Having high nighttime cortisol levels affects our morning cortisol. Usually the test shows levels of cortisol lower than they should be. Salivary cortisol is the best test for cortisol, because having a blood draw is stressful for obvious reasons. When morning cortisol is not as high as it should be, this is just like the sun only rising halfway. Your brain thinks it is afternoon when it is really morning. The body needs higher morning cortisol because that is when we are ready to work. Many of us drink morning coffee to stimulate our minds. But then 3 or 4 hours later, we become sluggish and the momentum falls. Part of this is that we are often trying to do too much in the first place. But it is also in part to cortisol dropping because it cannot stay up normally.

A typical scenario for many of us is when you get home from work, had a stressful drive home, we eat dinner, then sit down to watch TV, and then get on your iPad or phone and then it’s suddenly 11pm, and you need to get up at 6am. You’ve been stimulating your brain, and it is expected that you will have a harder time going to sleep. Alternatively, you will go to sleep, only to awake a few hours later and find it difficult to return to sleep. These are the type of situations where your cortisol and other hormones are just not where they should be, it is always a little off. Remember, too much cortisol at night means that you are not going to release those anabolic hormones and the body’s repair mechanisms will be compromised. Predictably, you will wake up tired and need caffeine for morning stimulation just to get going.

Cortisol is a primitive hormone, meaning that since humans have been around, the physiologic rhythm has been the same. It is a fight or flight hormone, when there is an acute stress, we are going to increase cortisol because we need to make new blood sugar, turn off pain receptors, and run away from the danger. Modern society has turned cortisol from an acute hormone, to a chronic hormone. As most of us are no longer in daily life-threatening situations, thus we are stimulating our cortisol way more than necessary.

We all create scenarios in our heads everyday – the driver in the car who just honked in front of you must not be a good person, a colleague does not say good morning, as so on. We all make these stories up in our minds, and true or not, they trigger a cortisol response. We are not being chased by the tiger, but our cortisol is being stimulated as if we were. That perceived stress is the same as the real one. After years of this, our bodies will have a hard time keeping up with cortisol demands and we lose our reserve of cortisol.

What happens when we experience a major stress? Death of a loved one, car accident, loss of a job, etc. Your cortisol reserve becomes completely exhausted and we start to see the beginnings of cancer, heart disease, and autoimmune reactions. Especially in the elderly, the reserve of cortisol is lower, so things like a broken hip, COVID-19, or a heart attack can have bigger consequences. Daily life stressors can also decrease our reserve of cortisol. Nowadays it is the COVID-19 virus or the Floyd riots that are causing nonstop stress. In normal times, every day we are stuck in traffic, stressing over the food we eat, climate change, politics, something our spouse or children did (or didn’t do), etc. In the context of degenerative disease, cancer, cardiovascular disease, neurological diseases these everyday minor stressors can add up. Think about the person with Multiple Sclerosis who stresses about getting in and out of a car, going to the pharmacy, medical appointments, or even getting to the store.