How To Lower Cortisol Levels Naturally in 3 Steps

Restore Stress Hormone Balance to Create Resilience

• What is Cortisol?|
• Symptoms|
• Step-By-Step Guide|
• Restore Balance|

Cortisol gets blamed for many health issues. I’m sure you’ve seen the commercials pointing to high cortisol levels as the cause of stubborn belly fat and the social media posts dedicated to how to lower cortisol levels naturally. 

But there’s some nuance at play. It may surprise you to learn that high cortisol levels aren’t always a bad thing—indeed there are times when we want a robust cortisol response. The key is to foster an environment in the body that allows for a healthy cortisol curve.

In this article, I’ll clarify the confusion that sometimes surrounds cortisol, and share a road map for naturally restoring balance to your stress system. So, let’s dive in.

What is Cortisol?

Cortisol is a steroid hormone that’s made in the adrenal glands. It’s regulated by the hypothalamus-pituitary-adrenal axis (HPA-axis) and is a key player in the stress response.

Without going too far into specifics, when your hypothalamus senses a need for cortisol, it stimulates the pituitary gland to secrete a hormone (ACTH). ACTH then triggers the adrenal glands to use cholesterol to make and secrete cortisol [1].

Cortisol is most well-known for governing the stress response, but it also influences [1]:

• Brain function and mood
• Immune system function
• Heart health and blood pressure
• Breathing
• Reproductive health
• Muscle health
• Bone health
• Skin and hair health

Normally, cortisol rises and falls over a 24-hour period. It should be lower in the evening, which allows us to prepare for and get good sleep. Around 3 a.m., cortisol begins to rise, getting us ready for the upcoming day. As the day progresses, cortisol again declines to prepare us for restful sleep.

The cortisol response is complex and has many moving parts. A breakdown anywhere in the system can lead to cortisol dysregulation and negative downstream effects.

The following health conditions can develop when cortisol isn’t regulated like it should be [1, 2]:

• Cushing’s syndrome: Very high levels of cortisol
• Addison’s disease: Very low levels of cortisol
• Mild hypercortisolism: Mildly elevated cortisol levels  

These are all fairly rare conditions requiring specific treatments like medications or surgery. Outside of these, chronic stress can trigger life-disrupting symptoms. This is because stress can cause higher cortisol levels overall or blunt morning cortisol when you should be at your peak.

Symptoms of High Cortisol Levels

On the most serious end of the high-cortisol spectrum, Cushing’s syndrome causes [1]:

• Weight gain
• Diabetes
• High blood pressure
• Excessive hair growth (in women)
• Fatty deposits (between the shoulder blades)
• Muscle weakness
• Weak bones [1]

Mild hypercortisolism can cause these and other symptoms like [2]:

• Heart disease
• Mood disorders
• Fatty deposits (in the organs)
• Muscle damage
• Infections 

Even if you don’t have one of these clinical conditions, high cortisol from  chronic stress can lead to a number of uncomfortable symptoms like [3]:

• Bone and muscle breakdown
• Fatigue
• Depression
• Pain
• Memory impairments
• Electrolyte imbalances
• Orthostatic hypotension (dizziness when going from seated to standing)
• Impaired pupillary light reflex
• Inflammation
• Increased heart rate 

What should you do if you’re having these symptoms pretty regularly? You may be tempted to diagnose yourself with “adrenal fatigue” and seek out an adrenal test to check your cortisol levels. But testing isn’t the answer, and let me tell you why. 

Do You Need Adrenal Testing?

When you feel awful day in and day out, you want answers and a fix. Adrenal testing (where your salivary cortisol levels are tested at four points throughout the day) may seem like a great place to start, but it’s not.

It’s true that the test is pretty simple to do, not all that expensive, and used ubiquitously in integrative medicine. The rub for me is that it distracts from targeting the root cause and prioritizes chasing a lab value.

Research tells us that adrenal testing doesn’t accurately diagnose true HPA-axis dysfunction [4, 5]. And, people living with chronic stress (like those with PTSD or a trauma history) don’t always have high cortisol patterns despite having negative symptoms [6, 7].

My point here is you could have “normal” cortisol levels but still feel lousy from being in a high-stress state. If you’re just following the lab, you may miss out on identifying the root cause of your symptoms, which prolongs your recovery. 

Adrenal testing isn’t informative and doesn’t tell us anything about the fix. 

In my experience in the clinic, the symptoms of altered cortisol are often a byproduct of poor gut health and unmanaged stress. Improving gut health and managing stress are ways to lower cortisol levels naturally—it’s also how you restore vibrant health more quickly.

Targeting stress and gut health may seem like a tall mountain to climb. But I’ve got great news! You don’t need any expensive or fancy testing or handfuls of supplements. With a few natural solutions, you can begin to restore balance to your stress system and your gut.

How to Lower Cortisol Levels Naturally: A Step-By-Step Guide

We have many effective, natural therapies for targeting gut health and stress. These will, in turn, help to normalize your cortisol response. Diet is unquestionably the most effective strategy we have for improving gut and overall health, so that’s where we start.

Step 1: Diet and Lifestyle Reset

You probably already know that diet and lifestyle have a significant impact on your wellness and gut health, but they also impact your stress response.

When it comes to choosing the right diet for you, you may consider a dietary pattern that: 

• Helps to control inflammation
• Limits allergens and intolerances
• Contains the right amount of fuel for gut bacteria

Another very important concern is blood sugar (glucose) regulation, even if you don’t have type 2 diabetes. Skipping meals, eating too many high-glycemic carbohydrates, and skimping on protein can contribute to a blood sugar roller coaster ride, which can increase cortisol levels.

On the other hand, high cortisol levels can stimulate glucose production. When blood sugar levels (and cortisol levels) are higher than they should be, you can experience unwanted weight gain, especially in your abdomen. 

If you’re new to making diet-related changes, the Mediterranean diet may be a great place to start. This diet has been well-researched and some studies have found that it lowers cortisol levels. Let me share what we know.

A 2018 study evaluated how stress and diet impact inflammation in adolescents. The researchers analyzed the relationship between salivary cortisol levels, inflammation, and adherence to the Mediterranean diet. Here’s what they found [8]:

• Cortisol was positively linked to inflammation levels.
• Those who followed the Mediterranean diet more closely had lower levels of inflammatory markers.
• The Mediterranean diet appeared to mitigate the inflammatory effects of stress, potentially reducing future mental health risks.

Another study (in primates) found that the Mediterranean diet lowered the cortisol response in acute stress and improved the ways the body dealt with stress. This means a healthy, anti-inflammatory diet may increase stress resilience, but we need studies in humans to be sure [9].

Does this mean the Mediterranean diet is the only option? Not at all. If you’re already following a pretty healthy diet and still experiencing some negative symptoms, you may want to consider these other options:

• Paleo
• Low FODMAP
• Autoimmune Protocol  

While you’re working on diet-related changes, you can layer in these lifestyle strategies to optimize your results: 

• Regular Exercise: Zone 2 exercise (the type you can do while still holding a conversation relatively easily) may be the best option for improving stress resilience. Zone 2 reduces pro-inflammatory chemicals (cytokines) and increases anti-inflammatory chemicals [10].
• Stress Management: Meditation has been shown to reduce cortisol (as well as other stress markers) in a range of people [11]. And mindfulness-based stress reduction (MBSR) and cognitive behavioral therapy both reduced salivary cortisol levels and helped stressed adults adapt to a stressful task [12].
• Massage: In healthy women, vagus nerve massage, regular soft shoulder massage, and resting for 10 minutes significantly reduced stress and increased relaxation levels [13].

In my book, Healthy Gut, Healthy You, I take a deep dive into how lifestyle impacts gut health and stress levels. Other stress-reducing lifestyle habits to add to your daily routine include:

• Practicing healthy sleep hygiene
• Spending time in nature
• Doing deep breathing exercises
• Spending time with loved ones

If you work through diet and lifestyle but still feel the physical health effects of stress, you may want to consider moving on to step 2.

Step 2: Probiotics

Diet and lifestyle are fairly obvious antidotes for stress-related symptoms. But probiotics may be a lesser-known option in the stress equation. 

A randomized controlled trial of 80 students aged 18–24 found multi-strain probiotics (plus glutamine) lowered stress, depression, anxiety, and cortisol levels [14].

Part of the explanation is that altered cortisol responses are the byproduct of poor gut health. The gut is the upstream cause of a dysregulated stress response. So, when you target it with probiotics, you can [15, 16, 17, 18, 19, 20]:   

• Restore balance to the nervous system
• Increase your stress resilience
• Get rid of negative symptoms 

But remember I mentioned in the intro that our goal isn’t to lower cortisol levels as much as possible all of the time. We actually want a robust amount of cortisol in the morning—this helps us wake up and get out of bed with gusto.

When cortisol levels are too low in the morning, you can feel fatigued and have a hard time getting moving even if you’ve gotten enough sleep.

In the research setting, we can test the cortisol awakening response (CAR), which may be the most accurate way to test cortisol. In my video, The Gut’s Connection to Stress, I discussed a study that looked at how gut health, the gut microbiome, and the stress response intersect  But here’s the gist.

Healthy women with moderate-to-low stress were compared to women with irritable bowel syndrome (IBS). IBS is a condition characterized by gut-brain dysfunction [15].

The IBS group had a blunted cortisol awakening response at baseline. After four weeks on a multistrain probiotic: 

• CAR normalized (meaning healthy cortisol levels)
• Sleep quality improved
• Inflammation was reduced
• Symptoms of anxiety and depression were better 

These results were sustained for another four weeks. At the eight-week mark, the probiotics were stopped and by week 16, CAR went back down to baseline. Anxiety and depression symptoms worsened but didn’t return to where they were at the start of the study.

This study highlights the correlation between probiotics, cortisol, and symptom improvement. So whether you’re struggling with high cortisol or a low CAR, probiotics (along with a healthy diet and lifestyle) can help keep cortisol levels balanced in the 24-hour cycle. 

Here’s our evidence-based probiotic protocol:

We use the triple therapy probiotic approach. This just means we use all three categories of probiotics in combination. Research supports this approach, and we’ve had much success with it in the clinic [21, 22]. 

If you’re following a balanced diet, have your lifestyle dialed in, and try probiotics for a few months but still feel overwhelmed with stress, consider step 3. 

Step 3: Targeted Supplementation

I’m not a fan of loading up on supplements. Time after time, our clients in the clinic get the best results when they first lay a healthy foundation with diet and lifestyle. Then if symptoms could still improve, we layer on probiotics. For many of our clients, this works beautifully. 

But a subset of clients need more support in getting across the finish line, so we consider some specialized supplements:

There are several supplement options, but I want to reiterate the importance of creating a healthy foundation first. Starting with supplements before your diet and lifestyle are in order likely won’t improve your symptoms much and will probably leave you frustrated.

It’s also important to discuss any dietary supplements with a trusted healthcare provider first.

Restore Stress Hormone Balance Naturally

The stress hormone cortisol is a key player in many bodily functions. A healthy body experiences the ebb and flow of cortisol over a 24-hour period. But poor gut health and unmanaged stressors can wreak havoc on the cortisol curve.

When cortisol levels are higher or lower than they should be, you can experience everything from fatigue and depression to memory problems and inflammation. 

Rather than focusing on cortisol lab values, restore balance to the system by targeting the root causes of negative symptoms. Start with an anti-inflammatory dietary pattern and healthy lifestyle changes (like physical activity, stress management, relaxation techniques, a healthy bedtime routine, and time in nature). 

If you need additional measures, consider adding multistrain probiotics and specialized supplements as needed. And as always, if you have more questions about how to lower cortisol levels naturally, we’re here to support you at the Ruscio Institute for Functional Health when you need us.

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