High cortisol chronic anxiety

Discussion in 'Fibromyalgia Main Forum' started by monicaz49, Jan 20, 2007.

  1. monicaz49

    monicaz49 New Member

    Why the heck am i soooo chronically anxious? I can feel "it" running through my veins. I suppose its adrenaline? I can get so panicked for no reason in the comfort of my own home. I dont know how to stop it.

    Ive been diagnosed with CFS and have dysautonomia issues and many many symptoms but am wondering 2 things.

    First....is anxiety part of cfs or is this a whole nother basket of worms i have to deal with??????

    Second...is there anything i can do besides tranquilizers (SSRIs made my anxiety 100x worse).? My cortisol is sky high all day and allll night. I had the saliva test done. Only briefly in the early am is it a little low. How do i safely lower cortisol if thats even whats causing it...and will that in turn reduce my anxiety?

    Pleeease give me some encouraging advice. I feel like im goin just a tad mad.
  2. Slayadragon

    Slayadragon New Member

    A supplement called Seriphos can conceivably lower cortisol somewhat. I've never heard of any side effects, but (considering how messed up our systems all are) that doesn't mean that ones aren't possible.

    If you're magnesium deficient, you will be anxious. Try to get magnesium glycinate or some other form that absorbs well if you try supplementing.

    Lack of B vitamins can cause feelings of irritability and stress, although that's not necessarily the same thing as anxiety. It may be worth trying though.

    L-theanine is a substance that causes encourages the brain to go into a state similar to that produced when people drink lots of green tea and meditate deeply. That seems to be helpful for me in terms of feeling relaxed.

    5HTP is an amino acid that is sometimes used for anxiety. It works on the same neurotransmitters as the SSRI's, though. It also has interactions with prescription drugs and sometimes exacerbates manic-depressive tendencies. Use with care.

    (The other supplements above don't seem to be associated with side effects, which again doesn't mean that you absolutely can be sure you won't have one.)

    A few of questions:

    When did you start feeling anxious? Was it at the same time that something else happened?

    Have you ever had a head injury?

    Does your anxiety seem to come on in "attacks"? (Not classic panic attacks. Just that one minute you feel fine and the next it overwhelms you for no discernible reason.)

    Is your anxiety at all correlated with your menstral cycle?

    Does the Klonopin work to your satisfaction?

    How is your DHEA level? (Low DHEA and high cortisol can produce screwy sensations.)

  3. monicaz49

    monicaz49 New Member

    When did you start feeling anxious? Was it at the same time that something else happened? IVE HAD MILD ANXIETY FOR 10 YEARS...GOT CRAZY AFTER TRYING PROZAC AND HAVE NEVER BEEN THE SAME.


    Does your anxiety seem to come on in "attacks"? (Not classic panic attacks. Just that one minute you feel fine and the next it overwhelms you for no discernible reason.)

    Is your anxiety at all correlated with your menstral cycle? DEFINITELY NO DOUBT GETS MORE SEVERE DURING PMS AND MENSTRUATION..BUT IS ALWAYS THERE.


    How is your DHEA level? (Low DHEA and high cortisol can produce screwy sensations. DHEA IS SLIGHTLY LOW..CORITSOL HIGH. I DONT KNOW HOW TO CONTROL IT AND DOCTORS DONT THINK ANYTHING OF IT.

    THANK you for your reply.
  4. abcanada

    abcanada New Member

    The only thing I know about cortisol is that my dog has Adison's Disease & his cortisol is very screwed up. He got sick at age 4, lost 20 lbs in 48 hours & the vet said had we not brought him in when we did he would have went into shock & died. He has to take florinef(controls his electrolites) & prednisone for the rest of his life & becomes very shakey if we forget his meds. He is a large German shorthaired pointer. An awesome hunting dog. He's my hubby's baby,so we grin & bare the cost of his prescriptions. We are so lucky to have an awesome dog who is very accepting of all our young kids. These things are worth getting checked, as I said he got sick VERY quickly(we were actually out in the woods on a hunting trip)and this IS a human disease involving cortisol. I posted his picture, as he deserves a turn. Laura
    PS the other morning I woke up & he had been shaking quite badly, my kids were up first. They got him into my son's bed & covered him with blankets as they thought he was cold.
  5. monicaz49

    monicaz49 New Member

    My doc says i dont have addisons but wow my cortisol is sky high! Thank you...and im sorry your dog is not well. Sounds like you are taking good care of the lil guy though and he is in good hands. :)
  6. monicaz49

    monicaz49 New Member

    oh...i just looked up addisons and its LOW cortisol. Mine is high..which i believe is more like Cushings. I think. LOL
    But thx
  7. jaltair

    jaltair New Member

    If your doctor has ruled out disease causing the high cortisol, then the level must be due to anxiety.

    "Another thing the doctor may do is repeat testing at a time when you feel less stressed and / or give you varying doses of a medicine that replaces cortisol (usually dexamethasone) to see if this decreases your cortisol level. Multiple tests are often needed to tell if stress or disease is causing a high cortisol level." (http://www.labtestsonline.org/understanding/analytes/cortisol/faq.html)

    You probably have a "generalize anxiety" or even experiencing a "generalized panic attack." The anxiety you are having may be due to your chronic illness. I am not saying that CFS causes is in a physiological sense, but changes in lifestyle due to the fatigue may cause the anxiety. Anxiety is not unusual when a person has a chronic illness, and is easily treated via medicine.

    I understand your reluctance to take medicine - I don't like taking medicine either. However, you may want to choose take something so that your body isn't in a constant "fight or flight" situation. Being continually anxious can be devastating to your physical being as changes in structure can happen and even be life-threatening.

    What about doing some “relaxation” therapy? I’ve done that and it can help tremendously. This is better than medicine.

    Another idea is to use chamomile tea to help you relax or some other herbs.

    I hope that through some of what you had in the way of response to your post will help alleviate the anxiety. I’ve experienced having anxiety and it’s terrible. I’ve gone back on Celexa as I’ve found that to be most beneficial for the anxiety as well as to help with the pain that I’m having from the FMS.

    Warm wishes, Jeannette

  8. Slayadragon

    Slayadragon New Member

    Well, if the anxiety got worse after the Prozac, it doesn't sound like it's being caused by the cortisol. The Prozac must have screwed up your neurotransmitters somehow. I've never heard of that before, but those SSRI's are very dirty drugs and CFS patients get all kinds of strange effects from things.

    That's the best reason I've heard not to take SSRI's so far.....and I've heard a lot of reasons!

    I think that by far the best thing for you to do would be to talk to a really good psychpharmacologist. This is an MD who specializes in prescribing psychotropic drugs. (I would strongly advise not seeing someone who also does talk therapy......they don't know nearly as much about meds and yours is an unusual case.)

    My first thought is that the Prozac acted on you the way it acts on people with manic-depression, increasing the severity of the ups and downs. (Obviously in your case this is anxiety rather than depression, but the two are closely related.) Usually that effect goes away with the withdrawal of the drug. However, some people have put forth a theory of "kindling"----that once the ups and downs start and are uncontrolled for a while, it is harder to get them to stop.

    (How long were you on the Prozac, by the way?)

    I bring this up because my husband had a problem similar to yours, with low-level constant anxiety and "attacks" of extreme anxiety. (After the attacks, he would be really exhausted and crash.)

    His anxiety didn't follow a drug trial, but he did have a head injury in his past. (He was dropped on his head as a baby. It wasn't until high school that he started getting the anxiety attacks though.)

    When he was almost 50, he did a trial of the anticonvulsant drug Lamictal (used to treat manic-depression). His anxiety attacks went away almost completely the day after he started taking it and have not returned. I have not heard of anticonvulsants being used for anxiety before (I actually came up with this idea myself), but if convulsions from head injuries can cause mania to occur, there seems to be no reason why it shouldn't cause anxiety, depending on exactly where on the brain the injury occurred. Anxiety and mania/depression are very closely related.

    I can't believe this problem is that unusual if my husband has it, but I've never seen it discussed in the literature. You therefore would need a really good psychopharmacologist if you're going to explore that route. Perhaps they could give thoughts on the Lamictal hypothesis, and may have other ideas as well.

    My husband also really likes fish oil.....it's the one supplement he always takes. Apparently it gives some feelings of stabilization to him.

    That would be an easy thing for you to try. It comes in those big gel caps. Try a couple of capsules a day and then work up to maybe eight, since a larger amount has been associated with a better response in some studies. (This actually has at least one published study in a major journal with regard to the control of manic-depression. I think there's some proof that it's helpful for anxiety as well.)

    The fact that you feel worse during PMS suggests you need progesterone. Avoid birth control pills though. Progestin (artificial progesterone in birth control pills) has lots of negative side effects.

    Progesterone generally has no side effects (although again, someone on this board probably has had some.....we're very weird people). They are labeled with all the side effects that Progestin causes though, even though they are not the same thing.

    I would think the progesterone would help the "going crazy" part more than the pure anxiety, although I don't know if the former is what's tied strongly to the PMS for you.

    Apparently you're getting mildly addicted very fast to the Klonopin then. My husband will not take it either, except for very special occasions like when he has to give a talk in front of a big group. He claims it is immediately addictive (causing withdrawal symptoms) for him too. I don't think he takes it at all since going on the Lamictal.

    I would be inclined to think your cortisol is not a major cause here. The trigger incident of the Prozac usage would seem to me to by and large rule that out.

    That doesn't mean that high cortisol is good for you or your mental health, though. If nothing else, high cortisol decreases immune system activity. If you've got CFS, that's the last thing you want.

    Try the Seriphos if you like. I've had it recommended to me many times for this purpose, in one case by a very good doctor. It might help at least a little.

    Upon reflection, I think the high cortisol might be an effect of the anxiety. Cortisol levels rise with stress, of course. In that case, it's going to be hard to bring them down unless you lower the stress level by fixing the anxiety.

    I'm sure that you don't want to take more psychotropic medications since the first one did you in, but Lamictal is my best guess for you based on the information I have available. I suspect that most doctors would be hesitant to try it for this purpose, though. Finding a good psychopharmacologist, again, seems the way to go.

    The easiest thing for you to do would be the fish oil. That seems to have a shot at being at least a little effective for what seems like it may be your core problem.

    I don't think that magnesium and B vitamin deficiencies are your core problem, but they may be contributing to the "feeling crazy" part. If you're under enough stress from the anxiety that your cortisol levels are elevated, you're running through a lot of B vitamins. And almost all of us are short on magnesium and feel better emotionally when we supplement. These would both be easy to find and try too.

    L-theanine is not available everywhere, but (like meditation if you've got enough of an attention span to do it) it seems to have a small amount of relaxation benefit for everyone. You could try this is you get around to it.

    If you have a good gynecologist, ask about natural progesterone. This is available either through gel caps sold through regular pharmacies (the brand name is Prometrium) or through compounding pharmacies in various forms (the most usual being creams). Most over-the-counter creams are very weak and thus won't help a whole lot (although some people do get beneficial effects).

    If your gynecologist won't prescribe it, look for a doctor who specializes in bioidentical hormones or a more "holistic" M.D. (since they tend to use this approach too). There are more such doctors available since the Suzanne Somers books and other bioidentical hormone discussion.

    This is a lot to absorb, but you present a rather unusual case. A really good psychopharmacologist might find this an interesting challenge, if you want to explore that possibility.

    Keep me informed of your progress and let me know if you have further questions.

  9. Slayadragon

    Slayadragon New Member

    The stuff in turkey (urban legend would have it) is supposed to be l-tryptophan, I think. This is converted in the body of 5HTP and then to serotonin.

    Do most people get sleepy after consuming a turkey sandwich? Or more relaxed?

    Maybe after all that food on Thanksgiving, the body wants sleep to digest the food.

  10. Slayadragon

    Slayadragon New Member

    Another theory is that viruses get into the brain in CFS and affect various sites.

    That's a possible explanation for why people feel somewhat depressed (usually not really depressed) with CFS.

    Similarly, people often feel anxious for no reason on CFS. I don't know that it's "supposed" to be the sort of extreme anxiety you're facing though. I haven't seen that much on the board.

    I tend to think there may be a deeper cause for that.
  11. cherylsue

    cherylsue Member

    I have periodic anxiety, too. I figured it probaby was due to high cortisol levels, especially at night. Sometimes, in the am. I take klonopin for sleep, and that seems to help.

    Lisa, regarding klonopin and addiction. I find that I have next day sedation with klonopin. When I pull back to .25 mg, I start getting brief mild headaches. You mentioned your husband finds it very addictive. I'm not sure whether I should continue the klonopin, reduce it, and wean from it. Disruptive sleep would be a real big problem, then. I still wake up a few times on klonopin. I get deeper sleep, but that doesn't necessarily make me feel better during the day.

    Thanks for your advice.

  12. mbofov

    mbofov Active Member

    A little over 3 years ago I started taking Seriphos (phosphorylated serine) because of high cortisol levels. It helped almost immediately, within a day or two. I had to experiment a little to get the correct dose. It calmed me down without drugging me, and helped with sleep. I too had the same feeling of my nerves running through my veins.

    I started out with 8 capsules a day 3 years ago, and now am down to 1 a day. I could probably get by without this one, but have a lot going on right now, getting ready to move with a broken foot, etc.

    I found it was very important to take it in the morning. It screwed me up taking it at night, because of the body's natural rhythms. So I took 4 first thing in the morning on an empty stomach, and 4 late morning before lunch on empty stomach. I had NO bad side effects, and I am very sensitive to meds.

    I did notice after about 6 months I was getting unusually tired, and realized my cortisol levels were going too low now, so I cut my dose and gradually just kept cutting it back.

    It was severe long-term anxiety and stress I am sure which first caused the high cortisol levels, but once they were up there, it was almost impossible to get them down without the Seriphos. The Seriphos enabled me to do the things I needed to do to lower my stressors.

    It can be dangerous to let high cortisol go untreated, because it makes your body become catabolic - it starts burning its own tissues for fuel, instead of what it should.

    I had my saliva testing done by and order the Seriphos through Clymer Healing Research in Pennsylvania (you can find them on the Internet), and also several places on-line sell it.

    If I were you, I would start the Seriphos, and then start addressing other issues -

    Identify the causes of your stress and do everything you can to eliminate or minimize them;

    Get relaxation tapes;

    Learn to meditate (it's very easy - a very good book to begin is The Relaxation Response);

    Make sure you're taking enough calcium and magnesium - I take them in equal doses, 1600 mg. of each a day;

    l-theanine is very good for natural calming, it helps the brain produce GABA;

    Make sure you're taking a good B vitamin complex and maybe extra pantothenic acid which is very important for the adrenals;

    Eliminate or have very little coffee, alcohol and sugar, which are stressors;

    Make sure your diet is good (you know, low sugar, no white bread or sodas, good protein, lots of vegies, etc.)

    Good luck!

  13. Slayadragon

    Slayadragon New Member


    Have you ever tried melatonin?


    My husband (the anxiety patient I described above) tried Wellbutrin for a short while and got much more anxious as a result.

  14. mbofov

    mbofov Active Member

    Here's an article re Seriphos I downloaded a few years ago, which you might find helpful.

    Please note in this article that when they say “PS”, they are referring to phosphatidyl serine, NOT Seriphos, which is phosphorylated serine.

    Seriphos is less expensive and more efficient in converting the stress hormone cortisol than regular phosphatidyl serine (PS). Seriphos (Phosphorylated Serine) is a pure product and not derived from animal tissue. The serine is from vegetable sources and the phosphate is from a pure phosphate donor compound.

    Regular PS acts as a precursor molecule and is not the active form of the nutrient. In the tissue, regular PS is linked to glyceroland, the appropriate fatty acids specific to each tissue, and is not linked to the fatty acids provided in PS. In short, fatty acids can oxidize in regular PS.

    Seriphos, Phosphorylated Serine, is less expensive and does not oxidize. Absorption does not depend upon enzyme availability in the gastro-intestinal tract of the user as does PS.

    Seriphos, like PS, stimulates neuronal plasticity, acting as a compensatory adaptive mechanism to cell deterioration, and is capable of preventing or delaying the age-dependent decline of neurotransmitter function.

    Chronic stress, physical and mental, can desensitize the hypothalmic-Pituitary-Axis and elevate cortisol. Seriphos can help optimize the stress response, and repair the damage wrought by catabolic stress hormones. PS, when consumed in food provides only 20% of active phosphorylated serine. Each 100 mg of PS only yields 20mg of activated serine following consumption. The bulk of the weight is derived from two fatty acids, acting as a precursor molecule and is not the active form of the nutrient. Seriphos is more stable, economic, and a more active molecule than PS.

    Seriphos can improve memory and sleep. Clinical studies show an improvement on both computerized and standard neuropsychological performance tests.

    Suggested usage:

    Like all macro minerals, it is best absorbed when taken before meals at least 15 minutes before eating. For stress, take one capsule at least 15 minutes before eating.

    NOTE: Seriphos works with the pineal gland. Take two in the morning and two at lunch time before meals for better sleep at nighttime. This mimics the cortisol "curve".

  15. mbofov

    mbofov Active Member


    By Dr. Joseph A. Debé

    Exercising regularly and making healthful dietary choices takes discipline and dedication. Some people do it for their appearance - they want to build muscle and/or lose bodyfat. Others are motivated to improve their health and vitality. And then there are the competitive athletes. No matter what your fitness goals are, one of the main determinants of whether you will reach them is your hormonal status.

    Although many hormones have an influence, two of the most important are cortisol and DHEA. These are the long-lasting stress hormones secreted by the adrenal glands. Cortisol has a general catabolic effect on the body. Catabolism refers to the breakdown of complex living tissue into simpler components, some of which are used as metabolic fuel. DHEA has largely opposite effects of cortisol, being an anabolic hormone. Anabolism is the process whereby food is converted into living tissue. Anabolism and catabolism are both essential processes. In order to achieve your fitness goals, cortisol and DHEA must be produced in the proper balance. Chronic stress results in imbalance, with increased cortisol and decreased DHEA production. This causes the body to shift into a catabolic state.

    It is critically important to understand that mental-emotional strain is only one of many different things the body perceives as stress. Two of cortisol's main functions are to raise blood sugar levels and to reduce inflammation. Thus, cortisol levels increase in response to drops in blood sugar and the presence of inflammation. Other types of stress include: chronic pain, chronic illness, chronic/severe allergies, trauma/injury, temperature extremes, surgery, toxic exposure, chronic or severe infections, late hours/insufficient sleep, light cycle disruption (as in working night shifts), and excessive exercise. That's right. Excessive exercise results in elevated cortisol to DHEA ratios. Over enthusiasm about exercise can easily produce cortisol-DHEA imbalance. In addition to overtraining, the three most common stressors to be concerned about are mental-emotional stress, dysglycemia (blood sugar fluctuation), and inflammation.

    How exactly does an elevated cortisol to DHEA ratio interfere with fitness goals? One way is by producing cellular amino acid deprivation. Amino acids are the building blocks of proteins, which are responsible for most of the cellular structure, and for enzymes which catalyze biochemical reactions. Under the influence of stress, (a high cortisol to DHEA ratio), protein synthesis slows and protein breakdown accelerates. The end result is reduced muscle mass. Proteins from the heart, bones and gastrointestinal mucosa (lining) are also targeted for breakdown. The amino acids released by the catabolism of these proteins are oxidized to produce carbon skeletons to be used for making glucose. Importantly, aging proceeds by this very process of cell protein degradation. Stress also results in the replacement of insulin-sensitive, slow oxidative type I muscle fibers by fast glycolytic type II-B muscle fibers, which impairs muscular endurance.

    Elevated cortisol levels also interfere with energy production by decreasing glucose utilization. High cortisol to DHEA ratios result in fat deposition, especially around the midsection. It is possible to sometimes build muscle under stress (high cortisol : DHEA), but at the expense of the internal organs. What happens is that resistance exercise (weight training) makes the skeletal muscles the organ of demand so that protein is "stolen" from the internal organs to be used by the muscles. Bodybuilders in this condition have been found to have up to thirty percent shrinkage of the liver and catabolism of other organs, as their muscles grew. Obviously, this is detrimental to health. For those concerned about their appearance, stress strikes another blow. Elevated cortisol levels reduce skin regeneration and lead to accelerated wrinkling. The protein breakdown that occurs under stress can also accelerate osteoarthritis and bone loss, and prolong healing of injuries. Other conditions which people hope to prevent or improve by a healthy lifestyle are actually promoted by elevated cortisol to DHEA ratios. These include hypertension, ischemic heart disease depression and various cancers

    Elevated cortisol: DHEA further impedes fitness goals by altering the levels and activities of other hormones. Thyroid stimulating hormone and triiodothyronine levels are reduced and reverse triiodothyronine levels increase. In other words, thyroid activity is diminished. This results in a slowing of the metabolic rate. Bodyfat becomes easier to store, more difficult to lose. Stress lowers levels of growth hormone, testosterone, and insulin-like growth factor I, all of which are muscle-building, fat-burning hormones. Stress increases levels of estrogen released from the ovaries and also increases conversion by fat cells of DHEA, androstenedione and testosterone to estrogen. The more bodyfat a person has, the more these hormones get converted to estrogen. Estrogen stimulates fat deposition, particularly around the thighs and hips. Stress is feminizing in men and women. Stress produces insulin insensitivity with subsequent elevation in insulin levels. This produces increased hunger with craving for carbohydrates. Elevated insulin levels increase fat cell proliferation and fat deposition. To sum it up, under stress, muscle is replaced by fat.

    So, how does one know if they have elevated cortisol: DHEA? The best way to measure these hormones is with the Adrenal Stress Index™. This is a simple test the person performs at home. Four saliva samples are collected over the course of one day by rolling cotton swabs under the tongue and then placing them into test tubes. The kit is then mailed to the laboratory and the hormones are measured from the saliva. The testing laboratory furnishes the test kit, with all supplies needed. The laboratory fee for the test is $99.

    Test results are sent to the ordering doctor within about two week’s time. Analysis of the test results, in combination with evaluation of the individual's lifestyle, leads to therapies to help restore any hormonal imbalance. Scientifically proven techniques for mental-emotional stress reduction can be used. Dietary and nutritional supplement recommendations to balance blood sugar levels are often needed. Women trying to lose weight often eat too much carbohydrate. Bodybuilders often eat too much protein. Both of these situations can result in elevated cortisol to DHEA ratios, as can simply not eating enough. Sources of inflammation must be sought out and dealt with appropriately to lower cortisol output. Thorough understanding of the individual's lifestyle can identify other sources of stress.

    A nutritional supplement called phosphorylated serine is often useful in lowering elevated cortisol levels. It appears to work at the level of the brain and pituitary gland. DHEA supplementation is usually called for when levels are found to be low. In some cases, sublingual administration is preferred; in other cases, micronized capsule form is best. In cases of sex hormone related problems such as prostate or breast cancer, DHEA should not be supplemented before performing an additional test called a DHEA challenge test. This test measures the increase in testosterone and estrogen levels after supplementing DHEA for just a week. For those individuals who convert a lot of DHEA to testosterone or estrogen and have certain health conditions, DHEA can be dangerous. 7-keto DHEA is a supplement that apparently is not converted to sex hormones within the body and so can be used safely, although it will not provide all the benefits of DHEA.

    An additional therapy to help lower cortisol levels is aerobic exercise. However, as was previously mentioned, excessive exercise can stress the body. There is a way to help determine if a given duration and intensity of exercise is stressing or de-stressing the body. Another test of cortisol levels is performed in relation to exercise. A saliva sample is taken five minutes before beginning exercise, five minutes after, one and three hours after finishing the exercise session. It is acceptable for cortisol levels to rise immediately after exercise. However, they should decrease by one hour after exercise. Three hours after exercise, cortisol levels should be equal to or lower than starting values. If they are, then the level of exercise is beneficial. If they are not, then this level of exercise is a stress to the body and is sabotaging fitness goals and undermining health. In this case, the type, intensity, and/or duration of exercise need to be adjusted. This test is particularly well suited for women who cannot lose weight even though they exercise aerobically and - inappropriately - eat a high carbohydrate diet and avoid weight training.
  16. Juloo

    Juloo Member

    And the progesterone (in cream -- OTC) as well. Both of these things have helped me in the anxiety area. I was up to 4 Seriphos capsules three times a day at my highest. I don't recall any side effects.
  17. monicaz49

    monicaz49 New Member

    seriphos something online or an rx?
  18. bigmama2

    bigmama2 New Member

    you can order seriphos on line thru Clymer (or other websites). It is not Rx.
  19. Jeanne-in-Canada

    Jeanne-in-Canada New Member

    Probably the simplist way to address anxiety, w/ a well known and easy to find supplement is by using St. John's Wort. St. J's is actually more effective at managing anxiety and PMS than depression. It also reduces pain levels and is used for neuralgia, most often due to rickets.

    This would be the quick hit. If you've already tried it and you can't tolerate it for some reason (we never know what we can be sensitive to), then there is longterm treatment which targets the healing of the glands, mainly the adrenals, which are obviously not functioning properly if they are dumping copious amounts of cortisol when you don't need it.


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