Cortisol- the fundamental definition:
Cortisol is a hormone produced and released by the adrenal glands of the human body during times of stress, fight or flight. People of all age and sex produce and release this hormone. Triggered by the Hypothalamus of the brain, this hormone prepares the body for fight or flight by increasing blood sugar, activating anti-stress mechanisms and suppressing other bodily functions. Presence of this hormone accelerates food metabolism and slows down bone formation.

Who is at risk?
People exposed to high levels of stress, anxiety, acute to high mental disturbances and excessive hard work are found to have higher levels of cortisol in their blood stream. Though this is a natural defense mechanism for the body, increased or excess levels of cortisol is not healthy, especially for a prolonged period. However, young people can overcome the excess hormone overload within a few hours. It is the older people whose body seems to take longer periods to get back to the original level of cortisol after stress exposure. Not only does the hormone subside slowly after stress, the hormone level takes an upward trend with age. When tested, a sixty-five year old shows higher levels of cortisol than a twenty-five year old (Perricone N, 2010). With the progression of age, cortisol levels increase alarmingly without most of us noticing it. Cortisol also has harmful effects on pregnancy and fetal brain development (LeWinn et al, 2009).

Risk factors/effects:
A high level of cortisol found in older persons can be associated with higher rates of mortality and other persistent and recurring diseases (Schoorlemmer  et al,  2009). High cortisol is also associated with osteoporosis, hypertension, diabetes mellitus (DM), lower resistance to infections and some mood disorders (Schoorlemmer  et al,  2009). The opposite is also true; stress can increase cortisol levels along with secondary effects like overeating and hence central obesity (belly fat). But what is more hazardous is probably the shortening of a chromosomal compound called the Telomere (Epel ES et al, 2009).  Chronically stressed people seem to have 50% shorter telomeres than ordinary people (Alison, 2011) with the effect that each shortening of telomere length accelerates aging. Some studies also link high concentrations (density) of cortisol in bloodstream to deadly neurologic diseases like Alzheimer’s Disease and Parkinson’s Disease. The most catastrophic damage that cortisol does to human health is the acceleration of brain damage.

It is certainly possible that the diseases discussed above would never arise in patients having low cortisol; because when a history of these diseases is investigated, cortisol frequently stands out as one commonly associated factor.

Telomeres are located at the terminal ends of chromosomes (the DNA strand found in the nucleus of living cells). Every time a cell reproduces, the telomeres shorten, fray and begin to wear out.  Ultimately a time comes when the cell can no longer divide, and this is called “cellular aging” or “cellular senescence”. Once the protective tips (the telomeres) wear out and become shorter, the aging process in humans accelerates. During each division of the cell, the specialized enzymes that duplicate the complex genetic code in each DNA strand cannot continue that replication to the terminal end of chromosomes.  If the telomeres were not present, the process of cellular division would end short of the terminus (end) of the chromosome, and that would result in the loss of some of the genetic information.  The telomeres serve as “disposable buffers” at the ends of the chromosomes, but they are consumed with each cell division.  Telomeres can be restored and replenished by the enzyme “telomerase” (telomerase reverse transcriptase).  Much of anti-aging science today is concentrated on this critical “youth enzyme”.  Now the telomere is also found to shorten with stress, both conscious and unconscious, real or perceived.  According to Hans Selye, Stress is not an event, but one’s perception of that event.  What is stressful to one person may be perceived as ‘exciting” by another. (Selye 1974)  scientific research has shown that the depth to which stress is present in one’s life, its depth and impact, and of course the chronicity – all have shown to have a relation with telomere shortening in humans.

Stress and Telomere Shortening:
One study has shown that women who were exposed to high levels of stress have shorter telomeres on an average than women who have a more relaxed life (Epel ES, 2004). The association is elusive but obvious—stress increases the hormone cortisol and cortisol reduces the telomere length. So, there must be a silent, mysterious role played by cortisol on telomere length. Since stress increases cortisol levels, and since telomere length has implications on an earlier onset of aging; cortisol may indeed play an active role in accelerated aging. Hence, the moniker ‘Death Hormone’ is quite suitable for cortisol.

The Trap of Misdiagnosis:
After labeling cortisol a death hormone, assumptions may be made that it is toxic to the body. However, having a certain amount of cortisol in the blood is also important for healthy living. Cortisol levels which are too low are probably as dangerous as elevated levels.  In the body, homeostasis, or “balance” is important.  Low cortisol levels increase the risk of Addison’s Disease, unsteady or fluctuating levels may indicate the presence of a pituitary tumor (or other gland or drug related problems), and high levels of cortisol are associated with stress, memory loss, behavioral symptoms, aging, Alzheimer’s disease, and many more degenerative or pathological conditions.

Doctors may fail to recognize the prevalence of this disease once a misdiagnosis occurs. High cortisol levels for prolonged periods may eventually lead to low levels (adrenal exhaustion) and both of these are equally disturbing to a healthy body system (Alison, 2011).  Cortisol expresses what is called a circadian rhythm.  People usually have steady high levels of cortisol in the morning (that’s why most heart attacks occur in the morning), variations in levels depend on the amount of stress experienced throughout the day and finally at bedtime, cortisol levels drop (causing fatigue and the desire to sleep).  Monday mornings are the most likely time to have a heart attack.  A meta-analysis published in the European Journal of Epidemiology, analyzed numerous studies of adults in different countries and found that the risk of a heart attack for men was almost 20 percent greater on Mondays, and 15 percent greater for women on Mondays. Research also demonstrates that heart attacks peak around 10 in the morning. (Hitti 2004)  Interestingly, cortisol also tends to peak around this same time.

In healthy adults, cortisol should follow a circadian rhythm, and should be maintained at healthy, physiologic levels.  If cortisol imbalance persists for more than a few months, the levels should be regularly examined by a physician to pinpoint the cause or pathology.  Irregularities in cortisol levels can assist in the diagnosis of a number of diseases.

Just as stress and other mental disturbances can result unsteady or uncontrollable cortisol levels, unbalanced cortisol levels can lead to mental illness in a patient.    

Conclusion:
The hormone cortisol is produced by human body in response to stress and anxiety. This natural response becomes toxic to the body when cortisol is present for prolonged periods and in excess amounts. In older people, the level does not readily drop as it does in younger individuals. This leads to an excess accumulation of cortisol in the blood stream as we age. This becomes toxic to the body and may result in a number of pathologic conditions, or may accelerate the aging process.
People undergoing repeated stressful events in their life, and who are not adequately ‘coping” with those events, produce more cortisol and hence this hormone accumulation is higher in their body. Now, this hormone has proven effects on the length of a telomere which causes aging in humans. Thus cortisol causes aging and is often referred as “the Death Hormone”.

In the scientific field of anti-aging, researchers have indeed labeled cortisol as the death hormone.  Not just aging accelerates with higher concentration of cortisol in blood, but this hormone also speeds up other diseases that usually occur at older age (cardiovascular disease for example).

Death and aging are not merely a breakdown of an organized body system or necessarily the result of an extreme physical trauma, rather these events may be programmed at the cellular level. The pattern, changes and the map of cell division and their alternations—all affect the aging process in humans.

Just like all people who have attained the age 80 years may not look the same, their cell division and alteration may not be done at the same rate. This may be reflected in their telomere length.  Lifestyle, eating habits and daily stress—each of these seemingly minor events matter at the end of life. These factors then decide how “aged” a person of 80 years should actually be!

Among many perhaps yet unidentified contributing factors, cortisol stands up as one of the foremost factors hastening death.  This hormone can be easily managed by dietary interventions, unique supplements, and certain stress coping techniques, and consequently the process of aging can be slowed down (we will discuss these in a subsequent article). Thus management of cortisol plays an important role for ‘pushing the Grim Reaper’ away.
Website:  http://www.deathhormone.com

References:

  • Perricone N, Cortisol – the Death Hormone, Accessed at: http://www.dailyperricone.com/2010/03/cortisol-the-death-hormone/  (Accessed: 5/13/2013)
  • LeWinn KZ, Stroud LR et al. Elevated maternal cortisol levels during pregnancy are associated with reduced childhood IQ.  Int J Epidemiol. 2009 December; 38(6): 1700–1710. PMCID: PMC2786250
  • Schoorlemmer R. M. M., Peeters G. M. E. E., et al. Relationships between cortisol level, mortality and chronic diseases in older persons.Clinical Endocrinology (2009); 71, 779–786.doi: 10.1111/j.1365-2265.2009.03552.x
  • Epel ES, Psychological and metabolic stress: a recipe for accelerated cellular aging?.Hormones (Athens). 2009 Jan-Mar; 8(1):7-22. PMID: 19269917.
  • Alison, Chronic Stress Kills: High Cortisol Levels Damage the Brain, May Lead to Shorter Life and Neurodegenerative Diseases Such As Alzheimer’s and Parkinson’s. 2011 May. Accessed at: http://emediahealth.com/ or http://emediahealth.com/2011/05/07/chronic-stress-kills-high-cortisol-levels-damage-the-brain-may-lead-to-shorter-life-and-neurodegenerative-diseases-such-as-alzheimers-and-parkinsons/ (Accessed:5/13/2013)
  • Epel ES, Blackburn EH et al. Accelerated telomere shortening in response to life stress.ProcNatlAcadSci U S A. 2004 December; 101(49): 17312–17315.PMCID: PMC534658.
  • Selye, H. Stress without distress. Philadelphia: J.B. Lippincott Company. 1974
  • Hitti M. WebMD. Dercember 20, 2004. Accessed at: http://www.webmd.com/heart-disease/news/20041220/morning-heart-attacks-may-follow-bodys-clock (Accessed:5/13/2013)
  • Author's Bio: 

    Dr. Steven Petrosino received his Baccalaureate (BA) degree in both Science and English from Penn State University in 1975, pursued his Masters degree (American Studies) with honors at Penn State in 1977-1978, and graduated Summa Cum Laude with a Doctorate in Nutrition from Lasalle University in 1995. He currently is enrolled in a Ph.D. program at Walden University (Public Health). In 1996-1998 he was involved in external post-doctoral research at the Ohio State University in the Department of Cancer Prevention and Natural Products Research. In 2002, he was enrolled in a post-doctoral external course (Immunobiology) at the University of Pennsylvania.

    Dr. Petrosino is currently employed as a Senior Medical Science Liaison with Human Genome Sciences, Inc. He is married to the former Lynn Tutoli, and he and his wife reside in Dublin, OH. They have two children, Angela Petrosino Johnson, (32) and Aaron (28). Visit his website here: http://www.nutritionadvisor.com