Q:  Weight Loss & Cortisol Reduction Treatments

First, thanks for a very informative website.
I have been on Depakote SR for 3 months and continue to LOSE weight (20+ lbs). I am eating well but no help.(and no other medical condition). I read your section on Cortisol and stress, and I am thinking if I have excess Cortisol output I can lose weight no matter what I eat. Should I try the new OTC Cortisol reduction treatments?


Dear Mr. B' -- 
Your letter prompted me to have a quick look around at websites offering cortisol reduction products. Though far from an exhausting search, this tour did support my concerns about health claims about cortisol (interestingly, a mix of cortisol (or similar molecules) is good, cortisol is bad, and general misinformation, usually from oversimplifying, about cortisol). I came away even more confused about cortisol -- which is notable, since even before this tour, cortisol was mystifying me, and should mystify us all. 

For example, there are two different cortisol receptors with nearly opposite effects in some cases. In other words, the same cortisol molecule can have nearly opposite effects depending on: 

a) where it arrives; 
b) how much of it arrives; and
c) how long that amount of cortisol sticks around.

These variables, and perhaps others not yet as well understood, quite markedly affect the body's response to cortisol. At minimum, we can conclude that the story is complex. Just measuring the amount of cortisol (e.g. the popular salivary cortisol tests) tells us very little about this complexity, in a given person. At minimum, such tests would have to be performed with a deliberate timing relative to the person's sleep cycle, as levels of cortisol change routinely and dramatically depending on the time of day. If this line of information is of interest, watch my "What's New?" page as I've started a plain-English summary of a recent review on this topic I should get up soon (have to put that down and write a few more letters!). 

Dr. Phelps

Published November, 2005