In the modern world, stress is no longer experienced in response to an occasional threat, as it once was, but has become a constant part of everyday life. Statistics from 2023 reveal that 76% of workers feel moderate to high levels of stress regularly, while 74% of the general public often feel overwhelmed by stress.
It is well known that chronic stress is linked to numerous adverse health outcomes and so finding effective stress-management strategies and ways to neutralise the ill-effects of unavoidable stress are more important than ever. In this article we will discuss not only how stress affects the body and can contribute to disease, but also how to support stress levels with nutrition, supplements and lifestyle.1
What is cortisol? 2-4
Known as the stress hormone, cortisol is a steroid hormone produced by the adrenal glands (that sit on top of each kidney) that is released, along with DHEA and adrenaline when we are faced with a stressor. Stress is a physiological and psychological reaction that activates the ‘fight or flight’ response to increase alertness, elevate blood pressure and increase heart rate to allow the body to react quickly to a threatening stimulus.
This stress response starts with the release of corticotropin releasing factor (CRF) and vasopressin from the hypothalamus, which stimulates the production of adrenocorticotropic hormone (ACTH) from the pituitary gland.
This prompts the adrenals to release glucocorticoids, including cortisol. Glucocorticoids are then transported into the blood stream by corticosteroid binding globulin (CBG) and diffuse through cellular membranes by binding to both mineralocorticoid receptors (MR) and glucocorticoid receptors (GR).
Once cortisol has been released to an appropriate concentration, it should signal a negative feedback mechanism to the hypothalamus to stop the release of CRH. This adaptive response in the short term triggers the suppression of inflammation, mobilises energy, increases focus and activates the immune system, which can all be useful when faced with a stressful situation or threat.
Along with its role in the stress response cortisol actually has many other functions in the body such as modulating inflammation, regulating blood pressure and supporting the metabolism through regulating blood sugar levels and playing a role in how the body uses macronutrients.
It is also vital for the regulation of the circadian rhythm; cortisol peaks in the morning (called the cortisol awakening response or CAR) to give us energy to get up and get ready for the day, and then gradually declines to its lowest point at midnight to allow for a restful night’s sleep.
Cortisol is therefore an essential hormone that affects almost every organ in the body.
Persistent stress and activation of the ‘fight or flight’ response halts non-essential functions such as digestion and repair. It also causes hyperactivity of the HPA axis leading to increased cortisol release and a dysregulation of the glucocorticoid negative feedback loop, which is linked to metabolic, immune and psychiatric dysfunction.
Symptoms of disrupted cortisol levels 5
Chronic ongoing stress resulting in continuous activation of the HPA axis means that cortisol is constantly being drawn upon, disrupting the delicate feedback mechanism and making the body less sensitive to its effects, known as cortisol resistance. This in turn can wreak havoc to health. Disrupted cortisol levels encompass both physical and psychological symptoms and include:
- Poor sleep and insomnia 6
- Fatigue upon waking
- Weight gain
- Poor immunity
- Food cravings for sugar
- Low libido
- Poor digestive health
- Anxiety
- Low mood and irritability
- Depression
- Pain sensitivity 7
- Migraines8
- Irregular mensural cycles
The impact of chronically high cortisol on health
Chronic stress resulting in a dysregulation of the HPA axis and cortisol resistance has been linked to many health concerns, conditions and diseases, many of which we will discuss below;
Blood sugar management 2, 9-11
In a healthy individual, cortisol works in harmony with insulin to keep blood sugar levels stable, with cortisol ensuring sufficient glucose levels and insulin helping to promote glucose uptake into the cells.
When the body is in a sympathetic nervous system state or experiencing “fight or flight”, cortisol can trigger glucogenesis in the liver (converting glycogen into glucose to be used as fuel), which promotes lipolysis in the adipocytes and inhibits insulin secretion. This means glucose is less able to enter the cells and instead stays in the blood stream, elevating blood sugar levels. Chronically high cortisol levels therefore can lead to persistent high blood sugar (hyperglycemia), promoting insulin resistance and the risk of type two diabetes. Furthermore, research has found that participants with diabetes have higher cortisol levels and increased glucocorticoid sensitivity at baseline, while other studies found that those with glucose intolerance and other features of metabolic syndrome have raised fasting cortisol concentrations.
Weight management 12
Weight management and obesity is a complex and multifactorial issue with a multitude of individual differences. Research has found that there is a relationship between HPA axis activation and energy homeostasis, with findings suggesting that while not all obese individuals have high cortisol levels, stress may play a role in the development and maintenance of obesity and weight gain.
CRH, released during the stress response initially suppresses appetite, but a short while after appetite returns due to neuropeptide Y stimulation, this reduces the sensitivity of leptin and insulin, promotes insulin resistance and increases the desire for energy dense sweet and fatty foods. Furthermore, cortisol enhances gluconeogenesis and lipolysis increasing free fatty acids that promote fat storage and insulin resistance, as well as contributing to a reduction in muscle mass and an increase of visceral fat accumulation, which increases the risk of obesity and metabolic syndrome.
Elevated cortisol may also play a role in food consumption, food choice and can affect sleep quality and duration, disrupting blood sugar levels and promoting unhealthy food choices.
Thyroid 13, 14
The Hypothalamic-pituitary-thyroid axis (HPT) control thyroid hormone production. The HPT axis is slightly upregulated during acute stress, however when this becomes prolonged and chronic, there is a dampening of this axis negatively affecting thyroid hormone production. Cortisol can reduce TSH which subsequently affects T3 and T4 levels, as well as increasing the conversion of T4 to reverse T3 (rT3). rT3 can then bind to T3 receptor sites, interfering with T3 binding. Although research is mixed, high rT3 has been linked to lower mental and physical functioning with one study finding that women with stress related mental health concerns exhibited lower levels of TSH and T3.
Inflammation 15,16
Cortisol functions to reduce inflammation in the body in the short term, hence it is used in medications for autoimmune and inflammatory disease. However, if the body’s production of cortisol is constantly elevated over time this can actually increase inflammation in the body and drive immune dysfunction.
Stress, when chronic, causes the immune system to overact and release excessive amounts of inflammatory molecules to push the body into a more inflamed state. This effects the permeability of the blood brain barrier and negatively influences the central nervous system, leading to the increased risk of neuroinflammation and subsequent conditions such as depression and anxiety. Imaging studies have found that inflammation impacts certain areas of the brain such as the amygdala, which is particularly involved in anxiety conditions.
Inflammation is bidirectionally linked to HPA dysregulation, with inflammatory mediators having a significant effect on the HPA axis and the malfunctioning of the HPA contributing to inflammation. Research has found that chronic and even acute stress can raise pro-inflammatory markers such as IL-6.
Immunity 17-19
Chronic stress can suppress the functioning of the immune system, altering immune cells and increasing the production of proinflammatory cytokines. Glucocorticoid hormones, catecholamines and opioids released from HPA activation can decrease the activity of cytotoxic T lymphocytes and natural killer cells. A healthy immune system has an optimal balance of Th1 and Th2 cells (T helper cells involved in cellular and humoral immunity), however glucocorticoids can modulate T cell function and cause a shift from Th1 to Th2, which is linked to autoimmunity. One study found that those with stress related disorders were associated with a higher risk of autoimmune disease compared to matched controls.
Stress mediators can pass through the blood brain barrier and can adversely affect a range of hormone receptors involved in immune function (for example growth hormone) altering immune function.
Cardiovascular 20
An association between stress and the cardiovascular system is well noted with researchers finding that stress can alter heart rate, strength of contraction, blood pressure and induces the narrowing of veins. It can signal to the autonomic nervous system to increase vasoconstriction, increase blood lipids and blood pressure, inducing vascular changes and atherogenesis which can cause cardiac arrythmias and myocardial infraction.
Researchers state that even raised morning cortisol have been associated with an increased risk of cardiovascular disease and that targeting stress reduction, among other factors, is a vital strategy in reducing the risk of cardiovascular diseases.
Methylation 21
Stress can impair by depleting crucial B vitamins such as B12 and folate, as well as reducing adrenaline clearance produced from the stress response. Long term exposure to stress can alter DNA methylation, and therefore gene expression, contributing to poor health and disease. Poor methylation is associated with increased levels of the waste product homocysteine which is associated with and increased risk of chronic disease including cardiovascular disease, metabolic syndrome and dementia.
Digestion 22,23
Stress may alter food consumption, digestion and nutrient absorption as well as affecting bowel motility, mucus secretion, stomach acid levels, microbial balance, pathogenic bacteria, inflammation and intestinal permeability.
Evidence points to a bidirectional communication pathway between the gut microbiota and the neuroendocrine system, with conditions such as irritable bowel syndrome (IBS), which is seen as a stress sensitive disorder, being associated with HPA activation. Gut microbiome imbalances can lead to inflammation and HPA activation. Research has found that pro and prebiotics can not only have a beneficial effect on the health of the gut, but can also be used to support the regulation of the HPA axis.
Sleep 24,25
The circadian rhythm, the 24-hour cycle that is part of the body’s internal clock, is very sensitive to external stressors and disturbed sleep has been found to be detrimental to mental and physical health, increasing the risk of cardiovascular disease, mood disorders, obesity, pain conditions and blood sugar imbalances. Greater daily stress is associated with shorter durations in sleep, greater trouble getting to and staying asleep and higher cortisol levels upon waking.
A typical diurnal pattern involves high cortisol upon waking with an increase 30 minutes later – called the CAR, followed by a gradual decrease, with lowest levels occurring at midnight. Chronic stress can not only impair this pattern, disrupting the sleep-wake cycle and affecting sleep, it can also have knock on effects with blood sugar management, inflammation and mood.
Brain health 26, 27
High stress levels are a risk factor for a multitude of other health conditions, including neurodegenerative diseases such as Alzheimer’s disease (AD). In addition to its complex pathophysiology, including the elevated levels of inflammatory markers and oxidative stress implicated in the disease, one of the proposed ideas is that one of the main brain areas compromised in AD, the hippocampus, also contains the highest numbers of glucocorticoid receptors, and therefore may be susceptible to chronic activation and subsequent damage.
Chronic stress and elevated cortisol may play a large role in the development of depressive disorders. Studies have found that those with major depressive disorder have higher cortisol levels compared to controls, suggesting that a dysregulation of the HPA may play a significant role in depression.
Other research has found that chronic stress can actually cause structural changes in different parts of the brain, including atrophy of the brain mass and reduction in overall brain weight, which can then alter cognition, memory and have long lasting effects on the nervous system.
How to reduce cortisol levels naturally
Reducing stress and cortisol is a lot easier said than done, in the modern world we live in, but being mindful of how stress can negatively affect health both physically and psychologically can highlight the importance of incorporating stress management techniques into your day to live a healthy life. While a great deal of everyday stress is unavoidable, there are things you can do to support yourself to be more resilient to stress and practices that can help reduce its ill effects.
Nutrition
An anti-inflammatory diet consisting of unprocessed, wholefoods, with an abundance of fruits and vegetables, good quality protein and healthy fats should be the foundation of any healing plan to ensure adequate nutrient intake. Pro and prebiotics, including fermented foods can support stress reduction due to the intrinsic link between the gut and the brain, known as the gut-brain axis.
Certain things are known to impact cortisol levels are and best avoided including:
- Caffeine is a stimulant that can activate the HPA axis and increase levels of salivary cortisol. 28 It is instead advised to opt for herbal tea, or green tea which contains L-theanine.
- Sugar can contribute to inflammation and effect glycaemic regulation by creating big fluctuations in blood sugar, with low blood sugar levels triggering cortisol release. 29
Lifestyle interventions to reduce raised cortisol
Exercise 30, 31
Light to moderate exercise has been shown to decrease cortisol levels and improve sleep. Research shows that regular exercise can have numerous beneficial effects on quality of life both physically and mentally, with those who maintain regular physical activity having better overall mood, self-esteem and feelings of well-being. Although exercise initially causes a short-term increase in cortisol, levels then decline, supporting the body’s resilience to physical exertion and improving the functioning of the HPA axis. It can also help to increase REM sleep and improve overall quality and help balance levels of leptin and ghrelin, modulating appetite to support blood sugar balance and weight management. Exercise even has immunomodulating effects, reducing inflammation in the body and promoting brain derived neurotrophic factor (BDNF).
Yoga 32, 33
Yoga asana and mindfulness movement are popular tools for stress reduction and have been found to be associated with better sympathetic nervous system regulation as well as reduced waking and evening cortisol, reduced cholesterol, higher heart rate variability, reduced blood pressure and fasting blood glucose.
One intervention study found that healthcare professionals who attended weekly yoga classes and practiced independently had better health and well-being outcomes, scoring better on scales for mindfulness, stress and perceived stress, sleep and vitality.
Sleep 34
Prioritising sleep is vital to support the immune system, cognition, blood sugar balance and mood and for the glycogenotic process of replenishing glucose storage in the neurons. Deep sleep inhibits the HPA axis and gives the body a chance to rest and repair. To support good sleep, aim to improve your sleep hygiene by avoiding screens before bed and aiming for 7-9 hours a night.
Meditation 35, 36
Meditation has been shown to support psychological health by enhancing mindfulness and supporting feelings of well-being and can therefore be a helpful tool for stress reduction. Meditation has been shown to increase activity in the left anterior brain, which is associated with happiness.
Other lifestyle practices to support stress reduction and management include spending time in nature 37 and breathwork, such as diaphragmatic breathing which have both been found to be effective stress management habits.38
Supplements that can help reduce cortisol
Magnesium 39
Magnesium is involved in almost all metabolic and biochemical processes in the body and deficiency is a common complaint that can present as fatigue, anxiety, headaches and muscle tension. Research has found that magnesium is an important mineral in the central nervous system and that stress can rapidly deplete levels in the body. Low magnesium could reduce the body’s resilience to stress, creating a cycle that can contribute to deficiency. Magnesium inhibits glutamatergic transmission and promotes GABA activity while playing an indirect role in reducing the release of ACTH by having a modulating effect on neurotransmission pathways to help decrease levels of cortisol.
B vitamins 40
B vitamins are key nutrients in supporting the nervous system and the production of energy, and are rapidly depleted in the stress response. They are also needed for the production of GABA which can in turn affects the hormonal control of cortisol.
Vitamin C 41
Vitamin C is an antioxidant that plays a role in adrenal function and has the ability to modulate monoaminergic and glutamatergic neurotransmitter systems.
L-theanine 42-44
L- theanine is an amino acid found in green tea leaves that has been shown to have a neuroprotective effect on the brain when exposed to stress. Studies have found that L-theanine has a relaxing effect and helps to reduce the stress response by having an effect on heart rate and blood pressure, alongside increasing alpha brain waves which are associated with a relaxed calm state – much like that achieved through meditation. It can also have a mild effect on levels of neurotransmitters in the brain such as serotonin, dopamine, glycine and GABA.
Ashwagandha 45,46
Studies have found that ashwagandha exhibits its significant stress reducing properties via its effect on the HPA axis, sympathetic-adrenal medullary axes and through serotonergic and GABAergic pathways. Studies have found the ashwagandha root attenuated the increase in glucocorticoids cortisol and corticosterone after stress. Further exploration of the mechanisms has suggested that ashwagandha’s use in anxiety, depression and insomnia may be due to its effect on reducing oxidative stress, pro-inflammatory cytokines and neuroinflammation, while modulating the GABA receptor and supporting immune function.
Rhodiola 47
Rhodiola is an adaptogen that has antioxidant, neuroprotective, anti-fatigue, anti-inflammatory and mood supportive effects, and is therefore a popular choice for those suffering with fatigue and ‘burnout’ from stress.
Omega-3 48, 49
Studies have found that omega-3 supplementation reduced overall cortisol levels compared to placebo. Authors theorised that omega-3 intake helped build up stress resilience by reducing the effects of elevated cortisol after a stressful experience, while other research found that supplementing omega-3 inhibited adrenal activation associated with stress.
Probiotics 50
The evidence of the gut-brain axis signifies the important relationship between the gastrointestinal tract and the central nervous system. Probiotics are now thought to have the potential to exert psychotropic effects on depression, anxiety and stress, perhaps due to their ability to regulate neurotransmitters including GABA, serotonin and glutamate. Certain strains of Lactobacillus spp and Bifidobacterium spp such as Lactobacillus plantarum are thought to be directly involved in the production of GABA and serotonin.
Key takeaways:
- Cortisol is a steroid hormone produced by the adrenal glands (that sit on top of each kidney) that is released, along with DHEA and adrenaline when we are faced with a stressor.
- Chronic ongoing stress resulting in continuous activation of the HPA axis means that cortisol is constantly being drawn upon, disrupting the delicate feedback mechanism and making the body less sensitive to its effects, which in turn can wreak havoc to health.
- Cortisol functions to reduce inflammation in the body in the short term, however, if the body’s production of cortisol is constantly elevated over time this can actually increase inflammation in the body and drive immune dysfunction.
- Chronic stress and elevated cortisol may play a large role in blood sugar imbalances, obesity, thyroid dysfunction, inflammation, poor immunity, cardiovascular health, digestion dysfunction, sleep issues and depressive disorders.
- Dietary and lifestyle adjustments which support adrenal health include eating a balanced anti-inflammatory diet, getting plenty of quality rest, supporting gut health, using adaptogenic herbs and ensuring adequate micronutrient levels; especially B vitamins, magnesium and vitamin C.
References
- Pindar J. Stress Statistics UK | 2022 Data. Champion Health. Published June 17, 2022. https://championhealth.co.uk/insights/stress-statistics/
- Thau L, Gandhi J, Sharma S. Physiology, cortisol. National Library of Medicine. Published 2023. https://www.ncbi.nlm.nih.gov/books/NBK538239/
- Fogelman N, Canli T. Early life stress and cortisol: A meta-analysis. Hormones and Behavior. 2018;98:63-76. doi:https://doi.org/10.1016/j.yhbeh.2017.12.014
- Noushad S, Ahmed S, Ansari B, Mustafa UH, Saleem Y, Hazrat H. Physiological biomarkers of chronic stress: A systematic review. Int J Health Sci (Qassim). 2021;15(5):46-59.
- Signs and Symptoms of Stress. Mind. Published March 2022. https://www.mind.org.uk/information-support/types-of-mental-health-problems/stress/signs-and-symptoms-of-stress/
- Sleep: 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
- Pain: Hannibal KE, Bishop MD. Chronic stress, cortisol dysfunction, and pain: a psychoneuroendocrine rationale for stress management in pain rehabilitation. Phys Ther. 2014;94(12):1816-1825. doi:10.2522/ptj.20130597
- Migraine Maleki N, Becerra L, Borsook D. Migraine: maladaptive brain responses to stress. Headache. 2012;52 Suppl 2(Suppl 2):102-106. doi:10.1111/j.1526-4610.2012.02241.x
- Sharma VK, Singh TG. Chronic Stress and Diabetes Mellitus: Interwoven Pathologies. Current Diabetes Reviews. 16(6):546-556. Accessed April 26, 2024. https://www.eurekaselect.com/article/102244
- Joseph JJ, Golden SH. Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus. Ann N Y Acad Sci. 2017;1391(1):20-34. doi:10.1111/nyas.13217
- Udenze IC, Olowoselu OF, Egbuagha EU, Oshodi TA. Thyroid, cortisol and growth hormone levels in adult Nigerians with metabolic syndrome. Pan Afr Med J. 2017;26:52. Published 2017 Jan 31. doi:10.11604/pamj.2017.26.52.9909
- van der Valk ES, Savas M, van Rossum EFC. Stress and Obesity: Are There More Susceptible Individuals? Current Obesity Reports. 2018;7(2):193-203. doi:https://doi.org/10.1007/s13679-018-0306-y
- Jonsdottir IH, Sjörs Dahlman A. MECHANISMS IN ENDOCRINOLOGY: Endocrine and immunological aspects of burnout: a narrative review. Eur J Endocrinol. 2019;180(3):R147-R158. doi:10.1530/EJE-18-0741
- Van den Beld AW, Visser TJ, Feelders RA, Grobbee DE, Lamberts SW. Thyroid hormone concentrations, disease, physical function, and mortality in elderly men. J Clin Endocrinol Metab. 2005;90(12):6403-6409. doi:10.1210/jc.2005-0872
- Hassamal S. Chronic stress, neuroinflammation, and depression: an overview of pathophysiological mechanisms and emerging anti-inflammatories. Front Psychiatry. 2023;14:1130989. Published 2023 May 11. doi:10.3389/fpsyt.2023.1130989
- Saccaro LF, Schilliger Z, Perroud N, Piguet C. Inflammation, Anxiety, and Stress in Attention-Deficit/Hyperactivity Disorder. Biomedicines. 2021;9(10):1313. Published 2021 Sep 24. doi:10.3390/biomedicines9101313
- Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: A review. EXCLI J. 2017;16:1057-1072. Published 2017 Jul 21. doi:10.17179/excli2017-480
- Song H, Fang F, Tomasson G, et al. Association of Stress-Related Disorders With Subsequent Autoimmune Disease. JAMA. 2018;319(23):2388. doi:https://doi.org/10.1001/jama.2018.7028
- Morey JN, Boggero IA, Scott AB, Segerstrom SC. Current Directions in Stress and Human Immune Function. Curr Opin Psychol. 2015;5:13-17. doi:10.1016/j.copsyc.2015.03.007
- Crawford AA, Soderberg S, Kirschbaum C, Murphy L, Eliasson M, Ebrahim S, Davey Smith G, Olsson T, Sattar N, Lawlor DA, Timpson NJ, Reynolds RM, Walker BR. Morning plasma cortisol as a cardiovascular risk factor: findings from prospective cohort and Mendelian randomization studies. Eur J Endocrinol. 2019 Oct;181(4):429-438. doi: 10.1530/EJE-19-0161. PMID: 31325907; PMCID: PMC6733337
- Vidrascu EM, Bashore AC, Howard TD, Moore JB. Effects of early- and mid-life stress on DNA methylation of genes associated with subclinical cardiovascular disease and cognitive impairment: a systematic review. BMC Medical Genetics. 2019;20(1). doi:https://doi.org/10.1186/s12881-019-0764-4
- Videlock EJ, Shih W, Adeyemo M, et al. The effect of sex and irritable bowel syndrome on HPA axis response and peripheral glucocorticoid receptor expression. Psychoneuroendocrinology. 2016;69:67-76. doi:10.1016/j.psyneuen.2016.03.016
- Farzi A, Fröhlich EE, Holzer P. Gut Microbiota and the Neuroendocrine System. Neurotherapeutics. 2018;15(1):5-22. doi:10.1007/s13311-017-0600-5
- Zhao X, Li J, Ren X, Yang J. The effect of sleep on the salivary cortisol response to acute stressors: a review and suggestions. Sleep Med. 2021;77:35-44. doi:10.1016/j.sleep.2020.11.026
- Sladek MR, Doane LD, Breitenstein RS. Daily rumination about stress, sleep, and diurnal cortisol activity. Cogn Emot. 2020;34(2):188-200. doi:10.1080/02699931.2019.1601617
- Knezevic E, Nenic K, Milanovic V, Knezevic NN. The Role of Cortisol in Chronic Stress, Neurodegenerative Diseases, and Psychological Disorders. Cells. 2023;12(23):2726. Published 2023 Nov 29. doi:10.3390/cells12232726
- Bertollo AG, Grolli RE, Plissari ME, et al. Stress and serum cortisol levels in major depressive disorder: a cross-sectional study. AIMS Neurosci. 2020;7(4):459-469. Published 2020 Nov 13. doi:10.3934/Neuroscience.2020028
- Pritchard BT, Stanton W, Lord R, Petocz P, Pepping GJ. Factors Affecting Measurement of Salivary Cortisol and Secretory Immunoglobulin A in Field Studies of Athletes. Front Endocrinol (Lausanne). 2017 Jul 24;8:168. doi: 10.3389/fendo.2017.00168. PMID: 28790976; PMCID: PMC5522838
- Tsuda SI, Konishi K, Otoda T, Nagai T, Takeda-Watanabe A, Kanasaki M, Kitada M, Nakagawa A, Nishizawa M, Kanasaki K, Koya D. Restoration of the Hypothalamic-pituitary-adrenal Response to Hypoglycemia in Type 2 Diabetes by Avoiding Chronic Hypoglycemia. Intern Med. 2016;55(23):3471-3473. doi: 10.2169/internalmedicine.55.7001. Epub 2016 Dec 1. PMID: 27904111; PMCID: PMC5216145
- De Nys L, Anderson K, Ofosu EF, Ryde GC, Connelly J, Whittaker AC. The effects of physical activity on cortisol and sleep: A systematic review and meta-analysis. Psychoneuroendocrinology. 2022;143:105843. doi:10.1016/j.psyneuen.2022.105843
- Mahindru A, Patil P, Agrawal V. Role of Physical Activity on Mental Health and Well-Being: A Review. Cureus. 2023;15(1):e33475. Published 2023 Jan 7. doi:10.7759/cureus.33475
- Pascoe MC, Thompson DR, Ski CF. Yoga, mindfulness-based stress reduction and stress-related physiological measures: A meta-analysis. Psychoneuroendocrinology. 2017;86:152-168. doi:10.1016/j.psyneuen.2017.08.008
- Hilcove K, Marceau C, Thekdi P, Larkey L, Brewer MA, Jones K. Holistic Nursing in Practice: Mindfulness-Based Yoga as an Intervention to Manage Stress and Burnout [published correction appears in J Holist Nurs. 2022 Sep;40(3):NP1-NP5]. J Holist Nurs. 2021;39(1):29-42. doi:10.1177/0898010120921587
- Nicolaides NC, Vgontzas AN, Kritikou I, Chrousos G. HPA Axis and Sleep. In: Feingold KR, Anawalt B, Blackman MR, et al., eds. Endotext. South Dartmouth (MA): MDText.com, Inc.; November 24, 2020
- Mahindru A, Patil P, Agrawal V. Role of Physical Activity on Mental Health and Well-Being: A Review. Cureus. 2023;15(1):e33475. Published 2023 Jan 7. doi:10.7759/cureus.33475
- Koncz A, Demetrovics Z, Takacs ZK. Meditation interventions efficiently reduce cortisol levels of at-risk samples: a meta-analysis. Health Psychol Rev. 2021;15(1):56-84. doi:10.1080/17437199.2020.1760727
- Hunter, M.R., Gillespie, B.W., Chen, SY-P., (2019). Urban nature experiences reduce stress in the context of daily life based on salivary biomarkers. Frontiers in Psychology, 10
- Ma X, Yue ZQ, Gong ZQ, et al. The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults. Front Psychol. 2017;8:874. Published 2017 Jun 6. doi:10.3389/fpsyg.2017.00874
- Pickering G, Mazur A, Trousselard M, et al. Magnesium Status and Stress: The Vicious Circle Concept Revisited. Nutrients. 2020;12(12):3672. Published 2020 Nov 28. doi:10.3390/nu12123672
- Stachowicz M, Lebiedzińska A. The Effect of Diet Components on the Level of Cortisol. European Food Research and Technology. 2016;242(12):2001-2009. doi:https://doi.org/10.1007/s00217-016-2772-3
- The role of vitamin C in stress-related disorders. The Journal of Nutritional Biochemistry. 2020;85:108459. doi:https://doi.org/10.1016/j.jnutbio.2020.108459
- Evans M, McDonald AC, Xiong L, Crowley DC, Guthrie N. A Randomized, Triple-Blind, Placebo-Controlled, Crossover Study to Investigate the Efficacy of a Single Dose of AlphaWave®l-Theanine on Stress in a Healthy Adult Population. Neurol Ther. 2021;10(2):1061. doi:10.1007/S40120-021-00284-X
- Li MY, Liu HY, Wu DT, et al. L-Theanine: A Unique Functional Amino Acid in Tea (Camellia sinensis L.) With Multiple Health Benefits and Food Applications. Front Nutr. 2022;9. doi:10.3389/FNUT.2022.853846/FULL
- Kimura K, Ozeki M, Juneja LR, Ohira H. L-Theanine reduces psychological and physiological stress responses. Biol Psychol. 2007;74(1):39-45. doi:10.1016/J.BIOPSYCHO.2006.06.006
- Speers AB, Cabey KA, Soumyanath A, Wright KM. Effects of Withania somnifera (Ashwagandha) on Stress and the Stress- Related Neuropsychiatric Disorders Anxiety, Depression, and Insomnia. Curr Neuropharmacol. 2021;19(9):1468-1495. doi:10.2174/1570159X19666210712151556
- Wiciński M, Fajkiel-Madajczyk A, Kurant Z, et al. Can Ashwagandha Benefit the Endocrine System?-A Review. Int J Mol Sci. 2023;24(22):16513. Published 2023 Nov 20. doi:10.3390/ijms242216513
- Anghelescu IG, Edwards D, Seifritz E, Kasper S. Stress management and the role of Rhodiola rosea: a review. Int J Psychiatry Clin Pract. 2018;22(4):242-252. doi:10.1080/13651501.2017.1417442
- Madison AA, Belury MA, Andridge R, et al. Omega-3 supplementation and stress reactivity of cellular aging biomarkers: an ancillary substudy of a randomized, controlled trial in midlife adults. Molecular Psychiatry. 2021;26(7):3034-3042. doi:https://doi.org/10.1038/s41380-021-01077-2
- Delarue J, Matzinger O, Binnert C, Schneiter P, Chioléro R, Tappy L. Fish oil prevents the adrenal activation elicited by mental stress in healthy men. Diabetes Metab. 2003;29(3):289-295. doi:10.1016/s1262-3636(07)70039-3
- Cheng LH, Liu YW, Wu CC, Wang S, Tsai YC. Psychobiotics in mental health, neurodegenerative and neurodevelopmental disorders. J Food Drug Anal. 2019;27(3):632-648. doi:10.1016/j.jfda.2019.01.002
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Post originally published in 2017. Now completely updated and revised.
Last updated on 31st May 2024 by cytoffice
This is so true I have been suffering with these symptoms for the last couple of years I now take your adrenal fatigue supplements and they have really helped me as well as seeing a homeopath I’m now losing weight I gained beachside of high cortisol and sleeping better as I used to wake up between 2-3 in the morning .
I JUST TURNED 54 FEB.4TH. IVE BEEN SRTUGGLING WITH MY BMI A LONG TIME. I BELIEVE IF I GET OFF MY LAZY BUTT AND START JOGGING(HAVNT JOGGED SINCE I WAS 37) I COULD START LOSING THE EXCESS BMI. WORKING OUTSIDE AD A GROUNDS KEEPER AT THE TOPEKA SHAWNEE COUNTY LIBRARY,IVE LOST SOME WEIGHT. ITS THE EXCESS BMI THAT I HAVE TO LOSE. IM THE TYPE OF PERSON WHO WAITS TOO LONG TO GET SOMETHING DONE. I KNOW THIS IS WRONG AND DANGEROUS INVOLVING MY HEALTH. I STRUGGLE WITH WHAT TO TARGET FIRST. THATS WHY I BELIEVE ITS EASIER TO START WITH JOGGING,IF I STICK TO THIS REGIMEN,ILL START TO LOSE THE EXCESS BMI. THEN BUILD MUSCLE MASS,TO RING. I USE TO HAVE MUSCLES,BUT STOPPING LIFTING WEIGHTS FOR YEARS,IVE LOST MUSCLE MASS. IN 2019 DR. NOTICED ISSUES WITH MY THYROID. WAS TOLD I HAVE BONY SCRLOSIS. I JUST WATCHED A VIDEO ABOUT TEST BOOST MAX SUPPLIMENT. IM INTRIGUED BY HOW CORTISOL ELIMINATES THE JOB OF TESTOSTERONE. NOW THE INGREDIENTS THATS STATED IN THE SUPPLIMENT IS HARD TO OBTAIN IN THIER TRUE FORM AND HAVING TO EAT A POUND OF ASHAWANDHA TO GAIN THE RIGHT AMOUNT TO OBTAIN THE EFFECTS IT HAS AGAINST CORTISOL ALONG WITH 4 OTHERS. I GUESS PAYING FOR THINGS ON THE INTERNET IS SOMETHING NEW FOR ME,BECAUSE ODDLY(TO MOST PPL) IM JUST INVOLVING IN TODAYS TECHNOLOGY.(I CALL MYSELF A GREENHORN) TO PAY FOR SOMETHING BY A CARD AND A ACCOUNT # IS NEW TERRITORY WITH ME. ID LIKE ACCESS TO THINGS EASY. I HAVE TO NOT ONLY OBTAIN CORRECT INFO ON INFO LIKE THIS,BUT START FINDING WAYS TO PHYSICALLY START GETTING HEALTHY BEFORE ITS TOO LATE…WOULD YOU HAVE ANY SUGGESTIONS? THE INFO IVE READ TO THIS POINT TO LEAVE A COMMENTS ETC. WAS INFORMATIONAL. IM AT ODDS WITH MYSELF AND GETTING STARTED TO A HEALTHIER LIFE EVAN SEMI-HEALTHY IF THAT MAKES SENSE. DOING SOMETHING IS BETTER THAN NOTHING I BELIEVE. THANKS, DONALD COURTNRY
Hi Donald – Cortisol is made from the same building block as testosterone (DHEA) therefore if the body is making excess cortisol due to stress it can reduce other hormones such as testosterone. Cortisol also blocks sex hormone binding globulin which can affect the action and delivery of hormones including testosterone. Ashwagandha is not used to directly raise testosterone but to support the bodies resilience to stress and stabilise cortisol levels. Thanks, Helen
Diabetes is a chronic health condition that can have serious long-term effects if not properly managed. Diabetes care involves a wide range of health management strategies and treatments, including lifestyle modifications, regular monitoring, and medication.
Thank you for your comment. We have a recent blog on the topic that you might find interesting: Type 2 Diabetes and Associated Conditions – Cytoplan
My daughter is type 1
What are good supplements for her shes19 and is on the autism spectrum
Hi Michelle,
To be able to advise safely, we would need to understand what is it you are wanting achieve from taking supplements and a little more information about your daughter. I have included the link to our online Health Questionnaire, where one of our NT’s will be able to come back to you with advice.
Homeopathic potency ‘Adrenal gland’ is the single most effective intervention, after lifestyle factors, and above both herbal and nutritional supplementation; in my long experience as a practitioner
Very interesting article. Lots here that I’ve heard about from the functional therapist I have been seeing.
Hi Kathryn,
Thank you for your kind feedback, we are glad you found the article of interest.
Thank you for your generous sharing of such invaluable information on the effects of high cortisol. I’m 62 and have suffered since I was 7 years old with an excessive flight/fight way of living (a ‘nervous disposition’ as the doctors called it back then!). This was 100% due to parental breakup and extreme (dysfunctional) changes in childhood care. It was exhausting, due to the circadian interruptions and chaos within the family home. The patterns persist, even now, in my 60’s. Following this wonderful advice from Cytoplan, I’m definitely going to order some nutritional supplements. I’ve ’existed‘ for many years without sleeping tablets etc, but I feel confident in this marvellous holistic advice, so look forward to a good nights sleep…
Hello Vickie,
Thank you for your comment and lovely feedback. We are really glad the blog was so useful for you. Please do contact one of our nutritional therapists if you require any advice – nutrition@cytoplan.co.uk
This article has me puzzled, as some things I mentally tick and others do not apply. I am at my worst on waking and perk up when it is time to go to bed. I have a lot going on which should be stressing me but do not feel stressed – just miserable. But I am almost permanently tired and weak. If the adrenals sit on the kidneys, would CKD upset what they do?
Hello, sorry to hear about your health struggles. If you would like more personalised advice please don’t hesitate to contact nutrition@cytoplan.co.uk where we can take into account any medications and supplements you are taking and make the appropriate recommendations.
Great to see you mentioned how good yoga is ,as I have been a teacher for fifty years,and Tai chi,and qigong breathing exercises, fantastic for health and cytoplan vitamins I have had for years ,