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The 5 Best Supplements to Reduce Cortisol and Manage Stress

Written by Dr. Michael Ruscio, DC on February 4, 2025

Written by Dr. Michael Ruscio, DC on February 4, 2025 — Reviewed by Hilary Watts

• High Cortisol|
• Cortisol Curves|
• 5 Supplements|
• Dietary Dos & Don’ts|
• Mind & Body|

Cortisol is a key stress hormone produced by the adrenal glands. As part of the body’s fight-or-flight response, cortisol influences everything from heart rate and blood pressure to mood and immune function 1.

Flatter cortisol levels that stay too high for much of the day have been linked to symptoms such as abdominal weight gain, depression, fatigue, and burnout. If these symptoms resonate with you, you might be interested in supplements that can help normalize cortisol and reduce stress. 

However, separating the truth from the hype around the best supplements to reduce cortisol—and how to manage cortisol in general—can be tricky.In this article, I’ll explain cortisol-lowering supplements and how I help my clients keep their cortisol levels in check.

What Is ‘High’ Cortisol?

The only medically recognized high-cortisol condition is Cushing’s syndrome, which causes very high cortisol levels. Cushing’s usually results from using steroids too much or when a growth on the pituitary gland or adrenal glands causes the body to make too much cortisol. Treatment is often medication or surgery.

In functional medicine—and throughout this article—the term ”high cortisol” differs from full-blown Cushing’s syndrome. It typically refers to cortisol levels that don’t go up and down as they should throughout the day.

Healthy Versus Abnormal Cortisol Curves

In a healthy cortisol rhythm, the level peaks in the morning to prepare the body for the day. Cortisol levels should then trend steadily down toward the evening, with mini spikes in response to daily stressors along the way. However, prolonged stressful situations may start to flatten the cortisol curve. This means that cortisol levels typically don’t rise much in the morning and tend to stay higher throughout the day. Flatter cortisol curves have been linked to poorer mental and physical health outcomes.

A meta-analysis (highest-quality type of study) found that flatter cortisol levels often occurred with 2:

• Inflammation
• Disrupted immune system responses
• Fatigue
• Cancer
• Obesity
• Feelings of self-hatred and becoming withdrawn
• Aggression
• Depression 

The study couldn’t say whether the symptoms were definitely cortisol-related, or which came first: the symptoms or the disrupted cortisol level. 

But the links suggest that the cortisol curve could be worth examining when any of those symptoms or conditions are present.

5 Supplements to Reduce Cortisol

Science-backed supplements that may help keep cortisol levels in check include: 

• Probiotics
• Omega-3 fatty acids
• Tangeretin
• Adaptogenic herbs
• Magnesium 

Most people won’t notice benefits from more than one or two of these supplements. It’s ideal to work with a healthcare professional to find what supplements work best for you and your circumstances. 

As I’ll discuss in a later section, a healthy diet and supportive lifestyle changes should form the foundation of any plan to normalize cortisol. But first, let’s see what the research says about supplements.

1. Probiotics

Probiotics might not be the first supplement you think of for cortisol-related symptoms. But they can help restore normal stress responses and cortisol levels. This is because altered stress hormones, including cortisol, are often byproducts of poor gut health. 

Probiotics can work in a variety of ways to improve gut health and adjust cortisol levels 3. Taking a quality probiotic can thus help to restore a healthier stress response and increase stress resilience.

For example, in a randomized controlled trial (gold-standard experimental study) involving stressed-out students during exam season, one group took multi-strain probiotics and another group took a placebo.

The researchers found that the students who received the probiotics 4: 

• Had a reduction in cortisol levels 
• Felt less stressed 
• Were less prone to depression and anxiety 

In this study, the probiotic group took a Lactobacillus/Bifidobacterium probiotic and the soil-based probiotic, Bacillus coagulans.

At the clinic, we’ve also found that multistrain probiotics work best, but we usually enhance them by adding a third probiotic. Along with a Lacto/Bifido blend and a soil-based probiotic, we include the beneficial yeast, Saccharomyces boulardii.

A triple-therapy probiotic regimen like this is available in these convenient powder sticks that don’t require refrigeration.

2. Omega-3 Fatty Acids

Omega-3 fatty acids are the beneficial fats abundant in oily fish. They’re known for their anti-inflammatory properties and may also help balance cortisol levels.

A randomized controlled trial tested the effects of omega-3 supplements on stress responses, including cortisol levels and stress reactivity 5.

Participants were divided into three groups: One took a high dose of omega-3s, another took a lower dose, and the third group took a placebo. 

After 4 months, those taking omega-3s while under stress had:

• Lower levels of cortisol
• Lower IL-6 (an inflammation marker)
• Higher levels of telomerase (an enzyme that helps repair cells)
• Higher IL-10 (an anti-inflammatory substance) 

The group that took the higher dose of omega-3s had the greatest benefits.

In another randomized controlled trial, nurses who received omega-3 supplements for 8 weeks saw their cortisol levels decrease more than did nurses who took a placebo 6. The omega-3 group also had less burnout and emotional exhaustion.

3. Tangeretin

Tangeretin is a plant chemical found in citrus fruit that is known for its antioxidant properties.

A randomized controlled trial investigated the effects of tangeretin on the cortisol stress response in soccer players 7.

For 4 weeks, the athletes took 200 mg per day of tangeretin or a placebo. Multiple blood samples taken before and after they did high-intensity resistance exercises showed that the tangeretin group had: 

• Significantly lower levels of cortisol and ACTH (the hormone that stimulates the adrenal glands to release cortisol), especially after working out
• Higher antioxidant power after exercise 
• A lower white blood cell count after workouts, suggesting the tangeretin had inflammation-calming effects and possibly shortened their recovery time

4. Adaptogenic Herbs

Adaptogenic herbs have the reputation of ​​bringing the body back into balance by helping us adapt to both physical and mental stressors.

Rhodiola (Rhodiola rosea) is one such herb. In a randomized controlled trial involving patients with burnout and fatigue, those who took 576 mg of Rhodiola extract per day showed significant improvements. After a month, their waking cortisol levels were better regulated, fatigue symptoms decreased, and concentration improved compared to the placebo group 8.

Ashwagandha is another adaptogenic herb that appears to have a stress-reducing effect. A systematic (methodical) review of multiple studies found that taking anywhere from 60 to 5,000 mg per day reduced cortisol secretion 9. The study said Ashwagandha is safe to use for up to 3 months but could cause problems with longer use.

5. Magnesium

Several studies suggest that the mineral magnesium—which is often low in people—plays a role in the way the body handles stress and regulates cortisol levels.A systematic review looked at studies to see how magnesium affected people with anxiety related to high blood pressure, premenstrual syndrome (PMS), and having just had a baby. The review found that taking 75 to 360 mg/day for 6 to 12 weeks improved mild anxiety and PMS 10.

Are Supplements Enough to Support Cortisol? 

While probiotics, omega-3s, herbs, and magnesium may be helpful supplements to reduce cortisol, a healthy diet and lifestyle should form the basis of any cortisol-balancing plan. At the clinic, we begin with diet and lifestyle. 

The Dos and Don’ts of a Cortisol-Friendly Diet

There’s no specific diet that is best for controlling cortisol levels and stress, but there are some helpful general principles to bear in mind.

Do… Eat to Nourish the Microbiome

Taking probiotics can have big positive effects as long as the diet supports a healthy and diverse microbiome. This generally means eating more high-fiber, plant-based foods, which feed gut bacteria 11.

I recommend increasing fiber intake gradually, especially for my clients who get IBS-type symptoms, like gas and bloating. For more persistent gut issues, trying a low FODMAP diet under supervision can help people identify their tolerance for specific high-fiber foods.

Dietary polyphenols—found in high quantities in berries, cocoa, green tea, and spices—also positively influence the microbiome 12. 

Incorporating fermented foods (like sauerkraut, kombucha, and kimchi) can further nourish good gut bugs 13. Be cautious, though: Fermented foods are high in histamine and may not be suitable for those who are sensitive to it.

Don’t… Shun Carbs

While maintaining good blood sugar balance (which means reducing refined carbs) is important, cutting healthy carbs too drastically can be counterproductive. 

Research in women carrying too much weight found that including more whole-grain carbohydrates in a balanced diet may lower circulating cortisol and reduce stress-related spikes in cortisol 14. 

Do… Eat an Anti-Inflammatory Diet

Having chronically high cortisol levels can suggest high inflammation, but an anti-inflammatory diet can counteract it. An anti-inflammatory diet will usually have these hallmarks:

• A low glycemic load (less fast-release sugar and refined carbs, more whole-food carbs, like whole grains and legumes)
• Low levels of saturated fat (think fatty or processed meats) and trans fats (think deep-fried or ultra-processed foods)
• High levels of vitamins, minerals, and phytochemicals (like in nuts, berries, and vegetables)
• Lots of fiber
• Little or no alcohol

Don’t… Cut Calories Too Much

Similarly, severely cutting calories is not a good strategy for managing cortisol levels. A meta-analysis showed that people’s cortisol levels rose sharply during the early stages of following low-calorie diets 15. Fasting caused the most substantial increase in cortisol levels. 

Do… Follow the Mediterranean Diet

So, what kind of diet meets all these criteria? An unprocessed Mediterranean diet does. It features fruits, veggies, fish, and whole grains, and research suggests it’s good for managing cortisol. 

In one study involving over 200 teenagers, researchers found that those who ate a Mediterranean diet had lower cortisol levels than teens who didn’t 16. And a study on pregnant women found that the Mediterranean diet may lower stress and improve sleep, well-being, and cortisol regulation 17. 

Key Lifestyle Changes to Support Cortisol Levels

Mind-body therapies are practices that integrate mental and physical activities to help manage stress and enhance overall health.

Meditation and CBT

Meditation may reduce blood pressure and cortisol, which are “stress indicators” that can go up during times of stress. 

In one randomized controlled trial, people with moderate to high daily stress engaged in mindfulness-based stress reduction (MBSR) and cognitive behavioral therapy (CBT). These therapies led to 18:

• Reduced salivary cortisol levels
• The ability to handle a stressful task better than before 

Moderate Exercise 

Moderate exercise, like zone 2 training that lets you hold a conversation, is excellent for building stress resilience. It reduces pro-inflammatory chemicals and promotes anti-inflammatory ones 19, helping to protect the body from stress-induced inflammation.

Physical activity is also generally good for the brain and overall health. However, pushing yourself too hard when you’re fatigued can backfire. Too much intense exercise might lead to burnout, worsening the symptoms you’re trying to manage.

The key is to listen to your body and be mindful of your mental health. If more vigorous exercise feels good, go for it in moderation. But starting with a 10–30-minute daily walk is a great way to ease into building up a routine.

Cortisol Supplements in Context

When working to balance cortisol and manage stress and fatigue, certain supplements can be helpful. However, they are most effective when combined with more fundamental lifestyle changes that have a deeper impact on overall health.

When our clients face cortisol-related fatigue and chronic stress, we always start with essential changes in diet, stress management, and exercise. We typically add in probiotics, and we’ll sometimes use omega-3s, adaptogenic herbs, or magnesium when people need more. This holistic approach addresses flattened cortisol slopes more effectively than supplements alone.

Adopting a similar strategy could be helpful for symptoms that suggest disrupted cortisol, but it’s important to consult your doctor to find the best approach for your specific needs. Alternatively, you can connect with one of our experienced practitioners or explore more in-depth information on gut health in my book, Healthy Gut, Healthy You. 

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.