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From the Townsend Letter
January 2018

Cortisol Deficiency: Frequent, Life-Impairing, and How to Give Patients Their Lives Back by Correcting It  Part 1
by Thierry Hertoghe, MD
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Page 1, 2, 3, 4

Table 4 shows an overview of several of the studies showing the association of serum total cortisol levels within the reference range with increased risk of psychological and physical disease, and premature death.

Table 4

Table 4 as a .pdf, larger and more clear

Cortisol Binding Globulin (Transcortin)
High serum levels of cortisol binding globulin (CBG or transcortin) often cause intracellular cortisol deficiency. For a correct evaluation, physicians should also check the serum level of cortisol binding globulin, the main plasma protein that binds cortisol and transports it to the target tissues. The ideal transcortin level in the plasma is situated at the average or slightly below the average of the reference range. High concentrations (positioned in the upper half of the reference range) to very high levels (above the upper limit) of CBG are usually excessive because they bind excessive amounts of cortisol, literally "imprisoning" cortisol in the blood.151 This cortisol sequestration in the blood prevents most of it from penetrating into target cells and exerting their beneficial effects, thus producing – at least a mild degree of – intracellular cortisol deficiency.
A good example of excessive CBG levels with intracellular and, thus, physical and mental cortisol deficiency can be found in women who take birth control pills.152-153 The estrogen compound of these pills makes the women's livers overproduce transcortin through the accumulation of the pill's estrogen compound in the liver after absorption.

Part 2 addresses the treatments for cortisol deficiency.

Page 1, 2, 3, 4

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References .pdf

Born in Antwerp, Belgium, Dr. Hertoghe practices his medicine in his clinic in Brussels. With his sister, Dr. Thérèse Hertoghe, they proudly represent the fourth successive generation of physicians working with hormonal treatments – and this since 1892 (after Eugène Hertoghe, former vice president of the Royal Academy of Medicine in Belgium, and Luc and Jacques Hertoghe, endocrinologists). Dr. Thierry Hertoghe devotes his life to the promotion of a better, patient-oriented, and evidence-based medicine.
Author of numerous books, Dr. Thierry Hertoghe also travels a lot to take part in numerous conferences and congresses throughout the world. He co-organizes many of these specialized gatherings and holds important positions in several international and national medical organizations (which usually tend to fight against aging). He is the president of the International Hormone Society (over 2500 physicians), and of the World Society of Anti-Aging Medicine (over 7000 physicians), as well as the supervisor of two important postacademic trainings for doctors.

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