Cortisol Cocktails: Science or Snake Oil?
Deconstructing an Internet Trend and Getting to the Bottom of Cortisol Regulation
- What is a Cortisol Cocktail?|
- Quick Intro to Cortisol|
- Signs of High Cortisol|
- 3 Ways to Balance Cortisol|
- No Quick Fix|
If you’ve landed here, it’s likely because you’re curious about the cortisol cocktail trend that’s making its way through the health and wellness blogosphere. All manner of TikTok wellness influencers and recipe bloggers have been promoting the health benefits of this concoction. Claims include benefits to adrenal health and “adrenal fatigue”, blood sugar regulation, energy improvements, a boost to the immune system, and a mitigated stress response.
At this point, we don’t have any clinical evidence to support these claims, but I’d like to use this article space to share what a cortisol cocktail is, what it might actually do for you, and most importantly, some research-backed ways to support your adrenal glands and keep your cortisol levels in check.
What is a Cortisol Cocktail?
A cortisol cocktail, also called an adrenal cocktail or cortisol mocktail, is a non-alcoholic beverage crafted from ingredients that contain potassium, sodium, and vitamin C. The most commonly used components of the cocktail are coconut water (potassium), sea salt (sodium), and orange juice (vitamin C). You may also find recipes that include lemon juice, lime juice, cream of tartar, magnesium powder, collagen powder, coconut milk, coconut cream, and/or sparkling water.
Recipe ratios vary widely if you search online—some give equal ratios to coconut water and orange juice, while others will go heavy on the coconut water at a 4-to-1 ratio to orange juice.
Here are a few examples of various adrenal cocktail recipes:
The idea behind this combination of nutrients is that they may replenish the adrenal glands after a period of chronic stress. Advocates claim that nourishing the adrenal glands in this way helps the body manage stress and provides an overall relaxing effect.
But Does it Work?
While the cortisol cocktail is trendy on social media, with claims that it helps balance cortisol levels and boost energy levels, virtually all available information about its efficacy is anecdotal. It could be fun to try one of these recipes, but there’s not enough concrete evidence to presume that this trend provides a magic elixir for the adrenal glands.
That said, micronutrients like vitamin C may help lower stress and keep cortisol levels balanced. Supplemental vitamin C has been shown to reduce feelings of anxiety and lower stress-related increases in blood pressure 1.
So, when it comes to a cortisol cocktail, it might be better to think of this combination of electrolyte ingredients as a fun way to hydrate—as you would with a sports drink—rather than relying on it to balance your cortisol levels. It’s also a lot cheaper than a product like Liquid I.V. and with quite a bit less sugar.
Rather than relying on a trend like this to balance high cortisol levels, start with proven methods for balancing blood sugar levels and finding ways to mitigate chronic stress.
Quick Intro to Cortisol
Cortisol is known as the body’s stress hormone, but it affects many functions throughout the body. It is a key hormone produced in the adrenal glands and is regulated by the hypothalamus-pituitary-adrenal axis. Cortisol affects almost every part of the body because it has receptors everywhere 2.
Cortisol is not a “bad” hormone, despite all the negative press it gets. It’s normal for cortisol levels to rise at waking and then drop as you move about your day. But when levels remain high for a long time (most often due to stress), it can start to become a problem and lead to damage and inflammation in the body 3.
Maintaining balanced blood sugar throughout the day is one of the most foundational ways to keep cortisol levels under control. When blood sugar is out of balance—meaning there are lots of big spikes and dips—stress hormones like cortisol increase in the bloodstream.
Signs of High Cortisol and Chronic Stress
It’s likely you’ve landed here because of concerns about high cortisol—middle body weight gain, trouble concentrating, sleep problems, and possibly extreme fatigue. But both high cortisol and low cortisol can have negative health impacts. And both may represent a form of adrenal disease. Fortunately, these diseases are somewhat rare. However, symptoms of chronic stress and cortisol spikes are much more common.
Being chronically stressed can lead to lots of spikes in cortisol which may manifest as 4:
- 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
Luckily, simple shifts in diet and lifestyle can be game-changing when it comes to lowering stress and balancing cortisol.
3 Ways to Tweak Your Lifestyle to Support Healthy Cortisol
As with virtually every health condition, there’s a diet and lifestyle component to improving symptoms and getting at the root cause of the problem. Let’s take a closer look.
1. Diet for High Cortisol
The hormonal impacts of the foods you eat can’t be overstated. Stress, including mental and emotional stress, plays a role in the hormonal cascades that take place when we’re experiencing particularly difficult life events—especially if those events remain part of our daily experience for prolonged periods of time.
Things like taking care of an ailing parent with a long-term illness, dealing with a horrible boss or job situation, relationship problems, and financial woes are all examples of chronic stressors that may take a toll and lead to high cortisol levels and feelings of burnout.
Stress leads to inflammation in the body and brain, which can create anxiety, depression, and other physical and psychological symptoms. When cortisol goes up, so too does inflammation and stress in the body.
The tried and true Mediterranean diet has been shown to mitigate the inflammatory effects of stress, even lowering inflammatory markers in blood tests 5. Not only does it keep blood sugar balanced, but it’s also nutrient-dense and low in inflammatory foods. The Mediterranean diet also includes good sources of fiber and complex carbohydrates that will keep your blood sugar in check throughout the day.
One primate study showed that the Mediterranean diet reduced cortisol response to acute stress and protected the nervous system from age-related decline 6. And a recent study on pregnant women found that the Mediterranean diet lowered stress, improved sleep, improved well-being, and improved cortisol regulation 7. These results suggest a healthy diet may increase stress resilience. The Mediterranean diet is the least restrictive approach to reducing inflammatory foods in your diet. It includes whole foods like:
- Vegetables
- Fruits
- Whole grains
- Legumes (at least 3 servings a week)
- Nuts
- Seeds
- Extra-virgin olive oil
- Herbs and spices
- Fish and seafood (2-3 servings a week)
- Moderate amounts of cheese, eggs, poultry, and dairy products
- Low to moderate amounts of red wine with meals
- Limited sugar and sugary drinks
It’s really important to note that the “diet” portion of stress mitigation shouldn’t at all be about calorie restriction or going long periods of time between meals. Even if skipping a meal is unintentional because you’re busy, it’s not great for keeping things in balance and can lead to blood sugar spikes and dips.
In fact, there’s strong evidence that severe caloric restriction may be a bad choice for regulating cortisol. A meta-analysis looked at 13 studies involving over 350 participants and found an increase in cortisol levels in people eating very low-calorie diets. According to the results, fasting led to the greatest spike in cortisol 8.
2. Exercise for High Cortisol
Moderate exercise (zone 2 exercise), or the type of exercise you can do while still holding a conversation relatively easily) is the best form of exercise for improving stress resilience. On a cellular level, it reduces proinflammatory chemicals (cytokines) and promotes anti-inflammatory cytokines 9. This in turn can help protect your body from the negative effects of stress-induced inflammation.
Exercise is also good for your brain health, supporting recovery across multiple categories of injury and cognitive damage. A systematic review also showed that it offered specific help in the areas of anxiety, depression, sleep quality, and even substance use in PTSD patients 10.
It’s important not to push yourself too hard when you’re already in a state of fatigue or overload. Extremely strenuous exercise can lead to exercise burnout, which causes seemingly unrelated symptoms like poor sleep, changes in appetite, and feelings of depression, irritability, or mood swings—precisely the issues we’re trying to remedy in this protocol.
If you feel the pull to exercise harder because you love to break a good sweat—I’m with you!—consider sauna therapy. Not only will you get the sweat you’re looking for, but steam saunas, specifically, have been shown to help prevent high blood sugar, which is key to keeping your energy levels stable throughout the day 11. Once you start feeling more balanced, you can consider bringing your exercise back up to more intense levels.
Always talk to your healthcare provider before starting sauna therapy or major dietary changes, in case there are any specific to your health profile.
3. Supplements for High Cortisol
Although a cortisol cocktail may not be the solution for cortisol regulation, there are a few tried and true supplements that can help improve stress and cortisol levels. These may work best when used in addition to the diet and exercise strategies mentioned above.
Probiotics
Since we’re speaking of magical cortisol elixirs, the closest thing to a magical elixir I can think of is a probiotic supplement. But probiotics are actually better than magic because their efficacy can be explained and repeated in clinical research.
Probiotics for stress work by restoring gut health. Altered stress hormones (like cortisol) sometimes accompany poor gut health. Supporting the gut with probiotics not only improves, gut health but also helps modulate cortisol levels. The result is a more normal stress response and increased stress resilience 12.
Omega-3 fatty acids
Omega-3 fatty acids may also help reduce the effects of stress due to their anti-inflammatory properties 13. You can find omega-3 in foods like salmon, sardines, flaxseeds, and chia seeds. If you find it difficult to get enough omega-3 through diet alone, a good omega-3 supplement can be helpful and may help keep cortisol balanced. A recent study found that omega-3 supplementation had a protective effect when adults were exposed to stress. Adults took 2,500 milligrams of omega-3 daily for four months and were then tested with a stressful task. Compared to the placebo group, the omega-3 group had 13:
- Lower cortisol levels
- Reduced inflammation
- Less accelerated aging from stress
Tangeretin
One supplement you may not have heard of is tangeretin. Just like it sounds, it’s a compound derived from tangerines and other citrus peels. This supplement has been shown to significantly lower cortisol after about four weeks of use 14.
Adaptogenic Herbs
Ashwagandha and rhodiola, herbs used in the Ayurvedic tradition, have been shown to reduce stress and fatigue, respectively 15 16. Based on the available research, ashwagandha may be the most effective for lowering cortisol levels and reducing feelings of stress 17.
No Quick Fix
What you may be realizing after reading the suggestions I’ve laid out is that there’s no quick fix to balancing cortisol levels. The cortisol cocktail, while likely a delicious hydration method, is likely nothing more than that. If you’d like to reduce the negative symptoms associated with extreme or chronic stress, figuring out ways to improve your well-being through diet and lifestyle is much more likely to get you where you want to go.
Of course, behavior change never happens at the snap of a finger, but slow and steady wins the race. We are here to help. Contact our clinic for guidance on the best ways to reach your health goals.
The Ruscio Institute has developed a range of high-quality formulations to help our clients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you. The information on DrRuscio.com is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.
Dr. Michael Ruscio is a DC, natural health provider, researcher, and clinician. He serves as an Adjunct Professor at the University of Bridgeport and has published numerous papers in scientific journals as well as the book Healthy Gut, Healthy You. He also founded the Ruscio Institute of Functional Health, where he helps patients with a wide range of GI conditions and serves as the Head of Research.➕ References
Bibliography
- McCabe D, Lisy K, Lockwood C, Colbeck M. The impact of essential fatty acid, B vitamins, vitamin C, magnesium and zinc supplementation on stress levels in women: a systematic review. JBI Database System Rev Implement Rep. 2017;15(2):402–53. DOI: 10.11124/JBISRIR-2016-002965. PMID: 28178022.
- Thau L, Gandhi J, Sharma S. Physiology, Cortisol. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024. PMID: 30855827.
- Adam EK, Quinn ME, Tavernier R, McQuillan MT, Dahlke KA, Gilbert KE. Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis. Psychoneuroendocrinology. 2017 Sep;83:25–41. DOI: 10.1016/j.psyneuen.2017.05.018. PMID: 28578301. PMCID: PMC5568897.
- Hannibal KE, Bishop MD. Chronic stress, cortisol dysfunction, and pain: a psychoneuroendocrine rationale for stress management in pain rehabilitation. Phys Ther. 2014 Dec;94(12):1816–25. DOI: 10.2522/ptj.20130597. PMID: 25035267. PMCID: PMC4263906.
- Carvalho KMB, Ronca DB, Michels N, Huybrechts I, Cuenca-Garcia M, Marcos A, et al. Does the Mediterranean Diet Protect against Stress-Induced Inflammatory Activation in European Adolescents? The HELENA Study. Nutrients. 2018 Nov 15;10(11). DOI: 10.3390/nu10111770. PMID: 30445703. PMCID: PMC6266959.
- Shively CA, Appt SE, Chen H, Day SM, Frye BM, Shaltout HA, et al. Mediterranean diet, stress resilience, and aging in nonhuman primates. Neurobiol Stress. 2020 Nov;13:100254. DOI: 10.1016/j.ynstr.2020.100254. PMID: 33344709. PMCID: PMC7739065.
- Casas I, Nakaki A, Pascal R, Castro-Barquero S, Youssef L, Genero M, et al. Effects of a Mediterranean Diet Intervention on Maternal Stress, Well-Being, and Sleep Quality throughout Gestation-The IMPACT-BCN Trial. Nutrients. 2023 May 18;15(10). DOI: 10.3390/nu15102362. PMID: 37242244. PMCID: PMC10223296.
- Nakamura Y, Walker BR, Ikuta T. Systematic review and meta-analysis reveals acutely elevated plasma cortisol following fasting but not less severe calorie restriction. Stress. 2016 Jan 7;19(2):151–7. DOI: 10.3109/10253890.2015.1121984. PMID: 26586092.
- Li X, Yang T, Sun Z. Hormesis in health and chronic diseases. Trends Endocrinol Metab. 2019 Dec;30(12):944–58. DOI: 10.1016/j.tem.2019.08.007. PMID: 31521464. PMCID: PMC6875627.
- Björkman F, Ekblom Ö. Physical Exercise as Treatment for PTSD: A Systematic Review and Meta-Analysis. Mil Med. 2022 Aug 25;187(9–10):e1103–13. DOI: 10.1093/milmed/usab497. PMID: 34850063.
- Shiralkar VV, Jagtap PE, Belwalkar GJ, Nagane NS, Dhonde SP. Vandana V Shiralkar et al18Effect of Steam Sauna Bath on Fasting Blood Glucose Level in Healthy Adults. IJMB. 2018 Jun;22(1):18–21. https://www.researchgate.net/publication/326203347_Effect_of_Steam_Sauna_Bath_on_Fasting_Blood_Glucose_Level_in_Healthy_Adults
- Groeger D, Murphy EF, Tan HTT, Larsen IS, O’Neill I, Quigley EMM. Interactions between symptoms and psychological status in irritable bowel syndrome: An exploratory study of the impact of a probiotic combination. Neurogastroenterol Motil. 2023 Jan;35(1):e14477. DOI: 10.1111/nmo.14477. PMID: 36178333. PMCID: PMC10078522.
- Madison AA, Belury MA, Andridge R, Renna ME, Rosie Shrout M, Malarkey WB, et al. Omega-3 supplementation and stress reactivity of cellular aging biomarkers: an ancillary substudy of a randomized, controlled trial in midlife adults. Mol Psychiatry. 2021 Jul;26(7):3034–42. DOI: 10.1038/s41380-021-01077-2. PMID: 33875799. PMCID: PMC8510994.
- Liu M, Zhang Z, Qin C, Lv B, Mo S, Lan T, et al. Effects of 4-Week Tangeretin Supplementation on Cortisol Stress Response Induced by High-Intensity Resistance Exercise: A Randomized Controlled Trial. Front Physiol. 2022 May 19;13:886254. DOI: 10.3389/fphys.2022.886254. PMID: 35665223. PMCID: PMC9160924.
- Della Porta M, Maier JA, Cazzola R. Effects of Withania somnifera on Cortisol Levels in Stressed Human Subjects: A Systematic Review. Nutrients. 2023 Dec 5;15(24). DOI: 10.3390/nu15245015. PMID: 38140274. PMCID: PMC10745833.
- Olsson EM, von Schéele B, Panossian AG. A randomised, double-blind, placebo-controlled, parallel-group study of the standardised extract shr-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue. Planta Med. 2009 Feb;75(2):105–12. DOI: 10.1055/s-0028-1088346. PMID: 19016404.
- Tóth-Mészáros A, Garmaa G, Hegyi P, Bánvölgyi A, Fenyves B, Fehérvári P, et al. The effect of adaptogenic plants on stress: A systematic review and meta-analysis. J Funct Foods. 2023 Sep;108:105695. DOI: 10.1016/j.jff.2023.105695.
Discussion
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