Overview
Have you been dealing with a lot of stress that has left you with overwhelming levels of anxiety and depression? Chances are that you are experiencing a cortisol imbalance induced by your body’s physiological stress response. Cortisol is a regulatory steroid produced in the adrenal glands. It is infamously known as the stress hormone because of its function in the body’s fight or flight response.1 Additionally, the hormone plays a role in the body’s inflammatory response, blood pressure regulation and glucose metabolism.
The body naturally regulates cortisol levels via the circadian rhythm, peaking at the start of the day and then gradually declining until the next morning.2 However, factors like prolonged exposure to stress, irregular sleeping patterns and consumption of drugs or even stimulants like caffeine impede this regulatory pathway 3, thereby inducing a cortisol imbalance.
Elevated cortisol levels for extended durations can have severe implications, especially on your mental health, which is why it is vital to balance cortisol levels. It can also result in Cushing syndrome which has a range of health implications. This article will give you some effective ways to regulate cortisol and outline some signs and symptoms of high cortisol levels.
Tips to help you balance cortisol levels
There are many ways to balance your cortisol levels; the main premise behind these being the induction of a relaxed state. This is because, outside the natural cortisol rhythm, this hormone is secreted in response to stress and anxiety. So when you begin to relax, your cortisol balances out by gradually reducing to normal levels.
Outlined below are ways to induce this relaxed state that will help you balance your cortisol levels;
- Get enough sleep: Sleep deprivation has been linked to excess cortisol secretion because of its inhibitory effect on the cortisol rhythm.4 Research sets adequate sleep for adults at 7 to 9 hrs daily. You can get more sleep with a good bedtime routine, restricted caffeine intake before bed and incorporating naps during the day if you work at night
- Practice mindfulness: Cortisol is produced in response to elevated stress levels to sustain the alert state induced by the secretion of adrenaline in the fight or flight response. Therefore, a way to balance high cortisol levels is by reducing stress, which can be achieved with mindfulness. This simple principle requires you to be present. It can be practiced by meditation, journaling, yoga, or simply having moments where you notice your thoughts. This relaxing practice is effective in stress management and has even been found to lower blood and salivary cortisol5, 6
- Exercise regularly: Regular exercise has numerous health benefits, and a main one is its effect on elevated cortisol levels. Firstly, regular exercise lowers stress while improving sleep quality. These two factors are associated with proper cortisol regulation.5, 7 However, you should avoid vigorous exercise as it can elevate your cortisol levels. According to the CDC, you should ideally spend 150 minutes a week on moderately intense physical activities to get the beneficial effects of exercise
- Eat a nutritious, balanced diet: Like exercise, there are many benefits of eating a nutrient-rich, balanced diet. To regulate cortisol levels, you should switch refined carbohydrates with fiber-dense whole carbs. While the former elevates blood sugar levels which promote cortisol production, the latter not only reduces cortisol 8 but supports the gut microbiome.9 You should also aim to consume enough vitamin C, Omega-3 fatty acids and magnesium.10 Trying the Mediterranean diet is a delicious way of enriching your diet with these nutrients. It is also encouraged to take Ashwagandha or Chamomile supplements for their calming, cortisol-reducing effects and prebiotics plus probiotics benefits
- Reduce caffeine intake: A cortisol imbalance might prompt you to increase your caffeine intake because the stress hormone induces adrenal fatigue. However, this decision leads you to a vicious cycle as caffeine stimulates cortisol secretion.11 It also lowers sleep quality, thereby inhibiting the body’s cortisol-balancing rhythm. So if you indulge in a few cups of coffee daily, you should decrease your caffeine intake
- Take a deep breath: Research found that deep breathing techniques can substantially lower cortisol levels. This is achieved by stimulating the parasympathetic nervous system, which induces the rest and digest response.12 So when you experience stressful situations, take a few deep breaths, focusing on your exhales more than inhales, to counter the cortisol-stimulating fight or flight response
- Enjoying your life: This last tip is simple and backed by science. Filling your days with things that bring you joy can significantly aid in cortisol balancing. You could take more nature walks, indulge in your hobbies, prioritize healthy relationships or even get a pet. Doing these activities helps with stress reduction and ultimately lowers cortisol levels
How to respond to low cortisol levels.
Cortisol imbalance is typically related to elevated hormone levels, which is why these strategies aim to reduce its levels. Hypocortisolism, the clinical term for cortisol depletion, indicates more severe health issues like Addison’s disease or an autoimmune response. If this is the case, you should consult a GP for advice on how to balance your cortisol levels.
Signs of high cortisol levels
If you suspect that your cortisol levels might be elevated, here are a few symptoms that may indicate this hormonal imbalance.
- Fatigue
- Weight gain, especially between the shoulders (buffalo hump) and the face (moon face)
- Acne
- Increased appearance of purple or pink stretch marks on your arms, abdomen, breasts and/ or thighs
- Prolonged illness
- Cuts and bites heal slower due to increased skin fragility
- Irregular menstrual cycle and development of facial hair in people assigned female at birth
- Erectile dysfunction and decreased fertility and sex drive in people assigned male at birth
- Irritability, depression or anxiety
- Difficulty concentrating
- Weakened muscles
If you experience a combination of the multiple symptoms, your cortisol imbalance has likely progressed to Cushing syndrome. If you believe this transition has happened, apply the hormone-balancing tips outlined above and contact a doctor, especially if you use corticosteroid drugs. These symptoms could also indicate a myriad of deeper concerns like a tumour in the pituitary gland or an adrenal gland malfunction. Therefore, you should ensure to see your GP to rule these out or to get treatment that you can supplement with the tips above.
An imbalance due to hypocortisolism may result in weak muscles, low mood, fatigue, low appetite, increased thirst and weight loss.
Suppose you experience a long-term cortisol imbalance without intervention; it could induce infertility, insulin resistance, type 2 diabetes, decreasing muscle mass, osteoporosis and obesity.
FAQs
What foods raise cortisol levels
Food that is high in sugar or heavily processed, alcohol, caffeine and a high trans-fat diet can elevate your cortisol levels.
How long does it take for cortisol levels return to normal
Typically, cortisol is metabolized after a few hours of being released for a stress response so its levels return to normal within a period 4 to 6 hours.13 If you have had high cortisol for a prolonged duration then it can take up to 6 months for the hormone imbalance to return to normal.
What organs are affected by high cortisol levels
Cortisol can act on almost all of the body’s organs because it is a glucocorticoid hormone. It therefore interacts with glucocorticoid receptors which line every organ system which are essential for endocrine responses.14
Summary
If you suspect your cortisol levels are elevated, follow the proven lifestyle changes explored above. Improving your sleep quality, diet and mindfulness can significantly lower cortisol levels. This hormone is stress-related, so effective stress management following the tips above is guaranteed to get you on your way to balancing your cortisol levels. Though the leading cause of a stress hormone imbalance is overwhelming stress, there is a rare chance that the underlying cause of a cortisol imbalance is due to a more severe health concern. Therefore, in addition to these practical tips, you should consult a GP to determine the cause of your cortisol dysregulation.
References
- Harvard Medical School. Understanding the stress response [Internet]. Harvard Health Publishing. Harvard Health Publishing; 2020 [cited 2023 Jan 23]. Available from: https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response
- Chan S, Debono M. Review: Replication of cortisol circadian rhythm: new advances in hydrocortisone replacement therapy. Therapeutic Advances in Endocrinology [Internet]. 2010 Aug [cited 2023 Jan 23];1(3):129–38. Available from: http://journals.sagepub.com/doi/10.1177/2042018810380214
- Aleksic A. 63 factors that may raise stress & cortisol levels [Internet]. SelfDecode Health. 2019 [cited 2023 Jan 23]. Available from: https://health.selfdecode.com/blog/63-factors-raising-stress-cortisol-level-backed-science/
- Leproult R, Copinschi G, Buxton O, Van Cauter E. Sleep loss results in an elevation of cortisol levels the next evening. Sleep [Internet]. 1997 Oct;20(10):865–70. Available from: https://pubmed.ncbi.nlm.nih.gov/9415946/
- Turakitwanakan W, Mekseepralard C, Busarakumtragul P. Effects of mindfulness meditation on serum cortisol of medical students. J Med Assoc Thai. 2013 Jan;96 Suppl 1:S90-95.
- Sanada K, Montero-Marin J, Alda Díez M, Salas-Valero M, Pérez-Yus MC, Morillo H, et al. Effects of mindfulness-based interventions on salivary cortisol in healthy adults: a meta-analytical review. Front Physiol [Internet]. 2016 Oct 19 [cited 2023 Jan 23];7:471. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5069287/
- Dolezal BA, Neufeld EV, Boland DM, Martin JL, Cooper CB. Interrelationship between sleep and exercise: a systematic review. Advances in Preventive Medicine [Internet]. 2017 [cited 2023 Jan 23];2017:1–14. Available from: https://www.hindawi.com/journals/apm/2017/1364387/
- Soltani H, Keim NL, Laugero KD. Increasing dietary carbohydrate as part of a healthy whole food diet intervention dampens eight week changes in salivary cortisol and cortisol responsiveness. Nutrients [Internet]. 2019 Oct 24 [cited 2023 Jan 23];11(11):2563. Available from: https://www.mdpi.com/2072-6643/11/11/2563
- Madison A, Kiecolt-Glaser JK. Stress, depression, diet, and the gut microbiota: human–bacteria interactions at the core of psychoneuroimmunology and nutrition. Current Opinion in Behavioral Sciences [Internet]. 2019 Aug [cited 2023 Jan 23];28:105–10. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2352154618301608
- Lam J. Foods to lower cortisol levels and help you deal with stress [Internet]. Dr. Lam Coaching - World Renowned Authority on Adrenal Fatigue Recovery. 2022 [cited 2023 Jan 23]. Available from: https://www.drlamcoaching.com/blog/foods-to-lower-cortisol-levels/
- Lovallo WR, Farag NH, Vincent AS, Thomas TL, Wilson MF. Cortisol responses to mental stress, exercise, and meals following caffeine intake in men and women. Pharmacology Biochemistry and Behavior [Internet]. 2006 Mar [cited 2023 Jan 23];83(3):441–7. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0091305706000645
- Zaccaro A, Piarulli A, Laurino M, Garbella E, Menicucci D, Neri B, et al. How breath-control can change your life: a systematic review on psycho-physiological correlates of slow breathing. Front Hum Neurosci [Internet]. 2018 Sep 7 [cited 2023 Jan 23];12:353. Available from: https://www.frontiersin.org/article/10.3389/fnhum.2018.00353/full
- Cooper J. 6 ways to get your stress hormones under control, this week [Internet]. Body + Soul. 2020 [cited 2023 Jan 24]. Available from: https://www.bodyandsoul.com.au/mind-body/wellbeing/6-ways-to-get-your-stress-hormones-under-control-this-week/news-story/4650b41b2ec79577c9df999708cb1b84
- Oakley RH, Cidlowski JA. The biology of the glucocorticoid receptor: New signaling mechanisms in health and disease. Journal of Allergy and Clinical Immunology [Internet]. 2013 Nov [cited 2023 Jan 24];132(5):1033–44. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0091674913013882