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If your hormones feel out of whack, it may be time to take a look at cortisol.

Today’s podcast guest, Dr. Sara Gottfried, author of four New York Times best-selling books, including The Hormone Cure and Brain Body Diet, she explained cortisol’s role in your body. You can see more of her blogs on her website, www.SaraGottfriedMD.com… 

At a basic level, what is cortisol’s role in the body?

Cortisol is the hormone that governs your digestion, hunger cravings, digestion, sleep/wake patterns, blood pressure, physical activity, and your capacity to cope with stress. Cortisol is the main stress hormone and is released when you’re in a fight with your partner or mom or under deadline – that is, when you’re in fight or flight. Cortisol’s job is to raise blood pressure (so you can run), blood sugar (to power your muscles), and modulate your immune system.

When does it become problematic?

Cortisol production is controlled by the adrenal glands, which in turn is managed by the hypothalamic-pituitary adrenal (HPA) axis. In the normal sequence of events, in times of stress, the HPA axis signals the adrenal to increase cortisol production. The increased cortisol levels then acts to inhibit the HPA axis, which can settle down until the next stressful event. Once cortisol levels increase, it basically tells the HPA – ‘don’t worry, we’ve got this’, and the HPA can stop inducing the adrenal glands to increase cortisol production.

The problem is that most of us run around stressed all the time. When stress levels are chronic, cortisol is constantly produced, and it doesn’t act as a negative inhibitor to the HPA axis. The HPA axis keeps triggering the adrenals to produce more and more cortisol.

High cortisol levels wreak havoc over time, and make you store fat—especially in your belly, deplete your happy brain chemicals like serotonin, and rob your sleep. High cortisol is also linked to depression, food addiction, and sugar cravings.

What does a healthy pattern/curve look and feel like?

Different amounts of cortisol are produced at different times of the day. Increased levels are produced in the morning; less is produced during the day, and very little in the evening, as we go to sleep. Only minimal amounts of cortisol are produced while we sleep. This cycle is known as diurnal variation (diurnal means a daily cycle). In general, cortisol levels gently decline over the course of the day.

When your cortisol levels are in balance, you feel calm, cool and collected all the time. You sleep well, and are able to manage stress without it overcoming you. Your blood pressure and fasting glucose (blood sugar) levels are normal.

What’s the possible connection between cortisol and sleep issues?

Cortisol levels should be lowest around midnight, while you are asleep, and it is then that your cells can perform their greatest repair and healing. If your cortisol levels are still high while you are sleeping, your body can’t do the repair and healing it needs. When you experience chronic stress, you can’t wind down, and you may get a second wind. High evening cortisol makes you feel like you don’t need rest, at the time when you actually need it most. You can have trouble falling asleep or sleeping deeply. This depletes your adrenals, which heal at night. Depleting your adrenals can cause neurotransmitter levels to decline, including serotonin, dopamine, norepinephrine, and epinephrine. The lack of sleep makes it harder to sleep because of stress and high cortisol, and it becomes an endless cycle.                                   

Are there better times of the day to exercise, drink coffee, etc. to support good cortisol rhythms?

Cortisol levels peak in the morning. It’s probably better to exercise and drink coffee in moderation in the morning, to make sure that your cortisol levels are still able to gently decline during the day, ensuring a healthy cortisol rhythm.

How do other hormonal shifts (adolescence, pregnancy, perimenopause, menopause) affect cortisol production? Are there specific strategies for managing these changes?

When women experience hormonal shifts, they are at a greater risk of higher stress levels, which can cause cortisol levels to rise. Women need to be especially careful around these shifts and implement lifestyle changes to manage their cortisol levels. A combination of a whole-foods diet, appropriate exercise, and stress management techniques such as meditation, deep breathing, and yoga can help keep cortisol levels in check.

What behaviors/lifestyle changes tend to support and promote a healthy cortisol pattern?

I have found that when it comes to high cortisol, lifestyle and supplemental strategies are powerfully effective for most. A combination of a whole-foods diet, appropriate exercise, and stress management techniques such as meditation, deep breathing, and yoga can help keep your cortisol levels in check. Here are several practices and botanicals I recommend to support and promote healthy cortisol patterns.

1. Eat nutrient-dense food. Avoid refined carbs and sugar like the plague. Craving for sugar or alcohol could be a symptom of high cortisol. Don’t go there. It just keeps spiraling downward and doesn’t make you feel better.

2. Omega-3s: Men and women who took 4,000 mg (4 grams) of fish oil a day for six weeks lowered morning cortisol levels to healthier levels and increased lean body mass.¹ I recommend choosing a form of fish oil that has been third-party tested and free of mercury and other endocrine disruptors.

3. Contemplative practice is nonnegotiable. This is especially true if you are struggling with your weight. A study from The University of California at San Francisco, showed that obese women who began a mindfulness program and stuck with it for 4 months lost belly fat.²

4. Adaptive exercise. Running raises cortisol. Switching to resistance training and yoga made all the difference in my weight.

5. Take Rhodiola. Rhodiola is an herb and one of the forms of ginseng, and it’s the best proven botanical treatment for lowering cortisol. I recommend taking 200 mg once or twice a day.³

6. Vitamin B5: B5 appears to reduce the hypersecretion of cortisol in humans under high stress and is a low-risk treatment. If you’re chronically stressed, I recommend taking 500 mg/day.⁴

7. Vitamin C: Shown to lower cortisol in surgical patients and children in stressful situations, vitamin C is a safe supplement to add to your regimen. I suggest 750 to 1000mg per day, as more may cause a loose stool. (Gromova, E. G., et al. “[Regulation of the indices of neuroendocrine status in surgical patients with lung cancer using optimal doses of ascorbic acid].”Anesteziologiia i Reanimatologiia 5 (1989): 71-74; Liakakos, D., et al. “Inhibitory effect of ascorbic acid (vitamin C) on cortisol secretion following adrenal stimulation in children.” Clinica Chimica Acta 65, no. 3 (1975): 251-255; Peters, E. M., et al. “Vitamin C supplementation attenuates the increases in circulating cortisol, adrenaline and anti-inflammatory polypeptides following ultramarathon running.” International Journal of Sports Medicine 22, no. 07 (2001): 537-543.))