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How Cortisol Levels Affect Autism Spectrum Disorders

By Edited Jul 9, 2016 1 5

Cortisol and Autism: The Dance Between Melatonin and Cortisol

How Cortisol Levels Affect Autism Spectrum Disorders

If you’re wondering how cortisol levels affect autism spectrum disorders, it actually works in partnership with the hormone melatonin. While most people think of melatonin in connection with sleeping issues, cortisol plays the larger role. When one of these two hormones is low, the other is high. Together, they fluctuate throughout the day and night to keep our circadian rhythm functioning properly.

Cortisol plays a major role in our ability to handle stress and excitement. That can be particularly important for children and adults on the autism spectrum. When levels get out of balance with melatonin, the dysfunction causes a wide variety of symptoms and behaviors that parallel many of the behaviors and health abnormalities associated with autism. While we can’t totally eliminate stress and excitement from our children’s lives, there are many things we can do to help the body cope.

Fight-or-Flight Response Helps the Body Cope with Stress

The body’s natural response to stressful situations, excitement, or a sudden need for energy is called the fight-or-flight response. The hypothalamus in the brain triggers this response and causes the body’s survival systems located in the gut to awaken and kick into gear. This self-preservation system involves the pituitary center in the brain, the central nervous system, and the adrenal glands.

When these body systems release the dozens of hormones needed to handle the perceived situation, the immune system, digestive tract, endocrine system, and several other body functions immediately shut down, so that survival mechanisms can utilize current resources to handle the threat. Cortisol is one of the neurobiological stress hormones released when you are excited or stressed. It sends a signal to the liver to release a flood of glycogen. Glycogen is the storage form of carbohydrates, so the liver converts the glycogen into glucose and dumps it into the bloodstream to give us the energy we need to handle the problem.

In ancient times, this immediate energy source was necessary for man to fight the physical opponent confronting him, or it gave him the surge in blood sugar he needed to run away. When the problem is emotional or mental, rather than physical, the brain still stimulates the release of cortisol, but the energy doesn’t get used. That can make an autistic child aggressive and combative, or it can make them want to leave their current environment as quickly as possible. Cortisol overloads the child with excess energy that must be dealt with by the body.

In addition to cortisol, the body secretes adrenaline. Blood glucose levels rise and energy continues to build in preparation to fight or run. Survival becomes the body’s number one goal. Clear thoughts and the ability to reason shut down, because they closely coincide with the amount of stress hormones currently in the blood. Energy can’t just sit there. It has to be used, and if it’s not, the brain will find unusual ways to adapt to the situation. Sometimes, body cells will do unusual things they don’t normally do, and sometimes, unusual behaviors such as stimming or meltdowns can occur.

Cortisol Levels Partner with Melatonin Levels

When Cortisol is Low, Sleeping Isn't a Problem

You may have already heard about melatonin in connection with sleeping problems. When the body’s levels are too low in the evening, difficulties going to sleep and staying asleep can result. While soothing music and turning down the lights can help children relax, melatonin is not the only hormone that plays a role in getting a good night’s sleep. Equally important, and maybe even more so, is the role that cortisol plays in daily energy and sleeping patterns.

When this hormone is functioning correctly, it rises during periods of stress or excitement and then returns to normal levels as the body handles the threat. Since this hormone is responsible for increasing blood glucose levels, it also rises in the early morning hours to wake you up. That gives you the energy you need to start the day. Levels are lowest in the evening and highest in the morning. That is in opposition to melatonin levels, which are highest in the evening and lowest in the morning.

Effect of Stress on Autism Spectrum Disorders

Dr. David Clark is the Director of the Center for Autism Recovery in Dallas, Texas. He is a licensed and board-certified chiropractic neurologist who works with many of those who have autism spectrum disorders, ADHD, and dyslexia. In his professional opinion, sleep disorders do not come from a lack of melatonin. They come from cortisol problems.[3] In fact, he is so adamant about this point, that he created a video to help the parents of autistic children understand why it’s a mistake to give their children melatonin if they have sleeping issues.

Why Taking Melatonin for Sleeping Problems is a Mistake

Since the brain releases cortisol whenever you face a stressful situation, many individuals suffer from the effects of a consistently elevated cortisol level. This includes many autistic individuals because a threat does not have to be real. You just have to perceive it that way. Any form of excitement, emotion, or health condition can keep cortisol levels high:

  • sensory issues
  • fears associated with social interaction
  • difficulties and frustrations in learning and behavior
  • faulty memory
  • food allergies, sensitivities and intolerances
  • chemical allergies, sensitivities and intolerances
  • environmental issues
  • gastrointestinal problems
  • body or brain inflammation
  • yeast overgrowth problems
  • autoimmune issues and diseases
  • gut or viral infections

Even autism treatments and therapies can create the degree of stress required to trigger a cortisol reaction. Whenever you feel frustrated, angry, confused, or overly excited, the fight-or-flight response can be triggered.

However, the problem for those with autism is even more complex. According to a recent scientific study that looked at the amount of cortisol produced by autistic children, “A significantly higher serum cortisol response was found in the group of children with autism.”[2] Not only did autistic children secrete more cortisol during stressful situations than the neurotypical controls did, but the cortisol stayed elevated longer, and the autistic children had a more difficult time returning to normal levels.

This study suggests that children with autism have a heightened response to stress, which then results in cortisol regulation difficulties, as well as the inherent dangers that come from consistently elevated cortisol levels.

Danger of Consistently Elevated Cortisol Levels

Daily Living Can Trigger Stress and Raise Cortisol Levels

Daily living, illness, diet, exercise, and environmental toxins all play a role in the way the body handles stress. How you perceive that stress determines the degree of fight-or-flight response the body initiates. For some individuals, even a slight frustration can set off an excess amount of stress hormones. While neurotypicals can easily take an active role in reducing their overall stress, those with autism spectrum disorders do not always have that option. Since flight-or-fight is about survival, many body systems such as logical thought will be set aside in order to handle the perceived emergency.

When cortisol levels remain elevated, every body system and organ is affected. Sometimes that effect is helpful, but often it’s not. The presence of consistent stress hormones can put every other body system in danger of breaking down. Under normal conditions, cortisol disappears from the blood within an hour or two and body systems return to normal, but when stress or excitement is continuous, as it often happens in those with autism spectrum disorders, the body never has time to return to normal function. Some of the major systems that go wrong are:

  • virual infections
  • gut infections or bacteria imbalances
  • brain cells misfiring
  • food intolerances
  • autoimmune conditions

The nervous system, muscle function, endocrine system, and digestion all interact with each other to keep the body healthy, but prolonged episodes of cortisol elevation will eventually contribute to immune system suppression and disease.

Addressing the Problems

Addressing the potential problems that can keep cortisol elevated is the best way to keep the body functioning normally. While you cannot prevent autistic individuals from feeling frustrated, overly excited, or stressed out, you can reduce the demands that life places on them, be considerate of their sensory issues, and take the necessary steps to deal with their health problems.

Insomnia and other sleep abnormalities is often a sign that stress hormones are high. Taking sleeping medications or hormones to correct the problem is more like a band-aid then a helpful practice because it just creates more imbalance in the body. For parents who desire to take a nutritional and biochemical approach to their child’s treatment program, it’s always best to get the proper medical tests performed, rather than trying to self-medicate them. But educating yourself on the possibilities can also be helpful.

It’s only by addressing the specific issues that nutrition, environmental factors, liver function, food intolerances, and other imbalanced biochemical pathways cause that we can make a real headway in helping our special children overcome their limitations and manage their lives. While issues and behaviors, such as throwing toys or a temper tantrum in public, can be exhausting for family and child alike, the benefits of teaching your children how to calm down, put their frustrations into words, and problem solve can go a long way toward reducing and eliminating the stress in their lives.

Only then can excessive hormone production and sleep problems return to normal without having to upset the balance that plays out between melatonin and cortisol.



Nov 15, 2013 3:53am
you take very nice pics and write also very Excellent.
Jan 13, 2014 2:59am
You make a very good point about the cortisol. I also like your illustrations, especially of the couch lady with her dark glasses, it says a thousand words, so thumbs up!
Elevated cortisol crops up a lot in many situations. As you say, melatonin supplements are not the answer. Main problem to watch out for is adrenal fatigue with all that adrenaline. Does that also affect the Asperger's behaviour?
Also, why does it affect more males. Could it be testosterone?
Feb 10, 2014 3:04pm
I am so sorry for the late reply. I've had a lot of health issues lately. I think you're right. Adrenal fatigue is an important issue and cortisol problems can crop up for all sorts of things. I have hyperthyroidism, which is causing water retention and sleeping problems, but the endo wants to treat the anxiety first. Testosterone is a good question too. Thanks for commenting.
May 13, 2014 6:00pm
I can definitely identify with the effects of cortisol just hanging around because the stress isn't physical. I've seen it in several of my kids, as well as in myself and hubby. You've given me a whole new topic to explore. Thanks!
May 22, 2014 11:59am
This is definitely true for all of us. The article is just slanted toward autism because I originally wrote it for Suite 101's autism section. Since I have recently been diagnosed with Graves' Disease, this has been quite an interesting topic for me. I need to delve into it further.
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  1. "Cortisol." Wikipedia: The Free Encyclopedia. 13/06/2013 <Web >
  2. Eve G. Spratt, et al "Enhanced Cortisol Response to Stress in Children with Autism." Journal of Autism and Developmental Disorders. 42 (2012): 75-81.
  3. Dr. David Clark "Are You Making This Melatonin Mistake with Your Autistic Child." Dr. Clark’s Brain Based Blog. 13/06/2013 <Web >
  4. "Stress, Cortisol, Insulin and Glucose." Natural Health Services. 13/06/2013 <Web >
  5. Dina Aronson, MS, RD "Cortisol – Its Role in Stress, Inflammation, and Indications for Diet Therapy." Today’s Dietician: The Magazine for Today’s Professionals. 13/06/2013 <Web >

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