I have extensive internal inflammation and cortisol issues. How to reduce stress?
Possible causes of symptoms in 3 mins

Q. How to manage stress in an individual with extensive internal inflammation and cortisol issues?

Answered by  
Dr. Shaikh Sadaf
and medically reviewed by   iCliniq medical review  team.


Professional Bio: Dr. Shaikh Sadaf is a Specialist in Diabetology and Endocrinology. She completed her MBBS from the University of Pune, MRCPI Internal Medicine from Ireland, MRCGP (Membership of the Royal College of G... 

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This is a premium question & answer published on Nov 10, 2023
Patient's Query

Hi doctor,

I was 160 pounds and felt good and gained 40 pounds in the last two years, 25 of those pounds in three months with no diet change. I typically only eat once a day. I eat more and gain more weight. Yes, I know it is bad for me, but I cannot change it unless I get some help. I have been told over the years I have extensive internal inflammation and that I probably have cortisol issues. I have not done any testing. Then just had a saliva cortisol test says the normal rise in cortisol in the morning and afternoon sample was fine, but then cortisol goes way up in the evening and before bed. It was a typical not stressful evening. I have diligently, over the years, tried to reduce stress to the best of my ability. Now, what should I do further with it? Or will a little licorice root and whatever the others I have found fix this? Could I have been taking licorice root for the past 20 years instead of living with this? Yes, extreme stress for many years in the past. I was hypervigilant for years. This should have corrected itself by now. I take natural thyroid twice a day, Glucophage twice a day 1000 mg for polycystic ovarian syndrome, an Iodine pill to help the thyroid, and now Progesterone at night before bed. I have also had testosterone and estrogen pellets every four months. Nothing working yet. Please help.

Answered by  Dr. Shaikh Sadaf


Welcome to icliniq.com.

I just read your query and understand your concern.

From what you have mentioned, it does seem that you have a stress-induced rise in cortisol levels. To diagnose hypercortisolism, you must do 24-hour urinary-free cortisol measurements, and if that is high, we can come to some conclusion. Regarding your high evening cortisol levels, as you mentioned, you have had previously a very highly vigilant lifestyle, and that is why the body has not reset itself even now. It takes a long time to get back. Would it not be better that you to take a break and have a vacation somewhere else for a week or two if it is possible? I am sure that it will be helpful. Besides the hormones, that you take for your PCOS (polycystic ovary syndrome), they also are contributing to this. Are you sure that at the age of 49 years, you still need progesterone? Please check with your gynecology doctor about whether it can be stopped now. Anyways, please continue whatever you are doing alternatively like taking licorice, and yoga and meditation. Restart walking and exercising. One step at a time. Gradually increase your walks initially, start with ten minutes and keep increasing to five minutes every week. Have you tried mind-body relaxation? You could find online some classes beneficial for you. Do your urinary-free cortisol, and then we will see what can be done.

Hope you find my advice of some benefit.

Good luck.

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