I’m so sorry, but I’m going to be the contrarian here: I call bullshit. I’ve been the vegan locavore who’s obsessed with how processed my food is and where it comes from. I’ve been very acutely attuned to my vitamin and mineral intake. None of this has saved me from the deep psychological work I’ve had to do on myself to recover from cPTSD. I know that you identify with this term, and I won’t pretend to know what your experience has been like. But for me, it’s been so incredibly liberating to know that I can’t fully heal through diet and exercise alone. Acknowledging the psychological and spiritual elements at play (especially, in terms of food and consumption) has been the basis for my healing and, ultimately, some peace. I recognize that a Substack comment is not the best medium for this discussion. But just wanted to share a differing (but true to me) perspective.
Hi Bethany! You don’t have to be sorry! I think you lost the plot a bit though - the article specifically talks about more than one factor being in play at the same time for those of us dealing with cortisol issues - while your diet alone didn’t do the trick, it certainly contributed very positively. this article is also very specifically against buying random supplements without understanding how they work. I understand the desire to want to take things personally, as a traumatized person I do that, too, but I actually don’t think we’re coming from different places. I’m really glad you’ve found what works and hope you keep on healing!
I don’t think your perspectives are at odds with each other! The point of it all seems to be that we ultimately need to take stock of the many forces in our lives that contribute to stress - eating nourishing foods, going out in nature, limiting alcohol consumption, going to therapy! The key, however, doesn’t lie in an influencer’s supplement recommendation. Glad you have experienced healing in the way your body and soul needed it! 💕
thank you for writing this!! very annoyed by how easily novel names for nonexistent concepts/problems (moon face, tomato girl, hip dips) go viral and make it easy to stop thinking critically
Great article. However, with the high rates of sexual assault and domestic violence alone, it's asinine to say that most people have never had a fight-or-flight experience.
Firstly, I very much agree that taking nutritional supplements from the Kardashians is only like to end one way. And also on the importance of not looking at stress management as one thing (it's certainly not a deficiency of Ashwagandha gummies).
But there's one nuance that I'm called to touch on here as it's very important, which is the black-and-white consideration of whether cortisol activity 'is' or 'is not' a problem for us, whether adrenal fatigue 'is' or 'is not' real.
The most important question when considering whether our HPA axis is supporting us in a functional manner is whether the cortisol activity matches the demands. If the stress on the system is high, then cortisol activity should be high to match this. If it is not, you have an unpaired stress response.
There are two main limitations to making any conclusions on the role of the adrenals from cortisol levels alone, as these only speak to the adrenal output... they do not tell us about a) the level of stimulation the adrenals received in order to produce the amount we're seeing, and b) the activity of this cortisol at cells.
To touch in on the physiology of cPTSD here, the archetypal pattern here is an overactive sympathetic response (and, with it, increased activation of the HPA axis). By definition, we should be seeing high cortisol levels, yet this is often not the case (and we need not speculate as to the level f HPA activation; taking Heart Rate Variability measurements tells us what we need to know here). Just as importantly, 'normal' cortisol levels in blood/serum/urine does not mean we have normal cortisol activity at cells, because reduced sensitivity of cortisol receptors is one of the hallmarks of any long-term stress on the system.
So I'm not saying these tests have no use, far from it (I've run about 2,500 of them and they are definitely useful). More that medicine repeatedly runs checks for 'out of range, yes or no' to make conclusions on if this is a problem or not. But doing so can easily leave people with a whole load of symptoms caused by HPA dysfunction (see below) and an even harder job of getting where they want to be.
Signs often seen with low cortisol activity: fatigue, brain fog, lowered tolerance for stress, feeling 'tired but wired', slow to wake up in the morning/switch off at night, low appetite in the morning, feeling worse for going several hours without eating, energy dips in the afternoon followed by a 'second wind', worsened sleep for afternoon exercise, feeling wired from coffee, salt cravings, low blood pressure, dizziness upon standing, unrefreshing sleep, sensitivity to bright lights/loud noises, increased startle reflex, cold hands/feet, frequent urination...
So I drop this here not as a criticism of any kind - it's not, as I think your article is good and makes an important point - just pointing out a little detail that I have found to be a really big deal when working with human beings on the frontline, and I hope that is useful/interesting for you and your readers.
I had high cortisol, as tested by saliva. Unbeknownst to me at the time, I also had unbelievably low cellular mag levels. I had barely slept in a couple of years. Sleeping pills weren't really helping. To say I was a mess was an understatement. I also (and I didn't figure this out until much later) have a genetic "thing" that prevents me from processing many pharmaceuticals in a predictable manner. Anti-depressants weren't an option
I pretty much figured this out on my own. My doctor says as much. I had been through several years of severe stress, and then major surgery. Relaxing wasn't something I seemed capable of, and exercise just meant worse insomnia.
Salt, vitamin C, and magnesium were my big 3 for recovery. I still use salt to help my sleep, and to settle anxiety. I no longer need sleeping pills regularly, and have built up some tolerance to exercise. I can generally "manage" anxiety by self-care. I am learning what I enjoy, and sometimes I can even relax for a few minutes! How I haven't become insulin resistant is beyond me.
"The bodies general response for any demand to change" is the perfect definition of stress. As someone with Addison's Disease who doesn't make any cortisol, this is exact how I describe stress. As long as everything is going along in it'd hum drum, normal, boring way I am fine. Any slight deviation though increase my hydrocortisone demands. Keeping my diet to whole foods, plenty of sunshine/fresh air and exercise is key to keeping me in a relatively healthy state. I bounce back fairly quickly from stressful events and in 12+ years have been able to avoid a severe adrenal crisis. I know many with this disease who have terrible quality of life and I think diet and lifestyle play a huge role.
I’m so sorry, but I’m going to be the contrarian here: I call bullshit. I’ve been the vegan locavore who’s obsessed with how processed my food is and where it comes from. I’ve been very acutely attuned to my vitamin and mineral intake. None of this has saved me from the deep psychological work I’ve had to do on myself to recover from cPTSD. I know that you identify with this term, and I won’t pretend to know what your experience has been like. But for me, it’s been so incredibly liberating to know that I can’t fully heal through diet and exercise alone. Acknowledging the psychological and spiritual elements at play (especially, in terms of food and consumption) has been the basis for my healing and, ultimately, some peace. I recognize that a Substack comment is not the best medium for this discussion. But just wanted to share a differing (but true to me) perspective.
Hi Bethany! You don’t have to be sorry! I think you lost the plot a bit though - the article specifically talks about more than one factor being in play at the same time for those of us dealing with cortisol issues - while your diet alone didn’t do the trick, it certainly contributed very positively. this article is also very specifically against buying random supplements without understanding how they work. I understand the desire to want to take things personally, as a traumatized person I do that, too, but I actually don’t think we’re coming from different places. I’m really glad you’ve found what works and hope you keep on healing!
I don’t think your perspectives are at odds with each other! The point of it all seems to be that we ultimately need to take stock of the many forces in our lives that contribute to stress - eating nourishing foods, going out in nature, limiting alcohol consumption, going to therapy! The key, however, doesn’t lie in an influencer’s supplement recommendation. Glad you have experienced healing in the way your body and soul needed it! 💕
Agreed, 100%!
I love your newsletter so much.
Thank you so much, Caroline. I really appreciate that :)
thank you for writing this!! very annoyed by how easily novel names for nonexistent concepts/problems (moon face, tomato girl, hip dips) go viral and make it easy to stop thinking critically
I could not agree more!!! Thank you for reading this! Also, I am scared to google tomato girl???
god bless you.
You have the coolest name in the universe!!!
Haha sheesh thanks I did not pick it out myself :)
Great article. However, with the high rates of sexual assault and domestic violence alone, it's asinine to say that most people have never had a fight-or-flight experience.
Hey Sam, I actually totally agree with you. I did not word that accurately and will edit that now. Thank you for your comment and feedback!
Thank you for writing this! I really needed to read it today.
Thank you for being here! You've got this.
Firstly, I very much agree that taking nutritional supplements from the Kardashians is only like to end one way. And also on the importance of not looking at stress management as one thing (it's certainly not a deficiency of Ashwagandha gummies).
But there's one nuance that I'm called to touch on here as it's very important, which is the black-and-white consideration of whether cortisol activity 'is' or 'is not' a problem for us, whether adrenal fatigue 'is' or 'is not' real.
The most important question when considering whether our HPA axis is supporting us in a functional manner is whether the cortisol activity matches the demands. If the stress on the system is high, then cortisol activity should be high to match this. If it is not, you have an unpaired stress response.
There are two main limitations to making any conclusions on the role of the adrenals from cortisol levels alone, as these only speak to the adrenal output... they do not tell us about a) the level of stimulation the adrenals received in order to produce the amount we're seeing, and b) the activity of this cortisol at cells.
To touch in on the physiology of cPTSD here, the archetypal pattern here is an overactive sympathetic response (and, with it, increased activation of the HPA axis). By definition, we should be seeing high cortisol levels, yet this is often not the case (and we need not speculate as to the level f HPA activation; taking Heart Rate Variability measurements tells us what we need to know here). Just as importantly, 'normal' cortisol levels in blood/serum/urine does not mean we have normal cortisol activity at cells, because reduced sensitivity of cortisol receptors is one of the hallmarks of any long-term stress on the system.
So I'm not saying these tests have no use, far from it (I've run about 2,500 of them and they are definitely useful). More that medicine repeatedly runs checks for 'out of range, yes or no' to make conclusions on if this is a problem or not. But doing so can easily leave people with a whole load of symptoms caused by HPA dysfunction (see below) and an even harder job of getting where they want to be.
Signs often seen with low cortisol activity: fatigue, brain fog, lowered tolerance for stress, feeling 'tired but wired', slow to wake up in the morning/switch off at night, low appetite in the morning, feeling worse for going several hours without eating, energy dips in the afternoon followed by a 'second wind', worsened sleep for afternoon exercise, feeling wired from coffee, salt cravings, low blood pressure, dizziness upon standing, unrefreshing sleep, sensitivity to bright lights/loud noises, increased startle reflex, cold hands/feet, frequent urination...
Cortisol is not actually bad - https://www.marekdoyle.com/is-cortisol-good-or-bad/
The Physiology of 'Adrenal Fatigue' - https://www.marekdoyle.com/the-physiology-of-adrenal-fatigue-what-does-the-science-say/
So I drop this here not as a criticism of any kind - it's not, as I think your article is good and makes an important point - just pointing out a little detail that I have found to be a really big deal when working with human beings on the frontline, and I hope that is useful/interesting for you and your readers.
I had high cortisol, as tested by saliva. Unbeknownst to me at the time, I also had unbelievably low cellular mag levels. I had barely slept in a couple of years. Sleeping pills weren't really helping. To say I was a mess was an understatement. I also (and I didn't figure this out until much later) have a genetic "thing" that prevents me from processing many pharmaceuticals in a predictable manner. Anti-depressants weren't an option
I pretty much figured this out on my own. My doctor says as much. I had been through several years of severe stress, and then major surgery. Relaxing wasn't something I seemed capable of, and exercise just meant worse insomnia.
Salt, vitamin C, and magnesium were my big 3 for recovery. I still use salt to help my sleep, and to settle anxiety. I no longer need sleeping pills regularly, and have built up some tolerance to exercise. I can generally "manage" anxiety by self-care. I am learning what I enjoy, and sometimes I can even relax for a few minutes! How I haven't become insulin resistant is beyond me.
"The bodies general response for any demand to change" is the perfect definition of stress. As someone with Addison's Disease who doesn't make any cortisol, this is exact how I describe stress. As long as everything is going along in it'd hum drum, normal, boring way I am fine. Any slight deviation though increase my hydrocortisone demands. Keeping my diet to whole foods, plenty of sunshine/fresh air and exercise is key to keeping me in a relatively healthy state. I bounce back fairly quickly from stressful events and in 12+ years have been able to avoid a severe adrenal crisis. I know many with this disease who have terrible quality of life and I think diet and lifestyle play a huge role.
‘This plate will save your life’ says it all ♥️
So glad I found your substack! Finally a voice of reason 🙏
Everytime I read you I go eat an apple. Your newsletters are so knowledgeable and real. Thank you for sharing your work.
This felt like the type of reality check and tough love that we all need -- thank you!
https://pmc.ncbi.nlm.nih.gov/articles/PMC4102104/
This piece is so good. Thank you!
A-freaking-MEN! 🎯