Cortisol, Fatigue, and Auto-Immunity




I’ve seen discussion regarding the connection between #cortisol levels and #fatigue. While we are still uncovering the cause of #CFS – and we don’t know if it’s #autoimmune or not yet – here are some clues to the nature of an auto-immune condition:

First, cortisol’s main role is to help maintain energy to cope with stress.

Second, in people with auto-immune conditions, the cortisol response may be compromised.

For other people, their stress response may still be responsive, but there may be irregularities in their immune cells/cortisol receptors. This is relevant, because cortisol is released both in response to stress, but also in response to inflammatory triggers. For people who have developed #cfs or #chronicfatigue, some people have higher cortisol levels, and some people have lower cortisol levels.

Too little cortisol may be a biomarker of chronic fatigue (and, perhaps, a protective mechanism by the body so we slow down and heal). Cortisol targets so many areas in the body it’s no wonder too much or too little can affect our health and well-being so greatly. It targets the liver, the immune system, the blood vessels, the kidneys, the muscles, our bones, and our brains. It also shares the same precursors as DHEA, which repairs cells, is made in times of low cortisol production, is the most common hormone in the body (Church, 2009).

In some studies, people with chronic fatigue have higher cortisol levels. This state may be a precursor to them falling lower – or not. Yet, whether cortisol levels are higher or lower than average, changes in cortisol levels are relevant.

Why is this relevant to #chronicfatigue? Chronic fatigue has been linked to – or even called – a #neuroinflammatory condition. Changes in cortisol may indicate autoimmunity. Auto-immune means an activated immune system.

Is stress the big elephant in the room? And what do down-regulated and up-regulated mean?

It is critical to understand your stress response. Down-regulated essentially means your stress response system may have adjusted, or is inhibited, or is not easily responsive to stressors, resulting in a chronic under-release of cortisol. This, in turn, can potentially affect immunity and inflammation.

To give a bit more scientific answer, down-regulated means there is a decrease in the number of receptors on cell surfaces. It means there is a decrease in gene expression. This is often due to overexposure to stress. Up-regulation, on the other hand, means an increase in the expression of a gene. For example, it can refer to an increase in the expression of inflammatory genes. Could it also mean a constant release of too much cortisol?

If we look to the field of #psychoneuroimmunology, we find the immune system is activated by stress. In fact, this is where psychoneuroimmunology may shed light. The study of psychoneuroimmunology points to a relationship between your stress response system, #HPA axis reactivity and the development of auto-immunity.

Here’s more information:

Low/High Cortisol or Abnormal Cortisol Receptor Scenarios (based on the work by Esther Stermberg):

“Cortisol – a powerful anti-inflammatory hormone and the main GC, glucocorticoid – in blunted and/or excess amounts can impair immune function. Cortisol is released in response to stress and after inflammatory triggers. Its main role is to help maintain energy to cope with stress. [Usually] it modulates the inflammatory process as well. But there are two ways cortisol expresses abnormally:

*Your stress response is abnormal, resulting in an either elevated or lower release of cortisol than normal. Elevated cortisol impairs immune function, leading to slow wound healing and more intense viral infections. Low cortisol affects blood sugar, blood pressure, and immune function. It can show up as depression, nausea, vomiting, diarrhea, dehydration, irritability and fatigue.

*Your stress response is normal, but the cortisol receptor (in your immune cells) is abnormal (inflammation can cause cells to die).”

These two scenarios can result in auto-immunity according to Esther Sternberg (Sternberg & Gold, 2002).

You can read more here, in my book:



#psychoneuroimmunology #cortisolandfatigue#whatispsychoneuroimmunology #signsofautoimmunity #autoimmunity#symptomsofchronicfatigue