How to lower cortisol levels

Do you feel stressed? You are not alone- stress is a natural response to challenges in our lives that everyone experiences at some point. The hormone cortisol plays an important role in stress regulation and helps us react to immediate danger. However, long term exposure to stress hormones like cortisol can cause inflammation and lead to health problems such as high blood pressure, weight gain, fatigue, and heart disease. In this blog, you will learn about the role cortisol plays in stress regulation and the risks associated with long-term elevated cortisol levels. We will also discuss natural ways to lower your cortisol levels to improve and maintain your health. 

An overview of cortisol

• Stress is the body’s natural response to a perceived danger or threat. When the brain recognizes potential danger, the stress response causes a flood of hormones to be released that help prepare the body to react quickly. This is also known as the “fight or flight” response.  
• Cortisol is the most important hormone in the stress response, along with adrenaline. As a part of the stress response, cortisol increases blood sugar and heart rate, as well as slows down body functions that are non-essential or harmful in a fight or flight situation.
• Cortisol’s other functions include regulating the immune system, metabolism, and the sleep-wake cycle.
• Persistent stress or medical conditions can lead to increased cortisol levels in the body and have a negative effect on physical and mental health.  

Source: German Society for Endocrinology, 2023; Cleveland Clinic, 2023

How can I tell if my cortisol level is too high?

Cortisol levels naturally fluctuate throughout the day and high cortisol levels from time to time are normal. However, if cortisol levels remain elevated long term due to constant stress or a medical condition, health problems can arise. Long-term high cortisol can cause the following symptoms:

• Weight gain 
• Anxiety or depression
• Digestive problems
• Increased blood sugar level
• High blood pressure
• Increased susceptibility to infections
• Poor sleep quality
• Headaches, fatigue 
• Skin changes

Source: Mayo Clinic, 2021

Does high cortisol put my health at risk?

Heart disease 

Chronic stress and high cortisol levels are a risk factor for several health problems. Increased cortisol levels are linked to an increased risk of cardiovascular events, and high cortisol can increase blood pressure, blood sugar, and cholesterol, which are all risk factors for heart disease (American Heart Association, 2021). Stress also contributes to unhealthy behaviors such as smoking, overeating, and lack of exercise, which can further increase the risk of heart disease (Mayo Clinic, 2023).

Would you like to check your heart health from home? Homed-IQ’s Heart Disease Blood Test measures blood sugar (HbA1c) and cholesterol levels (HDL, LDL, total cholesterol, and triglycerides). You can also use our Cholesterol Test to specifically measure your cholesterol and lipid levels.

Depression and anxiety

In addition to heart disease, high cortisol levels may be associated with depression and anxiety. Elevated cortisol levels have been found in approximately 50% of people newly diagnosed with depression (Dziurkowska & Wesolowski, 2021). However, the relationship between cortisol and mental health is complex, and other factors such as genetics, environmental factors, and lifestyle may also play a role (Stetler & Miller, 2011).

Insulin resistance

In stressful situations, cortisol ensures that more sugar enters our bloodstream and we have more energy. This means that cortisol counterbalances insulin, which ensures that sugar from the bloodstream enters the cells (UCSF, 2023). Long-term elevated cortisol is associated with insulin resistance, meaning that insulin is less effective at controlling blood sugar in the body. This contributes to increased blood sugar and type 2 diabetes risk (Sharma et al., 2022). 

Sleep problems

Approximately 10% of the total population suffers from insomnia- a pathological sleep disorder (Cleveland Clinic, 2023). Cortisol works with melatonin and fluctuates throughout the day to form the sleep-wake rhythm, or the internal “clock” that makes us feel tired in the evening and wake up in the morning. If this rhythm is disrupted, sleep quality or ability to fall asleep may be impacted (Hirotsu, 2015). 

What can I do to lower my cortisol levels?

The first step in lowering your cortisol levels is checking whether your cortisol is high or not with a cortisol test. This test measures the cortisol level in your urine, blood, or saliva one or more times in a single day. Sometimes more than one type of test sample is taken to get the most complete picture of cortisol levels and how they fluctuate throughout the day. Your healthcare provider can advise which test(s) are right for you.

If your cortisol levels are high, see your doctor to rule out a medical condition (Cushing’s Syndrome) or side effects of medication use. They can advise specific treatment based on the cause of high cortisol or medications you are using. If your cortisol levels are slightly increased due to chronic stress, lifestyle changes and stress management can be effective in decreasing cortisol over time and improving your overall health. 

Sufficient sleep 

Adequate sleep is essential for good health, and a sleepless night can leave you feeling particularly stressed or irritable. A lack of sleep or poor quality sleep (i.e. due to frequent waking)  is associated with increased cortisol levels, perhaps in an effort to increase alertness (Cleveland Clinic, 2020). Getting enough sleep and maintaining a consistent sleep schedule may help regulate cortisol levels and prevent interruptions in the sleep-wake rhythm. For an adult, 7 to 9 hours of sleep per night is optimal, although this can vary between individuals. To improve sleep quality, aim to sleep and wake up around the same time each day, sleep in a dark and quiet room, exercise during the day, and reduce screen time in the evening. Avoiding large meals, caffeine, and alcohol before bedtime can also help improve sleep quality (CDC, 2022).

Regular physical activity 

Whether you ride your bike to work every day, walk your dog, or go to the gym, physical activity is beneficial for both mental and physical health. Exercise has been found to reduce the level of stress hormones in the body and boost endorphins- chemicals in the brain that can boost mood (Harvard Health, 2020). While going on a walk may seem less effective than a run or HIIT workout, less intense exercise may actually be the most beneficial for cortisol levels; low to moderate intensity physical activity has been found to lower cortisol levels in the body, while high intensity exercise can provoke an increase in cortisol levels (Hill et al., 2008).

Mindfulness and meditation

Mindfulness and meditation are practices that involve using physical and mental techniques to clear and calm the mind. While these practices have been used for centuries in different religions, mindfulness and meditations are now recognized as valuable stress management and mental health tools. Several studies have shown that meditation practices can reduce cortisol levels, and meditation can be used to learn how to deal with stress and stressful thoughts more effectively (Pascoe et al., 2017). 

Eat a healthy and balanced diet

Our diet has a huge impact on our health and well-being. The following tips can help you regulate your cortisol levels and reduce the risk of other factors that increase stress.

Reduce caffeine consumption

Caffeinated beverages such as coffee and energy drinks are very popular and consumed daily by many people. However, caffeine can temporarily increase cortisol levels in the body (Lovallo et al., 2006). This increase is larger in people who do not usually drink coffee compared to daily coffee drinkers (Lovallo et al., 2005). Limiting your caffeine intake to 1-2 beverages a day and not consuming caffeine in the evening can help limit the impact of caffeine on sleep and overall cortisol levels.

Limit inflammatory foods 

Long-term high cortisol is associated with chronic inflammation, a condition that is a factor in diseases such as type 2 diabetes, arthritis, heart disease, inflammatory bowel disease, and Alzheimer’s disease (Cleveland Clinic, 2021; Snead, 2023). One important way to combat inflammation is through diet. Inflammatory foods include those high in sugar (such as pastries, candy, sugar-sweetened soda), those high in refined carbohydrates (bread and pasta made with white flour), deep fried foods, red meat, and processed meat (such as sausages and lunchmeat). A balanced diet rich in fruits, vegetables, and whole grains can help reduce inflammation and cortisol levels in the body. 

Interested in checking the level of inflammation in your body? Homed-IQ’s Inflammation Test measures the amount of highly-sensitive CRP (hs-CRP) in your blood, a marker of inflammation. This test can be completed from home using a simple finger prick sample.

Take advantage of the protective effects of food

Many foods contain valuable nutrients that can help the body cope with stress or have preventive effects. The following nutrients may have a positive effect on cortisol levels:

• Antioxidants: Oxidative stress is a condition that occurs when there are too many free radicals in the body’s cells and not enough antioxidants to get rid of them, leading to cell and tissue damage (NCI). Oxidative stress is associated with high cortisol A diet high in antioxidant-rich foods, such as fruits, vegetables, and nuts can help reduce oxidative stress and promote overall health (Cleveland Clinic, 2023). 
• Anti-inflammatory foods: As inflammation is associated with increased cortisol levels, following an anti-inflammatory diet can be a useful step in reducing cortisol. A diet rich in unprocessed anti-inflammatory foods such as leafy greens, berries, nuts, and fatty fish can help reduce inflammation in the body and promote overall health (Cleveland Clinic, 2023). 
• Omega-3 fatty acids: These “healthy fats” have a positive effect on cortisol levels, can support heart health, and can have an anti-inflammatory effect (McCabe et al. 2017). Foods rich in omega-3 fatty acids include salmon, avocados, flaxseeds, and chia seeds.
• Magnesium and B vitamins: Foods rich in magnesium and B vitamins can aid in the metabolism of cortisol and reduce inflammation (Cleveland Clinic, 2023).  Foods high in B vitamins include beef and chicken, and those rich in magnesium include avocados, bananas, broccoli, and dark chocolate.

Elevated cortisol levels as a result of chronic stress can have negative effects on our health and wellbeing. Healthy lifestyle choices such as getting adequate sleep, exercising regularly, and following a balanced diet can help manage stress and reduce cortisol and inflammation levels the the body. If you are experiencing symptoms consistent with high cortisol, see your doctor and get tested. 

References

American Heart Association. (2021, September 13). Elevated stress hormones linked to higher risk of high blood pressure and heart events. https://newsroom.heart.org/news/elevated-stress-hormones-linked-to-higher-risk-of-high-blood-pressure-and-heart-events

Centers for Disease Control and Prevention. (2022, September 13). Good Sleep Habits. https://www.cdc.gov/sleep/about_sleep/sleep_hygiene.html

Cleveland Clinic. (2022, August 27). How to reduce cortisol and turn down the dial on stress. https://health.clevelandclinic.org/how-to-reduce-cortisol-and-turn-down-the-dial-on-stress/

Cleveland Clinic. (2023, February 13). Insomnia. https://my.clevelandclinic.org/health/diseases/12119-insomnia#:~:text=About%2010%25%20of%20the%20world%27s,health%20options%20%E2%80%94%20to%20treat%20it.

Deutsche Gesellschaft für Endokrinologie. (2018, June 25). Wenn Cortisol und Wachstumshormone den Blutzuckerspiegel durcheinanderbringen: Seltene Hormonerkrankungen als Ursache für Diabetes in Betracht ziehen. https://www.endokrinologie.net/pressemitteilung/seltene-hormonerkrankungen-als-ursache-fuer-diabetes.php

Dziurkowska, E., Wesolowski, M. (2021). Cortisol as a biomarker of mental disorder severity. J Clin Med. 10(20). doi: 10.3390/jcm10215204. 

Harvard Health. (2020, July 7). Exercising to relax. https://www.health.harvard.edu/staying-healthy/exercising-to-relax#:~:text=Exercise%20reduces%20levels%20of%20the,natural%20painkillers%20and%20mood%20elevators.

Hill, E., Zack, E., Battaglini, C. L., Viru, M., Viru, A., & Hackney, A. C. (2008). Exercise and circulating Cortisol levels: The intensity threshold effect. Journal of Endocrinological Investigation, 31(7), 587–591. https://doi.org/10.1007/bf03345606

Hirotsu, C., Tufik, S., & Andersen, M. L. (2015). Interactions between sleep, stress, and metabolism: From physiological to pathological conditions. Sleep Science, 8(3), 143–152. https://doi.org/10.1016/j.slsci.2015.09.002

Lovallo, W. R., Whitsett, T. L., Al’Absi, M., Sung, B. J., Vincent, A. L., & Wilson, M. T. (2005). Caffeine Stimulation of Cortisol Secretion Across the Waking Hours in Relation to Caffeine Intake Levels. Psychosomatic Medicine, 67(5), 734–739. https://doi.org/10.1097/01.psy.0000181270.20036.06

Lovallo W.R., Farag N.H., Vincent A.S. , Thomas T.L., Wilson M.F. (2006). Cortisol responses to mental stress, exercise, and meals following caffeine intake in men and women. Pharmacology Biochemistry and Behavior, 83 (3).  441-447.https://www.sciencedirect.com/science/article/abs/pii/S0091305706000645

Mayo Clinic. (2021. July 8). Chronic stress puts your health at risk. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037

Mayo Clinic. (2023, February 6). Tips to keep stress from hurting your heart. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/tips-to-keep-stress-from-hurting-your-heart#:~:text=Periods%20of%20excessive%20and%20pervasive,engaging%20in%20less%20physical%20activity.

Mayo Clinic. (2023, April 28). Cushing Syndrome. https://www.mayoclinic.org/diseases-conditions/cushing-syndrome/symptoms-causes/syc-20351310

McCabe D., Lisy K., Lockwood C., Colbeck M (2017).. The impact of essential fatty acid, B vitamins, vitamin C, magnesium and zinc supplementation on stress levels in women: a systematic review. JBI Database System Rev Implement Rep., 15(2), 402-453. Doi: .https://pubmed.ncbi.nlm.nih.gov/28178022/

NCI Dictionary of Cancer Terms. (n.d.). National Cancer Institute. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/oxidative-stress

Pascoe, M. C., Thompson, D. R., Jenkins, Z. M., & Ski, C. F. (2017). Mindfulness mediates the physiological markers of stress: Systematic review and meta-analysis. Journal of Psychiatric Research, 95, 156-178. doi: 10.1016/j.jpsychires.2017.08.004

Sharma, K., Akre, S., Chakole, S., & Wanjari, M. (2022). Stress-Induced Diabetes: A Review. Cureus. https://doi.org/10.7759/cureus.29142

Snead, L. (2023, April 4). Anti Inflammatory Diet. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/wellness-and-prevention/anti-inflammatory-diet

Stetler, C. & Miller, G. E. (2011). Depression and hypothalamic-pituitary-adrenal activation: a quantitative summary of four decades of research. Psychosomatic Medicine, 73(2), 114-126. https://journals.lww.com/psychosomaticmedicine/Fulltext/2011/02000/Depression_and_Hypothalamic_Pituitary_Adrenal.2.aspx