How To Lower Cortisol Levels When You're Feeling Stressed & Anxious
Cortisol is our stress hormone, and in recent years, it's gotten a bad reputation, as the side effects of chronic stress—and thus, chronic cortisol release—can be a major contributor to declining health. Yet, cortisol is also required for us to be alive. Our body likes to be in balance and maintain something called homeostasis, where homeo means "similar" and stasis means "stable." We need to maintain this balance both mentally and physically—and diseases and their symptoms occur when our body has to overcompensate to try to maintain this balance, putting stress on the body.
How to understand cortisol levels—and what that means for your health.
Cortisol is made in the adrenal cortex by the adrenal glands, which sit on top of the kidneys. The adrenal cortex also makes norepinephrine and epinephrine, the primary sex hormones—like estrogen, progesterone, testosterone—and aldosterone, which helps control salt-water balance in the body. Signals come from two structures in the brain, called the hypothalamus, speaking to the pituitary, to tell the adrenal cortex to release cortisol in times of stress. When there is enough cortisol, both the hypothalamus and pituitary cease speaking, and cortisol levels decline.
However, a state of constant stress overrides these mechanisms, and the body adapts a higher threshold to get the job done than before, leading to an imbalance, potentially worsening existing conditions or contributing to new ones. In addition, the amount of cortisol may also be affected by how much of its binding molecule is present, which actually also binds up some other metabolites, especially progesterone. Balancing cortisol levels is further complicated by the fact that cortisol is affected by hypothyroidism, obesity, high estrogen, and type 2 diabetes. Treatments have to take those into account.
Normal cortisol levels: What it does in the body.
When I said earlier that cortisol isn't all bad, I meant it! In our body, 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; 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.
When cortisol is not in balance, it can lead to weight gain, low libido, headaches, anxiety, depression, low energy, insomnia, blood sugar issues, skipped menstrual periods, infertility, gut issues, osteoporosis, and cardiovascular disease. 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, beauty 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. It probably won't surprise you to learn that women are more susceptible to chronically elevated stress and cortisol changes.
The consequences of having high cortisol levels.
High cortisol also affects the thyroid; under stress, the thyroid hormone 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 hippocampus. 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 estrogen 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.
As a naturopathic doctor, I work with people with high cortisol all the time. And when I'm trying to improve a patient's stress response and lower their cortisol levels, it's imperative to understand the factors playing a role in their chronically elevated cortisol. 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.
Supplements that help lower cortisol.
There are a number of supplements that can help lower cortisol, such as phosphatidylserine, which helps blunt the cortisol response and also nourishes cell membranes. Magnesium, known as nature's "relaxation mineral," is used in over 300 reactions in the human body and reduces the responsiveness of the adrenal glands. Many of us are deficient in magnesium, and it can be a great tool for decreasing chronic high 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.
Holy basil (Ocimum sanctum) is an adaptogenic herb (meaning it helps normalize endocrine function and promotes a healthy stress response) that contains ocimumosides, which are beneficial for reducing cortisol and glucose and improving neurotransmitter balance. B vitamins—especially B12, B9, and B6—are also imperative in modulating our stress response, especially through clearing homocystiene, a source of inflammation and stress, as well as having direct effects on neurotransmitter levels in the brain. B vitamins and magnesium, as well as other water-soluble compounds, are likely excreted in times of stress due to increased urges for urination, which means chronic stress may make it more important for us to supplement with these nutrients. That being said, while supplements are helpful tools, they can never replace the need for lifestyle changes that help lower cortisol.
How to lower cortisol with lifestyle changes.
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 OK. 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 7½ to 9 hours also helps weight loss efforts and leptin response, which we know from before are related to cortisol.
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 brands even contain lavender, a known herb to invoke a sense of calm and relaxation. 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 and can sometimes feel like every time you take two steps forward, you also take one step back. This is why seeing a naturopathic doctor or integrative or functional medicine expert to create a customized treatment plan is important, as we each have different reasons we may need to lower cortisol. Working with a knowledgeable health care practitioner to further assess appropriate lab work and perhaps additional tests (like neurotransmitter testing and genetic testing), and devising a plan that takes into account herb/drug/nutrient interactions are paramount.
Stressors in life will always be present, and to some extent are embedded in our DNA. However, we can empower ourselves with awareness, our response, and our choice to also heal other imbalances to lower cortisol.
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