What To Do When You're Feeling Stressed & Anxious
Whether you're working on the frontlines of the COVID-19 pandemic, or you're doing your part to stop the spread by staying at home—the strain on your usual routine and uncertainty about the future is probably sending your cortisol levels into overdrive right now.
Of course, it's totally normal to have elevated stress right now. But too much cortisol for a sustained period of time it can be a major contributor to declining health. Yet, cortisol is also required for us to be alive1. Our body likes to be in homeostasis both mentally and physically, so while a little bit of stress helps regulate our systems, diseases caused by stress occur when things go out of balance for too long.
Just know that you're not alone if you're experiencing a spike in stress during these strange times. It's a natural response, but there are some ways that you can help calm your body to help support your health.
What is cortisol?
To back up for a minute, cortisol is a hormone made by the adrenal glands, which sit on top of the kidneys. Cortisol stimulates the liver to convert amino acids into glucose, increases fatty acid metabolism, helps fight inflammation and allergies, prevents loss of sodium in urine (an important mineral for cellular health), maintains resistance to stress, and can help us focus and stay calm.
It is highest from about 6 a.m. to 8 a.m. to help us wake up, and then it declines throughout the day. As cortisol falls during the evening, melatonin—our most potent endogenous antioxidant and sleep hormone—rises at a similar rate and the two hormones work inversely, creating a natural sleep-wake rhythm for optimal function.
What happens when cortisol levels are too high or too low.
Signals coming from the brain tell the adrenal cortex to release cortisol in times of stress. When you're in a state of sustained stress, the body is constantly getting those signals to produce more of the stress hormone, and it adapts a higher threshold of cortisol, leading to an imbalance in hormones.
Cortisol is a huge part of our body's "fight or flight" response, which is activated in times of high stress—like running from a bear. When this stress response is triggered, our bodies divert blood flow to ensure we can breathe and move effectively to stay alive. However—as we are not usually running from a bear in modern times—stressors can be due to factors such as underlying disease (e.g., hormone imbalance, obesity), poor diet, poor sleep, unhealthy relationships, suppressed emotions, emotional stress, and chemicals in the environment (e.g., skin products, pollution).
Chronic cortisol production keeps our bodies in "fight or flight" mode and forces us to de-prioritize bodily functions like reproduction (e.g., fertility, regular menses, libido), digestion, and rest. Balancing cortisol levels is further complicated by the fact that cortisol is affected by hypothyroidism2, obesity, high estrogen, and type 2 diabetes.
The consequences of having high cortisol levels.
When cortisol is not in balance, it can result in weight gain, low libido, headaches, anxiety, depression, low energy, insomnia, blood sugar issues, skipped menstrual periods, gut issues, osteoporosis, and cardiovascular disease. High cortisol also affects the thyroid; under stress, the thyroid hormone is lowered—it can get converted to reverse T3 (also inactive) instead of converted to T3 (the active form). Other contributing factors to an altered stress response may stem from cortisol shrinking the hippocampus3. Physically, cortisol increases insulin release, which stimulates appetite, especially for carbohydrates or fatty foods, and most commonly affects our abdomen, as those fat cells tend to be more sensitive to cortisol. These cycles feed each other as increased weight, for example, can raise estrogen4, and elevated estrogen can lead to increased weight gain due to binding up thyroid hormone, increasing insulin secretion, loosening gut tight junctions, and decreasing sensitivity to leptin (a hormone that tells us we're satiated after eating).
Cortisol testing: What you need to know.
When trying to improve your stress response and lower your cortisol levels, it's imperative to recognize what's making you stressed in the first place and try to get that under control. That being said, tests can also be a helpful way to evaluate the severity and cause of a cortisol imbalance.
Cortisol testing is ideally done through methods that measure it unbound, such as in the saliva or dried urine. Both can be done at different times throughout the day, providing a more accurate picture of someone's stress response and how it relates to an optimal cortisol curve of highest in the morning and lowest in the evening. Serum (blood) testing, on the other hand, measures both bound and unbound but may be complicated with the stress of needles, perhaps leading to false elevation.
Natural ways to support normal cortisol levels.
There are a number of supplements that can help promote normal cortisol levels, such as magnesium, known as nature's "relaxation mineral."* It's used in over 300 reactions in the human body and supports the responsiveness of the adrenal glands5.* Many of us are deficient in magnesium, and it can be a great tool for supporting normal cortisol levels.* Consider the magnesium glycinate form of magnesium, as glycine is a calming amino acid and has high bioavailability and minimal gastrointestinal side effects, which are common with other forms of magnesium.*
It's important to note that chronic cortisol elevations did not happen overnight, so it's going to take some time and effort to bring back balance. Part of this process will be communicating to our bodies that everything is okay. Our body thrives on rhythm, so when it knows what's going to happen, there's no need to worry or stress. Maintaining a regular bedtime between 10:30 and 11 p.m. allows cortisol to drop to a point where an optimal amount of melatonin is being produced, and this can help ensure high-quality sleep. Getting at least seven and a half to nine hours of sleep per night also helps weight loss efforts and leptin response, which are related to cortisol. (mbg's sleep support+ supplement may also acts as a natural sleep aid, to help you fall asleep and establish a healthy routine.)
A healthy diet brimming with vegetables, fruits, healthy fats like avocado, fiber like ground chia seeds, and protein (vegetarian or non-vegetarian) will provide a wide range of vitamins and minerals needed to address processes involved in elevated cortisol. Epsom salt baths are rich in magnesium, and some salts contain lavender, a known herb to invoke a sense of calm and relaxation6. Consider adding in mindfulness techniques such as asking yourself in times of stress, "Am I in imminent danger?" as well as lifestyle techniques like more movement and stretching-type exercises like yoga or tai chi versus bootcamp-like activity. It might also be wise to decrease caffeine intake if you're trying to lower cortisol.
Healing takes time. If your conditions are not improving, work with a knowledgeable health care practitioner to further assess your condition, order appropriate lab work, and devise a plan that takes into account herb, drug, and nutrient interactions.
The Bottom Line
Stressors in life will always be present, and to some extent are embedded in our DNA. However, we can empower ourselves with awareness, lifestyle changes, and supplementation to help lower cortisol naturally.
Serena Goldstein, N.D. is a naturopathic doctor who specializes in treating hormone concerns such as weight, sleep, low energy, stress, PMS, peri/menopause, and andropause through nutrition, homeopathy, and botanical medicine by creating plans specific to each patient. Goldstein has been published in well-known health and wellness resources in addition to mindbodygreen, such as Consumer Health Digest and the Hearty Soul, and she's appeared on Sirius XM, NYU Doctor Radio, and the Everlast Podcast. She is also on the advisory board of Natural Practitioner magazine and lends her expertise at the NYU Poison Control Center.