Chris Kresser: I would be very cautious with exercise in a patient with very, very low free and total cortisol. That patient is the closest that you’ll get to actual so-called adrenal fatigue. Again, the low cortisol levels are not probably because their adrenals can’t produce it. They’re due to HPA axis regulatory and tissue-specific regulatory mechanisms, as you all know now. But that’s a hypocortisolism state, and it definitely means that they won’t be able to mount an effective cortisol response to the inflammatory effect of exercise. That inflammatory effect is hormetic in cases where cortisol levels are sufficient, but in cases where cortisol is very low, the inflammation that results from intense exercise actually can become problematic. That person is a good candidate for something like walking, gardening, light swimming, cycling, restorative yoga, tai chi, qigong, maybe light hikes in the woods, spending time on the beach, outdoors, etc. That’s the kind of physical activity that that person would typically benefit from.
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If someone has very low cortisol and low cortisol metabolites, would exercise be a way to raise it if they weren’t too tired?
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