Health

Cortisol – What it Does and How to Maintain Healthy Levels

Evidence Based Article 📄
This article has been based on relevant and up-to-date scientific studies. Our writers are unbiased and objective and present the facts as they are known. Numbers in brackets within the article refer to sources included in the reference list at the end of the article.

What is Cortisol?

Cortisol is a hormone (chemical messenger) produced by the adrenal glands (at the top of your kidneys) which is always present in your bloodstream in small quantities and plays an important role in your body.

Its uses include regulating blood pressure, maintaining glucose levels in the bloodstream, controlling your metabolism and keeping inflammation down.

Cortisol is closely related to sleep patterns, with the highest levels first thing in the morning, decreasing towards evening (and vice-versa in those who work regular night shifts).

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Additional cortisol is released with adrenaline and other hormones in response to physical or mental stress, giving it the nickname ‘the stress hormone’.

While adrenaline raises heart rate and blood pressure, cortisol boosts available energy by stopping any systems which would be non-essential in a ‘fight or flight’ situation, such as the digestive or reproductive processes, and increasing blood sugar levels.

These chemical responses are a necessary and positive response to perceived danger on a temporary basis, after which levels drop again and everything returns to normal.

Causes and Risks of Raised Cortisol Levels

Chronically elevated cortisol levels can be caused by an adrenal or pituitary tumour causing over-production of cortisol, which is a serious medical issue and will be managed by your healthcare team.

This article relates to the type of increase in cortisol levels caused by long-term exposure to stress.

This (combined with other stress-response hormones) can put pressure on the cardiovascular system due to chronically increased heart rate and blood pressure.

High levels of cortisol also trigger unhealthy changes in behaviour such as poor sleep, eating or drinking too much, smoking or lack of physical activity, as described in a 2008 study (1) looking at the effects of stress hormones.

According to the Mayo Clinic, over-exposure to stress hormones can leave you at greater risk of other health issues, such as:

  • Anxiety
  • Depression
  • Digestive problems
  • Headaches
  • Heart disease
  • Sleep problems
  • Weight gain
  • Memory and concentration impairment

Stresses can take many forms, all of which can trigger the same cortisol rise.

The 2008 study quoted above mentions previous studies which found associations between greater cortisol increases when waking in the morning with individuals who suffer from loneliness or low self-esteem.

Those with low self-esteem have also shown a greater rise in cortisol in response to stressful situations.

Chronic stress due to work overload has been strongly associated with raised cortisol levels in a 1998 University of Trier, Germany, study (2) which also measured morning cortisol levels.

The chronically stressed participants had a significantly greater cortisol increase on awakening than the non-stressed participants.

Even a calorie counting diet has been associated with cortisol increases in a study (3) which found that restricting calories increased cortisol output and monitoring calories increased perceived stress.

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How can you reduce cortisol levels naturally?

As cortisol production is increased by stress (whether physical or mental), reducing stress will also reduce cortisol levels.  We can’t always escape a stressful situation.

Diets might be necessary for health reasons.  Some people can’t help living alone.  Not everyone can simply leave a job which has work overload.  Fortunately, there are many ways to counteract the stress response and bring cortisol levels down.

Increase Physical Contact

A 2005 study undertaken by the University of Miami School of Medicine, (4) found a 31% reduction in cortisol levels following massage therapy.

A 2007 study (5) reported in the Psychoneuroendocrinology publication, groups of women had either no interaction, verbal social support or physical contact from their partners prior to being exposed to stress.

Those who had the physical contact had significantly lower cortisol levels when exposed to stress.

If you can’t access formal massage, hugging a family member or friend can help the same way.

The same benefits can even be achieved if the source of the physical contact is an animal, rather than a human.

A 2012 study (6) published in Frontiers in Psychology, reviewed a number of previous studies which found evidence for the cortisol-reducing effects of petting a dog.  Similar cortisol reduction was not found in individuals who engaged in reading or resting instead.

If you don’t have a pet of your own, you might want to spend time with a friend’s pet, particularly as another study (7) found that contact with a dog had greater cortisol-reducing effects than a supportive friend during a stressful situation.

Breathe Deeply

Spend some time every day doing a deep breathing exercise.

Deep breathing as a relaxation technique has been found to reduce stress, with a 2017 Italian study (8) finding that regular deep breathing training was associated with a reduction in salivary cortisol by almost 50%, compared with individuals who spent the same amount of time sitting, but did not practise deep breathing.

Listen to Music

Music has been found to have relaxing powers, reducing the cortisol increase associated with stress.

A 2004 study (9) at the Osaka Medical Centre for Cancer and Cardiovascular Diseases, found that patients who listened to music during a colonoscopy had a much lower increase in salivary cortisol levels than those who did not.

A similar study (10) in Germany on patients undergoing hip replacements with spinal anaesthesia and light sedation found that those who listened to the music had significantly lower cortisol levels after the procedure than those who did not.

Go for Green

A UK study (11) reported a lower rise in cortisol levels on waking in people living in urban areas with more green space than those in areas with less green space.

It has been suggested that even a short time spent in green space can improve emotional wellbeing.

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Although cortisol was not measured, self-reported wellbeing was better following a park visit than before the visit, in a 2019 study (12) at the University of Alabama which looked at the effects of a visit to a park.

Regular visits to a park or time spent in a garden, will let you access the stress-reducing and cortisol-lowering benefits of green spaces.

Good Social Support

As loneliness increases cortisol levels, social support contributes to lower cortisol levels.  A 2002 study (13) found evidence that positive social experiences were associated with healthier cortisol levels.

If you live alone and don’t come into contact with other people at work, look for ways of spending time with other people during the day.  This could be a regular visit to a friend, joining a club, or even just talking to people you meet when you’re out shopping.

Lead a Healthy Lifestyle

Poor quality or inadequate sleep interacts with stress to raise cortisol levels in your bloodstream, according to a study published in 2015 (14).  Do your best to get adequate sleep at night, avoid caffeine in the evenings, and seek medical advice if you have problems getting to sleep or staying asleep on a regular basis.

Exercise is known to improve mental wellbeing, so try and incorporate regular exercise, such as walking, into your day.  Keep it moderate, as strenuous exercise will raise cortisol levels.

Certain foods and supplements have been claimed to reduce cortisol levels but the evidence supporting these claims is not clear.  Eating a nutritious and balanced diet will, however, assist with maintaining an overall healthy body and mind.

Be Happy

Greater happiness and positive thinking are associated with lower salivary cortisol in studies (15 and 16).  Doing things that make you happy, give you more purpose in life, or improve your self-esteem will all reduce the stress and raised cortisol associated with negative feelings.

Some activities combine several factors.  Taking up a hobby like gardening will harness the benefits of being outside in a green space and give you a sense of purpose and accomplishment.

Joining a walking group gives you social interaction too as well as the mood enhancing benefits of exercise.  Volunteering in your community is an excellent opportunity to make friends, do something worthwhile and build confidence.

Develop Resilience

Most of these recommendations are aimed at reducing cortisol levels which are already elevated.  Developing resilience can help prevent the cortisol rising, because it helps you to become less adversely affected by stressful situations.

Resilience training is popular in businesses, helping employees to cope with work-related stresses and reducing stress-related sickness absence, but is equally beneficial in non-work-related situations.

Focusing on emotional, cognitive and mental, physical and spiritual resilience, the training helps you change the way you view the challenges in your life and reduce the stress.

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It can be accessed as an online course from various providers.

Develop Your Faith

If you are religious, developing your faith can also help your resilience to life’s stressors, limiting the negative impact.

References

1) Central effects of stress hormones in health and disease: understanding the protective and damaging effects of stress and stress mediators

Bruce S. McEwen

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2474765/

(2) Increased free cortisol secretion after awakening in chronically stressed individuals due to work overload

Peter Schulz PhD, Clemens Kirschbaum PhD, Jens Prüßner MS, Dirk Hellhammer PhD

https://onlinelibrary.wiley.com/doi/abs/10.1002/(SICI)1099-1700(199804)14:2%3C91::AID-SMI765%3E3.0.CO;2-S

(3) Low Calorie Dieting Increases Cortisol

  1. Janet Tomiyama, Ph.D.,aTraci Mann, Ph.D.,bDanielle Vinas, B.A.,c Jeffrey M. Hunger, B.A.,b Jill DeJager, MPH., RD,d and Shelley E. Taylor, Ph.D.c

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895000/

(4) Cortisol decreases and serotonin and dopamine increase following massage therapy.

Field T1, Hernandez-Reif M, Diego M, Schanberg S, Kuhn C.

https://www.ncbi.nlm.nih.gov/pubmed/16162447

(5) Effects of different kinds of couple interaction on cortisol and heart rate responses to stress in women

Author BeateDitzenabInga D.NeumanncGuyBodenmanndBernadettevon DawanseRebecca A.TurnerfUlrikeEhlertaMarkusHeinrichs

https://www.sciencedirect.com/science/article/abs/pii/S0306453007000698

(6) Psychosocial and Psychophysiological Effects of Human-Animal Interactions: The Possible Role of Oxytocin

Andrea Beetz,1,* Kerstin Uvnäs-Moberg,2,3 Henri Julius,1 and Kurt Kotrschal4,

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408111/

(7) The presence of a dog attenuates cortisol and heart rate in the Trier Social Stress Test compared to human friends.

Polheber JP1, Matchock RL.

https://www.ncbi.nlm.nih.gov/pubmed/24170391

(8) The role of deep breathing on stress.

Perciavalle V1, Blandini M2, Fecarotta P3, Buscemi A2, Di Corrado D4, Bertolo L2, Fichera F2, Coco M5.

https://www.ncbi.nlm.nih.gov/pubmed/27995346

(9) Reduction in salivary cortisol level by music therapy during colonoscopic examination.

Uedo N1, Ishikawa H, Morimoto K, Ishihara R, Narahara H, Akedo I, Ioka T, Kaji I, Fukuda S.

https://www.ncbi.nlm.nih.gov/pubmed/15086180

(10) Effects of Music Listening on Cortisol Levels and Propofol Consumption during Spinal Anesthesia

Stefan Koelsch, Julian Fuermetz, Ulrich Sack, Katrin Bauer, Maximilian Hohenadel, Martin Wiegel Udo X. Kaisers, and Wolfgang Heinke

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3110826/

(11) More green space is linked to less stress in deprived communities: Evidence from salivary cortisol patterns

CatharineWard ThompsonaJennyRoeb1PeterAspinallb2RichardMitchellc3AngelaClowd4DavidMillere

https://www.sciencedirect.com/science/article/pii/S0169204611003665#!

(12) Factors associated with changes in subjective well-being immediately after urban park visit

Hon K. Yuen &Gavin R. Jenkins

https://www.ncbi.nlm.nih.gov/pubmed/30757907

(13) Social relationships, gender, and allostatic load across two age cohorts.

Seeman TE1, Singer BH, Ryff CD, Dienberg Love G, Levy-Storms L.

https://www.ncbi.nlm.nih.gov/pubmed/12021414

(14) Interactions between sleep, stress, and metabolism: From physiological to pathological conditions

Camila Hirotsu, Sergio Tufik, and Monica Levy Andersen

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688585/

(15) Positive affect and biological function in everyday life.

Steptoe A1, Wardle J.

Psychobiology Group, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK. [email protected]

https://www.ncbi.nlm.nih.gov/pubmed/16213629

(16) Positive affect and health-related neuroendocrine, cardiovascular, and inflammatory processes

Andrew Steptoe,* Jane Wardle, and Michael Marmot

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1088362/

Additional Sources

https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037

https://www.healthline.com/nutrition/ways-to-lower-cortisol#section5

https://www.medicalnewstoday.com/articles/322335.php#natural-ways-to-lower-cortisol

https://www.webmd.com/a-to-z-guides/what-is-cortisol#1

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