Maintaining Natural Cortisol Balance
According to the American Psychological Association’s recently completed Survey of Stress in America, three out of four Americans routinely experience stress related headaches, upset stomachs, muscle tension, teeth grinding, and dizziness.
Almost as many Americans, 73 percent, have stress-related psychological symptoms, including irritability, anger, nervousness, lack of energy, and feeling on the verge of tears. Nearly half of those surveyed, 49 percent, were kept awake at night, losing on average of 21 hours of sleep each month due to stress. And one third of American adults report they feel extremely stressful most days of the month.1I am going to share natural ways to reduce the effect stress has on your health. We’ll talk about the plant medicines ashwagandha, magnolia extract, Epimedium koreanum, the amino acid L-theanine, and the nutrient phosphatidylserine and how they can help you feel less stressful and more energetic during the day, and help you sleep more soundly at night – without giving you a morning “sleep hangover”.
While smoking, drinking alcohol, and overeating may temporarily ease stressful feelings, these stress-busting supplements can reduce and even eliminate many physical and psychological symptoms of stress – simply by helping your body more effectively regulate its production of cortisol. And managing cortisol levels not only eases stress, but it also helps reduce the risk of heart disease, diabetes, obesity, and a whole host of other chronic conditions.
What exactly is cortisol?
Cortisol is a hormone made in the adrenal gland, the same gland that makes adrenaline. While both adrenaline and cortisol help us during times of stress, they work in very different ways. Adrenaline, the fight-or-flight hormone, is fast acting. If our home’s smoke alarm goes off at 2:00 in the morning, adrenaline is pumped into our blood stream to make our heart and lungs work faster, and puts our muscles and our brain on high alert. Within fractions of a second, adrenaline gets us up and out of a burning house.2
Cortisol, on the other hand, is slower acting. Regulated by a feedback control mechanism between the brain and the adrenal glands, cortisol helps the body recover from the rush of adrenaline. Because the fight-or-flight response uses huge amounts of available energy, cortisol releases stored sugar and fat to refuel the heart, lungs, and legs.2,3
How is cortisol linked to stress-related health problems?
It sounds like we actually need cortisol. We do! We could not live without it. But when cortisol is released in response to every day unrelenting stress, it can hurt our health much more than help it. This chronic cortisol production occurs when we worry about our children, our jobs, or those endless “to do” lists. The cortisol in our blood stream swings into action, causing inflammation in our blood vessels, kidneys, and heart, trying to help us recover from the effects of adrenaline. The longer this unneeded inflammation is present, the more damage it can do.2
Several serious health problems are directly linked to widespread inflammation, including:
- High blood pressure
- High cholesterol
- Heart attacks
- Kidney failure
Unfortunately, in our modern day society, these everyday stresses are always present. Try as we might, none of us can completely switch off our worries or eliminate stress. But, if we can get at least eight hours of sleep we might be able to eliminate or reduce the chronic cortisol production and prevent much of the harm it does to our bodies.4
How can sleeping for eight hours do all that? What does sleep have to do with cortisol?
While cortisol is made in the adrenal glands, its production is controlled by the brain. Its levels naturally rise and fall at different times of day, regardless of stress. Cortisol levels tend to be greater in the morning than at night. However, when we are sleep deprived, cortisol levels rise, negatively affecting our sleep patterns and making it difficult to fall or stay asleep when we finally do go to bed.3 This altered sleep cycle requires several days to weeks for the body and cortisol levels to adjust.2
What’s more, cortisol levels are not affected by how much sleep you get, only by the hour at which you arise. Researchers at London’s Westminster University examined cortisol levels in 42 healthy adults at waking times that ranged from 5:22 a.m. to 10:37 a.m. over a two-day period. People who woke earlier tended to have higher concentrations of cortisol during the first 45 minutes of their day. While the early risers enjoyed some advantages, such as greater powers of concentration, the early birds also reported more anger at the end of the day. Those participants who woke later had lower cortisol levels and were more leisurely and less stressed.5
Most people that I know are lucky to get six hours of sleep at night. Do we really need eight full hours?
Yes, we do! Our great-grandparents would be appalled at the measly amounts of sleep we’re getting each night. Before the late 1800s, and the appearance of electric lights, people generally went to bed when the sun set and woke with its rising. Which meant, that in the dark days of winter, our ancestors were sleeping 10 to 12 hours each night! 6 For those of us living in the 21st century this amount of sleep sounds almost decadent (and a little slothful). But, the evidence is clear - eight hours of sleep should not be viewed as a luxury, but as a medical necessity!
How can the cortisol-lowering supplements help?
Cortisol is made in the adrenal glands, so keeping these glands wellnourished is important. One way to accomplish this is with the plant medicines ashwagandha and magnolia, the amino acid l-theanine, and phosphatidylserine - a nutrient clinically proven to reduce cortisol levels and decrease feelings of stress, too.7-9
Ashwagandha (Withania somnifera) has been used for over 3,000 years to relieve stress, nourish the nervous system, and restore adrenal gland function. Native to India, ashwagandha also improves mood, reduces anxiety, increases energy, and reduces corticosterone, a hormone that’s very similar to cortisol. 10-11
L-theanine is an amino acid known to reduce stress by helping muscles relax. It also increases the concentration of certain neurotransmitters, including serotonin and dopamine that help people fall asleep.12 Magnolia extract has been clinically shown to increase relaxation and enhance stress reduction. In a study, 78 percent of the participants rated magnolia extract as “highly effective” in making them feel relaxed; 74 percent felt that magnolia helped them have deep restorative sleep withoutmaking them feel groggy in the morning.13 The plant extract Epimedium koreanum helps the brain stay alert when it should and helps it relax when it can.14
Have the cortisol-lowering nutrients been clinically studied?
Indeed they have. Researchers recently recruited voluteers to determine what effect these nutrients had on sleep, stress, and the subjects’ cortisol levels. They divided the subjects into two groups. The first group completed an anxiety self assessment questionnaire, obtained samples of their own saliva (five times during the study and five times throughout each sample day) and then took the supplement right before going to bed. The second group also completed the anxiety questionnaire and took the supplement before bed, but they did not collect their saliva. Both groups did this for 28 days.
At the end of the study:
- 71% of the participants felt more relaxed during the day
- 71% experienced a better night’s sleep
- 64% slept more soundly
- 57% fell asleep easier
- 57% felt less stressed
- 57% felt they could handle stress better
- 35% felt less worried
When the saliva samples were tested, salivary cortisol levels decreased by approximately 61 percent after the first dose and remained lower the remainder of the study. There were no side effects and the product was well tolerated. Unlike with other sleep products, the participants reported that they woke feeling refreshed and not groggy.15
What should I do if I suspect my cortisol levels are elevated?
Because other health problems can cause similar symptoms you need to begin with your doctor. As cortisol naturally rises and falls during the day, distinguishing normal from abnormally low or high cortisol levels can be difficult. That’s why most doctors recommend obtaining several different sample collections in a 24-hour period.
I read that cortisol levels can be measured in saliva. Is this true?
Yes. When cortisol is chronically elevated, it makes its way into a variety of tissues, including the tongue, cheek, and soft palate of the mouth.2 This means that saliva is an ideal medium to measure cortisol levels. Controlled collection times allow for accurate baseline testing and the effective monitoring of treatments. Patients can even collect their own saliva samples at home or at work. The first sample is taken one hour after getting up in the morning, followed by three more samples spaced four hours apart. Studies have consistently shown that cortisol levels in both normal and stressed people vary throughout the day with levels typically dropping dramatically from the morning to the afternoon. Salivary cortisol levels for men and women range from 1.0 nanograms/per milliliter to 8.0 ng/ml in the morning; and from 0.1 ng/ml to 1.0 ng/ml in the afternoon.16
What other benefits can I receive from managing cortisol levels?
How does weight loss, diminished food cravings, reduced “emotional” eating, increased morning energy, clearer skin, fuller hair, better healing, and less colds and flu sound? Because chronic cortisol secretion can cause numerous symptoms, putting a halt to elevated cortisol often makes people feel much better, fairly fast.2,3
There’s an old Irish proverb that claims a good laugh and a long sleep are the best cures in the doctor’s book. More than mere beauty treatment, a good night’s sleep is the answer to chronic cortisol production and the headaches, upset stomachs, teeth grinding, and irritability that accompanies it. Taking ashwagandha, magnolia extract, Epimedium koreanum, Ltheanine, and phosphatidylserine can help you to wake up refreshed and ready to take on the day!
- American Psychological Association. 2007 Stress in America Survey. Accessed on November 16, 2007. Available at: http://apahelpcenter.mediaroom.com/index.php?s=pageA.
- Porth CM. Cortisol and stress. Pathophysiology: Concepts of Altered Health States. 7th ed. Philadelphia, Pa: Lippincott; 2004:542-567.
- Guyton AC, Hall JE. Cortisol production. Textbook of Medical Physiology.11th Ed. Philadelphia, Pa: W.B. Saunders Company; 2005: 1213-1231.
- Trenell MI, Marshall NS, Rogers NL. Sleep and metabolic control: waking to a problem? Clin Exp Pharmacol Physiol. 2007;34:1-9.
- Edwards S, Clow A, Evans P, Hucklebridge F. Exploration of the awakening cortisol response in relation to diurnal cortisol secretory activity. Life Sci. 2001;68:2093-103.
- Gibbs N. One day in America. TIME. 2007:170;22:36-50.
- Hellhammer J. Effects of soy lecithin phosphatidic acid and phosphatidylserine complex (PAS) on the endocrine and psychological responses to mental stress. Stress. 2004 Jun;7(2):119-26.
- Monteleone P. Effects of phosphatidylserine on the neuroendocrine response to physical stress in humans. Neuroendocrinology. 1990 Sep;52(3):243-8.
- Benton D. The influence of phosphatidylserine supplementation on mood and heart rate when faced with an acute stressor. Nutr Neurosci. 2001;4(3):169-78.
- Sankar SR, Manivasagam T, Krishnamurti A, Ramanathan M. The neuroprotective effect of Withania somnifera root extract in MPTP-intoxicated mice: An analysis of behavioral and biochemical varibles. Cell Mol Biol Lett. 2007 Apr 6; [Epub ahead of print]
- Sudhir S, Budhiraja RD, Miglani GP, Arora B, Gupta LC, Garg KN. Pharmacological Studies on Leaves of Withania somnifera. Planta Med. 1986;52:61-3.
- Berliner S. An introduction to amino acids. Adv Nurse Pract. 2006;14:47-8,82.
- Kuribara H. The anxiolytic effect of two oriental herbal drugs in Japan attributed to honokiol from magnolia bark. J Pharm Pharmacol. 2000 Nov;52(11):1425-9.
- Unger M. Botanical sedatives. Pharm Unserer Zeit. 2007;36(3):206-12.
- A proprietary in-house open-label pilot study of the safety and effectiveness of a cortisol-reducing combination supplement in healthy adults. Unpublished study. June 6, 2006.
- Melamed S, Ugarten U, Shirom A, Kahana L, Lerman Y, Froom P. Chronic burnout, somatic arousal and elevated salivary cortisol levels. J Psychosom Res. 1999 Jun;46(6):591-8.
About the author
Dr. Holly Lucille is a nationally recognized licensed Naturopathic Physician, author and educator. She graduated from the Southwest College of Naturopathic Medicine in Tempe, AZ where she received the prestigious Daphne Blayden Award and is the past president of the California Naturopathic Doctor’s Association.