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The Cortisol & Insulin Connection (& How To Manage Stress)

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The Cortisol & Insulin Connection (& How To Manage Stress)

Understanding the relationship between cortisol and insulin resistance is crucial for those concerned about metabolic health and diabetes prevention. Chronically high cortisol levels, produced in response to stress, can lead to insulin resistance, a major risk factor for type 2 diabetes. 

In this article, we will explore the connection between cortisol and insulin and how effective stress management practices are vital for improving insulin sensitivity and reducing the risk of metabolic diseases.


The Role of Cortisol in the Body

Cortisol is a steroid hormone secreted from the adrenal glands that regulates stress, metabolism, immunity, inflammation, and blood pressure

When the body undergoes a stressful event, the sympathetic nervous system activates the fight or flight response. This causes a chain of reactions to stimulate the hypothalamic-pituitary-adrenal (HPA) axis. When the HPA axis is activated, the adrenal glands release cortisol and epinephrine.

Cortisol regulates several functions throughout the body. Elevated levels of cortisol can cause imbalances in blood sugar and blood pressure. This occurs because cortisol increases blood sugar levels by stimulating the release of glucose. Cortisol also enhances the activity of epinephrine and catecholamines, which can cause an increase in blood pressure and heart rate.

Factors Influencing Cortisol Levels

Blood levels of cortisol fluctuate throughout the day, with secretion highest in the morning and lowest in the evening. Several lifestyle factors can contribute to cortisol imbalance:

What Is Insulin Resistance? 

Insulin resistance is a metabolic disorder characterized by an inability of your cells to respond to insulin, resulting in improper uptake of glucose from the blood. This results in the pancreas needing to make more insulin to keep blood sugar balanced. 

The Role of Insulin in the Body

Insulin is a peptide hormone secreted from the pancreas that acts as a signaling molecule for almost every organ in the body. 

  • Insulin regulates blood glucose levels through its effects on skeletal muscle, liver, and fat cells. In healthy individuals, insulin release occurs in response to carbohydrate intake. 
  • Insulin acts to restore blood glucose levels by instructing the body to either use the glucose for energy or to store it as fat. 

What Leads to Insulin Resistance?

Several factors can lead to the development of insulin resistance:

The Connection Between Cortisol and Insulin Resistance

Elevated cortisol levels can significantly impact blood sugar regulation and insulin sensitivity, leading to the development of insulin resistance. Cortisol acts on the liver, muscle, adipose tissue, and pancreas

Elevated cortisol levels result in an increase in gluconeogenesis in the liver, a process that produces glucose from non-carbohydrate sources. This causes an increase in the amount of blood glucose in the liver. 

Cortisol interferes with insulin signaling by directly acting on the pancreas to decrease insulin production, contributing to dysregulated blood sugar levels. High cortisol levels are also linked to an increase in abdominal obesity. Obesity can then lead to insulin resistance because fat cells release inflammatory cytokines which can disrupt insulin signaling. 

The continuous elevation of blood glucose caused by elevated cortisol levels results in chronic hyperglycemia, increasing the risk of developing insulin resistance. 

Identifying and Managing Cortisol-Induced Insulin Resistance

Symptoms and Diagnosis

Elevated cortisol levels and insulin can cause many undesired side effects. The following are signs and symptoms of high cortisol:

The following are signs and symptoms of insulin resistance:

Diagnosing elevated cortisol levels can be done by performing a morning cortisol test. This quantifies cortisol levels upon rising when they should be the highest. 

Diagnosing insulin resistance requires the measurement of several biomarkers that affect glucose regulation:

  • Fasting blood glucose: This test shows how well your body is processing glucose in the absence of food
  • Hemoglobin A1C: This marker tells us how our bodies control blood glucose over a long period of time
  • Serum insulin levels: A fasting blood insulin test is used to measure insulin levels after an overnight fast, providing information on insulin secretion and fasting insulin sensitivity

For more details about diagnosing insulin resistance, you can read this article: Exploring the Link Between Insulin Resistance & Obesity.

Lifestyle and Dietary Interventions

The following lifestyle modifications and dietary changes can help lower baseline insulin levels:

  • Low carbohydrate diet: Limit processed and refined sugar and replace them with complex carbohydrates such as whole grains, fruits and vegetables, sweet potatoes, etc. 
  • The Mediterranean diet has been shown effective in reducing insulin levels
  • Regular physical exercise
  • Managing stress levels through meditation and yoga can help reduce cortisol levels and improve insulin sensitivity.
  • Focus on improving sleep quality.

When Should I Seek Medical Intervention? 

Consulting a healthcare professional is important when experiencing signs and symptoms of elevated cortisol and insulin resistance. If you are experiencing fatigue, unexplained weight gain, or high blood pressure, it is crucial to receive a proper diagnosis from a healthcare professional. 

A trained functional medicine practitioner can offer personalized guidance on managing cortisol and insulin levels and rule out any conditions that warrant more serious interventions. 

Frequently Asked Questions (FAQ)

#1. Can stress cause insulin resistance? 

Yes, prolonged stress causes an elevation in cortisol levels, which directly causes imbalances in insulin signaling and sensitivity (41). 

#2. Does lack of sleep impact my cortisol and blood sugar levels? 

Yes, a lack of sleep disrupts your circadian rhythm and signals the fight or flight response (sympathetic response) to activate, leading to elevated cortisol. The elevated cortisol levels interfere with insulin signaling, causing reduced insulin sensitivity and blood sugar imbalances (41). 

#3. Can losing weight improve my cortisol levels and insulin resistance?

Yes, weight loss is associated with improved insulin resistance. Obesity is associated with increased lipid accumulation within the liver, which directly impairs insulin signaling. Adopting a healthy diet and including aerobic exercise can greatly assist in weight loss and improved insulin sensitivity (1). 


Key Takeaways

  • Cortisol, a steroid hormone produced in response to stress, impacts insulin signaling through various mechanisms
  • Prolonged periods of stress cause insulin resistance, which can lead to obesity, type 2 diabetes, and metabolic syndrome
  • If you are experiencing sweet cravings, weight gain, hypertension, dizziness, and/or brain fog, it is recommended to consult your healthcare provider to evaluate insulin levels
  • Insulin resistance can be reversed by adopting a healthy diet and participating in regular physical exercise
The information provided is not intended to be a substitute for professional medical advice. Always consult with your doctor or other qualified healthcare provider before taking any dietary supplement or making any changes to your diet or exercise routine.
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