Part 1 in the March/April 2026 issue explored the manifestations of a dysfunctional circadian rhythm and offered ways to restore balance. However, it left unanswered the question of what occurs when such dysfunction persists for decades.
Cortisol, produced from the adrenal glands, is inherently anti-inflammatory. When a circadian rhythm is consistently misaligned, it becomes challenging to manage chronic inflammation, directly impacting the immune system. A well-functioning circadian rhythm ensures cortisol production during the day, peaking with sunlight, and declines as night falls, allowing melatonin production to increase. Both hormones play crucial roles in immune regulation: cortisol as an anti-inflammatory and melatonin as a potent antioxidant.
During the day, cortisol’s anti-inflammatory properties help the body interact with its environment, including food, stress, and pathogens. At night, the body shifts to repair mode, facilitated by melatonin’s antioxidant effects. Cortisol also promotes alertness, especially in the morning. Consistently poor sleep disrupts the timing of cortisol production, leading to fatigue and grogginess the next day. This fatigue often leads to increased consumption of caffeine and sugar, further exacerbating sleep irregularity.
To support this hormonal balance, daily habits must reinforce – not fight against – your circadian rhythm. Consistent sleep and wake times, morning sunlight exposure, minimizing artificial light at night, and managing stress are foundational practices that help regulate cortisol and melatonin naturally. When these inputs are aligned, the body is better equipped to maintain immune balance, reducing the likelihood that inflammation spirals into dysfunction. Over time, small, consistent choices create an internal environment where hormones can communicate clearly and effectively.
Cortisol and melatonin are hormones, small messengers that communicate with the body to perform specific tasks, akin to a game of telephone. If communication breaks down, the intended job fails to materialize. Autoimmune diseases occur when the immune system attacks its own tissues. However, this explanation may not fully capture the complexity of these diseases, given the typical treatments, symptoms, and timing of diagnoses.
Understanding Autoimmune Diseases
Autoimmune diseases are described as the body’s immune response directed against its own tissues; essentially, the body is attacking itself. I don’t find this to be the entire story, given the typical treatments prescribed to individuals with autoimmune diseases, as well as the symptoms and the timing in which these individuals are often diagnosed.
Steroids, commonly prescribed for autoimmune diseases, are bio-identical cortisol, implying the body’s inability to produce sufficient cortisol on its own. While not universal, prolonged stressors, irregular routines, increased demands, poor sleep habits, long work nights, and repetitive exposure to blue light after dark can prime the system for autoimmune diseases.
While this is not the only circumstance, longstanding stressors, irregular routines, increased demands, poor sleep and waking habits, long nights at work, and persistent exposure to blue light after dark – you name it – have a way of priming a system ripe for what is referred to as autoimmune disease.
Compounding the issue, 75–80% of those diagnosed with autoimmune conditions are women. Many are diagnosed in their 20s, but diagnoses accelerate in women entering perimenopause, between 45 and 50 years old, when progesterone production declines. Progesterone is highest during pregnancy, working with a specific form of estrogen to down-regulate the immune system and prevent the body from rejecting the fetus. In nonpregnant women, progesterone peaks after ovulation, during the two weeks before menstruation. This is the time when things get turbulent for women in perimenopause – of course, the aches and pains settle in, while the irritability is unmatched.
Although estrogen production decreases, estradiol, a potent anti-inflammatory, also declines. As women lose these long-standing anti-inflammatory mechanisms, the body must adapt. This is why a woman’s life before menopause can predict her post-menopausal experience.
Consider a woman in her early 40s. She is busy, capable, and accustomed to managing a full life. Sleep has never been perfect, but it’s all she knows. Meals are inconsistent, though she eats relatively well. She is raising young children, caring for aging parents, and holds a high-level corporate job that requires monthly travel. This persistent stress is about to catch up with her. Cortisol has done its best, but without proper support, as estradiol and progesterone plummet, it struggles to control inflammation.
Hormones are messengers. What messages are you sending them to convey?
Dr. Lyndsey Maher, ND, MSAc, is a naturopathic physician and founder of Soleil Acupuncture and Naturopathic Wellness in Hamden, CT. With specialties in acupuncture, hormone health, and holistic aesthetics, she combines evidence-based therapies with individualized care to help patients optimize their health from the inside out. She is passionate about empowering individuals and entire organizations to take an active role in their well-being; blending the best of science and natural medicine to create lasting, meaningful change. Call 203.871.3262.