We know that stress increases levels of the hormone cortisol in the body. But is the opposite true? Does reducing cortisol reduce stress? And can you lower cortisol levels—and perhaps stress—with supplements? Cleveland Clinic endocrinologist Divya Yogi-Morren, MD, says it is much more complicated than that.
Cortisol is a hormone, a chemical messenger. The pituitary gland in your brain sends out the chemical messenger adrenocorticotropic hormone (ACTH) to regulate your body’s cortisol levels. Example: If you were being chased by a lion, your body would go into its fight-or-flight mode, and the pituitary gland would send a burst of ACTH to your two adrenal glands, one on top of each kidney, where cortisol is made, stored and released. The extra cortisol flows through your blood to pump up your heart and blood pressure and release sugar for energy. But that extra cortisol is needed only until you get away from the lion. That type of short-term stress is called acute stress. The problem is when levels of stress and cortisol stay high for too long, potentially causing chronic inflammation, cardiovascular disease and high blood pressure over time.
Cortisol is important for many functions—it helps manage your body’s use of energy from foods, blood sugar and blood pressure…and even your sleeping and waking times. So your pituitary gland walks a tightrope to keep cortisol at the right level. Cortisol levels fluctuate during the day. They go up in the morning to help you get going…and down in the evening to help you rest and sleep.
When cortisol levels just aren’t right: Your health-care provider may order tests to determine if your levels of cortisol are too high (Cushing’s syndrome) or too low (Addison’s disease). Symptoms of high cortisol include weight gain and fat redistribution, hypertension, hyperglycemia (abnormally high blood glucose levels), changes to the skin, muscle weakness and more. Symptoms of low cortisol include fatigue and weakness, weight loss, hypotension (low blood pressure), salt cravings, and nausea, vomiting and abdominal pain. Both conditions are dangerous and need to be treated…and the diagnoses are complex and require multiple blood tests along with a 24-hour urine test (which evaluates various substances in urine collected over an entire day), which offers a more precise assessment of kidney function, hormone levels and metabolic processes than a single urine sample.
The best way to lower cortisol levels caused by stress is to avoid or learn how to control stress. One of the best ways to do that is with mindfulness-based stress reduction, a type of meditation. Mind-body exercises such as Tai chi and yoga also are effective…as well as getting a good night’s sleep. In severe cases, you may need the help of a mental health practitioner to identify your stressors and learn the best ways to manage and avoid stress.
There hasn’t been enough scientific evidence to say that herbal supplements are a safe and/or effective way to lower cortisol levels and therefore stress. But there is some research that supports safer supplement options including nutrients, vitamins and omega-3 fatty acids…
Lutein and zeaxanthin: These natural plant pigments are strong antioxidants that help fight inflammation and are recommended for eye health. Studies from researchers at University of Georgia suggest that these nutrients, called carotenoids, can help regulate high cortisol levels caused by stress. The best sources of lutein and zeaxanthin are green leafy vegetables, egg yolks, peppers and sweet yellow corn, but supplements are available. While lutein and zeaxanthin may help lower cortisol through anti-inflammatory and mitochondrial-supporting mechanisms, there is no established clinical dose specifically for cortisol reduction. Standard dosages of 10 mg of lutein and 2 mg of zeaxanthin daily may offer indirect benefits. More research is needed to confirm the effects on cortisol regulation.
Vitamin C: A recent study published in Stress and Health found that vitamin C supplements could lower high cortisol levels caused by chronic stress. People with higher levels of vitamin C may have fewer mental and physical signs of stress when under acute stress, and they seem to bounce back more quickly after a stress reaction. The best way to get more vitamin C is by adding citrus fruits…red, yellow and green peppers…and other fruits and vegetables to your diet. Vitamin C supplements are another option. Vitamin C supplementation at 1,000 mg to 1,500 mg a day appears to effectively lower cortisol levels and reduce stress responses.
Vitamin B: B vitamins, especially B-12, have been studied for stress and cortisol reduction. A review of 11 articles in the journal Nutrients found benefits of B vitamin supplementation for people at risk from stress. You also can get vitamin B from grains, fish, vegetable, eggs and dairy foods. B-vitamin supplementation, particularly B-6, B-9 (folic acid) and B-12, has been shown to reduce stress and modulate cortisol levels. Dosages of 40 mg to 100 mg of B-6…400 mcg to 800 mcg folate…and 500 mcg to 1,000 mcg B-12 per day appear to be effective, with high-dose B-complex formulations showing the most consistent benefits in clinical trials.
Fish oil: Omega-3 fatty acids are probably the best-studied supplements for stress reduction. Omega-3s, healthy fats found in found in cold-water fish, also are available as supplements. With these, you can kill three birds with one stone—omega-3s support cortisol health, cardiovascular health and cognitive health. Omega-3 fatty acid supplementation, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), has been shown to reduce cortisol levels and improve stress regulation. A dose of at least 500 mg EPA and DHA daily, with higher doses (1,500 mg to 3,000 mg) for stronger effects, is recommended for optimal stress and cortisol management.
