Unexplained High Blood Sugar: Is It High Cortisol While You Sleep

What causes high blood sugar?

Most of the time we know what causes high blood sugar. Eating too much food. Especially simple carbohydrates and junk food. But there are other factors which can elevated blood sugar independent of diet.

Other causes of high blood sugar include:

• Stress and cortisol
• Nutritional deficiencies

The adrenal glands, cortisol and the stress response

The adrenals are two small glands which sit on top of the kidneys. Their job is to make numerous hormones which regulate stress response including cortisol, epinephrine and aldosterone. For the purpose of keeping things simple, I’m just going to focus on cortisol.

Cortisol is out "Fight or Flight" hormone. Normally it follows a diurnal, rising to it’s highest point in the morning, and then slowly decreasing during the day. Ideally it is lowest at night when we go to sleep.

Chronic stress can deregulate this pattern. Stress is simply the body’s adaptation to any extra demand. This can be psychological stress, or physical stress from an injury. The body's physiological response is the same. The adrenals release cortisol. It’s job is to get more blood and nutrients to the heart, lungs and brain to help you survive an emergency.

Short term elevations of cortisol are essential for survival. But when stress in our daily lives does not go away, cortisol levels get thrown off.

Cortisol may be high, or in some cases the adrenals became exhausted and cortisol is too low. Neither is good. It is also possible for cortisol to be normal for some parts of the day, but deregulated at other times.

Lab tests for blood sugar

Since cortisol raises blood sugar, that means even if you eat a good diet, stress by itself may cause a blood sugar issue. Blood test can help figure this out.

• Blood glucose: This is your blood sugar levels at any one moment. This test helps diabetics regulate their medications, supplements or diet. A single reading should never be used to determine if someone is a diabetic or has a blood sugar problem. It's possible for blood sugar to be ok during part of the day, and very much off at other times.
• HgA1c: Used to test blood sugar over time. Hemoglobin is in our red blood cells. Its job is to bind oxygen. Over time blood sugar will glycosylated hemoglobin. The higher the blood sugar over time, the higher HgA1c will be. This test can not be used for short term rises in blood sugar. Instead if shows if blood sugar has been elevated over several months.

Mysteriously high blood sugar and cortisol

If you follow the following pattern, you may be experiencing a spike in cortisol while you sleep, causing high blood sugar:

• Elevated HgA1c
• Normal blood glucose levels on blood tests
• You are not eating a high carbohydrate, or high sugar diet
• You wake up in the middle of the night for no reason (not all the time, but common)

How to test for middle of the night spikes in blood sugar and cortisol

Go to any drug store and buy a glucometer. I recommend getting a cheap one, as you probably are not going to be using it that often. Take your blood sugar at night and in the morning. If you wake up in the middle of the night, take your blood sugar then as well. It's normal to see some increase in blood sugar as your sleep. This is part of your body getting ready to wake up. However a very large spike can indicate that cortisol is too high. In some people cortisol is normal during most of the day, but goes up way to high at night.

The other test is a saliva cortisol. Theses are commonly used by naturopathic doctors, or other functional medicine practitioners. One of the advantages in using a saliva cortisol tests is that samples can be taken multiple times during the day and even in the middle of the night. If I have a client who is waking up in the middle of the night, I have them take a cortisol sample then, so we can see exactly what is happening.

If blood sugar is spiking in the middle of the night, there is a good chance it is cortisol. The glucometer blood sugar test is therefore a way to infer if cortisol is going up to much at night. The saliva cortisol is a direct measurement.

The advantage to testing blood sugar is you get immediate results. Taking a saliva sample, sending it off to the lab and waiting for results takes about two weeks. You also need to either order a kit from a company that sells it, or get one from a practitioner you are working with. Neither test is that difficult to do, so doing both is really the best option for difficult cases.

How to fix elevated cortisol

The real answer is going to be different for everyone. When working with clients I often use herbs or homeopathics which are best individualized. There are also many different way to lower stress response with lifestyle modifications such as meditation and exercise. Each person needs to find what works for them. In the office I also use a system called Neuro Emotional Technique to help the body release emotional triggers it is holding onto.

Some common supplements for stress, cortisol and blood sugar

These are some supplements that often work. Since everyone is different I can't guanantee these will work for everyone. But, without knowing anything more about a case, other than there is a stress response at night, these are the supplements that come to mind to try first.

• Seriphos or phosphatidyle serine. Both of these are similiar. Seriphos will actually get converted into phosphatidyle serine in the body. For some people one may work better than the other. Phosphaidyle serine blunts the adrenals from being signaled into making too much cortisol. Doses can vary a lot. My last year in naturopathic school I developed middle of the nigh insomnia. I woke up about 3AM every night, for 8 months in a row. I didn't discover the cause until finally getting a cortisol test from my schools clinic. My cortisol was more than double what it should have been in the morning. One of my teachers told me to try 200 mg of phosphatidyle serine. It did nothing until I took 800 mg before bed.
• Chromium: this is the most commonly used supplement for elevated blood sugar. Without chromium insulin can not function properly. It's very simply, but does work.
• Ashwagandah: A very common herb for the adrenals. Some herbs which are used for the adrenals such as rhodiola, American ginseng or licorice can be very stimulating. Ashwagandah is more gentle and over time helps to repair the nervous system. Not a quick fix but generally very good. There are other options, but I can only recommended the bests helps I know if going over a case one one one.

As a side notes, some people may wake up in the middle of the night because cortisol and blood sugar are too low. In those cases eating a snack at night, or taking the herb licorice may help. The herb valarian is also generally for good for sleep. For those those with too much heat (Pitta in Ayurvedic terms) it can actually make their sleep worse. This is why going over a case properly and treating the person is much better than trying various supplements based only on their symptoms or disease.