innate and adaptive immunity, two systems that work synergistically together to fight infections" - See vitamin D at Amazon.com.

Link shown between environmental toxicants and atherosclerosis - Science Daily, 10/11/11 - "Environmental toxicants such as dioxins, PCBs, and pesticides can pose a risk for cardiovascular disease ... The current study measured the circulating levels of the above group of compounds in about 1,000 Swedes living in Uppsala ... The findings show a clear connection between increasing levels of environmental toxicants and atherosclerosis"

Eating your greens can change the effect of your genes on heart disease - Science Daily, 10/11/11 - "The research, which represents one of the largest gene-diet interaction studies ever conducted on cardiovascular disease, involved the analysis of more than 27,000 individuals from five ethnicities -- European, South Asian, Chinese, Latin American and Arab -- and the affect that their diets had on the effect of the 9p21 gene. The results suggest that individuals with the high risk genotype who consumed a prudent diet, composed mainly of raw vegetables, fruits and berries, had a similar risk of heart attack to those with the low risk genotype"

Abstracts from this week's Doctor's Guide Nutrition/Dietetics plus abstracts from my RSS feeds (Click here for the journals, the PubMed ones at the top):

Omega-3 Fatty Acids Eicosapentaenoic Acid and Docosahexaenoic Acid in the Management of Hypercalciuric Stone Formers - Urology. 2011 Oct 13 - "All patients received empiric dietary recommendations for intake of fluids, sodium, protein, and citric juices. All subjects with hypercalciuria (urinary calcium >250 mg/d for males or >200 mg/d for females) on at least two 24-hour urine collections were counseled to supplement their diet with fish oil (1200 mg/d) ... Twenty-nine patients were followed for 9.86 +/- 8.96 months. The mean age was 43.38 +/- 13.78 years. Urinary calcium levels decreased in 52% of patients, with 24% converting to normocalciuria. The average urinary calcium (mg/d) decreased significantly from baseline (329.27 +/- 96.23 to 247.47 +/- 84.53, P <.0001). Urinary oxalate excretion decreased in 34% of patients. The average urinary oxalate (mg/d) decreased significantly from baseline (45.40 +/- 9.90 to 32.9 +/- 8.21, P = .0004). Urinary citrate (mg/d) increased in 62% of subjects from baseline (731.67 +/- 279.09 to 940.22 +/- 437.54, P = .0005). Calcium oxalate supersaturation decreased in 38% of the subjects significantly from baseline (9.73 +/- 4.48 to 3.68 +/- 1.76, P = .001)" - See Mega Twin EPA at Amazon.com and Jarrow Max DHA at Amazon.com.

Periodontal Disease and Decreased Kidney Function in Japanese Elderly - Am J Kidney Dis. 2011 Oct 14 - "periodontal inflamed surface area (PISA) ... During the 2-year follow-up (2003-2005), 45 participants (14.2%) developed decreased kidney function. The highest PISA quartile was associated significantly with a greater cumulative incidence of decreased kidney function (OR, 2.24; 95% CI, 1.05-4.79) than the referent group (the other 3 quartiles) after adjusting for covariates" - Note:  Out of my pet peeves, people not getting their teeth cleaned is up there.  Besides causing heart disease, kidney disease and probably other problems that haven't been researched yet, it’s as offensive as the odor from road kill while I jogging.  It’s probably a similar bacteria. Some lady at my ballroom dance place on Friday night was knocking me over from 15 feet away.  Here's my suggestion along with frequent dental cleaning by a dental hygienist:

Lactobacillus gasseri suppresses Th17 pro-inflammatory response and attenuates allergen-induced airway inflammation in a mouse model of allergic asthma - Br J Nutr. 2011 Oct 14:1-10 - "Our results showed that oral administration of a high dose of L. gasseri (4 × 106 CFU) decreased airway responsiveness to methacholine, attenuated the influx of inflammatory cells to the airways and reduced the levels of TNF-α, thymus and activation-regulated chemokine (TARC) and IL-17A in BAL fluids of Der p-sensitised and -challenged mice. Moreover, L. gasseri decreased IL-17A production in transforming growth factor-α and IL-6 stimulated splenocytes and cell numbers of IL-17 producing alveolar macrophages in L. gasseri-treated mice as compared to non-treated, Der p-sensitised and -challenged mice. In conclusion, oral administration with L. gasseri can attenuate major characteristics of allergen-induced airway inflammation and IL-17 pro-inflammatory immune response in a mouse model of allergic asthma, which may have clinical implication in the preventive or therapeutic potential in allergic asthma" - See probiotics at Amazon.com.

Oral inoculation of probiotics Lactobacillus acidophilus NCFM suppresses tumour growth both in segmental orthotopic colon cancer and extra-intestinal tissue - Br J Nutr. 2011 Sep 30:1-12 - "Modulation of the cellular response by the administration of probiotic bacteria may be an effective strategy for preventing or inhibiting tumour growth. We orally pre-inoculated mice with probiotics Lactobacillus acidophilus NCFM (La) for 14 d. Subcutaneous dorsal-flank tumours and segmental orthotopic colon cancers were implanted into mice using CT-26 murine colon adenocarcinoma cells. On day 28 after tumour initiation, the lamina propria of the colon, mesenteric lymph nodes (MLN) and spleen were harvested and purified for flow cytometry and mRNA analyses. We demonstrated that La pre-inoculation reduced tumour volume growth by 50.3 %, compared with untreated mice at 28 d after tumour implants (2465.5 (sem 1290.4) v. 4950.9 (sem 1689.3) mm3, P < 0.001)" - See probiotics at Amazon.com.

Green tea polyphenol epigallocatechin-3-gallate suppresses melanoma growth by inhibiting inflammasome and IL-1β secretion - Biochem Biophys Res Commun. 2011 Oct 1 - "This paper provides a novel mechanism for EGCG-induced melanoma inhibition: inflammasome downregulation→decreased IL-1β secretion→decreased NF-κB activities→decreased cell growth. In addition, it suggests inflammasomes and IL-1β could be potential targets for future melanoma therapeutics" - See green tea extract at Amazon.com.

Protective Effect of Lycopene against Radiation-induced Hepatic Toxicity in Rats - J Int Med Res. 2011;39(4):1239-52 - "Lycopene supplementation significantly reduced radiotherapy-induced oxidative liver injury" - See lycopene at Amazon.com.

Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT) - JAMA. 2011 Oct 12;306(14):1549-56 - "Oral selenium (200 μg/d from L-selenomethionine) with matched vitamin E placebo, vitamin E (400 IU/d of all rac-α-tocopheryl acetate) with matched selenium placebo, both agents, or both matched placebos for a planned follow-up of a minimum of 7 and maximum of 12 years ... This report includes 54,464 additional person-years of follow-up and 521 additional cases of prostate cancer since the primary report. Compared with the placebo (referent group) in which 529 men developed prostate cancer, 620 men in the vitamin E group developed prostate cancer (hazard ratio [HR], 1.17; 99% CI, 1.004-1.36, P = .008); as did 575 in the selenium group (HR, 1.09; 99% CI, 0.93-1.27; P = .18), and 555 in the selenium plus vitamin E group (HR, 1.05; 99% CI, 0.89-1.22, P = .46). Compared with placebo, the absolute increase in risk of prostate cancer per 1000 person-years was 1.6 for vitamin E, 0.8 for selenium, and 0.4 for the combination" - Note:  The study used rac-α-tocopheryl acetate.  See my vitamin E page for several articles regarding taking only one of the  eight forms of vitamin E.  See Jarrow FamilE (contains all eight members of the vitamin E family, includes Tocomin) at Amazon.com.

Fish Consumption and Ischemic stroke in Southern Sweden - Nutr J. 2011 Oct 11;10(1):109 - "Stroke risk decreased with fat fish intake ([greater than or equal to] 1/week versus <1/month) in both men and women; adjusted pooled Odds Ratio (OR) 0.69, 95% Confidence Interval (CI): 0.54-0.89. However, stroke risk for women increased with intake of lean fish; adjusted OR 1.63 (95% CI: 1.17-2.28), whereas there was no association with men's lean fish intake; adjusted OR 0.97(95% CI: 0.73-1.27). Fish intake was self-reported retrospectively, yielding uncertain exposure assessment and potential recall bias. The findings regarding lean fish would be explained by recall bias if an individual's inclination to report lean fish consumption depended on both disease status and sex. The fact that the association between fat fish intake and stroke was similar in men and women does not support such a differential in recall ... The results suggest fat fish intake to decrease ischemic stroke risk and lean fish intake to increase women's stroke risk. The inconsistent relationship between fish intake and stroke risk reported in previous studies is further stressed by the results of this study"

Change in high-density lipoprotein cholesterol and risk of subsequent hospitalization for coronary artery disease or stroke among patients with type 2 diabetes mellitus - Am J Cardiol. 2011 Oct 15;108(8):1124-8 - "During a mean follow-up of 55.8 +/- 23.8 months, 3,023 patients (10.1%) experienced a CVD hospitalization. After multivariate adjustment, each 5 mg/dl of baseline HDL cholesterol was significantly associated with a 6% lower CVD hospitalization risk (hazard ratio 0.94 per 5 mg/dl, 95% confidence interval 0.92 to 0.95, p <0.0001) and each 5-mg/dl increase in HDL cholesterol was associated with a 4% CVD risk reduction (hazard ratio 0.96, 95% confidence interval 0.94 to 0.99, p <0.003). In the categorical analysis, a ≥6.5-mg/dl HDL cholesterol decrease was associated with an 11% increased CVD risk (hazard ratio 1.11, 95% confidence interval 1.00 to 1.24, p = 0.047) and a ≥6.5-mg/dl increase was associated with an 8% CVD risk reduction (hazard ratio 0.92, 95% confidence interval 0.84 to 1.01, p = 0.077) relative to those with stable HDL cholesterol"

Benefit of early statin therapy in patients with acute myocardial infarction who have extremely low low-density lipoprotein cholesterol - J Am Coll Cardiol. 2011 Oct 11;58(16):1664-71 - "Intensive lipid-lowering therapy with a target LDL-C value <70 mg/dl is recommended in patients with very high cardiovascular risk. However, whether to use statin therapy in patients with baseline LDL-C levels below 70 mg/dl is controversial ... Statin therapy significantly reduced the risk of the composite primary endpoint (adjusted hazard ratio [HR]: 0.56; 95% confidence interval [CI]: 0.34 to 0.89; p = 0.015). Statin therapy reduced the risk of cardiac death (HR: 0.47; 95% CI: 0.23 to 0.93; p = 0.031) and coronary revascularization (HR: 0.45, 95% CI: 0.24 to 0.85; p = 0.013). However, there were no differences in the risk of the composite of all-cause death, recurrent MI, and repeated percutaneous coronary intervention rate"

High Serum Testosterone Is Associated With Reduced Risk of Cardiovascular Events in Elderly Men The MrOS (Osteoporotic Fractures in Men) Study in Sweden - J Am Coll Cardiol. 2011 Oct 11;58(16):1674-81 - "During a median 5-year follow-up, 485 CV events occurred. Both total testosterone and SHBG levels were inversely associated with the risk of CV events (trend over quartiles: p = 0.009 and p = 0.012, respectively). Men in the highest quartile of testosterone (≥550 ng/dl) had a lower risk of CV events compared with men in the 3 lower quartiles (hazard ratio: 0.70, 95% confidence interval: 0.56 to 0.88). This association remained after adjustment for traditional CV risk factors and was not materially changed in analyses excluding men with known CV disease at baseline (hazard ratio: 0.71, 95% confidence interval: 0.53 to 0.95). In models that included both testosterone and SHBG, testosterone but not SHBG predicted CV risk"

Neat Tech Stuff / "How To's":

  • Black Diamond Sprinter Headlamp - I bought one of these for when I run in the morning and it's still dark.  It's great plus it's good that have around for electrical outages, running wires through the attic, soldering, etc.  There are cheaper ones but this one is rechargeable so you make it up in the cost of batteries plus it's lighter and a lot brighter (68 llumens) than the others I've seen.

Health Focus (Cortisol):

Related Topics:

Note:  To lower cortisol, I feel the best way to go is phosphatidylserine (PS), Remeron (mirtazapine) and/or Avandia (rosiglitazone) although there is only one study on mice that I know of with Avandia.  An effective PS dose of 800 mg per day lowered cortisol in one study by 30%.  However that amount runs about $6 per day.  See my dedicated page on the only study I've seen regarding Remeron (an antidepressant).  Click here for articles on Avandia.  Remeron and Avandia are available through OffshoreRx1.combut check with a doctor before taking any supplement or medication.

I was watching Dr. Perricone anti-aging lectures on PBS in late August 2002 and he claims that DHEA can help protect the brain from the negative effects of cortisol.

Popular Supplements thought to Reduce Cortisol:

Medications that may reduce cortisol:

The important news:

  • Mortality and Morbidity in Cushing's Syndrome in New Zealand - Clin Endocrinol (Oxf). 2011 May 24 - "36 patients died during follow-up compared with 8.8 expected deaths (SMR 4.1, 95%CI 2.9-5.6) ... CS is associated with both high mortality and a high prevalence of co-morbidities, even when biochemical cure rates are between 80-90"
  • Older age memory loss tied to stress hormone receptor in brain - Science Daily, 4/6/11 - "one receptor was activated by low levels of cortisol, which helped memory. However, once levels of this stress hormone were too high they spilled over onto a second receptor. This activates brain processes that contribute to memory impairment ... high levels of the stress hormone in aged mice made them less able to remember how to navigate a maze. The memory recall problem was reversed when the receptor linked to poor memory was blocked ... lowering the levels of these stress hormones will prevent them from activating a receptor in the brain that is bad for memory ... The researchers are currently investigating a new chemical compound which blocks an enzyme -- 11beta-HSD1 -- that is involved in producing stress hormones within cells"
  • High blood cortisol levels significantly increases death rate in patients with acute coronary syndrome - Science Daily, 5/27/10 - "1036 patients with acute coronary syndrome were studied for an average period of 7.7 years. There were no significant differences in the serum cortisol levels between patients with and without acute coronary syndrome. However, the patients with ACS and high cortisol levels had a significantly elevated number of deaths when compared to the patients with ACS and the lowest cortisol levels. 758 total deaths were reported during the follow-up period. The ACS patients with the highest cortisol levels (i.e. the highest 25% serum cortisol) were significantly more likely to die from fatal cardiovascular events than those with the lowest cortisol levels (the lowest 25% serum cortisol). (The hazard ratio for highest versus lowest quartile of SCC was 1.89"
  • The relationship of serum and salivary cortisol levels to male sexual dysfunction as measured by the International Index of Erectile Function - Int J Impot Res. 2009 May 7 - "testosterone (T) and cortisol (F) ... (Total-T, Free-T, Bioavailable-T, Total-F and Bioavailable-F) and salivary hormones (Saliva-T and Saliva-F) ... International Index of Erectile Function (IIEF) ... Free-T and Bioavailable-T showed significant inverse correlations with age (P<0.01). In the group not taking antidepressants, the levels of Bioavailable-F and Saliva-F showed significant inverse correlations with a portion of the IIEF score (P<0.05). However, reductions in Bioavailable-T and Saliva-T showed no association with the IIEF score. In the group taking antidepressants, these hormone levels showed no correlation with IIEF"
  • Effects of phosphatidylserine supplementation on exercising humans - Sports Med. 2006;36(8):657-69 - "S-PtdSer 800 mg/day reduced the cortisol response to overtraining during weight training while improving feeling of well-being and decreasing perceived muscle soreness"
  • Associations of salivary cortisol with cognitive function in the Baltimore memory study - Arch Gen Psychiatry. 2007 Jul;64(7):810-8 - "Higher levels of pretest and mean cortisol as well as the area under the curve of cortisol over the study visit were associated with worse performance (P < .05) in 6 domains (language, processing speed, eye-hand coordination, executive functioning, verbal memory and learning, and visual memory). For instance, an interquartile range increase in the area under the curve was equivalent to a decrease in the language score expected from an increase in 5.6 (95% confidence interval, 4.2-7.1) years of age"
  • Chronic Exposure To Stress Hormone Causes Anxious Behavior In Mice - Science Daily, 4/17/06 - "Scientists already knew that many people with depression have high levels of cortisol, a human stress hormone, but it wasn't clear whether that was a cause or effect. Now it appears likely that long-term exposure to cortisol actually contributes to the symptoms of depression"
  • Pharmacologic management of Cushing syndrome : new targets for therapy - Treat Endocrinol. 2005;4(2):87-94 - "Compounds with neuromodulatory properties have been effective in only a limited number of cases of hypothalamic-pituitary-dependent Cushing disease, the most common form of Cushing syndrome. These agents include serotonin antagonists (cyproheptadine, ketanserin, ritanserin), dopamine agonists (bromocriptine, cabergoline), GABA agonists (valproic acid [sodium valproate]), and somatostatin analogs (octreotide). Interesting new avenues at the pituitary level involve the potential use of thiazolidinedione compounds, such as rosiglitazone, and of retinoic acid, which are ligands of different nuclear hormone receptors involved in hypothalamic-pituitary regulation"
  • Diabetes Drugs May Help Cushing's Syndrome - Reuters Wire, 11/07/2002 - "Cushing's syndrome results from high levels of the hormone cortisol, and can cause fat accumulation in the upper body and face, and thinning of the arms and legs. Patients can experience high blood pressure and high blood sugar, along with depression, fatigue, irritability and weakened bones ... a protein called PPAR-gamma, which is found on pituitary gland tumor cells, appears to be linked to overproduction of ACTH ... researchers injected mice with ACTH-secreting pituitary tumor cells and then treated them with commonly used diabetes drugs, rosiglitazone (Avandia) and troglitazone, or an inactive placebo ... There was an 85% reduction in ACTH and a corresponding 96% reduction in their cortisol-like hormone"
  • Mirtazapine Regulates Stress Hormones, Improves Sleep In Depressed Patients - Doctor's Guide, 8/8/01 - "Mirtazipine might be the best option for depressed patients with sleep disturbance and irregularities in stress hormone function ... Depression is often accompanied by sleep disturbance -- subjective and objective -- as well as [hypothalamic-pituitary-adrenal] HPA-axis dysregulation ... Mirtazapine is a treatment that [profoundly affects] the HPA-axis within hours and promotes sleep within days ... They tested the 24-hour urinary free cortisol (UFC) levels of 16 healthy men and 20 men and women with major depression ... mirtazipne significantly reduced UFC concentrations, which is often elevated in depressed patients"
  • Cortisol - Keeping a Dangerous Hormone in Check - Life Extension Magazine, 7/04 - "daily cortisol production increased by 54% from a group of 21- to 30-year-old men to a group of men over 70 ... Phosphatidylserine, DHEA, and ginkgo biloba all have been shown to reduce the amount of cortisol produced during stressful events, and these stress fighters can help retard the negative consequences of this hormone" - See iHerb or Vitacosticon phosphatidylserine products.
  • The Role of Cortisol and Depression: Exploring New Opportunities for Treatments - Psychiatric Times, 5/04 - "Although glucocorticoid production is essential for survival, overproduction is associated with a significant disruption of cellular functioning, which, in turn, leads to widespread physiological dysfunction ... Cortisol, a glucocorticoid released from the adrenal cortex, is the end product of the HPA axis ... The physiological function of DHEA and its sulphated metabolite (DHEA-S) is unclear, but these circulating corticosteroids have been shown to possess antiglucocorticoid properties, and high cortisol/DHEA ratios are reported to be associated with persistent depression"
  • Why Are So Many Women Depressed? - Scientific America Women's Health: A Life Long Guide, Summer 1998 (see the subtopic "Stress and Cortisol") - "It is unclear whether depression is a cause or a consequence of elevated cortisol levels, but the two are undoubtedly related."
  • Wilson's Reverse T3 Dominance Syndrome - knoxintegrativemed.com - "However, when a person experiences prolonged stress, the adrenal glands respond by manufacturing a large amount of cortisol. Cortisol inhibits the conversion of T4 to T3 and favors the conversion of T4 to RT3. If stress is prolonged, a condition called Reverse T3 Dominance occurs and persists even after the stress passes and cortisol levels fall. Apparently, RT3 itself acts like cortisol and blocks the conversion of T4 to T3"
  • Wilson's Syndrome - providentmedical.com - "We know that elevated amounts of cortisol, the major stress hormone, can block 5 prime deiodinase, keeping T4 from being converted to T3.  This results in most of the T4 being converted into reverse T3, which then needs the available 5 prime deiodinase to be converted into T2."
  • Low-Dose DHEA Increases Androgen, Estrogen Levels in Menopause - Medscape, 12/12/03 - "Cortisol F plasma levels progressively decreased throughout the study." - See iHerbor Vitacosticon DHEA products.
  • A diet fortified with L-lysine and L-arginine reduces plasma cortisol and blocks anxiogenic response to transportation in pigs - Nutr Neurosci. 2003 Oct;6(5):283-9
  • Fish oil prevents the adrenal activation elicited by mental stress in healthy men - Diabetes Metab. 2003 Jun;29(3):289-295 - "In control conditions, mental stress significantly increased heart rate, mean blood pressure, and energy expenditure. It increased plasma epinephrine from 60.9 +/- 6.2 to 89.3 +/- 16.1 pg/ml (p<0.05), plasma cortisol from 291 +/- 32 to 372 +/- 37 micromol/l ... After 3 weeks of a diet supplemented with n-3 fatty acids, the stimulation by mental stress of plasma epinephrine, cortisol, energy expenditure, and plasma non esterified fatty acids concentrations, were all significantly blunted ... Supplementation with n-3 fatty acids inhibits the adrenal activation elicited by a mental stress" - See Mega Twin EPA at Vitacosticon or iHerb.
  • Disappointing Data Confound Claims For DHEA Effectiveness [against Alzheimer's] - Psychiatric News, 6/6/03 - "DHEA has been reported to reduce cortisol, the so-called "stress hormone," which in response to stress is released in large quantities that have been linked to neuronal stress and damage" -  Does anyone detect bias in that title?  I don't know if DHEA helps Alzheimer's or not but I feel the title should have been something like "Alzheimer's Shows Trend Toward Improvement with DHEA at 3 Months".  Their attitude seems to be that nothing works except what we write prescriptions for.  The way I understand it, Alzheimer's usually gets worse, not better and cholinesterase inhibitors slow the disease, they don't reverse it and three months is a short time to determine if it is working.  For example, see the following  in the same issue of Clinical Psychiatry News.  See iHerb or Vitacosticon DHEA products. - Ben
  • Light Sleeper, Heavy Gainer - HealthDay, 2/14/03 - "Sleep deprivation can increase production of cortisol, a stress hormone that stimulates the appetite"
  • Stress, Cortisol and Health - Supplement Watch Newsletter, 10/02 - "several lines of evidence have converged to solidify the concept that stress makes us fat (because of cortisol), thins our bones (because of cortisol), shrinks our brains (because of cortisol), suppresses our immune system (because of cortisol), saps our energy levels (because of cortisol), and kills our sex drive (because of cortisol) ... Take a daily multivitamin/multi-mineral supplement - because calcium, magnesium, vitamin C and B-complex vitamins are needed for a proper stress response ... Chief among the supplements with documented cortisol-controlling effects are Phosphatidylserine, Beta-sitosterol, Magnolia bark, Theanine, Epimedium, Ashwagandha and Passionflower"
  • Phosphatidylserine (PS) The Essential Brain Nutrient - Life Extension Magazine, 9/02 - "Among its list of functions, phosphatidylserine stimulates the release of dopamine (a mood regulator that also control physical sensations, and movement), increases the production of acetylcholine (necessary for learning and memory), enhances brain glucose metabolism (the fuel used for brain activity), reduces cortisol levels (a stress hormone), and boosts the activity of nerve growth factor (NGF), which oversees the health of cholinergic neurons"
  • A Supplement to Prevent Alzheimer’s - Dr. Weil, 8/20/02 - "In theory, PS works by strengthening cell membranes thus protecting them and their contents from damage, particularly from the stress hormone cortisol"
  • Testosterone Deficiency & Depression, Does DHEA Raise the Levels of Bioavailable Testosterone in Men? - Life Extension Magazine, 8/02 - "We know that as cortisol rises, testosterone levels tend to drop"
  • Hypercortisolemia Cited in Link Between Depression and Cardiovascular Disorders - Doctor's Guide, 4/9/02 - "Depressed patients who are also hypercortisolemic appear to have resistance to insulin and increased visceral fat, possibly accounting for a link between major depression and cardiovascular disorders"
  • Physical and Psychological Effects of Stress - MedicineNet.com, 2/02 - "Under excessive stress, we tend to produce cortisol, the classic anti-stress hormone produced by our body, perhaps to conserve energy. However the side-effect here is sexual dysfunction and infertility as cortisol also inhibits production of the hormones essential for sexual"
  • Errant Enzyme Causes Big Bellies - WebMD, 12/11/01 - "They looked at an enzyme called 11-beta hydroxysteroid dehydrogenase type 1. This enzyme is able to increase the level of cortisol in fat cells without raising the level of cortisol in the blood"
  • Single enzyme to blame for potbellies: study - MSNBC, 12/6/01 - "What they found was that a single enzyme in fat cells that raises levels of cortisol — the “fight or flight” stress hormone — triggers fat accumulation around the belly and its associated ill effects ... The researchers were drawn to the role of cortisol because patients with a rare illness known as Cushing syndrome — who have too much of the steroid hormone in their blood — develop severe obesity concentrated around their middles and become diabetic ... Since overweight people without Cushing syndrome typically don’t have too much cortisol in their bloodstreams, Flier hypothesized that they may be producing high cortisol levels solely in their fat cells — possibly because the enzyme HSD-1, which makes cortisol from an inactive molecule, is overactive ... The level of cortisol in their stomach fat tissue was 15 percent to 30 percent higher than in their non-engineered counterparts" - Note: The way I read this article, the final culprit is still the cortisol and there are ways to reduce cortisol now.
  • Retinoic acid prevents experimental Cushing syndrome - J Clin Invest, October 2001, Volume 108, Number 8, 1123-1131 - "This glucocorticoid excess produces abnormal fat deposition, adrenal hyperplasia, thinning of the skin, hypertension, and psychological disturbances"
  • Sleep Deprivation May Trigger Insulin Resistance - Clinical Psychiatry News, 10/01 - "sleep deprivation leads to the release of tumor necrosis factor-, which triggers cortisol release, and that, in turn, causes insulin resistance"
  • Researchers Explore New Meds for Mood Disorders - Clinical Psychiatry News, 10/01 - "Another approach being developed for patients with high levels of circulating cortisol involves the abortion pill mifepristone ... The findings, to be published this month in the Journal of Clinical Psychopharmacology, suggest that a rapid antidepressant response (approximately 7 days) may occur in some patients"
  • Researchers Hopeful Antidepressant Augmentation Will Improve Remission - Clinical Psychiatry News, 9/01 - "In psychotic depression, a corticosteroid antagonist looks most promising. Mifepristone, which is used to induce abortions but was originally designed as treatment for Cushing's disease, has achieved rapid reversal of symptoms in some 30 psychotically depressed patients, ostensibly by blocking cortisol receptors. The drug is now being investigated in a large double-blind trial, he said"
  • Two studies implying that cortisol is the cause, not the result of depression:
  • Procaine HCI - aidsmap.com, 6/28/01
  • AACE Clinical Practice Guidelines For The Evaluation and Treatment of Male Sexual Dysfunction - American Association of Clinical Endocrinologists - "Other endocrine disorders that may cause libido or erectile difficulties include hypothyroidism, hyperthyroidism, adrenal insufficiency, or excessive levels of adrenal corticosteroids [cortisol]"
  • How You React to Stress May Affect How Your Clothes Fit - WebMD, 1/16/01 - "fat created by cortisol is the "deep-belly" kind, which, one expert says, is known to increase health risks"
  • RU-486 could aid variety of ills - MSNBC, 11/2/00 - "RU-486's ability to block the action of a different hormone � cortisol � has prompted doctors to try it for psychotic depression. In addition to feeling sad and worthless, people with this devastating condition have distorted thinking and often suffer delusions or hallucinations. Many
    become suicidal.

    They have very, very disturbing and crazy thoughts ... and they have no ability to suppress them,� said Joseph K. Belanoff, a California psychiatrist who is chief executive officer of Corcept Therapeutics Inc., a small pharmaceutical company. Corcept is sponsoring a study of RU-486 for psychotic depression.

    Several lines of evidence have led researchers to suspect that some of the symptoms of psychotic depression are caused by an excess of cortisol in the brain. Cortisol levels rise in response to stress and may be abnormally elevated in depressed individuals. Similar symptoms can occur in patients with Cushing's syndrome, an overabundance of cortisol usually caused by a tumor, and RU-486 has cured the mental disturbance in some
    such cases.

    Our feeling has been that a lot of the cognitive problems and delusions that you see in some of the patients are due to the [cortisol],� said Alan F. Schatzberg, chairman of the psychiatry department at Stanford University School of Medicine, where researchers are conducting a study that will test RU-486 on 30 patients with psychotic depression.

    RU-486 or other cortisol-blocking drugs �may be better alternatives than ... some of the typical treatments� such as antipsychotic drugs or electric shock therapy, he said."
  • Neuroscience finds foggy link between depression and memory loss - CNN, 4/18/00 - "Studies show that prolonged depression or stress leads to elevated levels of cortisol, a "stress" hormone produced by the adrenal glands. This in turn appears to shrink or atrophy the hippocampus, the sea-horse shaped part of the brain associated with many kinds of memory and learning."
  • STGI Announces Anticort's FDA Phase I/II is Moving Forward - aegis.com, 7/28/99 - "Procaine (the active ingredient of Anticort(TM)) has been used clinically for more than 40 years, primarily as the local injectable anesthetic Novocaine. Despite the widespread use of procaine, reports of side effects have been rare, and are usually associated with excessive dosage, rapid absorption or inadvertent intravascular injection ... For the pharmacokinetics study, participants will receive Anticort(TM) at a single oral dose of 200 mg (cohort A), 400 mg (cohort B), 600 mg (cohort C) or 800 mg (cohort D). For the 8-week continuous dosing study, participants will receive 200 mg (1 pill per day; cohort A), 400 mg (1 pill twice daily; cohort B), 600 mg (1 pill three times daily; cohort C) or 800 mg (2 pills twice daily; cohort D). To ensure the safety of each dose level, these cohorts will be enrolled sequentially"
  • Study Supports Role Of Anticort In Treating Alzheimer's, HIV - Doctor's Guide, 4/17/98 - "Cortisol's role as a cause of disease is most recently confirmed in a study to be published in the May issue of the journal Nature Neuroscience. Authored by Dr. Sonia Lupien of McGill University, the study reports that high levels of cortisol play a key role in Alzheimer's, memory loss, shrinkage of the brain and aging. Dr. Lupien also states that such illnesses might be prevented with medications to reduce elevated cortisol levels."
  • Georgetown Researchers Report Development of New Way to Control Excess Cortisol Levels - Georgetown University Medical Center, 6/12/00 - "Although more work is needed to understand how Anticort works, these results clearly indicate that we now have a powerful tool to control the stress response and its detrimental effects on the body"
  • Endocrinology of Aging - Medscape, 3/00 - "Excessive lifelong adrenal cortisol feedback on the brain may exacerbate the aging-associated loss in neuronal synapses and plasticity"
  • Hypericum, Drug Interatcions, and Liver Effects  - MedHerb.com, 2/00 - "Endogenous hormones metabolized by the CYP3A enzyme system - estradiol, estriol, testosterone, cortisol"
  • The Neurobiology of Depression - Scientific America, 6/98 - "When a threat to physical or psychological well-being is detected, the hypothalamus amplifies production of corticotropin-releasing factor (CRF), which induces the pituitary to secrete ACTH. ACTH then instructs the adrenal gland atop each kidney to release cortisol"
  • Acetyl-L-carnitine in Alzheimer disease: a short-term study on CSF neurotransmitters and neuropeptides - Alzheimer Dis Assoc Disord 1995 Fall;9(3):128-31 - "beta-endorphins significantly decreased after treatment; plasma cortisol levels matched this reduction. Since both CSF beta-endorphins and plasma cortisol decreased, one possible explanation is that ALCAR reduced the AD-dependent hypothalamic-pituitary-adrenocortical (HPA) axis hyperactivity"
  • Adrenal Disease - Life Extension Magazine
  • Anxiety and Stress - Life Extension Magazine
  • About Relora - Relora.com
  • Psychotic Depression - healthyplace.com - "Researchers aren't exactly sure what causes major depressive disorder with psychotic features (psychotic depression), but it's frequently associated with high levels in the blood of a hormone called cortisol"
  • Gerovital GH-3 information - International Antiaging Systems - "It is also known that Gerovital-H3 can help reduce cortisol levels, the hormone responsible for stress and a rare hormone in that it is one of the few that increases with age. It is believed that high-cortisol levels lead to accelerated aging because cortisol “attacks” the hypothalamus, the area of the brain that “controls” the endocrine system. Ironically cortisol may run out-of-control due to its ability to damage the hypothalamus that controls the adrenal glands that produce cortisol!" - Note:  I'm not a doctor but the way I understand it, GH-3 (procaine HCl) reduces 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMG-CoA) activity.  This is what statins do to lower cholesterol.  Cortisol is made from cholesterol therefore less cholesterol equals less cortisol.  The company making Anticort (procaine HCl), stopped after phase II studies.  See J Pharmacol Exp Ther. 2003 Dec;307(3):1148-57. Epub 2003 Oct 14.  - Ben

Effects of cortisol on thyroid:

  • central hypothyroidism---fibromyalgia, hypothyroidism, thyroid hormone resistance - drlowe.com - "During stress (such as surgery or an auto accident), the adrenal glands increase their secretion of cortisol. The increase in cortisol inhibits the thyroid system in two ways: (1) it decreases TSH secretion by the pituitary gland, and (2) it decreases conversion of T4 to T3"
  • Wilson's Reverse T3 Dominance Syndrome - knoxintegrativemed.com - "However, when a person experiences prolonged stress, the adrenal glands respond by manufacturing a large amount of cortisol. Cortisol inhibits the conversion of T4 to T3 and favors the conversion of T4 to RT3. If stress is prolonged, a condition called Reverse T3 Dominance occurs and persists even after the stress passes and cortisol levels fall. Apparently, RT3 itself acts like cortisol and blocks the conversion of T4 to T3"
  • Wilson's Syndrome - providentmedical.com - "We know that elevated amounts of cortisol, the major stress hormone, can block 5 prime deiodinase, keeping T4 from being converted to T3.  This results in most of the T4 being converted into reverse T3, which then needs the available 5 prime deiodinase to be converted into T2."
  • Wilson's Thyroid Syndrome - "Conversion of T4 to T3 can also be impaired by glucocorticoids" - Maybe that is the mechanism by which cortisol causes depression, and if so, could T3 then cure the depression? - Ben, Related article:
  • Use OF T3 Thyroid Hormone to Treat Depression - DrMirkin.com, 5/11/01 - "some people become depressed when they take just T4 and their depression can be cured when they take both thyroid hormones, T3 and T4"

Alternative News:

  • Omega-3 supplements show benefits against anxiety: Human data - Nutra USA, 9/14/11 - "the Ohio State researchers recruited 68 medical students to participate in their parallel group, placebo-controlled, double-blind trial. The med students were given either placebo capsules or omega-3 capsules containing 2085 mg of EPA (eicosapentaenoic acid) and 348 mg DHA (docosahexanoic acid) ... Results showed a 14% reduction in levels of the production of pro-inflammatory interleukin 6 (IL-6), as well as a 20% reduction in anxiety symptoms in the omega-3 group, compared to the placebo group ... Proinflammatory cytokines promote secretion of corticotropin-releasing hormone (CRH), a primary gateway to hormonal stress responses; CRH also stimulates the amygdala, a key brain region for fear and anxiety. Accordingly, alterations in inflammation could also influence anxiety" - [Abstract] - See Mega Twin EPA at Amazon.com and Jarrow Max DHA at Amazon.com.  Note:  CRH increases cortisol.  See:
  • Grapefruit juice and liquorice increase cortisol availability in patients with Addison's disease - Eur J Endocrinol. 2011 Sep 6 - "Compared to the ordinary treatment, the median AUC for serum cortisol increased with liquorice (53783 vs. 50882, p<0.05) and GFJ (60661 vs. 50882, p<0.05). Cortisol levels in serum were also elevated 2.6h after tablet ingestion (liquorice 223 vs. 186 nmol/L, p<0.05; GFJ 337 vs. 186 nmol/L, p<0.01). Liquorice increased the median urinary cortisol/cortisone-ratio (0.43 vs 0.21, p<0.00001), whereas GFJ increased the (aTHF+THF)/THE-ratio (0.55 vs 0.43, p<0.05)" - Note:  From my readings, most have too much cortisol already.  I've read where licorice increases it.  Licorice and grapefruit juice sounds like an unlikely combination but people might want to be aware of it.
  • Preventive Action of Panax ginseng Roots in Hypercortisolism-induced Impairment of Hippocampal Neurons in Male C57BL/6N Mice - Phytother Res. 2011 Aug;25(8):1242-5 - "An increasing number of people suffering from hypercortisolism are at risk of developing hippocampus impairment and mental disorders. The aim of this study was to investigate whether the water extract of Panax ginseng roots (GWE) could prevent hypercortisolism-induced adverse consequences. Hypercortisolism was experimentally induced by repeated corticosterone injection in male mice. Treatment with corticosterone alone resulted in a significant decrease in hippocampus neurofilament light chain (NF-L) protein expression and induced depression-like behavior. Serum corticosterone was significantly increased in the corticosterone-treated mice. Treatment with GWE (800 and 400 mg/kg) during corticosterone treatment reduced or partially antagonized the effects induced by corticosterone toward the normal values of the controls; however, it failed to normalize increased corticosterone levels in corticosterone-treated mice. Overall, ginseng conclusively exhibited a protective action against hypercortisolism-induced impairment of hippocampal neurons" - See ginseng at Amazon.com.
  • Vitamin A Decreases Pre-receptor Amplification of Glucocorticoids in Obesity: Study on the Effect of Vitamin A on 11beta-Hydroxysteroid Dehydrogenase Type 1 Activity in Liver and Visceral Fat of WNIN/Ob Obese Rats - Nutr J. 2011 Jun 23;10(1):70 - "11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) catalyzes the conversion of inactive glucocorticoids to active glucocorticoids and its inhibition ameliorates obesity and metabolic syndrome. So far, no studies have reported the effect of dietary vitamin A on 11beta-HSD1 activity in visceral fat and liver under normal and obese conditions. Here, we studied the effect of chronic feeding of vitamin A-enriched diet (129mg/kg diet) on 11beta-HSD1 activity in liver and visceral fat of WNIN/Ob lean and obese rats ... Control groups received stock diet containing 2.6mg vitamin A/kg diet, where as experimental groups received diet containing 129mg vitamin A/Kg diet for 20 weeks ... Vitamin A supplementation significantly decreased body weight, visceral fat mass and 11beta-HSD1 activity in visceral fat of WNIN/Ob obese rats. Hepatic 11beta-HSD1 activity and gene expression were significantly reduced by vitamin A supplementation in both the phenotypes. CCAAT/enhancer binding protein alpha(C/EBPalpha), the main transcription factor essential for the expression of 11beta-HSD1, decreased in liver by vitamin A fed-obese rats, but not in lean rats. Liver X receptor alpha (LXR alpha), a nuclear transcription factor which is known to downregulate 11beta-HSD1 gene expression was significantly increased by vitamin A supplementation in both the phenotypes" - Note:  See my 11beta-HSD1 page.  11beta-HSD1 goes hand in hand with cortisol.
  • Fish Oil Lowers Cortisol and Body Fat Levels - Vital Choice, 12/13/10 - "Black tea is shown to rapidly normalize cortisol levels after stress ... Fish oil has also been found to improve body composition in preliminary clinical studies … an outcome attributed to various physiological effects of omega-3s ... In tests performed at the end of the six-week study, members of the fish oil group showed significantly lower cortisol levels" - See Mega Twin EPA at Amazon.com and Jarrow Max DHA at Amazon.com.
  • Assessment of psychotropic-like properties of a probiotic formulation ( Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in rats and human subjects - Br J Nutr. 2010 Oct 26:1-9 - "In the preclinical study, rats were daily administered PF for 2 weeks and subsequently tested in the conditioned defensive burying test, a screening model for anti-anxiety agents. In the clinical trial, volunteers participated in a double-blind, placebo-controlled, randomised parallel group study with PF administered for 30 d and assessed with the Hopkins Symptom Checklist (HSCL-90), the Hospital Anxiety and Depression Scale (HADS), the Perceived Stress Scale, the Coping Checklist (CCL) and 24 h urinary free cortisol (UFC). Daily subchronic administration of PF significantly reduced anxiety-like behaviour in rats (P < 0.05) and alleviated psychological distress in volunteers, as measured particularly by the HSCL-90 scale (global severity index, P < 0.05; somatisation, P < 0.05; depression, P < 0.05; and anger-hostility, P < 0.05), the HADS (HADS global score, P < 0.05; and HADS-anxiety, P < 0.06), and by the CCL (problem solving, P < 0.05) and the UFC level (P < 0.05). L. helveticus R0052 and B. longum R0175 taken in combination display anxiolytic-like activity in rats and beneficial psychological effects in healthy human volunteers" - Note, in case you missed it, it's saying that it also reduced cortisol. See probiotics at Amazon.com.
  • Dietary fatty acid composition alters 11beta-hydroxysteroid dehydrogenase type 1 gene expression in rat retroperitoneal white adipose tissue - Lipids Health Dis. 2010 Oct 8;9(1):111 - "The enzyme 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) amplifies intracellular glucocorticoid action by converting inactive glucocorticoids to their active forms in vivo. Adipose-specific overexpression of 11beta-HSD1 induces metabolic syndrome in mice, whereas 11beta-HSD1 null mice are resistant to it. Dietary trans and saturated fatty acids (TFAs and SFAs) are involved in the development of metabolic syndrome, whereas polyunsaturated fatty acids (PUFA) offer protection against this. Here, we report the effects of chronic feeding of different diets containing vanaspati (TFA rich), palm oil (SFA rich) and sunflower oil (PUFA rich) at 10%level on 11beta-HSD1 gene expression in rat retroperitoneal adipose tissue. 11beta-HSD1 gene expression was significantly higher in TFA rich diet-fed rats compared to SFA rich diet-fed rats, which in turn was significantly higher than PUFA rich diet-fed rats. Similar trend was observed in the expression of CCAAT-enhancer binding protein-alpha (C/EBP-alpha), the main transcription factor required for the expression of 11beta-HSD1. We propose that TFAs and SFAs increase local amplification of glucocorticoid action in adipose tissue by upregulating 11beta-HSD1 by altering C/EBP--gene expression. The increased levels of glucocorticoids in adipose tissue may lead to development of obesity and insulin resistance, thereby increasing the risk of developing metabolic syndrome" - Note:  11beta-HSD1 goes hand in hand with cortisol.
  • Emodin, a natural product, selectively inhibits 11beta-hydroxysteroid dehydrogenase type 1 and ameliorates metabolic disorder in diet-induced obese mice - Br J Pharmacol. 2010 Sep;161(1):113-26 - "11beta-Hydroxysteroid dehydrogenase type 1 (11beta-HSD1) is an attractive therapeutic target of type 2 diabetes and metabolic syndrome. Emodin, a natural product and active ingredient of various Chinese herbs, has been demonstrated to possess multiple biological activities ... Emodin is a potent and selective 11beta-HSD1 inhibitor with the IC(50) of 186 and 86 nM for human and mouse 11beta-HSD1, respectively. Single oral administration of emodin inhibited 11beta-HSD1 activity of liver and fat significantly in mice. Emodin reversed prednisone-induced insulin resistance in mice, whereas it did not affect dexamethasone-induced insulin resistance, which confirmed its inhibitory effect on 11beta-HSD1 in vivo. In DIO mice, oral administration of emodin improved insulin sensitivity and lipid metabolism, and lowered blood glucose and hepatic PEPCK, and glucose-6-phosphatase mRNA. CONCLUSIONS AND IMPLICATIONS This study demonstrated a new role for emodin as a potent and selective inhibitor of 11beta-HSD1 and its beneficial effects on metabolic disorders in DIO mice. This highlights the potential value of analogues of emodin as a new class of compounds for the treatment of metabolic syndrome or type 2 diabetes" - Note:  (11beta-HSD1) goes hand in hand with cortisol.  It seems like what came first, the chicken or the egg.  I googled emodin and didn't see any reliable places that sold it.  One article said that it was in some resveratrol products and that the emodin was what caused the stomach problems.
  • Oral treatment with L-lysine and L-arginine reduces anxiety and basal cortisol levels in healthy humans - Biomed Res. 2007 Apr;28(2):85-90 - "the treatment with L-lysine and L-arginine decreased the basal levels of salivary cortisol and chromogranin-A (a salivary marker of the sympatho-adrenal system) in male subjects"
  • Black Tea Soothes Away Stress - Science Daily, 10/4/06 - "the study participants – who drank a black tea concoction four times a day for six weeks – were found to have lower levels of the stress hormone cortisol in their blood after a stressful event, compared with a control group who drank the fake or placebo tea for the same period of time"
  • Cortisol, Stress, and Health - Life Extension Magazine, 12/05 - "Supplements to reduce high cortisol levels secondary to stress ... Vitamin C: 1000-3000 mg/day ... Fish oil (omega-3 fatty acids):1-4 gm/day ... Phosphatidylserine: 300-800 mg/day ... Rhodiola rosea: 100-200 mg/day, standardized extract ... Ginseng: 100-300 mg/day, standardized extract ... Ginkgo biloba: 100-200 mg/day, standardized extract ... DHEA: 25-50 mg/day (any hormone supplementation should be monitored by your physician)"
  • Can You Slim Down with Cortisol Blockers? - Dr. Weil, 10/7/04
  • A botanical to beat 'stress-eaters' - Nutra USA, 4/15/04 - "Relora appears to promote weight maintenance and decrease stress arousal as demonstrated by decreased evening cortisol and decreased systolic blood pressure" - See iHerb or Vitacosticon Relora products.
  • Is Stress Making You Fat?/a> - Dr. Weil, 1/16/04 - "In addition to the link to weight gain, elevated cortisol levels can have adverse effects on the immune system, memory, and sugar metabolism ... women with a high waist-to-hip ratio, whether they were overweight or slim, secreted more cortisol under stress and also reported more stress in their daily lives than women with low waist-to-hip ratios ... caffeine can elevate levels of cortisol"
  • Alterations in Stress Cortisol Reactivity in Depressed Preschoolers Relative to Psychiatric and No-Disorder Comparison Groups - Archives of General Psychiatry, 12/03 - "the first investigation of HPA axis reactivity in very young children with a clinical depressive syndrome ... Depressed preschoolers displayed a pattern of increasing cortisol levels throughout the assessment in response to both separation and frustration stressors"
  • Low-Dose DHEA Increases Androgen, Estrogen Levels in Menopause - Medscape, 12/12/03 - "Cortisol F plasma levels progressively decreased throughout the study. Both groups also experienced significantly reduced LH and FSH plasma levels"
  • Stress-Busting Help Comes From Hormone - WebMD, 8/2/04 - "The people who reported fewer symptoms and who performed best at their military tasks had "significantly higher" levels of the hormone DHEA-S compared with cortisol" [Abstract] - See iHerb or Vitacosticon DHEA products.
  • Exercise Boosts Physical/Mental Health in Diabetics, Breast Cancer Patients, Healthy Males - Doctor's Guide, 6/22/01 - "Researchers found minimal decreases in glucose levels when exercise occurred in the morning, afternoon or evening hours, but found dramatic decreases when subjects exercised at night. Increases in levels of the hormones cortisol and thyrotropin were greater in the evening and night."
  • It is Never Too Late to Regenerate Your Brain - Life Extension Magazine, 6/01 - "Lower your stress, lower your cortisol levels and it is likely that your brain can regenerate its powers to learn and remember"
  • Enhancing Cognitive Function - Life Extension Magazine, 5/00
  • Depression Protocol - Life Extension Foundation
  • Muscle Breakdown: Is Cortisol Leading You Down the Catabolic Pathway? - Rehan Jalali/thinkmuscle.com
  • Stress: The Hidden Factor For Weight Gain - Nutrition Science News, 4/01 - "Under stress, the body excretes corticotrophin-releasing hormone and adrenalin. This reaction stimulates the release of cortisol from the adrenal cortex. In turn, cortisol, a glucocorticoid, stimulates glucose release into the bloodstream, which, during periods of chronic stress, creates an excessive release of insulin. Insulin, which is part of the endocrine system, is a fat-storage hormone that overrides the stress signal from adrenalin to burn fat. The excess release of insulin gives the body the message to store fat in the abdomen"
  • Clinical Trial Update: STGI Announces Anticort's FDA Phase I/II is Moving Forward - Business Wire, 7/28/99 (same article as above dead link)
  • Sports Science - An Answer To Intense Training - Health & Nutrition Breakthroughs, 7/98 - "The research team found that, compared to placebo, the plasma cortisol response to exercise was about 16 percent lower for the 400 mg dose of PS and 30 percent lower for the 800 mg dose."
  • Anti-Cortisols May Offer New Hope For Retinitis Pigmentosa - Doctor's Guide, 11/17/97 - "According to Sapse, RP can be treated initially with a cocktail of anti-cortisol nutritional compounds including vitamin A, zinc, ginkgo biloba and acetyl-L-carnitine . . ."
  • Findings Show Cortisol's Major Role in AIDS and Other Diseases - Doctor's Guide, 6/21/96 - "Anticort, (to lower cortisol) a high dose form of stabilized procaine HCL, is being successfully tested in pilot clinical studies in Brazil and the U.S., in HIV+ and AIDS populations ... Researchers have already started to explore the therapeutic benefits of such an approach through the use of anti-cortisol drugs, such as RU-486, DHEA, Ketaconazole, Anticort and Tianeptine"
  • Effect of 5-hydroxytryptophan on serum cortisol levels in major affective disorders. II. Relation to suicide, psychosis, and depressive symptoms - Arch Gen Psychiatry 1984 Apr;41(4):379-87 - "Serum cortisol levels were significantly higher after administration of 5-hydroxytryptophan (5-HTP), 200 mg orally"
  • Study 20 - The Hypericum Homepage - "Both serum-cortisol and serum-prolactin were lowered significantly after three weeks of treatment with hypericum extract in male rats."

Other News:

  • Stress hormones may increase cardiovascular risks for shift workers - Science Daily, 10/3/11 - "working in shifts leads to changes in long-term cortisol levels, suggesting that the stress hormone cortisol might be one of the factors contributing to the increased cardiovascular risks of shift workers ... In this study, researchers collected hair samples from 33 shift workers and 89 day workers"
  • Overexpression of hepatic 5α-reductase and 11β-hydroxysteroid dehydrogenase type 1 in visceral adipose tissue is associated with hyperinsulinemia in morbidly obese patients - Metabolism. 2011 Jun 23 - "11-β-Hydroxysteroid dehydrogenase type 1 (11β-HSD1) converts cortisone to cortisol, mainly in the liver and visceral adipose tissue (VAT), and has been implicated in several metabolic disorders. The absence of systemic hypercortisolism in central obesity could be due to increased inactivation of cortisol to its tetrahydrometabolites by the hepatic enzymes 5α- and 5β-reductases ... Forty-one patients were recruited (age, 41.8 +/- 10.6 years; body mass index, 42.1 +/- 6.6 kg/m(2); 71% women). The expression of hepatic 5α- and 5β-reductases was positively correlated (r = +0.53, P = .004), and their expression levels were correlated with hepatic 11β-HSD1 expression (r = +0.61, P < .001 for 5α-reductase and r = +0.50, P < .001 for 5β-reductase). Hepatic 5α-reductase was associated with insulin (r = +0.34, P = .015). Visceral adipose tissue 11β-HSD1 expression was associated with glucose (r = +0.37, P = .025) and insulin (r = +0.54, P = .002). Our results showed that 5α-reductase and VAT 11β-HSD1 expressions were associated with insulinemia. These findings suggest that overexpression of 5α-reductase, through a higher inactivation of cortisol in the liver, could have a protective role in preserving hepatic sensitivity to insulin. The overexpression of liver reductases in obesity could be an adaptive response to an increase in cortisol production by the liver and visceral 11β-HSD1 to avoid systemic hypercortisolism"
  • New method to measure cortisol could lead to better understanding of development of common diseases - Science Daily, 5/2/11 - "Currently the standard method to measure cortisol levels is to take a blood or saliva sample. However, since cortisol is released in a circadian rhythm and with pulses throughout the day, levels can fluctuate considerably, meaning it is difficult to estimate an individual's long-term exposure to cortisol through blood and saliva tests alone ... hair cortisol levels correlated positively with waist to hip ratio (r=0.425, p=0.003) and waist circumference (r=0.392, p=0.007), meaning people with higher exposure to cortisol showed higher abdominal obesity ... measuring the amount of cortisol in hair can potentially be used to monitor a person's long-term exposure to cortisol"
  • Caffeinated Coffee Does Not Acutely Affect Energy Intake, Appetite, or Inflammation but Prevents Serum Cortisol Concentrations from Falling in Healthy Men - J Nutr. 2011 Feb 23 - "Our aim in this crossover study was to investigate the acute effects of caffeinated and decaffeinated coffee consumption on appetite feelings, energy intake, and appetite-, inflammation-, stress-, and glucose metabolism-related markers. Sixteen healthy men (age range, 21-39 y; BMI range, 19.7-28.6 kg/m(2)) received in a random order on 3 separate occasions a standard breakfast snack with 200 mL of either caffeinated coffee (3 mg caffeine/kg body weight), decaffeinated coffee, or water (control). Before intervention (-15 min) and at standard time points following breakfast consumption (0, 15, 30, 60, 90, 120, 150, and 180 min), participants recorded their appetite feelings and we collected blood samples for measurements of circulating glucose, insulin, cortisol, and appetite- and inflammation-related markers. At 180 min, participants consumed a meal ad libitum. The appetite-related ratings, the appetite plasma hormonal responses as well as the plasma glucose, serum insulin, and plasma and serum inflammatory marker responses did not show an overall intervention effect or a time x intervention interaction. Ad libitum energy intake did not differ among the 3 interventions. However, a significant intervention effect (P = 0.04) and a time x intervention interaction (P-interaction = 0.02) were found for serum cortisol; cortisol concentrations were significantly higher following the caffeinated coffee intervention, compared to control, at 60 min and thereafter. In conclusion, the usually consumed amount of caffeinated coffee does not have short-term effects on appetite, energy intake, glucose metabolism, and inflammatory markers, but it increases circulating cortisol concentrations in healthy men"
  • Association of Diurnal Patterns in Salivary Cortisol with All-Cause and Cardiovascular Mortality: Findings from the Whitehall II Study - J Clin Endocrinol Metab. 2011 Feb 23 - "We assessed all-cause, cardiovascular, and noncardiovascular death. Results: There were 139 deaths, 32 of which were deaths due to cardiovascular disease, during a mean follow-up period of 6.1 yr. Flatter slopes in cortisol decline across the day were associated with increased risk of all-cause mortality (hazard ratio for 1 sd reduction in slope steepness 1.30; 95% confidence interval (CI) = 1.09-1.55). This excess mortality risk was mainly driven by an increased risk of cardiovascular deaths (hazard ratio = 1.87; 95% confidence interval = 1.32-2.64). The association with cardiovascular deaths was independent of a wide range of covariates measured at the time of cortisol assessment. There was no association between morning cortisol, the cortisol awakening response, and mortality outcomes. Conclusions: These findings demonstrate, for the first time, the relationship between a flatter slope in cortisol levels across the day and an increased risk of cardiovascular disease mortality in a nonclinical population"
  • Simple spit and blood tests might detect burnout before it happens - Science Daily, 2/21/11 - "In addition to professional and personal suffering, burnout puts distressed workers at further risk of physical and psychological problems if ignored ... We hypothesized that healthy workers with chronic stress and with mild burnout symptoms would have worse physiological dysregulations and lower cortisol levels -- a profile consistent with burnout ... Cortisol is a stress hormone involved in our bodies stress response and naturally as part of our body's daily rhythm. Cortisol levels are often high in people suffering from depression, while it tends to be low in cases of burnout. Too much cortisol can be as bad as too little when it comes to both mental and physical health ... Critically, people with burnout are often treated with anti-depressant medications that lower cortisol levels. If cortisol is already lower than it should be, this course of treatment could represent a therapeutic mistake. "The use of an allostatic load index gives researchers and clinicians a window to see how chronic stress is straining the person"
  • Cortisol, dehydroepiandrosterone sulphate, their ratio and hypertension: evidence of associations in male veterans from the Vietnam Experience Study - J Hum Hypertens. 2011 Feb 10 - "Cortisol and the cortisol:DHEAS ratio were positively associated with hypertension (P<0.001), whereas DHEAS was negatively associated; the latter relationship was attenuated to non-significance (P=0.06) in models that adjusted for age, sociodemographics, place of service, health behaviours and BMI. The present analyses provide confirmation of a positive association between cortisol and the cortisol:DHEAS ratio and population hypertension"
  • Behavioral problems linked to cortisol levels: Study finds intervention needed as soon as behavioral problems appear - Science Daily, 2/9/11 - "Some youngsters with behavioral problems have abnormally high levels of cortisol, while others with identical problems have abnormally low levels ... Cortisol levels were abnormally high around the time problem behaviours began, but abnormally low when they had been present for a long time ... Problem behaviours were classified as either "internalizing" (depression and anxiety) or "externalizing" (aggression, attentional problems) ... Youngsters who developed depression-like symptoms or anxiety problems in adolescence had high levels of cortisol. However, those who developed symptoms earlier had abnormally low cortisol levels. The conclusion? Cortisol levels go up when individuals are first stressed by depression or anxiety, but then decline again if they experience stress for an extended period"
  • Why Women Feel Colder Than Men - CBS Chicago, 2/8/11 - "Women conserve more heat around their core organs, which means less heat circulates throughout the rest of their body ... It can often lead to a tug-of-war over the thermostat. That fight can get worse at night, when our bodies produce less cortisol ... cortisol is a very powerful hormone. It’s your fight hormone. So it keeps you warm, gets your adrenaline roaring and helps with body warming"
  • Persistent organic pollutants affect the stress hormone cortisol - Science Daily, 12/28/10 - "persistent organic pollutants (POPs), such as PCB and mixtures of different POPs, affect the way the adrenal cortex functions and thereby the synthesis of the stress hormone cortisol ... altered cortisol balance during early life may lead to a predisposition to develop several diseases in adulthood, such as diabetes and cardiovascular diseases"
  • Promising drug candidate reverses age-related memory loss in mice - Science Daily, 10/12/10 - "Such memory loss has been linked with high levels of 'stress' steroid hormones known as glucocorticoids which have a deleterious effect on the part of the brain that helps us to remember. An enzyme called 11beta-HSD1 is involved in making these hormones and has been shown to be more active in the brain during aging ... We found that life-long partial deficiency of 11beta-HSD1 prevented memory decline with aging. But we were very surprised to find that the blocking compound works quickly over a few days to improve memory in old mice suggesting it might be a good treatment for the already elderly ... We previously showed that carbenoxolone, an old drug that blocks multiple enzymes including 11beta-HSD1, improves memory in healthy elderly men and in patients with type 2 diabetes after just a month of treatment, so we are optimistic that our new compounds will be effective in humans. The next step is to conduct further studies with our preclinical candidate to prove that the compound is safe to take into clinical trials, hopefully within a year"
  • High stress hormone levels linked to increased cardiovascular mortality - Science Daily, 9/9/10 - "urinary cortisol did not increase the risk of non-cardiovascular mortality but did increase cardiovascular mortality risk. The third of the subjects with the highest urinary cortisol had a five-fold increased risk of dying of cardiovascular disease"
  • Chronic drinking increases levels of stress hormones, leading to neurotoxicity - Science Daily, 9/7/10 - "Both drinking and withdrawal from chronic drinking can raise circulating glucocorticoid levels, known as cortisol in humans and corticosterone in rodents. Prolonged and high concentrations of glucocorticoids can have damaging effects on neuronal function and cognition"
  • Hair provides proof of the link between chronic stress and heart attack - Science Daily, 9/3/10 - "Cortisol is considered to be a stress hormone. Its secretion is increased during times of stress. Traditionally it's been measured in serum, urine and saliva, but that only shows stress at the time of measurement, not over longer periods of time. Cortisol is also captured in the hair shaft"
  • Urinary Cortisol and Six-Year Risk of All-Cause and Cardiovascular Mortality - J Clin Endocrinol Metab. 2010 Aug 25 - "During a mean follow-up of 5.7 (SD = 1.2) yr, 183 persons died, of whom 41 died from cardiovascular disease. After adjustment for sociodemographics, health indicators, and baseline cardiovascular disease, urinary cortisol did not increase the risk of noncardiovascular mortality, but it did increase cardiovascular mortality risk. Persons in the highest tertile of urinary cortisol had a five times increased risk of dying of cardiovascular disease (hazard ratio = 5.00; 95% confidence interval = 2.02-12.37). This effect was found to be consistent across persons with and without cardiovascular disease at baseline"
  • Marriage and committed romance reduce stress-related hormone production - Science Daily, 8/17/10 - "We found that unpaired individuals of both sexes had higher cortisol levels than married individuals"
  • Cabergoline monotherapy in the long-term treatment of Cushing's disease - Eur J Endocrinol. 2010 Aug 11 - "Within 3-6 months, complete response was achieved in 11 patients (36.6%) and partial response in 4 (13.3%). After longer term therapy, 9 patients (30%) remain with a complete response after a mean of 37 months (range from 12-60 months) with a mean dose of 2.1 mg/wk of cabergoline. Two patients escaped after 2 and 5 years of complete response, but one transiently renormalized UFC after an increase in cabergoline dosage. No long-term response was maintained in 4 initial partial responders. Conclusions: Cabergoline monotherapy can provide an effective long-term medical therapy for selected patients with CD, but requires close follow-up for dose adjustments"
  • Link between depression, abdominal obesity confirmed by new study - Science Daily, 6/9/10 - "cortisol, a stress hormone, is related to depression and abdominal obesity. "So, there is reason to suspect that people who are depressed would have higher levels of abdominal obesity versus other parts of the body because of elevated cortisol,""
  • Stress hormone, depression trigger obesity in girls, study finds - Science Daily, 2/23/10
  • Stress peptide and receptor may have role in diabetes - Science Daily, 1/23/10
  • Partial restoration of GH responsiveness to ghrelin in Cushing's disease after 6 months of ketoconazole treatment: comparison with GHRP-6 and GHRH - Eur J Endocrinol. 2009 Aug 20
  • Stress Raises Belly Fat, Heart Risks - WebMD, 8/6/09 - "Even compared to other monkeys with the same body mass index and weight, CT scans showed that the stressed monkeys had a great deal more belly fat. And when the researchers looked at the animals' arteries, they found plaque clogging the arteries of the stressed monkeys ... it's not how much fat you have, but where it is located ... Over time, high cortisol levels cause belly fat to accumulate. It also makes individual fat cells get larger ... When you have lots more fat in visceral fat cells and all the characteristics of the metabolic syndrome, each of these things promotes atherosclerosis"
  • Symptoms Of Depression In Obese Children Linked To Elevated Cortisol - Science Daily, 6/11/09 - "There is evidence in adults that abnormal regulation of cortisol plays a role in both obesity and depression ... Cortisol levels in the saliva in the afternoon and evening correlated positively with symptoms of depression ... The more depressive symptoms that subjects reported, the higher the cortisol levels at those times"
  • Depression Raises Risk for Type 2 Diabetes - WebMD, 6/8/09 - "Depressed participants who were not being treated had significantly greater insulin resistance than study participants who were not depressed. But treatment for depression appeared to improve insulin sensitivity ... There are several theories about how depression may contribute to type 2 diabetes, but the most widely cited theory involves the stress hormone cortisol ... Cortisol is a key player in blood sugar metabolism and insulin sensitivity ... High cortisol levels are also associated with increased fat deposits around the abdomen, or belly fat, which is a risk factor for type 2 diabetes"
  • Asperger's Syndrome: Stress Hormone a Clue - Science Daily, 4/2/09
  • Work the Night Shift? Beware Diabetes - WebMD, 3/2/09 - "The 8.6 million Americans who work the night shift are at increased risk of obesity, diabetes, and heart disease. Why? ... much of the body's biological clock -- its circadian rhythm -- keeps day-shift time even when a person goes on the night shift ... Cortisol -- the so-called stress hormone that affects blood pressure and blood sugar -- rose and dropped at the wrong time"
  • Why some soldiers are cool under fire - MSNBC, 2/16/09 - "Blood samples taken from soldiers in the training programs showed those who fared best under extreme stress had lower levels of the stress hormone cortisol and higher levels of neuropeptide y, a chemical that dampens the body's stress response"
  • Symptoms Of Depression Associated With Increase In Abdominal Fat - Science Daily, 12/1/08 - "There are several mechanisms by which depression might increase abdominal fat, they note. Chronic stress and depression may activate certain brain areas and lead to increased levels of the hormone cortisol, which promotes the accumulation of visceral fat. Individuals with depression may have unhealthier lifestyles, including a poor diet, that could interact with other physiological factors to produce an increase in abdominal obesity" - Cortisol is like the chicken and the egg with depression.  They don't seem to know whether it is the cause or result.
  • Cushing's Syndrome Induced by Misuse of Moderate- to High-Potency Topical Corticosteroids (December) - Ann Pharmacother. 2008 Nov 18 - "Continuous use of moderate- to high-potency topical corticosteroids over several months can contribute to Cushing's syndrome"
  • Cortisol And Fatty Liver: Researchers Find Cause Of Severe Metabolic Disorders - Science Daily, 9/11/08 - "The researchers in Herzig's team specifically switched off the cortisol receptor in the livers of mice, thus blocking the hormone's effect. As a result, the triglyceride level in the livers of the experimental animals dropped considerably"
  • Effects of mirtazapine on dehydroepiandrosterone-sulfate and cortisol plasma concentrations in depressed patients - J Psychiatr Res. 2008 Aug 13 - "Mirtazapine significantly reduced both COR and DHEA-S concentrations, but had no impact on the COR/DHEA-S ratio"
  • Salivary cortisol is related to atherosclerosis of carotid arteries - J Clin Endocrinol Metab. 2008 Aug 5 - "area under the curve (AUC), which is a measure of total cortisol exposure while awake, and the slope, which is a measure of diurnal cortisol decline. Results: Total cortisol exposure while awake (AUC) was associated with higher plaque scores (beta = 0.08 per SD of AUC, 95% CI; 0.00 - 0.17, p-value = 0.04) in a fully adjusted linear regression model. Persons with an AUC in the highest tertile had a higher number of plaques of carotid arteries compared to those in the lowest tertile (3.08 versus 2.80 ... Our results support the hypothesis that increased total cortisol exposure is independently associated with atherosclerosis of the carotid arteries"
  • Stress Hormone Found To Regulate Brain Neurotransmission - Science Daily, 8/7/08 - "When we are subjected to a stress, our adrenal glands secrete hormones that affect our entire body. One of these hormones, cortisol, enables us to adapt physically and mentally to the stimulus. Following a major or repeated stress that the individual has no control over, however, cortisol is secreted in great quantities over a long period of time. This hypersecretion has damaging effects on the individual, to the point of accelerating aging and facilitating the onset of illnesses such as depression"
  • Depression can trigger diabetes, study suggests - MSNBC, 6/17/08 - "Depressed people were 42 percent more likely to develop diabetes ... depression also pushes up the levels of stress hormones such as cortisol ... Elevated cortisol levels can impair insulin sensitivity in the body and encourage belly fat, a risk factor for diabetes"
  • New Clue on Brain Problems and Diabetes - WebMD, 2/18/08 - "Too much of a stress-related hormone may be at the root of memory and other common brain-related diabetes complications ... increases in the stress hormone caused a drop in brain cell regeneration and a decline in memory formation in the rats. But normalizing the levels of the stress hormone reversed many of these negative effects and restored relatively normal brain function, regardless of changes in insulin production"
  • Stress Hormone Impacts Memory, Learning In Diabetic Rodents - Science Daily, 2/17/08 - "A new study in diabetic rodents finds that increased levels of a stress hormone produced by the adrenal gland disrupt the healthy functioning of the hippocampus, the region of the brain responsible for learning and short-term memory. Moreover, when levels of the adrenal glucocorticoid hormone corticosterone (also known as cortisol in humans) are returned to normal, the hippocampus recovers its ability to build new cells and regains the "plasticity" needed to compensate for injury and disease and adjust to change"
  • Patients With Mild Cushing Syndrome May Benefit From Adrenalectomy - Science Daily, 12/8/07 - "Diabetes and hypertension improved considerably in most affected patients after adrenalectomy. In addition, all eight patients who reported easy bruising before surgery noted resolution of the problem, and seven of the nine patients lost weight. Fat accumulation around the neck disappeared and muscle weakness improved, often markedly ... patients with subclinical Cushing syndrome rarely have enough cortisol in their urine to raise concern ... The cutoff values are intentionally set high so that we minimize the false positives"
  • Depression Associated With Low Bone Mineral Density - Medscape, 12/3/07 - "The novelty of this study is the fact that these women were not severely depressed ... Depression is considered a disease of chronic stress, Dr. Cizza said, with attendant increases in the stress hormone cortisol, and cytokines produced by the immune system. "Those substances are helpful to fight stress, but if there is too much cortisol or cytokines, there are side effects," he said. "One of the side effects is bone loss, so it was obvious to ask the question, 'do women with depression have low bone mass?'""
  • Feeling Stressed? How Your Skin, Hair And Nails Can Show It - Science Daily, 11/12/07 - "When a person becomes stressed, the level of the body’s stress hormone (cortisol) rises. This in turn causes an increase in oil production, which can lead to oily skin, acne and other related skin problems ... stress has a negative effect on the barrier function of the skin, resulting in water loss that inhibits the skin’s ability to repair itself after an injury"
  • Blood Pressure Drug Curbs Brain Damage From Alzheimer's, Depression And Schizophrenia - Science Daily, 11/6/07 - "Prazosin, also prescribed as an antipsychotic medication, appears to block the increase of steroid hormones known as glucocorticoids ... Scientists believe stress activates a neurochemical response in the brain that triggers the release of glucocorticoids in the brain, and that high levels of glucocorticoids in blood serum are associated with such psychiatric conditions as schizophrenia, depression, PTSD and Alzheimer's disease"
  • Relationship between cortisol and physical performance in older persons - Clin Endocrinol (Oxf). 2007 Jun 7 - "Physical performance is negatively associated with high cortisol levels in older persons"
  • Screening of Cushing's syndrome in adult patients with newly diagnosed diabetes mellitus - Clin Endocrinol (Oxf). 2007 Jun 4 - "unknown CS is not rare among patients with diabetes mellitus ... early diagnosis and treatment of CS may provide the opportunity to improve the prognosis of diabetes"
  • Low Cortisol Caused by Quetiapine - Doctor's Guide, 5/23/07 - "Quetiapine's 5-HT2 receptor blocking properties are thought to cause a strong inhibitory effect on ACTH and cortisol secretion" - Maybe Seroquel (quetiapine) might be way for people with high cortisol to reduce it but quetiapine has its own problems such as increased risk of diabetes and increased weight.
  • Relation of Cortisol Levels and Bone Mineral Density Among Premenopausal Women With Major Depression - Medscape, 5/4/07 - "a lower BMD and increased bone resorption were found in women with mild depression. Major depression had important effects on BMD and bone turnover markers. Depression should be considered among risk factors for osteoporosis in premenopausal women, therefore it may be useful to assess BMD values of MDD patients, and to treat them in cases of lower BMD values"
  • Scientists Unravel Clue In Cortisol Production - Science Daily, 4/24/07
  • Depression May Trigger Diabetes In Older Adults - Science Daily, 4/23/07 - "Carnethon theorizes that the culprit responsible for diabetes in persons who are depressed is a high level of a stress hormone, cortisol"
  • Salivary Cortisol Levels May Be a Biomarker for Late-Life GAD - Medscape, 3/6/07 - "The GAD group showed elevated basal levels compared with the control group. There was also a positive correlation between cortisol levels and severity of GAD"
  • Cortisol Secretion in Patients With Type 2 Diabetes: Relationship with chronic complications - Diabetes Care. 2007 Jan;30(1):83-8 - "the degree of cortisol secretion is related to the presence and number of diabetes complications"
  • Cortisol-cause and cure for metabolic syndrome? - Diabet Med. 2006 Dec;23(12):1281-8 - "reducing cortisol action may provide a novel therapeutic approach in the metabolic syndrome. There is substantial evidence that circulating cortisol concentrations are higher in people with hypertension and glucose intolerance ... Promising preclinical data suggest that novel 11beta-HSD1 inhibitors will have a role in lowering intracellular cortisol levels as a treatment for the metabolic syndrome"
  • Adults Who Go To Bed Lonely Get Stress Hormone Boost Next Morning - Science Daily, 10/31/06
  • Hormone Resistance Of Pituitary Tumors And Cushing Disease Explained - Science Daily, 10/28/06
  • Salivary Cortisol Response to Prednisolone Challenge Helps Understand Treatment-Resistant Depression - Doctor's Guide, 9/19/06 - "prednisolone is a better corticosteroid than dexamethasone to assess the HPA axis because it binds to 2 different receptors, not only the glucocorticoid receptors but also the mineralocorticoid receptors, providing a more physiological approach"
  • Reactions to Stress May Affect Brain Aging - Medscape, 8/14/06 - "the adrenal stress hormone cortisol appears to play an important role in mediating the effects of stress on the brain ... Although acute stress seems to enhance immune function and improve memory, chronic stress has the opposite effect and may even lead to disorders that become more prevalent with aging, such as depression, diabetes, and cognitive impairment"
  • Chronic Stress, Depression and Cortisol Levels Are Potential Risk Indicators for Periodontal Disease - Doctor's Guide, 5/31/06 - "being a caregiver to relatives with dementia, hypercortisolemia (overproduction of cortisol) or stress were associated with elevated plaque levels and increased gingival bleeding in a study that examined adults aged 50 years and older"
  • Antiglucocoticoid treatments for depression - Aust N Z J Psychiatry. 2006 May;40(5):402-5 - "Both preclinical and clinical studies report encouraging results which suggest that lowering circulating cortisol levels or blocking the effects of elevated cortisol with antagonists, which may up-regulate glucocorticoid receptors, has therapeutic benefits in terms of improvements in depressive symptoms and some domains of neurocognitive function"
  • Pasireotide (SOM230) Shows Promise for Treating Acromegaly, Cushing's Disease and Carcinoid Tumors - Doctor's Guide, 5/2/06
  • Stress-induced Levels Of Hormone Responsible For Binge Behaviour - Science Daily, 4/14/06
  • Got a Phobia? Hormone May Help - WebMD, 3/20/06
  • Cortisol correlates with metabolic disturbances in a population study of type 2 diabetic patients - Eur J Endocrinol. 2006 Feb;154(2):325-31 - "The degree of severity of several clinical measures of type 2 diabetes correlates with cortisol concentrations. Moreover, the results provide evidence for a positive relationship between metabolic disturbances and cortisol concentrations that are within the accepted normal range"
  • Stress Hormone: No Link to Obesity? - WebMD, 2/3/06
  • Adrenalectomy - Medscape, 8/31/05
  • Long-Term Stress May Shrink the Brain - WebMD, 5/20/05 - "Previous studies have already shown that stress hormones, such as cortisol, can increase the risk of heart disease and other ailments, but a new study shows that stress hormones may also shrink the brain"
  • Obesity and cortisol status - Horm Metab Res. 2005 Apr;37(4):193-7 - "Tissue hypercortisolism, due to increased intracellular activity of 11beta-HSD-1, which catalyzes reduction of cortisone to cortisol, has been reported in obese mice and humans"
  • Metyrapone May Be Effective as Additive Treatment of Major Depression - Medscape, 12/6/04 - "Alterations of the hypothalamic-pituitary-adrenal (HPA) axis are the most consistent pathological endocrine findings in depression"
    • Metyrapone - NetDoctor.co.uk - "Metyrapone works by stopping the natural production of a steroid hormone called cortisol"
  • Feds Sue Marketers Over Ads For Diet Pill - Intelihealth, 10/8/04
  • Dexamethasone Suppression Test Can Indicate Suicide Risk - Clinical Psychiatry News, 9/04 - "A positive DST at any point back then seems to indicate an increased suicide risk down the road"
  • Child’s Cortisol Level May Signal Depression Risk - Psychiatric News, 12/19/03 - "But even if individuals who were especially vulnerable to depression because of an abnormal cortisol response were identified, what could be done to keep them from developing depression? Using cognitive-behavioral therapy to teach them how to better deal with stress is one possibility, Feder said. Also, drugs are being developed to counter excessive cortisol secretion, and such drugs might likewise benefit individuals with this risk factor, she added"
  • Higher Risk of Hip Fracture with Increasing Pre-Fracture Doses of Corticosteroids - Doctor's Guide, 10/23/03
  • Stress Feeds the Need for Comfort Food - WebMD, 9/9/03
  • Increased Cortisol Levels Linked to Decrease in Attention - Medscape, 8/11/03 - "Corticosteroids may be responsible for cognitive complaints symptoms in patients who take high doses of the medication chronically"
  • Steroid-Treated Patients Have High Risk of Cardiovascular Event - Doctor's Guide, 6/23/03
  • Schizophrenia Drugs Linked to Diabetes - WebMD, 6/3/03 - "close to 25% of them developed high blood sugar levels while taking Clozaril, the first of these newer schizophrenia medications -- called "atypical antipsychotics." ... people with schizophrenia have a four- to six-fold risk of diabetes compared with the general population ... One possible explanation: Those with schizophrenia typically have higher levels of cortisol, known as the "stress hormone," because the body releases it during times of agitation. And high cortisol levels can cause problems in the way blood sugar is metabolized"
  • Mirtazapine Attenuates Hypothalamic-pituitary-adrenocortical Axis Hyperactivity in Depressed Patients - Doctor's Guide, 4/17/03 - "it has been shown to have an acute inhibiting effect on cortisol secretion in healthy subjects ... Apparently, mirtazapine rapidly attenuates HPA axis hyperactivity in depressed patients via direct pharmaco-endocrinological effects. However, this amelioration of HPA system dysregulation is not necessarily related to clinical improvement" - Click here for a previous study.
  • New Stress-Buster Drugs Block Hormone Binding - Clinical Psychiatry News, 4/03 - "A new class of anxiety-relieving drugs—agents that interrupt core hypothalamic-pituitary-adrenal (HPA) stress signals—will emerge in the next 2-3 years ... In his HPA axis model of depression, the affected individual has a blunted ability to counterregulate in response to stress-induced cortisol increases, and thus is unable to turn off the fight-or-flight HPA mechanism. The result is constant anxiety and overreaction to external stimuli, followed by a sense of learned helplessness and loss of motivation. Many symptoms of deeply entrenched depressionanxiety, loss of appetite, reduced libido, elevated heart rate, hypertension, and dyslipidemia—point to HPA dysregulation ... People with melancholic depression do tend to produce abnormally high levels of CRH. These individuals also have elevated levels of cortisol"
  • Nighttime Salivary Cortisol Test Has Excellent Specificity and Sensitivity - Doctor's Guide, 4/7/03 - "Pseudo-Cushing's may result from obesity, depression, anxiety, poorly controlled diabetes, alcoholism, liver disease, or excessive exercise ... The salivary cortisol test had "100% specificity for ruling out pseudo-Cushing's," ... the test provides the opportunity for long-distance monitoring and follow-up. The patient can collect a sample and mail it to a laboratory for measurement"
  • Videoscopic Adrenalectomy Reduces Operative Trauma - Doctor's Guide, 4/3/03
  • Belly full of danger - USA Today, 2/25/03 - "people with wide girths are more likely to have large amounts of deep-hidden belly fat around their organs. It might be the most dangerous kind of fat and could increase a person's risk of diabetes, heart disease, stroke and some types of cancer ... visceral or intra-abdominal fat, is linked to high cholesterol, high insulin, high triglycerides, high blood pressure and other problems ... So far, physical activity and weight loss appear to be the key ... It's very likely that genes, sex hormones and stress hormones (cortisol) play a role"
  • Surgeon Uses New Method To Remove Pituitary Tumors - Doctor's Guide, 1/30/03 (pituitary tumors is sometimes a cause of Cushings)
  • How Your Mind Can Heal Your Body - Time Magazine, 1/20/03 - "More and more doctors—and patients—recognize that mental states and physical well-being are intimately connected. An unhealthy body can lead to an unhealthy mind, and an illness of the mind can trigger or worsen diseases in the body. Fixing a problem in one place, moreover, can often help the other ... Somehow depression makes the body less responsive to insulin, the hormone that processes blood sugar—plausibly through the action of cortisol, a hormone that can interfere with insulin sensitivity and that is often elevated in depressed patients ... Cortisol may also make depressed patients more prone to osteoporosis ... Cizza estimates that some 350,000 women get osteoporosis each year because of depression. Cortisol appears to interfere with the ability of the bones to absorb calcium and offset the natural calcium loss that comes with menopause and aging"
  • Depression-Altered Immune Function/Steroid Regulation Unrelated to Elevated Cortisol - Doctor's Guide, 12/19/02
  • New Vistas in Antidepressant Development - Medscape, 11/21/02 - "The evidence for corticotropin-releasing factor (CRF) hypersecretion in depression and certain anxiety disorders is compelling ... CRF is transported to the anterior pituitary via the hypothalamo-hypophyseal portal system where it promotes the release of adrenocorticotropic hormone (ACTH) into the general circulation, which in turn stimulates the production and release of cortisol from the adrenal cortex ... Numerous studies have revealed that the direct injection of CRF into the CNS of laboratory animals produces effects reminiscent of the cardinal symptoms of depression, including decreased libido"
  • Ability To Cope With Stress May Play A Role In Cancer Progression - Intelihealth, 11/2/02 - "Studies have shown that people who adopt active coping strategies have better immune function and lower cortisol levels, and just the opposite for people who use passive coping strategies"
  • Chronic Stress And Metabolic Syndrome Linked - Doctor's Guide, 11/27/02 - "While the 24-hour cortisol metabolite and normetanephrine (three-methoxynorepinephrine) outputs were higher among cases than controls, HRV and total power were lower among cases" - Makes sense.  Stress increases cortisol, cortisol causes high blood sugar.  Also see my metabolic syndrome and stress pages. - Ben
  • Post-Adrenalectomy Radiosurgery Helpful In Adrenocorticotropic Hormone-Producing Pituitary Adenomas - Doctor's Guide, 11/13/02
  • Diabetes Drugs May Help Cushing's Syndrome - Reuters Wire, 11/07/2002 - "Cushing's syndrome results from high levels of the hormone cortisol, and can cause fat accumulation in the upper body and face, and thinning of the arms and legs. Patients can experience high blood pressure and high blood sugar, along with depression, fatigue, irritability and weakened bones ... a protein called PPAR-gamma, which is found on pituitary gland tumor cells, appears to be linked to overproduction of ACTH ... researchers injected mice with ACTH-secreting pituitary tumor cells and then treated them with commonly used diabetes drugs, rosiglitazone (Avandia) and troglitazone, or an inactive placebo ... There was an 85% reduction in ACTH and a corresponding 96% reduction in their cortisol-like hormone"
  • Foetal Programming Influences Hyper- and Hypocortisolism - Doctor's Guide, 11/7/02
  • Short Term Mifepristone Effective For Psychotic Major Depression - Doctor's Guide, 10/22/02 (mifepristone lowers cortisol)
  • Exercise, Eating to Enhance Memory? - Dr. Weil, 9/26/02 - "Dr. Khalsa explains that in addition to age, chronic stress can harm the hippocampus via the release of high levels of the hormone cortisol from the adrenal gland"
  • Secondary Causes of Osteoporosis Higher in Fracture Patients - Doctor's Guide, 9/23/02 - "The most common cause of secondary osteoporosis is corticosteroid excess, whereas others include malignancy, gastric surgery, alcoholism, and anticonvulsant therapy use. Prior studies have shown that as many as 30 percent of postmenopausal women exposed to corticosteroids demonstrate causes of secondary osteoporosis"
  • Sertraline Effects Differ in Depressed Women - Doctor's Guide, 6/6/02 - "The investigators say four-week sertraline therapy increased plasma cortisol levels in the depressed patients"
  • Stress Hormone Behind Bad Skin - WebMD, 5/17/02 - "In response to stress, the brain signals production of several hormones. One of them is stress hormone, which makes the oil glands in the skin go into overdrive. Triggering of the stress system can also lead to hair loss, skin aging, and other skin problems" - I believe they are talking about cortisol.
  • Apolipoprotein E May Modulate Cortisol Production - Clinical Psychiatry News, 4/02 - "increased cortisol has been associated with a higher risk of a number of age-linked diseases, including diabetes mellitus, hypertension, and osteoporosis. In Alzheimer's disease, increased cortisol levels may lower the threshold for damage or death of hippocampal neurons"
  • Early to bed, kids better handle stress - USA Today, 3/14/02 - "Prolonged output of cortisol can: Raise blood pressure and heart rate. Weaken immune response, so that colds and other viruses take hold more easily. Make it harder to concentrate when challenged"
  • Managing Stress Key To Success - Intelihealth, 2/26/02 - "an overload of adrenaline and other stress hormones such as dopamine and cortisol can inhibit brain centers that control recollection of memory. That includes physical movements, from finding chords on the piano to skating triple flips"
  • Stress Hormones Drive Night Eaters - WebMD, 2/12/02
  • U.S. Panel Outlines Strategies for Managing Adrenal Gland Tumours - Doctor's Guide, 2/7/02
  • Study: Stress Takes Toll On Brain - Intelihealth, 1/18/02
  • Stress Causes Lasting Brain Changes - WebMD, 1/17/02
  • Cortisol Feedback Could Be Normal in Major Depression Patients - Doctor's Guide, 1/2/02
  • Inhaled Fluticasone Linked to Acute Adrenal Insufficiency - Doctor's Guide, 11/6/01 - So does that mean it will lower cortisol? - Ben
  • Study: Women Cope Better With Stress - Intelihealth, 11/14/01 - "Men with higher levels of cortisol, a hormone produced during stress, recalled fewer words than males with lower levels"
  • The 'Language of Love' Good for Marriage -- and Health - WebMD, 8/28/01 - "positive interactions between couples can boost immunity and reduce the risk of heart disease by keeping stress hormones low ... language can affect cortisol levels ... women with cortisol increases were two to three times more likely to be divorced within 10 years"
  • Hormone Levels Could Spell D-I-V-O-R-C-E in Future - WebMD, 8/24/01 - "those who had the highest levels of three out of four key stress hormones during initial interviews were the most likely to be divorced 10 years later ... The hormones included epinephrine (better known as adrenalin, or the "fight-or-flight" hormone), norepinephrine, ACTH, and cortisol"
  • New Antidepressant Class May be On Its Way - Doctor's Guide, 8/9/01 - "A new class of antidepressants, which antagonize corticotropin releasing hormone 1 receptors, may be available soon"
  • Denial Speeds Progression To AIDS - Doctor's Guide, 4/2/01 - "The new study also linked higher average blood level of the stress hormone cortisol to speedier progression to AIDS"
  • Stress Linked to Functional Hypothalamic Amenorrhea - Doctor's Guide, 6/21/01 - "Increased levels of the stress hormone cortisol are clearly elevated in the bloodstream of child-bearing-aged women who have stopped menstruating"
  • Pattern of Corticotrophin-Releasing Hormone Increase Signifies Fetal Distress - Doctor's Guide, 6/21/01 - "The most plausible hypothesis is that stress leads to an increase in cortisol levels in the fetus and this then stimulates the placenta to make more CRH"
  • Frequent Flyer Beware: Jet Lag Is Bad for the Memory, Brain Cell and Memory Loss Related to Increased Stress Hormone - WebMD, 5/22/01 - "Over the long haul, Cho believes that elevated cortisol due to shifting time zones is responsible for both the loss of brain cells and the memory impairment. The higher the elevations in cortisol levels, the smaller the temporal lobe volumes on MRI"
  • Stressed Moms May Deliver Early - WebMD, 4/6/01 - "when traumatic or emotional situations occur, levels of the body's stress hormones, including cortisol, increase ... stressful events in the first few weeks of pregnancy may put them at risk for having a baby with birth defects of the face, lips, or heart"
  • How You React to Stress May Affect How Your Clothes Fit - WebMD, 1/16/01 - "fat created by cortisol is the "deep-belly" kind, which, one expert says, is known to increase health risks"
  • Cognitive Dietary Restraints is Associated with Higher Urinary, Cortisol Excretion in Healthy Pre-Menopausal Women - Doctor's Guide, 12/27/00
  • Stress May Cause Excess Abdominal Fat In Otherwise Slender Women - Doctor's Guide, 11/15/00
  • Stress is bad, but one expert says it's also fattening - CNN, 10/31/00
  • Spare Tire Around the Middle? Maybe Your Life Is Too Hectic - WebMD, 10/24/00
  • Stress May Cause Fat Around the Midsection in Lean Women - WebMD, 9/22/00
  • Women's Hormones Reveal State Of Their Marriages - Intelihealth, 8/8/00
  • Denial Speeds Progression To AIDS - Doctor's Guide, 8/1/00 - "The new study also linked higher average blood level of the stress hormone cortisol to speedier progression to AIDS"
  • Neuroscience finds foggy link between depression and memory loss - CNN, 4/18/00 - "Studies show that prolonged depression or stress leads to elevated levels of cortisol, a "stress" hormone produced by the adrenal glands. This in turn appears to shrink or atrophy the hippocampus, the sea-horse shaped part of the brain associated with many kinds of memory and learning."
  • Behavioral Program Boosts Antibody That Fights Breast Cancer - Doctor's Guide, 8/24/99
  • Stress Can Jeopardize Our Health - Dr. Dean, 8/17/99
  • Studies Look At The Harmful Effects Of Pent-Up Anger - Intelihealth, 8/10/99
  • Chronic Stress Could Damage Brain - Intelihealth, 4/14/99
  • Morning Coffee Boosts Blood Pressure, Stress Hormones Throughout The Day - Doctor's Guide, 3/5/99
  • What Cortisol is - University of Glasgow, 1996
  • Study finds high level of stress hormone impairs memory - CNN, 8/20/98
  • Why Are So Many Women Depressed? - Scientific America Women's Health: A Life Long Guide, Summer 1998 (see the subtopic "Stress and Cortisol") - "It is unclear whether depression is a cause or a consequence of elevated cortisol levels, but the two are undoubtedly related."
  • Study Supports Role Of Anticort In Treating Alzheimer's, HIV - Doctor's Guide, 4/17/98 - "Cortisol's role as a cause of disease is most recently confirmed in a study to be published in the May issue of the journal Nature Neuroscience. Authored by Dr. Sonia Lupien of McGill University, the study reports that high levels of cortisol play a key role in Alzheimer's, memory loss, shrinkage of the brain and aging. Dr. Lupien also states that such illnesses might be prevented with medications to reduce elevated cortisol levels."
  • The Cortisol Connection - Science News Online, 11/29/97
  • Anti-Cortisols May Offer New Hope For Retinitis Pigmentosa - Doctor's Guide, 11/17/97
  • Peptide Found In Brain Reduces Stress Response - Doctor's Guide, 7/28/97
  • One Child Enough To Put Working Mothers At Higher Stress, Health Risk - Doctor's Guide, 7/23/97
  • Antifungal Drug May Be New Treatment For Chronic Kidney Disease - Doctor's Guide, 4/1/97 - "chronic kidney diseases progressed fastest in patients whose adrenal glands produced a large amount of cortisol, the body's principal steroid hormone, and slowest in patients whose adrenal glands produced little cortisol"
  • Anticort Aids Treatment - Doctor's Guide, 2/11/97
  • NIMH Links Depression to Bone Loss - Doctor's Guide, 10/16/96 - "Excess cortisol secretion, a common feature of some forms of depression, is known to cause bone loss"
  • Findings Show Cortisol's Major Role in AIDS and Other Diseases - Doctor's Guide, 6/21/96 - "Anticort, a high dose form of stabilized procaine HCL, is being successfully tested in pilot clinical studies in Brazil and the U.S., in HIV+ and AIDS populations."

Cushing's syndrome is caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol. I've talked to doctors who implied that it was black and white, i.e. you have Cushing's or you don't.  My personal opinion, and I'm not a doctor, is that there is a linear gray area in between.

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