High cortisol levels are wreaking havoc on your health. Here’s how to get fatigue and forgetfulness from too much ‘stress hormone’ under control

This is called a “fight-or-flight” response, honed over many centuries in response to stressful situations. It works like this: When threatened, our bodies release a hormone called cortisol which allows us to remain on high alert. When the threat passes, our cortisol levels drop.

While cortisol is also responsible for our circadian rhythm and in part influences how much energy we have throughout the day, it is often called the “stress hormone” because of the role it plays in managing the body’s response to acute stressors.

“Cortisol is one of the steroids produced by the adrenal gland,” says Dr. Irina Bancos, associate professor of medicine division of endocrinology, ,etabolism and nutrition, and Adrenal Lab principal investigator at the Mayo Clinic. “Stress leads the pituitary gland to produce higher amounts of ACTH (corticotropin) that travels to the adrenal glands and communicates that cortisol needs to be produced.”

These stressors can be environmental, such as a potential car accident, or anticipatory, says Jeanette M. Bennett, Ph.D., associate professor, psychological studies at the University of North Carolina, Charlotte, such as preparing to speak in public or to have a difficult conversation with a boss or spouse.

“There is usually a sweet spot,” she says of cortisol levels in the body, “a range that’s heathy or helps our bodies function successfully.”

The problem is when cortisol levels are consistently too high, which can put you at risk of a host of health conditions including high blood pressure, a high heart rate and high blood glucose levels, says Bennett. One may feel fatigued, experience poor sleep, get sick more often and experience cognitive changes such as increased forgetfulness. Chronic stress is often the culprit.

“In the past, stressors were life or death, such as running away from a tiger or lion or doing battle with another tribe,” says Bennett. “Today, though, our bodies can still have that same biological response to everyday stressors. That’s where we need to work on how to mitigate and minimize the engagement of that biological stress response because more of the time it is not needed to manage the situation we are in.

How to lower cortisol levels

Blood, urine and saliva tests can detect high cortisol levels.

If your levels are found to be high, you first want to rule out whether or not you have an adrenal tumor producing cortisol, says Bancos. These tumors may be benign or malignant, and can contribute to Cushing’s Syndrome, a metabolic disorder than can result in weight gain, a moon face, high blood pressure, thirst and increased urination.

“If your cortisol is high due to lifestyle factors,” says Melissa Groves Azzaro, RDN, LD, owner of The Hormone Dietitian, “then you need to work on not only what’s causing your stress but also managing your response to stress. I think when people think about stress they tend to focus on external sources of stress like work, family, finances, but not so much on the internal sources that can contribute just as much to adrenal dysfunction.”

Watch what and when you eat

In addition to eating balanced meals, Azzaro urges her clients to maintain healthy consumption habits.

“Skipping meals or going too long without eating can add stress to the body,” she says. “Riding the ‘blood sugar rollercoaster’ all day by restricting and then binging is stressful to the body. “Keeping caffeine to no more than 200 mg a day and not consuming caffeine after noon is important, but also other things we “consume” like watching the news or scrolling social media before bed can stress the adrenals and result in higher cortisol production. Alcohol can also contribute to stress and inflammation in the body.” 

Get enough sleep and exercise

Both Bennett and Azzaro underscore the importance of consistent good sleep and exercise.

Studies have shown that poor sleep quality can lead to higher stress levels, making it more difficult to handle daily stressors and regulate emotions.

Aim for seven to eight hours a night, says Bennett. Sleep habits are also important. These include going to bed and waking at the same time each day, sleeping in a quiet, dark, cool room, removing devices from the bedroom and taking a break from them before bedtime, and avoiding caffeine and alcohol before bed, according to the U.S. Centers for Disease Control.

Exercise is also helpful in reducing stress levels, and has the added benefit of stabilizing mood, and improving sleep and self-esteem, according to the Anxiety and Depression Association of America. 

While the Physical Activity Guidelines for Americans calls for 150 minutes of moderate-intensity physical activity and two days of muscle-strengthening activity spread out over a week, Bennett says that may not be an option for folks just starting to exercise.

“Anything that gets your body moving is good,” she says. “That can be walking, or doing yoga, may be going for a bike ride, or parking further from the store or work and walking the parking lot.”

For folks already physically active and in high-stress situations, “then you need to add in other forms of stress management such as meditation or expressive writing,” she says, “reaching out to a therapist or finding someone you can talk with to address things you are struggling with and things and what might be triggering the anxiety.”

Change your thinking

Bennett says that in some cases finding ways to cognitively approach stress can help some folks gain control over the situations causing them angst and reduce the hold these stressors have over them.

“Find meaning,” she says. “If you’ve gotten yourself into a situation that may be overwhelming or unbearable, ask yourself what motivated you to get in the situation in the beginning. This should help you refocus on the why, or meaning for you, when you initially got involved or decided to do XYZ. If you can regain your control over the situation you can control your emotional or psychological response to it, even if you can’t control the situation or outcome. It could help calm down the body and mind.”

Practice self-care

Azzaro says that in addition to curtailing bad habits that might be contributing to your daily stressors, focus on things “that fill us up.”

“This is different for everyone,” she says, “but some ideas are reading for fun, music, gardening, learning a new skill, and spending time with those we love. Increasing oxytocin, which we make when hugging those we love, including our pets, is a quick hack for lowering cortisol and improving stress overall.”

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