Cortisol: Function, Symptoms, + How To Balance Levels

What Does Cortisol Do?

One basic way our body responds to stress is by releasing cortisol from the adrenal glands. This hormone is part of the fight or flight response, helping us move away from danger. Cortisol redirects energy and blood flow from digestion, immune function, and healing to functions useful for escaping danger. Cortisol raises blood sugar levels, and blood pressure, and acts as a stimulant to keep us awake and alert. Interestingly, cortisol dampens our memory so we can more easily forget stressful events.

Symptoms of High Cortisol

When cortisol levels are too high for a prolonged period it leads to depression and insomnia, anxiety, accelerated aging, and the development of chronic degenerative diseases such as diabetes, heart disease, osteoporosis, and Alzheimer’s disease. 

Cortisol Face

High levels of cortisol can also lead to weight gain, especially in the face, abdomen, and upper back. The rounded moon-shaped face associated with excess cortisol has recently been referred to as “cortisol face.”

Symptoms of Low Cortisol

Low cortisol often results from adrenal glands being "exhausted" due to persistent stress or prolonged use of corticosteroid drugs like prednisone. Low cortisol is associated with low energy levels, chronic fatigue, or complete exhaustion may complain of feeling "stressed out.” People with low cortisol levels, will typically also have a reduced resistance to allergies and infection, and be prone to inflammation. Learn more about adrenal gland support.

It is important to remember that cortisol has many benefits. It's a crucial hormone, and maintaining the right balance is key. Both too little and too much can be harmful. 

Causes Of High Cortisol Levels

High cortisol levels most occur when the hormone cortisol is produced in excess by the adrenal glands due to chronic stress, inadequate quality sleep, and poor blood sugar control. 

There is also a medical condition known as Cushing’s Syndrome where prolonged high cortisol levels can also be due to overuse of corticosteroid medications like prednisone or because of tumors in the pituitary gland or elsewhere that cause the adrenals to produce and release more cortisol.

High cortisol levels are usually diagnosed through laboratory methods including blood, urine, or salivary measurements of cortisol levels. If you suspect high cortisol levels, please consult a healthcare professional for an accurate diagnosis.

How To Balance Cortisol Levels

Normal cortisol levels follow a natural 24‐hour cycle. Levels are lowest during the evening sleep phase and rise throughout the night. Cortisol is kind of a biological alarm clock. Peak levels occur about 30 minutes after waking. 

Levels of cortisol should decline as the day goes on to help turn the mind off and allow for sleep. However, stress and a variety of other triggers can lead to the release of cortisol and loss of regulatory control of cortisol levels. The key to restoring balance involves the elimination of these triggers.¹

Since chronic stress and dietary factors are the most common triggers of the release of cortisol, the most important step in supporting normal cortisol balance is creating an effective stress management strategy involving lifestyle, diet, and supplemental measures to help reduce the effects of stress and improve metabolic health. 

Lifestyle Recommendations

The key lifestyle tools in stress management are regular physical exercise and measures to calm the mind and body such as quality sleep, deep breathing exercises, meditation, and prayer. These techniques promote what is known as the “relaxation response” which produces the exact opposite of the stress response. A stress-busting lifestyle must also avoid negative coping and lifestyle choices such as smoking (including vaping), alcohol or drug abuse, and other detrimental habits.^2-4 

Dietary Considerations

Diet is also an important strategy for stress reduction and balancing cortisol. The most critical dietary aspect is to eat to control blood sugar levels and utilize natural products for support. When blood sugar levels are highly volatile a person is on a blood sugar roller coaster. Every time their blood sugar goes to a rapid drop it leads to a surge of cortisol being released to counteract the drop. 

Preventing spikes and valleys in blood sugar levels starts with a health-promoting diet that avoids refined sugar and overconsumption of carbohydrates. In particular, high-sugar beverages, desserts, and refined carbohydrates such as white bread, pasta, pastries, and chips.⁵ 

It is also important to avoid eating late at night as this habit can disrupt the body’s daily rhythm and lead to cortisol spikes.⁶

Blood Sugar Support Supplements

Diet alone can be helpful, but supplementation can produce additional benefits in many cases of poor blood sugar control. There are many choices, but two natural products stand out in improving blood sugar control: highly viscous dietary fiber and berberine.

Different types of dietary fiber possess different actions. The type of fiber that exerts the most beneficial effects on blood sugar control is the water-soluble, highly viscous form. This type of fiber slows down the digestion and absorption of carbohydrates, thereby preventing rapid rises in blood sugar. Particularly good dietary sources of water-soluble fiber are beans, peas, other legumes, oat bran, nuts, seeds, pears, apples, and most vegetables. 

For people with definite blood sugar control or weight issues, it is also critical to supplement with a highly viscous soluble fiber supplement at all meals. Examples include psyllium, pectin, guar gum, and PolyGlycoplex (PGX®). Of these well-studied fiber supplements, PGX® has the best effect in flattening out the blood sugar roller coaster primarily by reducing after-meal elevations in blood sugar levels and improving insulin sensitivity.^7,8

The other important consideration for blood sugar support is berberine, an alkaloid from barberry bark. Berberine is an aid to metabolic health that has been shown to produce significant positive effects in blood sugar control in human double-blind clinical studies when given at 500 mg before meals.⁹ Consider berberine Phytosome, an advanced berberine formed by binding it in a phospholipid matrix for better absorption and clinical results.¹⁰

Stress Management Supplements

Three critical supplement considerations to help with stress management are B vitamins, fish oil supplements concentrated for omega-3 fatty acids, and magnesium. 

For the B vitamins, consider using a multiple vitamin-mineral formula or a specific B complex supplement supplying the active forms of B vitamins (e.g., 5-methyltetrahydrofolate instead of folic acid, methylcobalamin instead of cyanocobalamin or hydroxocobalamin, etc.). Higher B vitamin levels are associated with better mood and reduced feelings of stress.¹¹

Fish oils containing the long-chain omega-3 fatty acids EPA and DHA help the brain handle stress better. Take approximately 1,000 mg of the combined amount of EPA+DHA daily.^12-14

Magnesium exerts significant calming effects.^15,16 Perhaps one of the best habits to get into to get a good night’s sleep and handle stress better is taking 350 to 500 mg of magnesium at night. Consider powdered drink versions that supply easily absorbed forms like magnesium citrate, malate, or bis-glycinate.

Adaptogens

An adaptogen is a botanical medicine that helps us adapt to (cope with) stress as well as restore vitality, increase feelings of energy, and improve mental and physical performance. 

The most notable adaptogens are Chinese or Korean ginseng (Panax ginseng), rhodiola (Rhodiola rosacea), and ashwagandha (Withania somnifera). All of these plants exert beneficial effects on improving cortisol balance, and adrenal function and enhance resistance to stress.¹⁷ 

Another consideration as an adaptogen is black seed oil (BSO). A double-blind human clinical trial produced even greater effects in lowering cortisol levels than other adaptogens. Subjects took either 500 mg daily of a placebo or ThymoQuin, a BSO standardized at 3% thymoquinone and no more than 2% free fatty acids. Results showed ThymoQuin produced a significant reduction in upper respiratory tract complaints and improved overall well-being. These benefits may have been due to the significant decrease in cortisol observed in the group compared to placebo. Salivary cortisol levels dropped by 44% with ThymoQuin supplementation.¹⁸

There is tremendous scientific support for BSO supplementation from human double-blind clinical studies showing it to produce a myriad of positive effects in supporting metabolic health, weight management, and blood sugar control, as well as stress-busting and immune-supportive effects. It produces these benefits through multiple mechanisms including enhancing insulin action through promotion of GLP-1 secretion and activation of AMP-kinase, a key enzyme that regulates energy production and metabolism.^19,20

GABA for Situational Stress

Detailed human clinical studies show PharmaGABA, a natural form of the brain chemical GABA (gamma-aminobutyric acid), to lower cortisol levels produced by situational stress such as taking a test or crossing a canyon by foot via a suspension bridge. PharmaGABA has shown other effects in promoting improved brain energy and function as well as feelings of calmness and improved sleep quality. The typical dosage is 200 mg to produce these benefits and can be taken up to three times daily.^21,22