Cortisol is the Lisa Rinna of hormones—involved in everybody’s business and always getting blamed for the drama (RHOBH fans know!). To be fair, the stuff *is* connected to your body’s fight-or-flight response (there’s a reason it’s nicknamed “the stress hormone”). But cortisol also has a role in almost every major organ system, from brain function to joint and immune health. It regulates metabolism. It works with insulin to keep your blood sugar stable. It helps quell inflammation. Notice a trend? It’s not all bad!
In an age of rampant burnout, cortisol imbalance has become wellness gurus’ favorite scapegoat for all kinds of health issues, such as fatigue, acne, bloating, and more—leading to widespread misinformation about how this particular hormone works and what’s considered healthy and normal, says Arti Thangudu, MD, an endocrinology, diabetes, and thyroid specialist.
In reality, your cortisol levels go through ups and downs that correspond with your sleep/wake pattern. In the morning, they rise to raise blood sugar and blood pressure, increasing wakefulness and pumping you up for the day, then they drop off and fall to the lowest point when you sleep, Dr. Thangudu explains. When you eat, work out, or deal with a stressor (think: a new project lands on your desk or your babysitter cancels last-minute), you experience a tiny uptick.
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These natural ebbs and flows are appropriate and fine, says Elena Christofides, MD, an endocrinologist in Columbus, Ohio. Health problems only occur when you mess with the larger natural pattern of cortisol flow, like pulling an all-nighter a few days in a row. (Yes, an off-kilter cycle can affect sleep, digestion, and fat storage, says Dr. Thangudu.)
Meet the experts: Arti Thangudu, MD, is an endocrinology, diabetes, and thyroid specialist and the owner of Complete Medicine. Elena Christofides, MD, an endocrinologist in Columbus, Ohio, and a fellow of the American Association of Clinical Endocrinologists. Mike Molloy, PhD, is the founder of M2 Performance Nutrition.
Symptoms of High Cortisol Levels
Home test kits for measuring cortisol may not provide accurate results and are often not recommended by doctors. If you’re generally healthy, these three signs are enough to indicate your cortisol is not cycling properly without further workups.
- Basic health markers: If your heart rate is consistently higher than usual, something may be wonky. You can easily monitor this on your own with a wearable, Dr. Christofides says, such as a fitness tracker or smart watch.
- Cholesterol levels: “Cortisol levels and liver function are connected,” says Jessica Cording, RD, author of The Little Book of Game Changers, “and the liver controls how our body processes fats.” Ask about your LDL cholesterol at your annual physical.
- Changes in body comp: If you notice fat accumulation around your midsection but your weight and eating habits have remained the same, bring it up with your doc, says Dr. Christofides. This may be a sign that your cortisol levels are chronically off.
9 Ways to Balance or Lower Cortisol Levels Naturally
If you practice cortisol-conscious habits on the reg, your levels will take care of themselves. Get ready to feel more alert, less rattled, and on top of your game in every aspect of life.…
1. Sweat first thing.
Schedule your workout in the morning so it coincides with the biggest spike in your levels: between 6 a.m. and 8 a.m. Not an option? At the very least, avoid working out too close to bedtime, as your cortisol needs about four hours to reach its lowest level, which is optimal for sleep, says Dr. Christofides.
2. Prioritize strength training.
Daily intense cardio workouts elevate cortisol “without a huge payoff,” says Shannon Ritchey, DPT, founder of Evlo Fitness. “They don’t load our muscles enough to improve lean mass.” Swap a few HIIT days for weightlifting that targets different muscle groups, Ritchey recommends.
3. Watch the clock.
Spending up to an hour in a hardcore sesh stresses out your body way more than a high-intensity workout of short duration. Limit super-spicy sessions to 15 to 20 minutes and cap the frequency at twice a week.
4. Make sacrifices for Zs.
We know you know: Seven hours—ideally, closer to eight—nightly is ideal. This is so important that it’s wiser for you to skip working out early and try to fit it in later (if possible) if it means you’re not going to get your full snooze, Dr. Christofides says. Noted.
5. Don’t brush off walking.
Most people “massively underestimate” the benefits of a 30- or 45-minute walk, and of accumulating 10,000 steps per day, says Mike Molloy, PhD, founder of M2 Performance Nutrition. “It adds very little to no stress on the body,” Molloy says, noting that regular jaunts are one of the best habits for stabilizing cortisol.
6. Stay for the cooldown.
Elevating cortisol during your workout is not inherently bad as long as you can buffer it and bring it back down, says Ritchey. That’s why taking the time to recoup is so crucial—like via the mobility and mindfulness of yoga, breath work, or meditation.
7. Enjoy the early-bird special.
The second-largest cortisol spike? Between 4 p.m. and 5 p.m. Cortisol then drops off from there, says Dr. Christofides. Eating after 5 p.m. causes an unwanted boost when ya don’t want it. If you tend to dine late because you work overtime, set an alarm on your phone for an earlier mealtime and try to take a break to grab food instead of waiting until you clock out.
8. Fuel up post-sweat.
In the first 20 to 30 minutes after a heart-pounding gym session, consume about 30 to 40 grams of carbohydrates to bring cortisol back down. Why? When you consume a fast-digesting carb, it increases blood sugar levels, which sends a signal to your body to slow cortisol production, says Molloy.
9. Go easy on coffee.
Caffeine ramps up cortisol production. “If you’re downing four to five cups in the morning, you’re propping up your cortisol with an artificial stimulant,” says Molloy. Focus on improving your sleep and reducing your reliance on coffee. Perking yourself up with one to two eight-ounce cups is acceptable, but getting restorative rest should be your number one priority.
Oh, and one more thing: Beware of talk of and products targeted at treating adrenal fatigue...
If you spot the phrase “adrenal fatigue” on social media or online health forums, your Spidey sense should be buzzing. This is the false claim that a person can become so permanently stressed that their adrenal glands—which are responsible for pumping out cortisol—just stop working. This bogus diagnosis has led far too many individuals to go hunting for so-called adrenal support supplements and more questionable tactics, experts say. Yikes!
Adrenal glands don’t burn out because of emotional stress, says Dr. Thangudu. And OTC supplements often contain steroids and even thyroid hormone, a recent study found, which possess antidepressant and stimulant qualities. Taking them may make you feel like Superwoman temporarily, but it messes with the normal functioning of your adrenal glands and will leave you feeling “really crummy,” she warns.
While the concept of adrenal fatigue isn’t legit, chronic stress is a valid concern that deserves a closer look. Identifying the root causes and addressing them either on your own or with a mental health pro is the safest starting point. If you continue to feel sluggish or have other worrying symptoms, check in with your doc. “When we anchor on a diagnosis that’s not accurate, we run the risk of missing something,” says Dr. Thangudu. Heard that!
This article originally appeared in the April 2023 issue of Women’s Health.
Jackie Lam is the senior health editor at Women’s Health where she oversees health and weight loss content for the website and the Mind section of the print magazine. Originally from Hong Kong, she’s a journalist with more than 10 years of experience and a proud graduate of Cornell University and the Medill School of Journalism at Northwestern University. When she’s not at her laptop, she can be found experimenting with Japanese recipes in her kitchen with her husband as her main taste tester, discovering the latest in K-Pop, and dreaming up her next trips to Japan.