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The Stress-Cortisol-Insulin Connection

In summary, we learned that our body is well-equipped to handle stress through different channels as described here but it is designed to deal with it on a short and rare unexpected conditions. Not as the way modern day urban living dictates, a continuous cyclical set of low- to mid-range stresses one after another 24X7. The long term stressful lifestyle can and will lead to strenuous adrenaline-insulin-hormone imbalances with very undesirable health consequences.

To help us handle stress, adrenaline affects a variety of different parts of our body function. For example, it functions as a hormone (a well known fact) as described in our last blog, and as a neurotransmitter in the brain (not so well known). Our body produces adrenaline in large quantity in possible two scenarios – under physical stress or mental/emotional stress. That is why stress can be real or perceived (not real). But in effect, both of them causes the same effect of adrenaline release in our body.

Besides adrenaline and noradrenaline hormones, there is yet another hormone secreted by the adrenal gland (albeit by its external cortex section) that is also designed for helping us to deal with stress. Its name is cortisol. Unlike adrenaline which is activated directly by the instant electrical communication through the neurons, cortisol is activated biochemically by the pituitary gland which in turn is activated biochemically by the hypothalamus gland. Our body have cortisol receptors in just about every cell. As a result, cortisol has a wide range of impact when we go under stress.

The mechanism responsible for triggering cortisol release when our body determines there is insufficient amount of glucose in our blood to sustain brain functions (glucose is our brain’s main source of energy). The brain under the duress of lack of glucose, will call on the body to produce sugar from stored protein in our muscles through a metabolic process called gluconeogenesis, a process mediated by cortisol. It’s been stipulated that cortisol is also involved in the glycogenolysis process, which converts glycogen stored in the liver into sugar.

Our brain uses more sugar than any other tissue in our body. When sugar level falls, our brain “falls to sleep”. We get shaky, fainty, and bitchy – pardon my French (just trying to get the sentiment across. Besides they rhyme). Medically this is called hypoglycemia. Clearly it is a stressful situation for our body. From survival point, our body is designed to do everything and anything to supply the brain with proper amount of fuel. Cortisol and adrenaline hormones are its agent to initiate the fastest action to tap into the reserves to accomplishing that goal.

The most likely thing we do when we reach a low glycemic level in our blood is to reach for the high-sugar high-calorie foods. When that becomes our every mid-afternoon habit, we have created a craving event that will stimulate the production of insulin to send the glucose from our blood stream into muscle and fat cells on a regular basis. If we do not immediately utilized that energy surge by means of exercise or a burn off event, we build up fatty tissues in the belly area as our new energy storage units. And gain weight!

The excess amount of insulin needed to handle the excess sugar can cause a periodic low sugar level in the blood as well. Which triggers our stress hormones to start it up again to convert more sugar from the protein and other sources. Rounds and rounds of this can go on throughout the day causing a health condition dubbed syndrome X or metabolic syndrome. The interplay between the adrenaline/cortisol and sugar/insulin is a key factor in diabetes, syndrome X, hypertension, unexplained weight gain, hyperglycemia, and a whole array of other modern day illnesses.

But now, we have more than one hormone acting in parallel of each other to bring about the stress-adrenaline/cortisol-sugar-insulin-adrenaline/cortisol cascade cycles. This can obviously not be good for us on a daily and on-going basis. Despite of its desirable anti-inflammatory effects, excessive amount of cortisol over a long time can cause calcification of coronary arteries, plaques in carotid arteries, thyroid dysfunction, weight gain, high blood pressure, muscle weakness, mood swings, increased thirst and frequent urination to name a few.

In summary, we learned that our body is well-equipped to handle stress through different channels as described here but it is designed to deal with it on a short and rare unexpected conditions. Not as the way modern day urban living dictates, a continuous cyclical set of mid-range stresses one after another 24X7. The long term stressful lifestyle can and will lead to strenuous adrenaline-insulin-hormone imbalances with very undesirable health consequences.

We will dig into the hormone connection to stress and sugar imbalances specifically in our next blog.

Don’t mean to end this blog on such a negative note, but I ran out of space. In the next few blogs, let’s take a look at what actions can we take to mitigate our body and mind to handling the inevitable stress (however big or small) that bombards us every day.




“Beyond Fight or Flight,” by Robert M. Sargis, MD, PhD


“Adrenaline Dominance – A Revolutional Approach to Wellness,” by Michael E. Platt, MD




In this blog I will share some basic but intricate ways how our body handles stress.

I believe all of us have seen the “KEEP CALM” images somewhere. Is this a sign of time? Are we all so stressed that we need to constantly remind ourselves to “KEEP CALM”?

Kidding aside, I have observed, among my clients at our wellness center, a rather high percentage of them are coming for stress relief. Some of the time, the manifestation of their stress is expressed in ways far more complex and out of control than you might think. So, I have decided to explore into the subject of stress a little further and share some of my learning in a series of blogs for the next few weeks. Interested in joining me on this journey?

Coincidentally enough, we are right in the middle of the tax season. So, take a brief brake from that stress and read over the blogs to better understand about stress and how to address them.

In this blog I will share about basic but intricate ways how our body handles stress.

Just about everyone knows that we deal with stress by production of adrenaline from the inner adrenal medulla. But few people understand the implication of adrenaline on:

  • Hyperactivity, anxiety, PTSD, depression (nervous system)
  • Appetite control, bowel issues (digestive system)
  • Blood pressure (circulatory system)
  • Sugar balancing, insulin production, energy level (metabolic system)
  • Hormone imbalance and its reproductive and mood implications

Upon reception of a stressful signal, our body reacts to it using the electrical impulses through the nervous system as its first line of communication. Unlike other glandular system organs, the adrenal gland’s inner medulla has a direct line to our brain which acknowledges and processes decision on what needs to be done. This is obviously good because you sure don’t want to leave your hand on the hot stove even for a second long. We need to have a local instantaneous response to pull our hand off that hot spot to minimize damage.

What happens anatomically after that instance of stress is a thing to behold. In concert with your sympathetic autonomic nervous system, the inner adrenal medulla produces adrenaline (or epinephrine) and noradrenaline (or norepinephrine), two key hormones responsible for our reactions to stress. Since both the adrenaline and noradrenaline are produced in our adrenal gland and for the same purpose of getting our body ready for stress, we can call them collectively as our “survival hormones”, adrenaline. Adrenaline triggers the fight-or-flee response for immediate physical action. Adrenaline stimulates glucose release from stored-sources into the blood stream and directs this sugar-rich blood to the muscles so that you can fight harder and flee faster. Your heart rate and breathing pattern begin to accelerate to maximize its ability to distribute this sugar-rich blood to where it’s needed, such as the brain for higher alertness and focus. You pupil dilates to improve vision. The image shown below depicts these effects.

Adrenaline also dilates the blood vessels to where it is needed and constricts the blood vessels to organs not needed. Case in point, the digestive system. Ever been in a stressful period, when you don’t feel hungry long past your regular meal time? It’s your body’s way of keeping you fighting or fleeing using your reserved energy. And once the crisis is over, your appetite returns back to normal. Smart, isn’t it?

In nature, the fight-or-flee response is designed to last but for a short period of time and then should come to a quick end once the crisis is over. Our adrenaline level likewise is designed to resume to a normal dormant level immediately once the crisis is done with. Our parasympathetic system kicks in and has proper channels to reduce the adrenaline level, slowing down of the heart rate and lung performance, and increase blood flow to the digestive organs. It’s our restoring mechanism to help us to get back to our restful state as shown in the diagram. The sympathetic and the parasympathetic nervous systems normally function in opposition of each other, such that the sympathetic system prepares the body in response to stress (like the accelerator pedal on a car) and the parasympathetic plays its part by slowing that reaction and restore the body back to its homeostasis after the initial reaction (like the brake on a car).

In modern day urban living, the stresses we face every day are typically not few and far between. We may face less life-threatening dangers like the old-days but we face continuous low- to mid-range level stressors all day long in a way that as human beings we have not experienced historically. Our daily sources of stressor can come from stress experienced in traffic, at work, at school, deadlines, demands, expectations, financial challenges, family conflicts, insufficient sleep, continuous bombardment of noises, job transition, loss of a loved one, social engagements, so on and so forth…

As a result, we are in a constant state of adrenaline high. We learn to cope with it from day to day. In fact, some of us are so used to that “high”, we don’t know what to do when we are off the crisis mode. Many of us seek for that high by means of stimulating events and/or stimulant in-take (e.g. coffee, high energy drinks and other forms of stimulants) to artificially trigger the adrenaline into action. In the next blog, we will look at the implications of the consistent high level of adrenaline have on our body. I will get into the stress-adrenaline-insulin connection that is very prevalent in our society today. Perhaps you may be experiencing now!

Until then, Keep Calm and Carry On!