Adrenal Function and Cortisol

Medical Aesthetics & Laser Spa Serving Sherwood Park, Spruce Grove, St. Albert & Nearby Edmonton, Alberta

Your adrenal glands sit on top of each kidney. They secrete important hormones including:

      • Cortisol
      • Adrenaline
      • DHEA (Dehydroepiandrosterone)

These hormones help buffer stress and the demands of everyday life. Under stress, healthy adrenals increase cortisol and DHEA production to preserve health.

Cortisol is our ‘survival’ hormone that developed during Paleolithic times, when threats to our life occurred on an infrequent but recurring basis. In an emergency, abrupt elevations of Cortisol and Adrenaline, produced by the adrenal glands, make us stronger, faster and more likely to survive. In modern times, survival emergencies are few and far between. Most of us have instead traded intermittent stress of our ancestors for complicated, 24/7 stress elevated lives. Multiple stressors at work, home, financial and other problems have replaced these occasional threats we adapted to deal with. The problem being the ‘stress response’ was not designed for chronic activation.

Overproduction of adrenaline can cause you to feel:

    • Anxiety
    • Nervousness
    • Insomnia
    • Fatigue
    • Depression
    • Irritability
    • Digestive difficulties
    • Initial rise in blood sugar

If adrenaline and cortisol production becomes chronic from prolonged stress, this can result in:

    • Low immune function
    • Decreased cortisol leading to low blood sugar
    • Sleep issues/Insomnia
    • Increased lipid levels of blood fats
    • Water retention
    • Lowered cellular potassium (very important mineral)
    • Lowered insulin sensitivity (increased risk of diabetes)
    • Depleted DHEA
The longer we have worked with the sex hormones at True Balance, the more clearly we see the interconnection between the sex and stress hormones. A person with a poor stress management system will never feel great, even if their sex hormones are replaced and balanced perfectly. Take a look at our effective stress management suggestions many of which have little to no cost!


There are also a number of herbal adaptors, such as True Calm, that can be used to reduce the amount of Cortisol secreted in people with high stress levels and no easy way to make changes in their life at that time. For more information on supplements take a look at our supplements specifically designed to help you manage stress.

Identifying and treating adrenal fatigue, as well as incorporating lifestyle changes that will reduce stress and promote detoxification is vital to the success of your BHRT. Serum cortisol is often not all that useful and instead we first employ detailed questions on common life stressors and coping mechanisms. In complicated cases, sophisticated testing using a 4 point urine test may be suggested to give more insight into the stress-cortisol area ($375).

Cortef — is a bioidentical hormone, prescribed as a physiologic replacement.

        • healthy adrenals — produce about 35 mg/day of Cortisol
        • adrenal fatigue — may drop as low as 10 – 15mg/day of Cortisol

Prescriptions of cortef are kept within this range of normal hormone levels.

          • this method of use has a long standing safety record
          • does NOT cause harmful side-effects that can result from higher dosages
          • follow ALL instructions carefully

Recommended Standard Dose:

            • Take half a tablet (5mg) with each meal and at bedtime
            • Total 20mg/day

If you have been on a continuous dose for 4 weeks and are not feeling any improvement, you can increase your dose by 2.5mg

              • 7.5mg with each meal and at bedtime
              • Total 30mg/day (MAXIMUM DOSE)
              • This is the maximum dose that can be used safely and should NEVER be increased.


                • take with meals (or milk) to avoid GI upset and indigestion
                • it is more effective if daily dosage is spread out
                • doses can be taken as the same time if forgotten
                • If a history of peptic ulcer exists (of the stomach or the duodenum), you should ALWAYS take an antacid with each dose
                • Cortef does NOT interfere with other medications
                • a medic-alert bracelet should be worn at all times with mild or more severe adrenal deficiency. If you do not have one, please contact your pharmacy on how to order one refer to your patient checklist for personalized dose information

If you have upcoming surgery there are two options on how to proceed:

                • Taper by 5mg/day until off the Cortef 2 weeks before surgery.  OR
                • Inform your surgeon of the medication so they can schedule an anesthetic consult before handIf you choose this option you will likely receive another form of medication at the time of surgery

For other suggestions for dealing with stress which has led to this reduced adrenal function, see our Stress page and Adrenal Program for further supplement and lifestyle ideas.