You’ve probably heard of cortisol — which has been dubbed the “stress hormone” for its role in the body’s fight-or-flight response. But did you know that under normal circumstances, it also plays a role in maintaining overall homeostasis in the body by regulating metabolism, blood pressure, sleep-wake cycles, inflammation, blood sugar, and your response to all of life’s physical and mental stressors?
However, when cortisol is chronically elevated — usually in the face of chronic, unrelenting stress — a variety of health problems can result. Fortunately, there’s a lot you can do from a lifestyle perspective to keep cortisol levels in check and, in turn, optimize overall health.
Below, we’ll break down:
- The role of cortisol in the body
- What contributes to elevated cortisol
- The consequences of elevated cortisol
- How to lower cortisol levels naturally
The Role of the Hormone Cortisol
Cortisol is a steroid hormone that’s produced by the adrenal glands, which are situated right on top of the kidneys. On a daily basis, the release of cortisol is closely related to your body’s circadian rhythms, with about 50-60% of cortisol being released in the first 30-40 minutes after waking up. From there, levels fall and reach their lowest point around bedtime.
“Cortisol is basically the hormone that allocates resources in the body, so we’re prepared for daily activity,” says Dr. Bill Rawls, MD, Medical Director of Vital Plan. “We have a rise in cortisol in the early morning hours that wakes us up, gets us moving, and increases metabolism. In the evening, the decline in cortisol levels initiates a tide of calming hormones such as melatonin and GABA that prepare us for rest and repair mode so that cells can recover from the day’s activities.”
Levels of cortisol can also surge during times of stress. When you experience distressing thoughts, traumatic or life-threatening events, or even challenging health conditions, the sympathetic nervous system (SNS) becomes activated, which, in turn, triggers the body’s fight-or-flight response, and your adrenal glands release stress hormones as a result, including adrenaline and cortisol.
Our fight-or-flight response was only meant to be activated in short bursts of true danger — say, when a tiger is approaching. The hormones adrenaline and cortisol prepare you to think and act fast by increasing glucose levels in the bloodstream as a quick source of fuel and boosting blood flow to the brain and muscles. In the process, however, cortisol diverts resources from less essential functions (at least from a survival standpoint), such as digestion, the reproductive system, and healing and repair processes.
All of this is well and good, as long as the stress isn’t constant. When the perceived threat subsides, hormone levels return to normal, which results in heart rate, blood pressure, and blood glucose dropping back to a healthy range and other bodily systems resuming normal activities. But given the chronically stressful nature of modern life, our fight-or-flight response has the potential to be activated almost constantly — “the tiger never goes away,” says Dr. Rawls.
Together, a never-ending onslaught of work deadlines, mortgage payments, and family obligations, along with excessive screen time and negative news stories, can all sound the danger alarm bells and lead to repeated activation of your stress response. “If you’re punching that alert button all the time, your cortisol and adrenaline levels will remain elevated,” says Dr. Rawls, and this can trigger problems throughout the body.
The Consequences of Chronically Elevated Cortisol
If you don’t have healthy practices in place to periodically break the stress cycle, elevated cortisol may contribute to the following issues:
“Elevated cortisol into the evening hours keeps your body revved up and blocks sleep,” says Dr. Rawls. Poor sleep then compounds stress, creating a vicious cycle — and if you’re never getting a good night’s rest, “your cells don’t have an opportunity to repair and recover, and your body starts breaking down.” Even one night of poor sleep can activate inflammatory cellular pathways. Not to mention, poor sleep can contribute to poor mood, irritability, and brain fog.
You can think of cortisol as a “master hormone,” so when levels are out of whack, it’s going to lead to a cascade of other hormonal imbalances, according to Dr. Rawls. For example, elevated cortisol suppresses thyroid-stimulating hormone (TSH), which lowers thyroid hormone production and can negatively affect metabolism. Research also shows that chronically elevated cortisol can suppress testosterone production, contributing to problems such as erectile dysfunction and low libido in men.
Cortisol diverts resources from processes considered less essential during the fight-or-flight stress response — and one of those is digestion. Over time, this can slow things down at nearly every stage of digestion and trigger a cascade of GI troubles, from reflux to increased growth of bad bacteria to bloating and constipation, says Dr. Rawls. The longer waste sits in the colon, for example, the more time your body has to extract water from the stool, making it dry, compact, and harder to pass.
High Blood Sugar
As mentioned, cortisol’s job is to allocate resources in the body appropriately, so we’re prepared for activity. By enhancing the production of glucose by the liver and suppressing the effects of insulin (which, in turn, decreases the uptake of glucose by certain tissues), cortisol increases blood glucose levels so that the brain has a readily available fuel source. This helps you think fast and fight or flee from a threat, but over time, chronically elevated cortisol keeps blood sugar elevated and contributes to insulin resistance, which are risk factors for type 2 diabetes.
The elevated blood glucose and suppressed insulin function that result from high cortisol levels means that certain tissues in the body are essentially depleted of glucose — and this can stimulate appetite and cravings for highly palatable processed foods, which may contribute to overeating and weight gain, according to Dr. Rawls. Excessive cortisol has also been shown to promote the storage of fat, particularly in the abdominal region.
At healthy levels, cortisol has a mild suppressive effect on inflammation, says Dr. Rawls. This is a good thing and helps minimize the damage from normal daily activities. But chronically elevated cortisol may decrease cells’ sensitivity to cortisol and have the opposite of its intended effect, disrupting the body’s ability to respond to anti-inflammatory signals and allowing inflammatory processes to go unchecked. On the flip side, inflammation itself is considered a form of physical stress that further boosts cortisol levels, contributing to a vicious cycle.
Cortisol plays a role in constricting blood vessels and elevating blood pressure, which is important for temporarily boosting blood flow in fight-or-flight situations — but over time, this could lead to vessel damage and cardiovascular problems. In one study, participants with higher stress hormone levels in their urine were more likely to develop high blood pressure over the next 6-7 years, and for every doubling of cortisol levels, there was a 90% increased risk of cardiovascular events such as heart attack and stroke over the next 11 years.
7 Ways to Bring on the Calm
You may not be able to cut out all the stressful aspects of your life, but certain habits can put the brakes on an out-of-control stress response, giving your body a chance to recover and minimize the negative effects of cortisol on the body.
1. Pause and Breathe.
When you’re feeling frazzled, give yourself a moment to take a few slow, deep breaths (think: the kind that fills your belly). Unlike the short, shallow breaths we often take when stressed, this diaphragmatic breathing, or “belly breathing,” stimulates the vagus nerve that runs from your abdomen up to your brain. When activated, the vagus nerve — which contains parasympathetic nerve fibers — upregulates the parasympathetic nervous system (PNS), which turns on the body’s rest-and-digest response and helps lower cortisol. In addition to breathing exercises, yoga, meditation, and qi gong can help regulate breathing and elicit a calming response.
2. Move Your Body.
“The intended follow up to the fight-or-flight response is to be physically active,” says Dr. Rawls. “When you go for a 15-minute walk, you normalize all your stress hormones and lower cortisol and adrenaline.” If you can, get out in nature when you exercise, too. Spending time on a wooded trail, near grassy parks, or a body of water helps increase PNS activity and lower post-exercise heart rate and blood pressure. Don’t exercise too intensely, though, since overtraining can lead to excessively high cortisol levels, according to Dr. Rawls.
3. Get a Daily Dose of Adaptogens.
The hypothalamic-pituitary-adrenal axis, or HPA axis, governs the body’s response to stress — and overactivation of the HPA axis due to chronic stress contributes to elevated cortisol. But adaptogenic herbs (or adaptogens) such as ashwagandha and rhodiola — known for restoring homeostasis — have a balancing effect on the HPA axis system, which can lower cortisol output and help curb the various downstream effects of chronic stress.
4. Aim for 8 Hours of Sleep.
Disruptions in sleep can lead to increases in cortisol and a range of health problems. Take whatever steps you can to promote high-quality sleep — whether that’s limiting screen time or negative news before bed, avoiding afternoon or evening caffeine intake, shifting your exercise routine to the morning instead of the evening, or sipping on a herbal tea with calming herbs such as lemon balm, passionflower, or chamomile. “Eight hours is the minimum amount of sleep you need to properly recover from the day’s activities,” says Dr. Rawls.
5. Scale Back on Caffeine.
Certain chemicals in our environment and food can mimic excitatory hormones that trigger the body’s stress response, contributing to elevated levels of adrenaline and cortisol, according to Dr. Rawls. “Our bodies are equipped to handle a little bit of caffeine every day, but if you’re using large amounts to help you stay alert and compensate for lack of sleep, that’s a big problem,” he says.
Too much caffeine can lead to worse sleep, which further ramps up cortisol levels, creating a vicious cycle. To scale back on caffeine, consider swapping your coffee for green tea. “Green tea contains theanine, an amino acid that blocks the effects of caffeine in the brain, so it’s not as stimulating,” says Dr. Rawls.
6. Spend Time with Good People — and Pets!
Spending time with people you love can be an ideal antidote to stress. While social isolation has been associated with high cortisol levels, elevated heart rate and blood pressure, and even atherosclerosis (hardening of the arteries), research shows that a strong social support system has a protective effect. In studies where participants performed public speaking, for example, those who had the support of another person experienced a smaller rise in heart rate, blood pressure, and cortisol compared to those who were alone. And if you live or work alone, don’t stress — pets can help, too! In one study, spending time with a dog during a socially stressful situation lessened the rise in cortisol to a greater extent than spending time with a friend.
7. Eat an Anti-Inflammatory Diet.
Because inflammation can be a cause and consequence of elevated cortisol, focusing on a balanced anti-inflammatory diet that nourishes your body, neutralizes tissue-damaging free radicals, and supports stable blood sugar is your best bet for all-around health. In general, focus on whole or minimally processed foods such as vegetables, fruits, whole grains, legumes, nuts, seeds, fish, lean meats, herbs, spices, and high-quality fats like olive oil.
While chronic stress and elevations in cortisol can lead to a range of health problems, the fixes are pretty simple — prioritize movement, sleep, good people, and good food and experiment with herbal supplements that restore balance. If you’re still feeling frazzled and burnt out, consider reaching out to your doctor for lab testing that may reveal an underlying condition that’s exacerbating stress or driving imbalances, or talk to a therapist who can help you hone in on the mind-body practices that make the most sense for your life.
1. Adam EK, Quinn ME, Tavernier R, McQuillan MT, Dahlke KA, Gilbert KE. Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis. Psychoneuroendocrinology. 2017;83:25-41. doi: 10.1016/j.psyneuen.2017.05.018
2. Blood Sugar & Other Hormones. UCSF Diabetes Education Online website. https://dtc.ucsf.edu/types-of-diabetes/type2/understanding-type-2-diabetes/how-the-body-processes-sugar/blood-sugar-other-hormones/
3. Chao AM, Jastreboff AM, White MA, Grilo CM, Sinha R. Stress, cortisol, and other appetite-related hormones: Prospective prediction of 6-month changes in food cravings and weight. Obesity (Silver Spring). 2017;25(4):713-720. doi: 10.1002/oby.21790
4. Chu B, Marwaha K, Sanvictores T, et al. Physiology, Stress Reaction. [Updated 2021 Sep 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541120/
5. Cortisol. Cleveland Clinic website. https://my.clevelandclinic.org/health/articles/22187-cortisol
6. Eat These Foods to Reduce Stress and Anxiety. Cleveland Clinic website. https://health.clevelandclinic.org/eat-these-foods-to-reduce-stress-and-anxiety/
7. Gerritsen RJS, Band GPH. Breath of Life: The Respiratory Vagal Stimulation Model of Contemplative Activity. Front Hum Neurosci. 2018;12:397. Published 2018 Oct 9. doi: 10.3389/fnhum.2018.00397
8. Gladwell VF, Kuoppa P, Tarvainen MP, Rogerson M. A Lunchtime Walk in Nature Enhances Restoration of Autonomic Control during Night-Time Sleep: Results from a Preliminary Study. Int J Environ Res Public Health. 2016;13(3):280. Published 2016 Mar 3. doi: 10.3390/ijerph13030280
9. Hirotsu C, Tufik S, Andersen ML. Interactions between sleep, stress, and metabolism: From physiological to pathological conditions. Sleep Sci. 2015;8(3):143-152. doi: 10.1016/j.slsci.2015.09.002
10. Inoue K, Horwich T, Bhatnagar R, et al. Urinary Stress Hormones, Hypertension, and Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis. Hypertension. 2021;78(5):1640-1647. doi: 10.1161/HYPERTENSIONAHA.121.17618
11. Irwin MR, Wang M, Ribeiro D, et al. Sleep loss activates cellular inflammatory signaling. Biol Psychiatry. 2008;64(6):538-540. doi: 10.1016/j.biopsych.2008.05.004
12. Kargi AY, Iacobellis G. Adipose tissue and adrenal glands: novel pathophysiological mechanisms and clinical applications. Int J Endocrinol. 2014;2014:614074. doi: 10.1155/2014/614074
13. 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. Pharmacol Biochem Behave. 2006;83(3):441-447. doi: 10.1016/j.pbb.2006.03.005
14. Ozbay F, Johnson DC, Dimoulas E, Morgan CA, Charney D, Southwick S. Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry (Edgmont). 2007;4(5):35-40. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921311/
15. Panossian A, Wikman G. Effects of Adaptogens on the Central Nervous System and the Molecular Mechanisms Associated with Their Stress-Protective Activity. Pharmaceuticals (Basel). 2010;3(1):188-224. Published 2010 Jan 19. doi: 10.3390/ph3010188
16. Polheber JP, Matchock RL. The presence of a dog attenuates cortisol and heart rate in the Trier Social Stress Test compared to human friends. J Behav Med. 2014;37(5):860-867. doi: 10.1007/s10865-013-9546-1
17. Segerstrom SC, Miller GE. Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry. Psychol Bull. 2004;130(4):601-630. doi: 10.1037/0033-2909.130.4.601
18. Stress management: Chronic stress puts your health at risk. Mayo Clinic website. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037
19. Stress Hormone Blocks Testosterone’s Effects, Study Shows. UT News website. https://news.utexas.edu/2010/09/27/stress-hormone-blocks-testosterones-effects-study-shows/
20. Thau L, Gandhi J, Sharma S. Physiology, Cortisol. [Updated 2021 Sep 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538239/
21. Walter KN, Corwin EJ, Ulbrecht J, et al. Elevated thyroid stimulating hormone is associated with elevated cortisol in healthy young men and women. Thyroid Res. 2012;5(1):13. Published 2012 Oct 30. doi: 10.1186/1756-6614-5-13
22. Yang S, Zhang L. Glucocorticoids and vascular reactivity. Curr Vasc Pharmacol. 2004;2(1):1-12. doi: 10.2174/1570161043476483