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CORTISOL and Muscle
The pain in my muscles was so exaggerated it
seemed surreal. It felt almost as if Popeye had worked me over
after eating five cans of spinach. The intense aches I felt that
day would bring about an epiphany that would change everything. I
had been hitting the weights mercilessly for the past six months on
a schedule of five days on, one day off with sessions of
lung-burning cardio squeezed in. I was exhausted, sore and wasn’t
making the gains in muscle mass that I had expected from such an
intense training regimen. I tried everything—you name it: protein,
creatine, vitamins, minerals, etc. But they only seemed to help
minimally. I took two days off every 12 days, which I thought was
plenty; however, after doing some intensive research on overtraining,
I realized that high cortisol levels might be my problem. I quickly
went to my physician and had him measure my cortisol levels first
thing in the morning. The verdict was in—my cortisol levels were
too high. This was not only a problem for me, but it afflicts many
people across the nation. Now, most people have heard of cortisol.
And many know it’s bad news. But unfortunately, they don’t know the
extent of damage this catabolic hormone can cause. This
muscle-wasting hormone is literally eating away at their full
muscle-building potential. Weight training enthusiasts must declare
all-out war on this catabolic hormone if they have any aspirations
of building muscle. Before we attack all of your cortisol problems,
some background on this intriguing subject is in order. After all,
understanding leads to solutions (or was it madness).
Cortisol is the primary glucocorticoid.
It is a natural hormone of the adrenal glands. Although cortisol’s
precise actions are not completely understood, we know that it is
essential for life. Cortisol is necessary to maintain important
processes in times of prolonged stress. Most of it’s effects are
not directly responsible for the initiation of metabolic or
circulatory processes but it is necessary for their full response.
17-Hydroxyprogesteroneà11-Deoxycortisol à Cortisol.
Cortisol can exert it’s effects on peripheral
tissue. Once in circulation, cortisol is typically bound to a
specific glucocorticoid-binding alpha2-globulin called transcortin.
About 75% of cortisol is bound to transcortin, 15-20% bound less
tightly to albumin, and 5% of circulating cortisol is unbound (1).
This is an important factor to take into consideration when
measuring cortisol levels. The 24-hour urinary excretion of
unmetabolized cortisol is one of the best ways to accurately gauge
cortisol levels. This helps take into account bound and free
cortisol. Exogenous cortisol has a half-life of about 70-90
minutes. Cortisol can be converted to it’s 11-keto analogue
cortisone (you know, the stuff you take when you have some bad
swelling or inflammation).
Normal renal function also requires cortisol.
When there is an absence of cortisol or cortisol is decreased,
glomerular filtration rates fall and water cannot be excreted
rapidly. This can consequently lead to water retention and you’ll
look just like the Michelin man.
The major catabolic effects of cortisol involve
it’s facilitating the conversion of protein in muscles and
connective tissue into glucose and glycogen (cortisol may increase
liver glycogen). Gluconeogenesis involves both the increased
degradation of protein already formed and the decreased synthesis of
new protein. Cortisol can also decrease the utilization of glucose
by cells by directly inhibiting glucose transport into the cells
(1). A cortisol excess can also lead to a decrease in insulin
sensitivity. Cortisol also reduces the utilization of amino acids
for protein formation in muscle cells. A cortisol excess can lead to
a progressive loss of protein, muscle weakness and atrophy, and loss
of bone mass through increased calcium excretion and less calcium
absorption. That is one of the reasons long distance runners tend to
have skinny physiques. With the amount of stress that runners place
on their body’s, they have high levels of free radicals as well as
cortisol. Excess cortisol can also adversely affect tendon health.
Cortisol causes a redistribution of bodyfat to occur through an
unknown mechanism. Basically, the extremities lose fat and muscle
while the trunk and face become fatter. Some of the signs of
overtraining include higher cortisol levels which may cause
depression type of effects. Cortisol excess can also lead to
hypertension because it causes sodium retention (which can make you
appear bloated) and potassium excretion. In other words,
excessively high cortisol levels may turn you into a girly man! So
the real challenge becomes how can cortisol levels be controlled but
not inhibited completely because of cortisol’s necessary
anti-inflammatory effects. One way is to take anti-cortisol
supplements in the morning upon rising and then before bed time as
these are two times that cortisol levels seem to be raised. Timed
release would not be an option here because this may suppress
cortisol levels over too long of an extended period. The key is to
suppress elevated levels of cortisol not decrease normal
physiological levels of this hormone because as I mentioned earlier,
a small amount is needed for it’s anti-inflammatory and other
Another one of cortisol’s undesirable
effects for athletes is that it causes insulin resistance by
decreasing the rate at which insulin activates the glucose uptake
system, likely because of a post-insulin receptor block (2). Any
type of stress that occurs to the body signals the nervous system to
relay this to the hypothalamus. The hypothalamus then responds by
initiating the stress hormone cascade starting with CRF
(corticotrophin releasing hormone) followed by ACTH (adrenocorticotropic
hormone) release and finally glucocorticoid production (pretty
intense huh?). Stress to the human body can include trauma,
anxiety, infections, surgery, and even resistance training and
aerobics. Recent research has shown that increased cortisol levels
also increased protein breakdown by 5-20%. (3). Even mild
elevations in serum cortisol can increase plasma glucose
concentration and protein catabolism within a few hours in healthy
individuals (4). Cortisol increases with increasing time of intense
exercise. In overtrained individuals, cortisol levels increase
while testosterone levels decrease. That is why one measure of
overtraining is the testosterone: cortisol ratio. By the way,
overtraining is defined as an increase in training volume and /or
intensity of exercise leading to a decrease in performance. Cortisol
can increase bodyfat levels especially when it is increased
dramatically in the body. Increased cortisol levels have an adverse
effect on testosterone levels. In fact, one of the primary
anti-catabolic effects of testosterone and anabolic steroids is it’s
decreasing muscle cortisol metabolism (5). That is one reason why
many athletes can completely overtrain when taking anabolic steroids
and still increase lean body mass and strength.
Some research indicates that cortisol response
to resistance training normalizes after about 5 weeks and that the
testosterone: cortisol ratio is not adversely affected after long
periods of resistance training (6). This suggests that the body has
an adaptive response.
Cortisol can inhibit growth hormone levels by
stimulating the release of somatostatin (a growth hormone
antagonist). It may also reduce IGF-1 expression (IGF-1 is one of
the most anabolic agents in the body and is the substance that is
responsible for most of growth hormones positive effects because GH
converts into IGF-1 in the liver).
Cortisol has other hormone modifying effects.
Cortisol can directly inhibit pituitary gonadotropin and TSH
(thyroid stimulating hormone) (7). By doing so, it can make the
target tissues of sex steroids and growth factors resistant to these
substances. It may also suppress an enyme known as 5’ deiodinase
which converts the relatively inactive thyroid hormone T4 to the
active one known as T3 or triiodothyronine. This can decrease
metabolic rate and make it harder to lose bodyfat (it’s already hard
enough for people and anything making it harder definitely needs to
be kicked to the curb).
There are different stages in sleep and during
one stage, cortisol levels are elevated because protein is being
re-cycled. This is one reason that cortisol suppressing supplements
should be taken before bed time to help minimize excess cortisol
production during sleep.
Cortisol also seems to play a role in various
disease states. It is found in higher than normal levels in diseases
ranging from AIDS and multiple sclerosis to
Alzheimer's. Prolonged high levels of cortisol
can throw the immune
system into chaos and ravage the human body. A
growing number of researchers believe that many of the worst, and
least understood, diseases will soon be identified as caused by high
cortisol, and subsequently treated with cortisol-reducing drugs or
There was an anti-cortisol
conference (the second one ever conducted) held in Las Vegas in 1997
and headed up by Steroidogenesis Inhibitors Inc. and Dr. Alfred T.
Sapse. This conference had many researchers involved in anti-cortisol
research. Abstracts were presented on various supplemental and drug
therapies for decreasing cortisol levels especially in excessive
cortisol production disorders. In particular, there was an abstract
presented by Dr.Sapse that mentioned some nutritional supplements to
lower cortisol levels in the body. These included gingko biloba,
Vitamin A, Zinc, and acetyl l-carnitine (8). Other abstracts
presented there discussed the role of DHEA and it’s metabolites in
helping to decrease cortisol levels (9). Some abstracts presented
looked at the progression of cortisol induced diseases. Overall, the
conference was very informative and helped researchers answer many
questions on cortisol and anti-cortisol therapies as well as opened
the door for further anti-cortisol research.
Cortisol suppression may be an
essential part in the recovery process for athletes involved in a
rigorous training program. In fact, one of the signs of
overtraining syndrome is high cortisol levels. Moderating (not
completely diminishing) cortisol levels is an essential factor in
allowing weight training individuals to completely recover from
their exercise session and maximize results (something we would all
like to do).
It may be a very good idea to get
cortisol levels tested by a qualified physician (when I say
qualified, I mean one that has done this sort of thing before and
has been to med. school) on a regular basis. One of the best times
to test cortisol levels is first thing in the morning on an empty
stomach. This reference value or proper range for cortisol first
thing in the morning should be between 4-19 mcg/dl with sample being
taken from blood. The normal range for free cortisol levels
measured from urine is between 10-110 pg/ml. There is also another
way to measure cortisol through a salivary cortisol screening. The
normal range for cortisol with this test first thing in the morning
is 100-300nmol/L. These tests may not be the final say in
determining high cortisol levels but it will certainly give you an
idea about where your cortisol levels stand.
Here are some solid tips to help
control cortisol levels:
Diet – Make sure you are supplying your body with all
the essential nutrients you need to prevent deficiencies and for
optimal function. This includes plenty of high quality protein,
complex carbohydrates, essential fatty acids, and vitamins and
minerals. Try not to restrict calories continuously as some research
suggests that restricting normal caloric intake by 50% can lead to a
subsequent increase in cortisol levels by 38% (10).
Do not overtrain – Try not to work out 3 or more days
in a row without taking a day off. Keep workouts to under an hour
at the most and train efficiently and intensely. I know this phrase
has been beaten to death but LISTEN TO YOUR BODY!
Take enough rest days between workouts – If you are
really sore, then wait an extra day to train until your body fully
recovers from your previous workout. Remember, less may be more in
Relax and try not to get stressed out easily – Take an
evening walk with a loved one or take a nap when you get a chance.
Try to get at least 8 hours of sleep per night – Sleep
is crucial to the recovery and recuperation process.
Spike Insulin levels after a workout - Insulin
actually interferes with cortisol and may enhance cortisol clearance
from the body. Spiking insulin levels after a workout (by consuming
a high glycemic index carbohydrate) may help minimize excessive
cortisol levels since cortisol levels are elevated significantly
post resistance training.
Supplements that may help
control increased cortisol levels secondary to intense exercise
-This phospholipid which has been known mainly for it’s cognitive
effects seems to have cortisol suppressive properties. Recent
research shows that 800 mg Phosphatidylserine given in two divided
oral doses helps suppress cortisol secondary to intense weight
training (11). In fact, in this same study, the individuals using
PS experienced less muscle soreness as well. Earlier research by
Monteleone confirms these results. By decreasing cortisol levels,
the testosterone:cortisol ratio can increase possibly relating to
anabolic effects. PS seems to only decrease cortisol levels when
they are elevated and does not seem to decrease cortisol levels
below normal. Decreasing cortisol levels or suppression of cortisol
production is not desired in many instances as it may cause adverse
effects such as a decrease in reaction time to wounds and healing
mechanisms in the body. There are two forms of PS available: a
brain cortex derivative and a soy lecithin derivative. The brain
cortex PS has been used in most of the studies and shown to be
– This is basically the acetylated ester of L-carnitine. This
supplement may help prevent the decline in testosterone that occurs
during and after an intense resistance training session. It seems
to lessen the response to stress.
L-Glutamine - This
is the most abundant free amino acid in muscle tissue (12). It
seems to play a very important role in protein synthesis and is very
important to weight training athletes. Some research suggests that
glutamine levels may be a good indicator of overtraining or
overreaching (12). In other words, athletes who were overtrained
generally had low levels of glutamine along with high levels of
cortisol. One study actually showed that glutamine directly
prevents the cortisol-induced degradation of muscle contractile
proteins (13). Some of it’s positive effects include enhancing
protein synthesis, increasing GH levels which can counteract some of
the catabolic effects of cortisol, potent cell volumizing effects
which can create an anabolic environment in muscle cells, and
partially determining the rate of protein turnover in the muscle.
An oral glutamine supplement can help athletes prevent some of the
symptoms of overtraining. It may also enhance glycogen synthesis
through an unknown mechanism. It also helps provide a source of
fuel for the small intestine and may enhance anti-inflammatory
function. It has been shown to boost immune function. I hope you
get the point--Glutamine is a vital nutrient for weight training
– This vitamin,
mainly known for it’s anti-oxidant properties, may also have some
anti-cortisol effects. A study done by Stone entitled “Effects of
Vitamin C on cortisol and the Testosterone: cortisol ratio” showed a
decrease in cortisol levels in 17 junior elite weight lifters. This
study also showed that the individuals taking Vitamin C (an extra
gram a day) improved their testosterone: cortisol ratio by over
20%. This type of decrease in cortisol can lead to increased muscle
and connective tissue hypertrophy and enhanced recovery from
training. Since Vitamin C also decreases your chances of suffering
from a cold or flu infection by 30% (14) and may aid in collagen
synthesis, it would be wise to take some extra vitamin C when
involved in an intense weight training program.
- A mineral that is an essential cofactor in over 300 enzymatic
reactions in the body including testosterone synthesis and steroid
hormone production. Getting enough zinc may make the difference
between making great gains and only making average gains in a weight
– This vitamin which
is often times used for healthy skin function may also minimize
cortisol levels according to Dr. Sapse. He suggested this in an
abstract he presented at the 1997 conference on cortisol and anti-cortisols
Biloba – This herb is
mainly used for it’s excellent cognitive effects by increasing blood
flow and oxygen to the brain which can lead to greater mental focus
and concentration. It may also have additional benefits of
decreasing cortisol levels according to an abstract presented at the
1997 conference on cortisol and anti-cortisols (15). The
anti-stress and neuroprotective effects of ginkgo biloba in this
study were due to it’s effect on glucocorticoid biosynthesis. The
EGb 761 standardized gingko biloba extract was used in this study
and many of the studies showing that it enhances cognition.
- This natural hormone of the adrenal glands that declines after the
age of 30 seems to have some powerful anti-cortisol effects. Many
abstracts presented at the 1997 conference on cortisol and anti-cortisols
discussed DHEA’s role in decreasing cortisol levels. DHEA is fat
soluble so it can cross the blood-brain barrier and have some
effects on cognition as well.
This prohormone is a direct precursor to testosterone which may
explain it’s anti-cortisol effects since increases in testosterone
can bunt elevated cortisol levels secondary to intense weight
training. Different metabolites of androstenedione and
testosterone such as 4-androstenediol, 5-androstendiol, and
nornadrostenediol may also exert some anti-cortisol effects.
However, more research needs to be done in this area to make this
- This steroid
metabolite which is chemically known as Delta
5-androstene-3b,7b,17b,triol was shown in an abstract presented at
the 1997 conference on cortisol and anti-cortisols to counteract the
immunological effects of glucocorticoids (16). This is an
interesting compound that definitely needs to be looked at further.
This is a subject that will be studied
thoroughly in the future. Studies investigating supplemental
strategies against cortisol may help weight trainers get the most
out of their workouts and help enhance the recovery and recuperation
process. Now before you think suppressing cortisol levels can make
you Hercules, remember, cortisol levels are one piece to a large and
complex puzzle. It takes a combination of proper training,
nutrition, and supplementation to achieve your true muscle building
potential. However, getting cortisol levels checked by your doctor
and implementing strategies against cortisol may be a good idea,
especially during a calorie-restrictive dieting phase. So, the next
time you feel tired, sluggish or sore for an abnormally long time in
your weight training program, and you don’t know why, look into
cortisol levels, and you might find the answer.
Griffin J, Ojeda S. Textbook of endocrine physiology, 3rd
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Rizza, et al., “Cortisol-induced insulin resistance in man.
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Brillon, et al., “Effect of cortisol on energy
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Simmons, et al., “Increased proteolysis: an effect of
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Hickson, et al., “Glucocorticoid antagonism by exercise
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(1997) : 106-129.
Chrousos, et al., CRH, Stress and Depression: An
Etiological Approach (Las Vegas, NV: Conference on Cortisol and
Sapse, et al., Anticortisols in the Treatment of
Retinitis Pigmentosa (Las Vegas, NV: Conference on Cortisol and
Baulieu, et al., Anticortisols: Their Potential
Usefulness (Las Vegas, NV: Conference on Cortisol and Anti-Cortisols,
Kelley, et al., “Energy restriction and immunocompetence in
overweight women,” Nutrition Research 18.2 (1998) : 159-169.
Fahey, et al., Hormonal Effects of Phosphatidylserine (PS)
during two weeks of intense weight training (Orlando, Fl : ACSM
Rowbottom, et al., “The emerging role of glutamine as an
indicator of exercise stress and overtraining,” Sports Med
21.2 (1996) : 80-97.
Hickson, et al., “Glutamine prevents down regulation of myosin
heavy chain synthesis and muscle atrophy from glucocorticoids,”
Am J Physiol 268 (1995) : E730-E734.
Anderson, et al., “Vitamin C and the common cold: A double-blind
trial,” J Canadian Med Assoc 107 (1972) : 503-508.
Papadopoulos, et al., Regulation of Glucocorticoid Synthesis
by the Ginkgo Biloba Extract EGb 761 and isolated Ginkgolides
(Las Vegas, NV: Conference on Cortisol and Anti-Cortisols, 1997)
Norbiato, et al., In Vitro Immunomodulatory Effects of Delta
5-Androstene-3b,7b,17b Triol (AET) in Hypercortisolemic Patients
(Las Vegas, NV: Conference on Cortisol and Anti-Cortisols, 1997)
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