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Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

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July 05, 2007

The Definitive Guide to Stress, Cortisol, and the Adrenals: When ‘Fight or Flight’ Meets the Modern World

By Mark Sisson
253 Comments

One of my goals with this weekly column is to make significant human health issues easy to understand and discuss. I was pleased that last week’s piece, the Definitive Guide to Insulin, Blood Sugar & Type 2 Diabetes, garnered some rave reviews. The Case Against Cardio piqued some great conversation and interesting criticisms (one soul out there in the webosphere took issue with the fact that I positioned Cardio exclusively from my personal perspective as a runner rather than authoring a more scholarly article. Well wasn’t that spot on. It’s called my blog.) My opinions can’t please everyone, of course, but – based on my experiences and understanding – I am certain that contributing some insights on health in light of our (all together now) genetic blueprint is a worthwhile and timely endeavor.

Now to the topic at hand. Stress can make you gain weight, and it contributes to premature aging. Understanding how stress is related to your overall health and potentially even longevity is essential to achieving your health goals. But do not, repeat, do not go and buy yourself a bottle of Cortislim – just read this quick summary and you’ll know all you need to know.

Eerie, ain't it?

Ariel Amanda Flickr Photo (CC)

The adrenal glands are not unlike a walnut.

Understanding Stress

Most folks are aware that “fight or flight” is the body’s natural response to stress. When faced with a stressful situation, we either get aggressive or, in the words of a local surf instructor, we bail. This choice depends upon our perception of the circumstances and our corresponding judgment of the odds of success. The “fight or flight” response is, in terms of energy preservation, tremendously efficient. And it is very effective at ensuring greater odds of survival. This makes sense to everyone on a visceral level, but do you know the physiological mechanisms involved?

The fight or flight response begins in the brain. Various regions operate in concert to detect, sense, decode, and respond to a stimulus. Though there are a few different pathways for a given feeling (like fear) to travel, it is ultimately the hypothalamus that is responsible for triggering the fight or flight response. Once the hypothalamus goes to work, what I call your survival systems, i.e. the “gut”, kick into gear. They are the nervous system and the adrenal-cortical system.

Enter physical symptoms: sweating, heart palpitations, muscles tensing, hearing sharpening. You are now extraordinarily alert, but only on the issue at hand: concentration and awareness of anything else fly out the window. The nervous system has flooded your body with adrenaline (scientists often refer to this as epinephrine) and noradrenaline (norepinephrine). Meanwhile, the adrenal-cortical system (which produces these hormones) becomes activated by way of the pituitary gland. The pituitary gland secretes a hormone known as ACTH (adrenocorticotropic hormone…say that three times fast). ACTH journeys – via the bloodstream – to your adrenal cortex, where these small organs will pump out as many as 30 different hormones to address the stressful situation at hand (the adrenals are “fed” by cholesterol). And your immune system temporarily shuts down so your body can utilize all its resources to deal with the perceived threat.

The adrenal cortex produces cortisol, DHEA, estrogen and testosterone, among many other hormones. It’s a beautiful system. Unfortunately, what worked for our old friend Grok does not, I believe, work so well for us. Simply put, our modern lifestyle subjects us to a potentially enormous amount of stress on a daily basis that the body has simply not evolved to handle. To my mind it’s a bit like “deer in the headlights”. We have a big deer overpopulation problem in my area, and you always hear comments along the lines of how dumb the deer are around automobiles. Well, in my opinion they’re not so dumb – in evolutionary terms, after all, cars are very new on the scene. The deer simply haven’t adapted the appropriate stress response. Is it so different for humans?

Theoretically then, persistent, low-level stress – which the body unfortunately interprets as warranting a “fight or flight” response – is destructive to health. In other words, being stuck in traffic for two hours a day, every day, is the equivalent of a serious survival threat to your as-yet “primal” brain, and the adrenals pump accordingly. Cortisol serves many important functions, including the rapid release of glycogen stores for immediate energy. But persistent cortisol release requires that other vital mechanisms effectively shut down – immunity, digestion, healthy endocrine function, and so on. Among other stress-health associations, the link between elevated cortisol and weight gain has already been established.

At this point I hope you can begin to imagine the potential health ramifications of what is often called “adrenal fatigue”: daily compromised immunity, continuous stress hormone release, being “on edge” generally, exhausted sex hormones (remembering my admittedly pet theory of why male endurance athletes often suffer from diminishing testosterone production and consequent receding hair). Your body thinks it must survive at all costs – and is there ever a cost.

Though I’m no Green, nor do I think moving to the woods to commune with the grubs is a viable (or desirable) solution to mitigating stress, the tremendous volume and scope of stressful stimuli present in the modern, fast-paced lifestyle may play a very critical role in the high rates of diabetes, metabolic syndrome, obesity, depression and anxiety we’re seeing (among many health problems). At any rate, I firmly believe this to be so. (Humorous note: apparently shopping is physically stressful for men. But then, planning holiday events and managing social obligations is stressful to women. At the risk of announcing my bah-humbugness to the world, the holidays are inordinately stressful to everyone.)

Managing Stress

Managing stress, then, is paramount to maximizing optimal health. To the extent that you can, reduce the “noise” in your life – from entertainment, from frivolous or excess obligations, from fractious relationships, from debt, and so on. Managing stress is a very big topic indeed, and we’ll be addressing it more in future posts. For now, here are the key factors I believe are necessary to reducing stress:

Consume antioxidant-rich foods such as fruits and vegetables. I also recommend a multivitamin that contains a comprehensive and potent antioxidant profile. Completely avoid processed, empty calories found in snacks, junk food and fast food.

Consume adequate beneficial fats to utilize antioxidants, vitamins, enzymes and co-factors. Wild Alaskan salmon, pure fish oil pills, olive oil, nuts and avocados are good places to start. I don’t go in for the Omega-enhanced Tropicana or miracle mayonnaise, personally.

Manage expectations: your own and others’. Ambition and motivation and generous support are all great traits to possess. But don’t over-promise to others or yourself. None of us knows the future.

Exercise daily. I cannot stress this enough. Exercise releases endorphins and helps to regulate the production of critical brain hormones.

Unhook daily. Most of us spend so much time on the input-output cycle, we don’t give adequate time to simply absorbing it all. Reflect, relax, restore. I personally like to spend a little time each day reflecting on what I am grateful for (I call this doing my “appreciations”.) Prayer, meditation, singing, cooking and other activities that get you out of your head and into the moment are vital to helping you manage the stress of constant stimuli and energy demands. “Think positive” is nice advice, but it’s tough to do if you are at your limit. It’s easier to find an action that naturally lends itself to positive thinking and feeling, rather than trying to control your thoughts. That in and of itself can become stressful. Find an immersing action that works for you and do it religiously. Fuming not recommended.

Further reading:

More Primal Health posts

Managing Stress: 10 Tips

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[tags] stress, adrenals, adrenal cortex, hormones, pituitary gland, hypothalamus, fight or flight, ACTH, adrenaline [/tags]

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252 Comments on "The Definitive Guide to Stress, Cortisol, and the Adrenals: When ‘Fight or Flight’ Meets the Modern World"

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[…] West Nile Virus Link to Article cholesterol Stress, Cortisol, and the Adrenals: When ‘Fight or Flight’ Meets the Modern World » Posted at Mark’s Daily Apple on Thursday, July 05, 2007 One of my goals with this weekly column is to make significant human health issues easy to understand and discuss. I was pleased that last week’s piece, the Definitive Guide to Insulin, Blood Sugar & Type 2 Diabetes, garnered some rave reviews. The Case Against Cardio piqued some great conversation and interesting criticisms ( View Entire Article » […]
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[…] The Definitive Guide to Stress, Cortisol and the Adrenals: When ‘Fight or Flight’ Meets … […]

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[…] The Definitive Guide to Stress, Cortisol and the Adrenals: When ‘Fight or Flight’ Meets the Mode… […]

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[…] after about 40 minutes of working out your cortisol levels start to increase, your body releases this panic hormone to try and tell you that its time […]

Betty
Betty
7 years 10 months ago
Hi Mark, I am so grateful for your newsletter… it makes perfect sense. I was diagnosed (finally) after several years of health problems and weight gain with cysts on my left kidney and adrenal gland… I have worked very hard to change my diet, no more chemicals, processed foods, organic as much as possible, no more wheat and very few starches (most of the time!). I am off all prescription meds, was even able to quit my high bp medication which was a biggie, since it tended to make me tired constantly. I have lost 75 pounds, and still would… Read more »
Donnersberg
Donnersberg
5 years 5 months ago
I know this was posted about 3 years ago but would like to reply anyways. I’ve had heart palpitations my entire life. In fact, my heart would ache several times a year and mimic a heart attack. My entire left side of my upper body would be in so much pain I had to lift my left arm up to drain the blood. And I had all this while weighing 135 lbs at 5’10” (female). Finally by age 35 I had an allergy test done (outdoor stuff) and got allergy shots…which completely got rid of the heart palpitations but not… Read more »
Kitty
Kitty
5 years 5 months ago
Hi Donnersberg, I am happy to hear that the primal diet is working for you as well. I used to have the heart problems too; and no wonder, considering that I used to follow the “low-fat” diet that CW is preaching. Your post just reminded me that I also have stopped having these heart problems after I had been primal for about 6 months or so. Have been primal for about 12 months now but I am still trying to recover from the adrenal dysfuntion. A slow process but I am making progress. I am hoping to give Mark a… Read more »
Brian D
Brian D
5 years 3 months ago
I’ve had heart palpitations my entire life. In fact, my heart would ache several times a year and mimic a heart attack. My entire left side of my upper body would be in so much pain I had to lift my left arm up to drain the blood. I know this is an older thread but I have these exact same heart issues. In fact, last year I thought I was having a heart attack and went to the hospital. They did all the tests, even an angioplasty, but they said that it wasn’t a heart attack; although my left… Read more »
Jacks
5 months 21 days ago

Hey, another thing that can cause this heart attack mimicking is the ‘coccidiosis virus’ and it can infect the heart. I had it, and my functional medicine doctor, who was formerly head of cardiology at a nearby hospital, cured me of it somehow without using antibiotics of any kind. Something to think about. You can Google more about it and find out more… Hope you are still around?

Von
Von
2 years 10 months ago
Hello you and I have a similar issue. I have a rare form of benign spinal tumor, likely caused from spinal trauma inflicted by an anesthesiologist. Up from the tumor runs a cyst as well. I also have pressure on adrenal nerves. The tumor is pressing on my leg nerves and they don’t work. No amount of wishing or therapy is going to change the fact that when the nerve is damaged or pressure is applied that it can cause problems and I see the same issue with the adrenals. That being said, I’d suggest following up with an endocrinologist… Read more »
Daniel Leal
Daniel Leal
2 years 7 months ago

Dear Mark,

I just want to applaud you on your blog and the amount of precious information you make available in a clear and structured way. Bravo!!
I’m glad I came across your blog and have spent hours reading many of your posts in the last week. I’m a physician myself and will totally use these concepts when trying to help patients (almost all…) with metabolic issues.
Thank you!!

trackback
7 years 8 months ago

[…] The Definitive Guide to Stress, Cortisol and the Adrenals […]

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[…] Underground Wellness argued that stress makes you fat, which leads me into a discussion about cortisol and adrenal fatigue.  If you feel stressed out all the time or want to learn about how your stress hormones function, check out this video.   Mark’s Daily Apple also offers a more technical guide to stress. […]

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[…] Chronic cortisol (the major stress hormone) release is another powerful immune suppressor. As tough as times are, it behooves you to get a handle on stress and do whatever you can to mitigate it, whether it’s through meditation, yoga, prayer, biofeedback or just taking a few minutes each day to chill. People get sick when they are stressed out not from the stress itself, but from the fact that exposure to any virus or bacteria overwhelms their frail immune system. […]

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[…] oxidative damage to our cells (and particularly inside our mitochondria). Eating right, avoiding stress and exercising appropriately (i.e. not too much high-end cardio) are always the first lines of […]

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[…] damaging spiral. We’re talking immune dysfunction, high blood pressure, systemic inflammation…. Stress response can even contribute to heart disease and cancer in extreme […]

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[…] we’ve discussed before, chronic and/or severe stress can cause serious health damage and undo the “good” of a solid diet and exercise program. True wellness can’t […]

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[…] up at 6 AM, there was little adrenocorticotropin produced. Instead, they had elevated levels of cortisol, the body’s usual stress-response hormone. But when they were warned they would be getting up […]

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[…] kids being bused to their next “play date.” Working men and women accumulate enough stress for a dozen Groks in the course of a week, putting in overtime and working weekends, only to […]

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[…] kids being bused to their next “play date.” Working men and women accumulate enough stress for a dozen Groks in the course of a week, putting in overtime and working weekends, only to […]

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[…] strength growth also requires avoiding excess amounts of catabolic (muscle wasting) hormones like cortisol. Cortisol is the major stress hormone, and it exists for a very legitimate reason (dealing with […]

Angelina
Angelina
6 years 8 months ago
Hi Mark, I have only just found you after doing extensive research on the internet to find ways to cure myself. I have been on the decline for years. First I was told that I was hypothyroid and I have sooo many health problems. Too numerous to mention. Now it also appears that I have adrenal fatigue. It has taken many visits to the doctor before he would even listen to me and do the tests. Now I have to work out how to get back on track. I have been trying to read as many articles of yours as… Read more »
Anny
Anny
5 years 3 months ago
Hi Angelina, Reading your comment was like having you talk about my life this past year. I’m a long distance trail runner, and now I can’t even hike. The diagnosis started with autoimmune hypothyroidism, then adrenal stress, now autoimmune diabetes. I’m seeing integrative doctors and they put me on all sorts of supplements as well as Armour and Cortisol, but my energy level is still extremely low. And not being able to run is causing me severe depression. I eat very healthy – mostly organic greens, a little fruit and organic meat…no carbs since my body can’t handle it. Please… Read more »
Angelina
Angelina
5 years 3 months ago
Hi Anny, I WILL get back to you after my exams :o) I have kept with the primal diet and I am seeing some improvements. It is a slow process though…and I have kept the carbs really low, stayed very strict, and increased fats. I have also been taking herbs and vitamins that provide adrenal support and taken lots of rest. One of the important things is also to remove some of the things in your life that might be causing you stress and also don’t over-exericse…and get lots of sleep. I also gave up fruit because of the fructose..For… Read more »
NELLIE MARTIN
4 years 11 months ago

You may have Lyme Disease. I got bit about 6 years ago by those large animal-biting flies you see on dairy farms. The Lyme is very hard to detect. You need a doctor who believes Lyme exists.
My fatigue was awful along with serious depression. I could barely function. I also had headaches and involuntary tremors and pain in my arms and legs. Lyme is very tenacious and difficult to treat. It mimics other sickness and disorders. You really need to find a good lyme doctor if you want to check that out.

Becky
Becky
4 years 11 months ago
I was diagnosed 3 years ago with late Stage Lyme Disease. As near as I can figure, I was probably bitten somewhere between 1985-88. There came a point when I could no longer go camping or walk long distances, so that’s aprt of how I know, plus remembering a tick bite that my MD ignored. Since I was in school and working full time I thought my problems were due to stress. My MD said I was just getting older. (40?) Finally, after 9 years of watching pain and neuropathy creep up both legs, I got scared when it started… Read more »
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6 years 8 months ago

[…] reliable fat-burning systems can’t be done in a few days, nor without sending the proper signals. Stress hormones rise, diuretic hormones kick in, testosterone drops, inflammation increases and all manner of […]

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[…] be weak and unimpressive, and you’d probably injure yourself. You’d be way overstimulated, cortisol would flow like desiccated gluten through a leaky gut, and you wouldn’t know whether to burn fat […]

Jeanmarie
6 years 5 months ago
Mark, someone commenting on another blog has been saying that too much protein raises cortisol (I get that it can raise insulin, but cortisol?) and gives this as a reason low-carb is supposedly bad for the metabolism. She also claims that insulin is anabolic and so needs to be balanced with cortisol, which is catabolic. It sounds off to me, but hey, I’m no endocrinologist. This all came up in the context of Jimmy Moore announcing he’s eating just eggs, butter and cheese for the time being to reverse his recent weight gain. Apparently his metabolism is so broken that… Read more »
Marc
Marc
6 years 5 months ago

I believe a diet that is too low in carbs would certainly lead to an increased cortisol level and maybe weight gain. This would be especially true with females. My female friends who do low carb always complain about this. As soon as they add 10 to 20 more carbs everyday the weight starts coming off and they feel better. Then again some people feel fine on an all meat diet. I know that I do better with almost no carbs.

Jeanmarie
6 years 5 months ago

So “too low in carbs” is still an individual thing, only to be established by trial and error?
Thanks!

Angelina
Angelina
6 years 5 months ago
I agree that it is still an individual thing too. I have also heard that females do better with a little more carbs than the men. But I have always thought my system ran more like a males, and it appears that I was right. I also had some tests done not long ago and my doctor, to my surprise, said “your more like a male”. I tried to eat just a little extra carbs and it was doing me no good at all. I cut them out almost entirely and now I am starting to slowly get better from… Read more »
shrimp4me
shrimp4me
2 years 11 months ago
New reply to old post. I have thought for awhile that females needing somewhat more carbs may be due to the hunter-gatherer lifestyle itself. I am sure that Grokka ate some of the plants as she gathered them so she didn’t need to develop the means to turn protein into carbs as much as the hunting males did. I need SOME carbs but the slower the better; cut them back too much and I am fighting w/hypoglycemia. If I eat fruit for/with breakfast I have cravings all day; can’t get satisfied by whatever I eat. Looking forward to finding out… Read more »
Anon
2 years 8 months ago
I had similar issues with eating fruit & making me extra hungry after. No matter how I balanced my meals/snacks with protein/carb/fat the fruit set off my appetite! I’m studying to be a Registered Dietitian and currently specialize in IBS/thyroid/adrenal related issues. I wanted to let you know what I found after tons of self study into my imbalances that caused chronic hunger & hypoglycemia. By way of speciality testing: spectracell (nutrients intracellular), MRT Leap 150 (food sensitivities/chemicals), & comprehensive stool analysis test (gut flora balance) I saw inside what was out of balance do I could rebalance. I had… Read more »
Lena
Lena
6 years 5 months ago

This blog has excellent information and confirms much of what I was clued. Please continue to post great information as I am a reader who values it, because I’m trying to lose weight (I use to lose easily) and get healthy again. 30 lbs. to go….off and away.

LooksYoungerThanHeIs
LooksYoungerThanHeIs
6 years 4 months ago

Thanks for writing this.

1) You recc. exercising daily. However, didn’t we also agree that you shouldn’t exercise daily (overtraining article)?

2) Isn’t baldness caused by DHT, which is related to testosterone? ie: Wouldn’t it be: HIGH stress -> low testosterone -> less DHT -> LESS bald ?

Donnersberg
Donnersberg
5 years 5 months ago
I think by ‘exercise’ he means just moving the bones in general…not actually sweating your armpits off doing cardio. Means don’t get up in the morning and schlepp yourself to the couch where you remain watching TV until bedtime. Taking the dog for a walk, go to the park, walk around the mall and check out the newest silly outfits, play ball, rollerskate, go swimming, even going to the library and read a couple pages of books of interest without sitting down. I personally love going to the outdoor hot tubs, the smell of sulfur and slimey mineral water on… Read more »
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[…] mass. Too much exercise (especially highly stressful long distance steady state stuff) releases cortisol, a vitally important “flight-or-flight” hormone that can be incredibly damaging in unnaturally […]

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[…] Mark Sisson of ‘The Primal Blueprint’ puts it, “our modern lifestyle subjects us to a potentially enormous amount of stress on a […]

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[…] The Definitive Guide to Stress, Cortisol, and the Adrenals: When ‘Fight or Flight’ Meets the Modern World […]

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[…] a vitamin, in fact; it’s a secesteroid, a hormonal precursor that closely resembles steroids like cortisol, testosterone, and cholesterol. Most vitamins are exogenous and stem from outside sources. Vitamin […]

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[…] strength growth also requires avoiding excess amounts of catabolic (muscle wasting) hormones like cortisol. Cortisol is the major stress hormone, and it exists for a very legitimate reason (dealing with […]

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[…] release!” But we can heavily influence our hormonal responses through the things we do, the stress we undergo, the foods we eat, the weights we lift, and the sleep we […]

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[…] would be remiss if I failed to mention testosterone’s chief antagonist: cortisol. Cortisol, as you know, is one of the stress, fight-or-flight hormones. It kept us alive and our […]

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[…] would be remiss if I failed to mention testosterone’s chief antagonist: cortisol. Cortisol, as you know, is one of the stress, fight-or-flight hormones. It kept us alive and our […]

trackback

[…] The Definitive Guide to Stress, Cortisol, and the Adrenals: When ‘Fight or Flight’ Meets the Mod… […]

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[…] strength growth also requires avoiding excess amounts of catabolic (muscle wasting) hormones like cortisol. Cortisol is the major stress hormone, and it exists for a very legitimate reason (dealing with […]

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6 years 2 months ago

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[…] a vitamin, in fact; it’s a secesteroid, a hormonal precursor that closely resembles steroids like cortisol, testosterone, and cholesterol. Most vitamins are exogenous and stem from outside sources. Vitamin […]

Sydney
Sydney
6 years 29 days ago

I am interesting in following your exercise recommendations, but for someone who already has adrenal fatigue, what is the best approach? Intense exercise (such as lifting heavy weights or sprints) really whacks me, and it seems like it would just put more stress on the adrenals? Would you tweak your recommendations in this case?

The Foundry
6 years 14 days ago

One of our personal trainers just wrote a blog post on the effects of Cortisol.

http://www.foundryfit.co.uk/blog/what-soothes-graemes-aura-why-gear-grinding-is-bad-for-your-health-and-your-waistline/

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[…] A great article about stress, what causes it, how your body reacts to it, and how to deal with it can be found at Mark’s Daily Apple.com […]

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6 years 10 days ago

[…] Check out: Mark Sisson’s Guide to Stress […]

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[…] Sisson of Mark’s Daily Apple blog has a great post on dealing with stress and has written books extensively about optimal health with a return to more simple eating — […]

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[…] going to go on and on about how stress is a problem, or even why it’s a problem (I’ve already done that), because we know it. So, how do we avoid it and, once it’s here, how do we deal with it? […]

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[…] earlier study (full PDF) examined the effects of aspartame on prolactin, cortisol, growth hormone, insulin, and blood glucose levels and found it had none. The authors used the same […]

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[…] and success. They’re enough to stimulate our biochemical triggers without setting off the whole fight or flight cascade. These constructive trials of choice and circumstance offer a stark contrast to the getting and […]

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[…] would be remiss if I failed to mention testosterone’s chief antagonist: cortisol. Cortisol, as you know, is one of the stress, fight-or-flight hormones. It kept us alive and our […]

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[…] muscle-building proteins. Experts have measured the loss at approximately 2% per week. Higher cortisol levels measured during space travel also likely contribute to breakdown of […]

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[…] The Definitive Guide to Stress, Cortisol, and the Adrenals – Mark’s Daily Apple […]

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[…] The Definitive Guide to Stress, Cortisol, and the Adrenals – Mark’s Daily Apple […]

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[…] dieting and lifestyle has been addressed by pretty much everyone talking about evolutionary living. Cortisol is a nasty beast, and you don’t want to be producing more of it by agonizing over the […]

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[…] […]

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[…] This is a good article about the effect of hormones released during stress on health in general, including weight gain. I’m definitely a stress case. I’ve been trying to simplify my life, take better care of myself and just be mindful of how much I stress and what about. I keep trying to figure out just what is causing the mid-section spread (I’m not huge but much bigger than I was two years ago) and I think it’s one part diet issues and one part lots and lots of stress. I think I need to take a long hard… Read more »
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