Stress gets a bad rep, but the truth is, it serves a purpose. Feeling stressed can push us to finish a project by its deadline. It can remind us to wear a mask. In certain situations, it can even save our lives. But as any health expert will tell you, living in a perpetual stressed state of fight-or-flight is very detrimental to health—and it's directly tied to a hormone called cortisol.
"Cortisol is a fight-or-flight hormone that is outputted in times of stress and inflammation," says functional medicine dietitian and The Women's Guide To Hormonal Harmony ($30) author Lacey Dunn, RD. She explains that as the body perceives stress, the adrenal glands release cortisol, which causes heart rate and blood pressure to go up. Again, this isn't necessarily "bad," but when cortisol levels stay elevated for prolonged amounts of time, she says it can lead to a cascade of negative health consequences. "Cortisol and adrenal imbalance are the biggest demons to your health, happiness, and well-being," Dunn writes in her book. She says that chronically high cortisol levels can negatively impact your gut microbiome and digestive system, immune health, energy levels, and can decrease your insulin sensitivity, contribute to accelerated aging, and even invite feelings of anxiety and depression. Sooo, not great.
Harvard-educated doctor and author of Women, Food, and Hormones ($23), Sara Gottfried, MD, explains that stress isn't the only cause of perpetually high cortisol levels (though yes, it is a biggie). Not getting enough sleep or underlying health issues affecting the adrenal glands can cause cortisol levels to spike for a prolonged amount of time as well. Here's the good news, however: Dr. Gottfried and Dunn both say bringing balance to the body can absolutely be done, and no one has to live in a perpetual state of high cortisol. But before you know how to troubleshoot, it is important to know the signs of high cortisol.
Highs of high cortisol levels
Dr. Gottfried says that what's tricky about cortisol imbalance is that many people experience both too highs and too lows—often in the same day. "I'll have a patient who has cortisol levels that are too high when she first wakes up, then they dip too low in the afternoon," she says. "This happens because when the body is depleted of cortisol, it will try to make up for it by producing too much, and then you're stuck in this vicious cycle."
This is why she says if you feel your cortisol levels are out of whack, it's important to see your doctor who can check your cortisol levels through blood, saliva, or urine tests—ideally a few times over the course of a day since, to her point, cortisol levels can fluctuate. But there are some classic signs of high cortisol levels to watch for, which could (and should) in turn prompt consideration of a doctor's visit:
1. Feeling tired but wired
"The classic sign of high cortisol is feeling tired but wired," Dr. Gottfried says. If you feel exhausted but can't sleep for example, that's what she's talking about. "This is usually accompanied by a symptom of fatigue throughout the day," she adds. Dr. Gottfried previously explained to Well+Good that cortisol levels should bottom out around midnight, while you're asleep. “If your cortisol levels are still high while you're sleeping, your body can’t do the healing it needs," she says. "As a result, you wake up feeling fatigued, like you want coffee—which raises cortisol—and perhaps you have trouble recovering from exercise.” The cruel joke of it is that she says that not getting consistently good sleep—which she describes as between seven to eight-and-a-half hours a night—can contribute to high cortisol levels. It's a vicious cycle.
2. Brain fog
Dunn says if you experience brain fog or have trouble concentrating on a regular basis, it could be a sign that your cortisol levels are too high. This is because high cortisol levels can impair the prefrontal cortex—the region of the brain that controls most of our cognitive functions like decision-making and concentration.
3. Feeling perpetually on edge
You know that feeling of being on the verge of snapping but you can't pinpoint why? Yep, Dunn says it could be high cortisol. It makes sense when you think about it: High cortisol levels are an indication that you're in a state of fight-or-flight and the very essence of that state is being on edge.
4. Hair loss
Dunn also says that experiencing hair loss could be an indicator that there's something going on with your cortisol levels. This is because cortisol production triggers the body to produce an oily secretion called sebum and an overproduction of sebum can clog hair follicles.
5. High blood pressure
Another sign of high cortisol levels Dunn wants everyone to be aware of is high blood pressure. "When the fight-or-flight mode is activated and cortisol levels rise, we have an increase in blood pressure and heart rate, and blood vessels are constricted," she says. This is exactly why chronic stress levels can lead to heart problems.
Now that you know the signs of high cortisol, what can you do to bring balance to the body? Both experts offer up several habits to integrate below.
How to bring balance to the body
1. Get consistently good sleep
This tip can be a tricky one to implement since, as Dr. Gottfried explained, there is often a vicious cycle of poor sleep-high cortisol levels-repeat that needs to be broken. But she maintains that doing what you can on the sleep front is crucial. Establish an evening routine, invest in blackout shades, find a mattress you love—whatever will help you get those eight hours a night will help break the high cortisol-perpetually tired cycle.
2. Minimize stress
You knew this one was coming right? Besides sleep, it's the tip both Dr. Gottfried and Dunn underscore times 10. "Sometimes, people don't even realize they're stressed until their body sends the signal to them that they are; many people are so used to operating at a high-stress level that it's become their 'normal,'" Dunn says. Now that your body has sounded the alarm, it's time to do your part.
Not sure where to start? Try taking some deep breaths. "Diaphragmatic breathing, used in yoga, meditation, and tai chi, entails bringing air deeply into your lower and upper lungs," Dr. Gottfried says. "The relaxing and therapeutic form of breathing is also called abdominal breathing and has been shown to lower stress and cortisol." She adds that meditation or taking a warm bath are two other stress relievers to try, linked to lowering cortisol levels.
3. Work adaptogenic herbs into your daily routine
Adaptogenic herbs like ashwagandha, chaga, reishi, and lion's mane are starting to pop up in more places and Dunn is all for this since adaptogens are linked to bringing balance to the body, stopping the body from jumping into the fight-or-flight mode as easily. Even though Westerners are just starting to be aware of this connection, it's something that's been well-known for centuries in Ayurvedic medicine and Traditional Chinese Medicine.
4. Get your omega-3s
While omega-3s are always important for health, Dr. Gottfried says they are especially important when you're working to bring balance to your body. "People who took 4,000 milligrams of fish oil a day for six weeks lowered morning cortisol to healthier levels," she says, citing a study published in the Journal of the International Society of Sports Nutrition. Better yet, get your omega-3s through food: oily fish, walnuts, flax seeds, and chia seeds are all good sources.
"Orgasms can lower your cortisol levels and flood your brain with the happy neurotransmitter oxytocin," Dunn writes in her book. "Help your brain choose pleasure over stress."
While there is a lot you can do through food and lifestyle to keep your cortisol levels balanced, both experts emphasize that it's important to consult with a doctor and get your cortisol levels checked. And if you're cortisol levels are high, don't freak out—it's treatable. Don't stress over, you know, stress.
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