REVIEW: Wibe Wagemans and Ioana Bina MD PhD — Cortisol: The Master Hormone (BOOK)
Wibe Wagemans and Ioana Bina MD PhD FACG’s new book follows a sort of classic trend these days, specifically revisiting old mores in a medical context and deconstructing what they see as antiquated ideas. With the release of Cortisol: The Master Hormone — Improve Your Health, Weight, Fertility, Menopause, Longevity, and Reduce Stress, they unpack things in a manner that feels bedside as much as it feels daring, surprisingly investigative, even entertaining to a certain degree.
As far as they are concerned, cortisol levels in a sense both positive and negative always lead the way. “(In the words of clinical psychologist Alia Crum) ‘What’s adaptive is to be appropriately engaged — to be physiologically aroused to meet the demand. We found that the truly adaptive response was a moderate level of cortisol elevation. The students who had a “stress is enhancing” mindset were more likely to be in this desired middle range of cortisol response. By contrast, neither the freaked out nor the disengaged individuals had an appropriate response’…
When you’re in a state of chronic stress, glucocorticoids — cholesterol-derived steroid hormones produced in the outer cortex of the adrenal gland — are released into the blood. Under normal conditions, glucocorticoids regulate many cellular functions, including metabolism, cognition, inflammation, cell development and homeostasis. In times of stress, however, if the body occupies “fight or flight” mode, a rise in glucocorticoids suppresses the reproductive functions of the hypothalamic-pituitary-gonadal (HPG) axis — the complex processing center that coordinates an assembly line of sex hormones in both sexes.”
They add, “For women in stressful situations, high cortisol levels inhibit the expression of gonadotropin-releasing hormone (GnHR), the hormone that causes the pituitary gland in the brain to make and secrete luteinizing hormone (LH) and follicle-stimulating hormone (FSH). When your body is in a balanced state, LH and FSH stimulate the ovaries to make estrogen and progesterone. But with stress on the body from depression, malnutrition, infection, or anxiety, for example, the feedback loops that keep the HPG axis and its HPA partner axis humming along, are interrupted. And since making cortisol for survival is perceived by the body as a priority, sex hormone production is diminished or thwarted altogether.”
What Wagemans and Bina advocate for is a decidedly more holistic, self-aware, and less drug-dependent view of managing cortisol levels. It’s a welcome relief from the increasingly pill-addicted societal panorama making up the postmodernist world in professional and personal capacities. In my personal opinion, the book’s contents and focal points are elixirs to this kind of thinking — ideologically reinforcing the idea that accepting the natural aspect of all these things is a critical part of tailoring a solution to negative attributes affecting one’s physicality.
“What the body wants, (Sarah J.) Berga (PhD) says, is homeostasis,” the duo writes. “‘When all of your ‘U’s’ are at the right level, everything is interconnected hypothalamically, and everything works fine,’ she says. ‘The master signals are neural, and they cascade down into this exquisite machinery that I view with reverence. If you need a little extra cortisol to step up your game in the face of chronic stress, the body will give it to you. But that super-boost of cortisol is not going to be great for your reproduction. The body makes a tradeoff.’”