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Client with Elevated Cortisol Levels and Exercise

Posted Oct 07 2008 8:02pm

, I hope you can help with this. I have a new client that wants me to draw up a training prg for her. Female, age 30, height bout 160cm, 79,4kg, 37,5% body fat. Family history of diabetes, cancer and heart disease. She does not want to do weight? resistance training as she says she has high cortisol levels and the resistance training makes her pump up and grow muscle too quickly. I’m not too sure what she wants from me but could this be cushings disease. She has been training for a while but would it be a good idea to get a full doctors exam or report done. Can the resistance training make her swell or pump or grow because of the cotisol because I always thought cortisol was catibolic. Some insight would be appreciated. Regards Kenneth



I have a couple of questions for you before I get into this question, which is a great one:

1.    I always tell my students to do there research so they now there client. Sounds like you have done yours. But clients come in to learn from us (that is what she wants from you), so meet her at her level so she can benefit. As well, do you think clients just come to us for that reason…NO! They come to us so we can learn from them. So take this opportunity to learn from your client. So what do you think she “wants” from you?
2.    As well, never second guess your gut feeling with what you know or what you want to do with a client. This is your intuition and when you doubt it, you are doubting self.

The question is, where to start? The bottom line is you cannot base your treatment program based on symptoms. Otherwise you will just be a “holistic trainer” following the allopathic approach. Have you assessed your client in the areas of sleep, digestion, stressors, fluids and intake, food (quality and quantity), and detoxification systems. Some great resources for this are, How to Eat, Move and Be Healthy by Paul Chek and/or The Cortisol Connection by Talbott. All of these will allow you to periodize and individualize your clients treatment program.

When the body is stressed, many things happen. One important thing that happens is the HP-A-T-G-G (Hypothalamus, Pituitary, Adrenal, Thyroid, Gut and Gonad) axis’s are turned on. The body releases hormones and cortisol, which help regulate BP, blood sugar and help to fight stress/inflammation. Over time, if we don’t come back to homeostasis because of lack of adaption to the stressors in our lives, the adrenal glands have to work over time. This in turn slows our metabolism down, we become catabolic, end up with a hormones imbalance (Pregnenolone Steal = Pregnenolone is a precursor to progesterone, cortisol and DHEA→ which DHEA is a precursor to estrogens and testosterone. When over time we have to keep up with producing cortisol to cope with stress, the body steals Pregnenolone to overproduce cortisol. Reference for more in depth information), as well as end up with a gut dysfunction (secondary to the adrenal glands producing immunocytes = SIgA to protect the gut).

So if someone feels pumped up from working out, that is overweight, might be insulin resistant, has high body fat and is being bombarded with the “many faces of stress in their life,” the pumped up feeling in my opinion is inflammation if anything. This could be joint, arterial, venous, respiratory, the detoxification system and so forth. But you can still exercise someone that has a high physiological load, such as this client. You want to make sure that the goals are to:

Client Applications:
1.    Balance the biological oscillators in the body (brain, heart and gut)
2.    Balance toxicity levels in the body
3.    Help with immune support
4.    Emotional well being: depression, anxiety and anger
5.    Help with acute pain
6.    Assist with malnourishment, which most Americans are overfed and undernourished!

Energy Applications:
1.    Harvesting energy within the body
2.    Tuning biological oscillators
3.    Consciousness shift in healing and health maintenance over time

Intensity Zone (weight to be used):
1.    0%-40% intensity.
a.    You can base this off RM, - reps, BW, or exact weight to be used

Exercise Type:
1.    Breathing exercises such as yoga or qi gong
2.    Teaching your client how to breath
3.    Incorporating Feldenkrais movements, Alexander Techniques, Cycling, Rowing, Swimming, Hiking, etc into their daily life
4.    Exercise that fall within the clients postural needs, skill level and do not put any more stress on their body than they already have. With High Physiological load clients, anaerobic work does wonders to increase their GH levels and not cortisol levels. But keep it within their intensity parameters.
5.    You can see most of these are with minimal to no load. Any extra load with just put more fuel into the fire of sympathetic stress

For more information on the above, attend any of Paul Chek or Charles Poliquin courses!

Here are my recommendations:
1.    Work with this client within her physiological load
2.    Refer out for some nutrition and lifestyle assessments and education to meet her needs
3.    Refer out to in order to get the Adrenal Stress Profile (#201)
4.    With clients such as this, you can see that nutrition and lifestyle at this point, will out way her need for exercise.

Good luck!

Joshua Rubin

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