Updated: Apr 5
By Dr. Shawna Darou, ND
Cortisol is an extremely important hormone for women’s health, and as discussed in last week’s article, all of your hormonal systems are interconnected so a change in stress hormones can impact your thyroid function, blood sugar regulation, weight and body fat distribution as well as your reproductive hormone balance and fertility. Quite simply, when cortisol is out of balance you can feel very unwell – tired, moody, achy, anxious, and it can increase risk of many health issues whether it is too high or too low.
Cortisol is a hormone produced by the adrenal glands, two small endocrine organs that sit on top of your kidneys. Optimally, cortisol has a daily rhythm: highest in the morning, coming down in the afternoon, and lowest overnight. Cortisol responds to our day-to-day stresses, and over time the cortisol rhythm can shift.
In this article I will just talk about the signs of chronic high cortisol and chronic low cortisol, although there are some other patterns and rhythms that can happen, for example low in the daytime and high at night, or a flat cortisol rhythm. With these patterns, we typically see a combination of both set of signs and symptoms.
Signs of Chronic High Cortisol:
Central abdomen weight gain
Insomnia, difficulty falling asleep, poor sleep quality
Increased blood pressure
Osteoporosis / osteopenia (especially with high cortisol at menopause)
More infections / illnesses
Muscle loss (increased protein breakdown)
Signs and Symptoms of Chronic Low Cortisol:
Fatigue with apathy and lack of motivation
Poor tolerance for stress and easy overwhelm
Depression, worse in the evening
Craving salty foods
Needing more hours of sleep, but poor quality
Low blood sugar episodes
Low blood pressure
Dizziness on standing up quickly
Slow healing of cuts, and slow recovery from illness
In both cases, when the adrenal system is not working optimally, we can see signs in your menstrual cycle, for example: low progesterone, short or long cycle, heavier periods, irregular ovulation, difficult fertility, early menopause. It’s important to note that with all signs of hormone imbalance, we need to address stress and check cortisol levels.
What affects cortisol levels?
Basically cortisol is affected by prolonged periods of high stress. Initially the cortisol level will be too high – this phase can last for months or years depending on how your body adapts. Over time, the cortisol drops as the body attempts to slow down and reduce the experience of stress. Stresses come in many forms, and it’s important to remember that physiological stressors as well as mental emotional stressors cause changes in cortisol. For many of us, there are several layers of stresses and they stack up to create a bigger stress response in the body. Here are some of the factors that affect your cortisol response:
Mental / emotional stresses
Lack of movement
Blood sugar instability
Lack of sleep
(Stay tuned for an upcoming article with more details about body stresses).
How do we deal with cortisol levels?
After reading this article, you’re probably feeling like you have some issues with cortisol. We live in a go-go-go society, and the non stop pace plus physiological stresses do impact most of us. As with most hormonal conditions, the starting point is lifestyle: taking a look at how you are living your life and what is contributing to the imbalance. If stress appears to be taking a significant toll on your health, I would recommend first testing cortisol levels to confirm (blood or saliva testing depending). From here, we can provide additional support with adaptogen herbs, nutrients for adrenal function or supplements to help lower the cortisol response. What is even more important is to take a close look at the stresses that got you into this place, and address them. Here are the steps to follow:
Step 1: Reduce stresses
First take a look a the list above – are there any stresses that are easier to correct? For example, overly-intense exercise, not enough sleep, eating irregularly? Start here. The lower the load of stresses, the more your body can adapt.
Step 2: Build in relaxation and downtime
Your body needs regular rest and downtime in your day, week and year to keep your hormonal systems and health in balance. In this age of super-productivity, it’s important to note that the only time your body recovers and repairs is when you rest. Try this simple mental reframe to help prioritize regular breaks: downtime is productive for your health.
From here, book in small breaks into your workday. Allow for some evenings off, try to resist the urge to over-schedule your life.
Step 3: Focus on lifestyle
All of the regular self-care habits help with your stress response too:
Getting enough sleep (less than 6 hours per night turns on a stress response and negatively affects blood sugar regulation).
Eating well, and especially eating regularly to keep blood sugar levels stable. Minimize foods made with white flour and sugar.
Reducing caffeine and alcohol. Caffeine turns on your stress response, and makes it easier to push through fatigue. Alcohol interrupts sleep quality, making it harder to rest and repair.
Stay active, but don’t overdo the intensity and duration if you’ve got a high baseline of stress. Remember that intense workouts and very long workouts are additional stresses on your body. These are great if your baseline stress is optimal, but can tip you over into a stress response if you also have other sources of stress.
Respect your personal needs for a balance between social connection and alone-time. We all recharge in different ways!
If you would like to learn about how to support your stress hormones and cortisol levels better, or are interested in testing please book in for an appointment. This can make a profound impact on your feelings of health and wellbeing.