Blog

Jun 18, 2023

Cortisol Demystified: Your Guide to Understanding the Body’s Stress Regulator

When faced with a threat to our safety, our adrenal glands secrete cortisol, and the sympathetic nervous system releases epinephrine and norepinephrine. This causes our senses to heighten and makes us

When faced with a threat to our safety, our adrenal glands secrete cortisol, and the sympathetic nervous system releases epinephrine and norepinephrine. This causes our senses to heighten and makes us temporarily faster and stronger so we can flee the threat or defeat the thing threatening us. However, chronic elevation of these same hormones and neurotransmitters can cause health problems, diminishing sleep duration and quality and increasing the risk of insulin resistance, metabolic syndrome, and/or diabetes. It also puts us at higher risk for chronic fatigue, anxiety, and depression.

We are meant to overcome the threats to our safety relatively quickly, metabolizing cortisol, epinephrine, and norepinephrine until we return to our usual baseline.

Unfortunately, many of us are in a constant state of perceived threat with high levels of cortisol.

Do you experience sleep disruption? Chronic fatigue? Worsening anxiety, depression, or irritability? Do you have problems with your blood sugar? Any of these could suggest that your hypothalamic pituitary adrenal axis has become dysfunctional, meaning your adrenals may be making too much cortisol or releasing cortisol at the wrong time of day.

Mistimed release of cortisol can create sleep problems and affect the function of other endocrine glands as well. Cortisol is supposed to rise in the morning, peak around 8 a.m., and fall briskly by noon, staying low in the evening and through the night. A second peak later in the day can disrupt sleep. High cortisol throughout the day can cause chronic fatigue. It can also lead to nutrition depletion. Dysfunctional cortisol levels lead to increased wasting of magnesium, zinc, vitamin C, and B vitamins.1 As these nutrients are depleted, cortisol dysregulation worsens.

For patients with ongoing stress and dysfunctional cortisol levels, I recommend a program of stress management and targeted supplements. Stress management strategies include mindfulness and meditation training. In addition, I refer patients with early life stress or ongoing severe psychological stress to a talk therapist to address these issues.

Taking Epsom salts or Dead Sea mineral soaks can help address the magnesium depletion that often occurs with ongoing stress response. Targeted supplements are also a good option. For people with ongoing stress and dysregulated cortisol, I recommend a B complex, multivitamin, vitamin C, magnesium, and zinc.

I also recommend a blend of plant-based adaptogens to support normalizing cortisol levels and reducing sympathetic nervous system overdrive that causes high levels of epinephrine and norepinephrine. Plant adaptogens are herbs that have been demonstrated to help normalize the cortisol response to stress.2,3 These compounds increase the body’s ability to adapt to stress, manage fatigue, and improve sleep. One is Ashwagandha, which is helpful in reducing anxiety, supporting the hypothalamic pituitary adrenal axis, and normalizing the cortisol response.4 Likewise Magnolia bark extract and Phellodendron bark extract reduce anxiety, improve mood, and reduce cortisol dysregulation in stressed adults.5-7 Consuming additional L-theonine, which is in green tea and in Suntheonine®, is associated with improvement of sleep and cortisol response.8-13 Banaba leaf (corosolic acid) and maral extracts have a long history of medicinal use in Southeast Asia to improve glucose and lipid metabolism.14,15 Corosolic acid also inhibits the conversion of cortisone to cortisol and may modulate the rise in cortisol caused by chronic stress.16

We are well adapted to survive in the face of acute, short-term threats. We are not well adapted to survive ongoing daily threats or the chronic daily stress that too many of us experience. That can be really damaging to our bodies.

The basic program for addressing ongoing stress includes a referral to a practitioner who can provide talk therapy to address early life stress or severe ongoing psychological stress as well as the addition of stress management techniques such as mindfulness or meditation practices. There are several apps for your phone that offer guided meditations and mindfulness training. Time in nature, forest bathing, journaling, and free writing about life’s challenges can also be helpful, as can nutritional supplements to address mineral and vitamin depletions. Addressing sleep is another key step to improving cortisol balance. A good strategy to improve cortisol balance includes improved nutrition, targeted vitamin and mineral supplements, and herbal adaptogens.