why sugar level goes up while fasting?/ cortisol resistance

Short answer= cortisol

https://www.livestrong.com/article/419079-cortisol-blood-glucose/

High levels of cortisol put a strain on your body's health. It is normal for cortisol levels to rise during times of acute stress, but it is abnormal for these levels to remain high. Prolonged elevated levels of this steroid hormone affect immune function, metabolic pathways for use of energy and chronic disease risk. Blood glucose is particularly affected by elevated cortisol levels.

Stressful Conditions

In stressful situations, cortisol's role is to provide glucose to the body through utilization of protein stores.

This quick delivery of glucose prepares your body for the fight or flight mechanism.

When the body is in a persistent stressful state, cortisol is constantly obtaining glucose.

This constant flow of glucose leads to high blood sugar levels.

Effect of Cortisol

Cortisol obtains quick glucose for the body to use in times of stress.

At the same time, cortisol also reduces the effects of insulin.

Therefore, not only are blood glucose levels high, insulin is unable to perform its regular function of maintaining normal glucose levels, according to "Today's Dietitian." The pancreas continues to release insulin, but the cells are resistant to insulin. However, the pancreas continues to secrete insulin in response to high glucose levels, which puts extra stress on the pancreas.

https://idmprogram.com/closer-look-cortisol-hormonal-obesity-xxxx/

Cortisol is the so-called stress hormone.   It mediates the ‘flight or fight response’ with help from the sympathetic nervous system. Cortisol is part of a class of steroid hormones called glucocorticoids (glucose + cortex + steroid) produced in the adrenal cortex. Cortisol is produced in response to stress. In Paleolithic times, this was often a physical stress, such a being chased by a predator. The release of cortisol was essential in preparing our bodies for action – to fight or flee. Cortisol increases alertness and decreases the need for sleep.

Glucose availability is substantially enhanced. This provides energy for muscles that are needed to avoid being eaten. Non-essential metabolic activities are curtailed. All available energy is directed towards surviving the coming stressful period. Growth, digestion and other long-term issues are temporarily restricted. Proteins are broken down and converted to glucose (gluconeogenesis). In the fasted state, cortisol has several mechanisms to increase glucose in the body.




https://www.livestrong.com/article/189627-adrenal-glands-and-diabetes/

Significance of Cortisol

Cushing syndrome is a hormonal disorder of the adrenal glands. It happens when the adrenal glands produce too much cortisol. Under normal circumstances, cortisol stimulates the body to produce sugar. When the adrenal glands produce too much cortisol, as is the case in Cushing syndrome, blood sugar levels can get high, and this could lead to diabetes.

Adrenal Tumors

The adrenal gland is divided into two sections--the adrenal cortex and medulla. The adrenal cortex secretes cortisol and other hormones. Tumors in the adrenal cortex can cause the adrenal gland to produce high amounts of cortisol, and this leads to Cushing syndrome.

https://jonbarron.org/article/endocrine-system-adrenal-glands

General anatomy

The adrenal glands are located on top of each kidney; hence, the terms "ad renal" -- as in "added" to the renal glands. They are small glands, about 2 inches (5 cm) in length, and weighing about 5 gm each. As part of the kidneys, they are located way, way to the back of the body (as any good martial artist knows) and are abundantly supplied by three sets of blood vessels to ensure redundancy:

• Inferior phrenic arteries off the aorta.
• Middle suprarenal arteries off the aorta.
• Inferior suprarenal arteries of each renal artery.

Like the pituitary gland, the adrenal glands are composed of two entirely separate sections (the cortex and the medulla), and like the pituitary gland, the two sections actually evolve during embryology from two entirely different types of tissue. The adrenal cortex evolves from fetal mesodermal cells (essentially cells that produce connective tissue). The adrenal medulla, on the other hand, evolves from the nervous system. In fact, the adrenal medulla actually consists of modified neurons (neural crest cells). In the fifth week of fetal development, neuroblast cells migrate from the neural crest to form the sympathetic chain and preaortic ganglia. The cells then migrate a second time to the adrenal medulla. Forgetting all the technical names of cells and cell sources, the key point to remember here is that the two parts of the adrenal glands form two entirely different types of cells and share little in common -- other than location.

• The adrenal cortex is the outer layer.
• The adrenal medulla is the inner layer.

The adrenal glands, or at least the cortex of the glands, are absolutely essential for life. Then again, although it is possible to survive without the inner layer, the adrenal medulla, the quality of life would be severely compromised.
Let's now examine the adrenal cortex and medulla in more detail.

Adrenal cortex

The adrenal cortex produces three hormones in three separate zones.
Mineralocorticoids
Aldosterone is 96% of this group, and it controls water and electrolyte (sodium and potassium) balance in the body. Without the action of the mineralocorticoids in maintaining electrolyte homeostasis, you would die since this has a direct effect on regulating blood pressure. The action of the mineralocorticoids is on the kidneys, which under the direction of these hormones excrete sodium or potassium as required to maintain optimal balance. Adrenal adenomas (benign, actively secreting growths in the cortex) cause hyper-production of aldosterone, which may account for as much as 25% of high blood pressure patients. Treatment involves removal of the tumor, and positive results are virtually instantaneous. The trick, of course, is arriving at the correct diagnosis. Most adrenal adenomas are discovered by chance when an abdominal computed-tomography (CT) or magnetic-resonance imaging (MRI) scan is done for unrelated symptoms.
Glucocorticoids
Cortisol (also called hydrocortisone) is 95% of the total, plus corticosterone, and cortisone.

• Cortisol depresses the immune system.
• It is an anti-inflammatory (as a result of depressing the immune system).
• It retards allergic overreactions, but as a result slows wound repair.
• It promotes the breakdown of protein (catabolism).
• It promotes lipolysis, the conversion of triglycerides to stored fatty acids.
  • Many weight-loss supplements sold today theoretically address this problem by relieving stress, thereby reducing cortisol production and correspondingly eliminating excess fat storage. Although the theory is sound, how well any individual supplement works, of course, is open to debate.
• It promotes glucose formation (gluconeogenesis).
• It promotes resistance to stress, resulting in higher blood pressure.

Addison's disease results from acute adrenocortical insufficiency.

• The symptoms are lethargy, low blood pressure, weight loss, anorexia, and low blood sugar.
• Addison's disease is treated with a steroid hormone (cortisol in various forms, natural and synthetic) replacement.
• John F. Kennedy may be history's most famous Addison's disease patient and required regular cortisone injections to deal with stress. Since one of the side effects of cortisol injections is a "tanning" of the skin, JFK looked his best (tanned and relaxed) during times of stress -- immediately after injections.
• Full blown Addison's disease is extremely rare. However, "low level" adrenal fatigue is extremely common, and we will be discussing it in more detail later.

Cushing's syndrome, on the other hand, results from excessive adrenal cortical function. It results in spindly arms and legs, a moon-face,a buffalo hump on the back, flushed skin, hypertension, osteoporosis, and decreased resistance to infection or stress.
Androgens
Androgens are masculinizing hormones that occur in insignificant amounts in the adult male. The primary and most well-known androgen is testosterone. In men, the vast majority of androgens are produced in the testes, but in women, the adrenal glands are responsible for the overwhelming quantity of androgen production. Surprisingly, for women, the masculinizing hormones produced by the adrenal glands are essential for well being. In females, androgen accounts for sexual drive, energy, and "joie de vivre." It is converted into female hormones (estrogens) after menopause.
Incidentally, old treatments for breast cancer involved removing the pituitary gland to prevent the adrenal glands from producing estrogen by stopping release of ACTH that would normally have stimulated the adrenals. Nowadays, this is accomplished with pharmaceuticals.

Adrenal medulla

Hormones in the medulla are produced in the chromaffin cells ("chromium + affinity"). They get their name from the fact that they stain readily in the presence of chromium salts. Chromaffin cells are neuroendocrine in that they are activated by neurotransmitters released by nerve cells located in the autonomic nerve fibers coming directly from the central nervous system. In response to this input, the chromaffin cells of the medulla release hormone messenger molecules into the blood. In this way, they integrate the nervous system and the endocrine system, a process known as neuroendocrine integration.
Because the chromaffin cells are directly activated by the nerve fibers from the autonomic nervous system, they respond very quickly -- as is necessary in a system that responds to emergency situations. On the other hand, chromaffin cells continue to secrete adrenal hormones "long" after nervous stimulation has passed. In fact, hormonal effects can last up to ten times longer than those of neurotransmitters. In a sense, neurotransmitters respond in the short term to emergencies, whereas the medullary hormones cover the longer term. In this way the sympathetic division of the autonomic nervous system and the medullary secretions function together.

So which hormones are we talking about?
The adrenal medulla releases two hormones: adrenaline (80%) and noradrenaline (20%), more commonly known among the medical establishment as epinephrine and norepinephrine. Collectively, they are called catecholamines. As I mentioned earlier, unlike the adrenocortical hormones, the medullary hormones are not essential for life -- at least when the body is in the resting state. Without stress, you don't need these hormones -- with one primary exception. Standing up from a reclining or sitting position would entail an unsustainable drop in blood pressure, as blood pooled in the feet and legs, if not for a compensating action governed by the medullary hormones. (We will talk more about this in a moment.)

Adrenaline

Epinephrine (also known as adrenaline) increases heart rate, contracts blood vessels, dilates air passages and participates in the fight-or-flight response of the sympathetic nervous system. As a hormone, epinephrine acts on nearly all body tissues. Its actions vary by tissue type and by the differing responses of the various receptor sites scattered throughout the body. For example, epinephrine causes smooth muscle relaxation in the airways, but causes contraction of the smooth muscle that lines most arterioles.

As we mentioned earlier, one of the primary roles of cortisol is to promote the conversion of triglycerides into stored fatty acids. It also promotes glucose formation (gluconeogenesis). The bottom line is that chronically elevated cortisol levels contribute to the accumulation of abdominal fat and make it very difficult to eliminate

https://jackkruse.com/hormone-cascade-101/

Cortisol resistance, leptin resistance etc

We have established that as one gets fat, Leptin levels rise. Once they get high enough (around a Body Mass Index (BMI) of 20-24), Tumor Necrosis Factor (TNF) rises in several tissues. This also causes a rise of NF kappa beta and IL-6 in the brain.  TNF quickly destroys normal hepatic homeostasis, which sets the stage for fatty liver disease and type two diabetes over time. This rise in TNF also biochemically changes Leptin receptor signaling and changes its quantum properties by changing its “resonance” (think of a vibration-like effect in the receptor) at the hypothalamus level. Once TNF rises, it causes the liver to make an acute phase inflammatory protein called highly sensitive CRP. HS-CRP is therefore a very early biomarker for cellular inflammation before any disease is established. We have already established in earlier blogs that inflammation causes Leptin resistance. Leptin controls all energy production in the body. Inflammation stops T4 to T3 conversion in the liver and abruptly turns off your thyroid’s ability to function properly despite normal thyroid labs. As an analogy, your car engine no longer has a gas pedal to use. Simultaneously Vitamin D production caves as well because TNF takes that out too. Immunity fails and bad things commence for the cellular terroir.

In summary, once Leptin resistance occurs centrally in the brain, the liver soon follows and then the peripheral tissues become resistant, too. This affects fecundity, bone metabolism, cardiac metabolism, the thyroid, and the immune system in that order. Are you with me?

Resultant Hormone Cascade

Leptin resistance occurs first. Then insulin resistance happens next. This eventually leads to adrenal resistance. Cortisol is the stress hormone that allows for fight or flight syndrome (life or death). This is the hormone that allows you to run away from a hungry lion fast and live. Evolution always makes sure cortisol production stays ready for action at the expense of the other hormones that also are made from the same precursors. That precursor is pregnenolone. Pregnenolone is made from cholesterol, and cholesterol is made from LDL. So anytime the body is stressed or inflamed, it up-regulates cholesterol production to make more lifesaving hormones. It requires T3 and vitamin A as cofactors to complete this step. Blocking cholesterol production will increase cellular stress. This is why biochemically, to me, no statin drugs have ever made any sense under any circumstance in medicine. Moreover, this is why there is a chronic association of cancer to low cholesterol levels in the literature. If your cholesterol levels are low, you can not proper construct a mitotic spindle to pull apart your chromosomes correctly.  This is why cancer rates have been shown to be higher in 11 studies on statins.   This has been documented in the literature and the  Great Cholesterol Con, by Anthony Colpo.  In times of infection or stress, LDL levels always need to rise to protect the cell to make more cholesterol to make hormones and improve intracellular signaling.

The high cortisol also directly affects the Hypothalamic-pituitary-adrenal (HPA) axis. Cortisol directly blocks 5′ deiodinase enzyme that converts T4 to T3 (this occurs in the liver). Cortisol Releasing Hormone (CRH) (seen elevated in high cortisol production states) directly blocks TSH. The implication is huge because Thyroid Stimulating Hormone (TSH) and T3, the active thyroid hormone, are inhibited quickly in this process. Immediately, any excess T4 is then shunted to reverse T3. Reverse T3 is a COMPETITIVE inhibitor to T3, the active thyroid hormone. This basically turns off the thyroid! (You’re welcome ladies.), This is a biological switch needed to shut metabolism off in starvation mode. This is precisely what happens in starvation or in anorexia. Once T3 is turned off, no fat burning can occur at the muscles with UCP3. Remember, UCP3 activation requires T4, T3 and Leptin to be working well. With high cortisol, it cannot. Shutting off these things could be good biologically if you’re badly starving or if you’re morbidly obese. CRH also directly inhibits TSH. This is why TSH is a horrible marker for thyroid status. If you do not know the cortisol status, you can infer zero information from a thyroid panel. This is reason number one for many thyroid misdiagnoses. The sad part is that most endocrinologists seem to have forgotten this vital biochemical fact. It is the source of most patient frustrations with their thyroid condition.

CRH directly blocks secretion of Growth Hormone secretion as well. This means you get sarcopenia and osteopenia together! Low GH levels (IGF1) increase your body fat, decrease your lean muscle mass and increase your osteopenia to a great degree. It also causes the cardiac muscle to fail and decreases the stroke volume. Sarcopenia is the result of low IGF1 or GH level, and is a harbinger of ensuing death, especially with respect to the heart. There is now excellent data to support the use of GH and testosterone for cardiac health in aging because of these effects. High cortisol comes from stress. The causes of stress in humans are: psychological, traumatic, infectious, allergic, electromagnetic (EMF), xenobiotic and geopathic, as well as Leptin resistance and dysbiosis.

Key points about cortisol

1. Anything that causes a chronic elevation of cortisol causes chronic disease.
2. Any chronic elevation of cortisol and insulin will lead to some kind of chronic disease and death.
3. Signs and symptoms that you really have stress and a cortisol problem will cause most mainstream medicine docs to put you on one or more of these ten medications:
   • Statin
   • Premarin
   • Synthroid
   • Prilosec
   • Hydrocodone
   • Norvasc
   • Glucophage / Metaformin
   • Albuterol
   • Claritin
   • Prozac/sleeping pills.

The reason is simple. There is no good blood test available for serum cortisol that is accurate, and western doctors do not realize the salivary cortisol tests are deadly accurate. NASA and the FAA use salivary testing for their screening of astronauts and pilots. When I see this combo of drugs, I know from the demographic page on a patient’s medical chart that we likely have an undiagnosed cortisol problem without any test. I generally will eventually prove my clinical suspicion with a salivary cortisol assay. So they listen to the symptoms of the patients and treat the symptoms, and not the underlying cause, HYPERCORTISOLISM. By far, the number one cause in the USA is Standard American Diet loaded with too many carbs or too much PUFA’s, which drives Leptin resistance and adiposity. Both raise TNF alpha. We are now back at the top of the post. The circle of life in one post. You now are an endocrinologist. Actually, you may now know more than they do.

https://www.curejoy.com/content/ashwagandha-for-diabetes/

ashwagandha benefits

http://diabetesupdate.blogspot.com/2011/05/when-to-test-after-meals.html