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Cortisol, Insulin, Thyroid and The Bioenergetic Circuit

The hormonal and bioenergetic circuit are primarily involved with the maintenance of cortisol, thyroid, and insulin levels, and the organs that maintain those hormones, the adrenals, the thyroid, and the pancreas.

There is also some involvement of the cardionomic circuit. Because of the inter-relationship of the circuits in the NEM stress response model, what affects one of these circuits affects the others.

The pancreas and thyroid hormones, insulin and TSH, along with T3 and T4, exert an effect on metabolism and hormones. In order for your metabolism to remain healthy, glucose is required for fuel. If there is an imbalance in the triad of too little or too much insulin, there will be a significant effect on the bioenergetic circuit.

A weak metabolism can lead to a slow detoxification process and decreased nutrients being delivered to your cells. This will inhibit your ability to deal with stress and its effects on your body.

With continuing stress, the body requires more glucose to keep it geared up for dealing with whatever stress it encounters. This requires an increase in your basal metabolic rate. Imbalances in the thyroid-pancreas-liver interaction prevent this increase from occurring, allowing stress to wreak havoc on your body.

The thyroid is the gland that regulates the speed of your metabolism. If you have an imbalance in this triad that involves low levels of thyroid hormone, your metabolism will be slowed significantly. On the other hand, an imbalance that causes too much thyroid hormone will lead to an increase in your metabolism, burning up the nutrients in your food too rapidly.

Working together, the thyroid hormones and insulin control how effective your metabolic processes will be.

The other main circuit involved in this triad is the hormone circuit. Cortisol secreted by the adrenal glands is one of the most important hormones involved in adrenal fatigue and stress. When your body is under stress, your adrenals secrete cortisol. Continuing stress can lead to adrenal fatigue and a decrease in cortisol. Lower cortisol levels lead to lower thyroid functioning. This lower functioning of your thyroid leads to feelings of fatigue. It also slows your ability to respond to stress.

Your body attempts to conserve energy in your stressed state by slowing your thyroid function and metabolism even more. In contrast to the methods employed in integrative medicine, conventionally trained physicians often overlook the metabolic component and institute hormone therapy to stimulate the thyroid, covering up the underlying issue.

The adrenal hormones also affect the cardionomic circuit. Keeping the heart and lungs functioning appropriately is important for the fight or flight response. Norepinephrine and adrenaline are the two main hormones involved in this function. Adrenaline, or epinephrine, is the most powerful stimulant hormone your body produces. Both of these hormones are secreted by the adrenals. With the adrenals depleted due to continuing stress, these two hormones will also be in short supply. Continuing stress leads to an imbalance of the hormones from the adrenals.

The Interaction of Cortisol, Insulin, and Thyroid
As has been said above, the balance of these three hormones is important for your continuing good health. One of the main tenets of the bioenergetic circuit is that these three hormones affect one another.

A very important function of cortisol is to act in a synergistic way with thyroid hormone at the level of receptor genes. An appropriate level of cortisol is important for good thyroid functioning. Because of this synergy, it is possible for people with imbalanced cortisol levels to have normal thyroid levels but show symptoms of an out of balance thyroid.

All cells of your body have receptors for cortisol and thyroid. Every function of your cells needs appropriate levels of thyroid hormone to work efficiently.

High Levels of Cortisol
If the imbalance in your body involves overly high levels of cortisol, such as in the early stages of adrenal fatigue when the adrenals are overworked, your cells may no longer respond to signals from the thyroid. This brings on a condition called thyroid resistance. In this case, you may have normal thyroid hormone levels, but your cells don’t respond well to signals from the thyroid. When this resistance to thyroid occurs due to high levels of cortisol, other hormones including insulin are also affected. This resistance leads to the necessity of higher levels of hormones to produce the desired effect. When under chronic stress, with increased cortisol, you will feel physically beat because none of your hormones are working effectively.

For example, when cortisol is high, insulin resistance increases. This means your body requires more insulin to push it into your cells. This situation will lead you to gain weight around the middle of your body because you’re not burning fat but storing it. This is one of the reasons you will gain this kind of stubborn belly fat under conditions of adrenal fatigue.

Under conditions of high cortisol, women’s brains become less sensitive to estrogen. This is not a situation of low estrogen but changed brain receptors. Many non-integrative medicine physicians will add estrogen, thinking supplementation is needed to increase estrogen levels. Instead, it will push them into estrogen dominance which can lead to weight gain around the hips, retaining water, and mood swings.

Both high and low cortisol levels affect thyroid hormones. And both high and low levels of cortisol are brought on by continuing stress. In the early stages of high stress, your adrenals are producing a lot of cortisol to fight it. Later, as your adrenals become fatigued because of unrelenting stress, they do not produce sufficient cortisol. Cortisol that is too high or too low leads to resistance to the rest of your hormones, including thyroid and insulin.

High Cortisol and Thyroid
Cortisol decreases levels of TSH, the thyroid hormone. It also decreases conversion of T4 to active T3 and increases conversion of T4 to reverse T3.

Imbalances in cortisol also affect your blood sugar levels. Changes that lead to imbalances in cortisol, either high or low, can bring on hypoglycemia, hyperglycemia, or both. These imbalances in blood sugar affect your levels of insulin secreted by the pancreas. They also inhibit functioning of your thyroid gland and the bioenergetic circuit.

Another way cortisol levels affect the functioning of your thyroid is through its effects on your liver. Continuing high levels of cortisol inhibit your liver’s ability to remove excess estrogen from your blood. This leaves high levels of estrogen in your blood, which increases levels of thyroid TBG, the protein thyroid hormone binds to in your bloodstream.

Binding to TBG keeps the thyroid hormone inactive. It has to be separated from the TBG to become free fraction which allows it to stimulate receptors in your cells. Lab tests measure this kind of thyroid hormone as free T3 and free T4. High levels of TBG means low levels of free thyroid hormone.

High Cortisol and Insulin
Insulin is also involved in this triad. Insulin is produced in the pancreas, one of the organs of the bioenergetic circuit. When there you have high cortisol, insulin resistance results, making it hard for your cells to receive insulin. This results in two things. First, you have less energy because your cells can’t utilize glucose effectively. Second, high blood sugar levels develop because the glucose stays in your bloodstream instead of going into your cells.

Research indicates insulin resistance is closely associated with thyroid problems. Altered lipid levels and issues with the secretion of insulin are part of the complicated relationship between hormones involved in hypothyroidism and hyperthyroidism.
A study published in the International Journal of Health Sciences and Research showed a dysfunction in your thyroid leads to changesin lipid and glucose metabolism. This is a major risk factor for the development of cardiovascular disorders. In addition, a blood glucose related disorder called diabetes dyslipidemia can result.

Hypothyroidism has been shown to have a strong association with increased levels of insulin and increased insulin resistance. It also has been shown to decrease T3 and T4 hormones and increase TSH. This indicates an increased risk of developing health issues related to insulin resistance with hypothyroidism.

Estimates are that between 60 and 70 million people in the U.S. have insulin resistance. Forty percent of those over the age of 50 are more susceptible to this condition. Insulin resistance is often the precursor to type 2 diabetes and is part of metabolic syndrome.

Metabolic Syndrome
Metabolic syndrome as understood in integrative medicine is a combination of several conditions including high blood pressure, gaining excess fat around the waist, increased blood sugar levels, and high levels of triglycerides and cholesterol.

With this combination of conditions, there is a greatly increased risk of stroke, diabetes, and heart attack. Being overweight or obese and living a sedentary lifestyle make this condition more likely. Increased insulin resistance is said to be a cause of this metabolic syndrome.

Ongoing research confirms that both hypothyroidism and hyperthyroidism have significant associations with metabolic syndrome. Much of this association has to do with the effects of thyroid hormones on insulin.

Clearly, insulin has a significant effect on blood sugar. In addition, blood sugar levels are affected by a balance between how much glucose is synthesized (gluconeogenesis) and glucose ingestion. These levels are also affected by the metabolism of glucose and its dispersal in target tissues.

Glucose has to be transported to the target cells, and hypothyroidism decreases this transport in myocytes or muscle cells. This transport is regulated by glucose transporters on cell surfaces, controlling how much glucose gets into your cells. In hyperthyroidism, these transporter cells are stimulated, increasing the amount of glucose in your cells and decreasing it in your bloodstream. This shows the significant effect of thyroid hormones on secretion and clearance of insulin.

Studies have shown a significant number of people with metabolic syndrome to also suffer from thyroid problems. Women seem to suffer from both conditions more frequently than men. Larger waist circumference and lower HDL levels were prevalent among people with metabolic syndrome who also had thyroid dysfunction. Thus it is so important to have a balance in the bioenergetic circuit.


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