Lowering cortisol is the new wellness trend that tells you if you have x, y, or z symptoms, you probably have high cortisol and need to lower it. But the reality isn’t that high cortisol automatically means something bad.
Cortisol is a steroid hormone produced by the adrenal glands. It plays a role in various processes, including the stress response, the sleep-wake cycle, inflammation, and blood sugar and blood pressure.
Better words to describe fixing your cortisol levels are balance or a reset, so you can bring the highs and lows back to a more natural level and feel healthier for it. While chronically elevated cortisol levels can occur, it is quite rare and not likely the issue with most people. Here, we discuss why high cortisol likely isn’t what’s affecting you and what you can do to encourage better cortisol highs and lows, backed by real evidence.
What a Normal Cortisol Day Looks Like
Cortisol follows the 24-hour body clock known as the circadian rhythm. The hormone reaches its low point around midnight, several hours into sleep, then starts climbing at roughly 2 to 4 in the morning, well before you wake. It peaks 30 to 60 minutes after waking, in what’s known as the cortisol awakening response (CAR). This helps you wake up alert and ready for the day. As the day goes on, levels slowly decline so you can prepare for sleep.
Several things can interrupt this cycle, which is known as circadian misalignment, including:
- Stress
- Irregular shift schedules, such as shift work or sleeping and waking at vastly different times throughout the week
- Exposure to artificial light close to bedtime
- Jet lag
“Adrenal Fatigue” and the Test Kit Problem
People also often talk about adrenal fatigue in tandem with high cortisol, but that term isn’t medically recognized, and the use of the term only describes vague symptoms rather than a diagnosable condition or syndrome.
People who believe they have high cortisol levels can order at-home adrenal fatigue saliva test kits, but because the term isn’t medically defined, the kits aren’t typically considered clinically valid. Repeated sampling does not fix that. The Endocrine Society’s position is that there is no test that detects adrenal fatigue, and that salivary cortisol profiles sold for it have never been validated as a way to assess how the stress axis is working, so a series of readings cannot establish a personal baseline or tell you whether a number is high or low for you. If you do try a test at home, you would have to use it several times in a row to get a set of numbers, which you’d then need to take to a healthcare provider for accurate interpretation. Even so, your healthcare provider will likely want to run different, more clinically relevant tests to see what is causing the symptoms you believe are related to “adrenal fatigue.”
What Actually Helps Bring Cortisol Back Into Rhythm
Morning Light and a Consistent Wake Time
Research shows that getting morning light and having a consistent wake time, meaning you go to sleep and wake at the same time every day, can help keep your internal clock and cortisol levels balanced throughout the day. The study usually cited for the light half of that is a narrower piece of evidence than it sounds: eight healthy men kept awake for 36 hours in a lab, where bright light between 5 and 8 am raised cortisol sharply. It does not show what morning light does to the CAR after an ordinary night’s sleep.
In a controlled laboratory study of eight men, researchers examined exposure to bright light and its effects on cortisol levels and found that bright light between 5 and 8 am led to a rapid spike in cortisol, which supports morning waking.
Sleep
Focusing on sleep is a great way to rebalance your cortisol levels. In a narrative review of findings across multiple study papers, researchers looked at how sleep restriction affected cortisol and found that sleeping 5.5 or fewer hours per night increased next-day cortisol levels the following evening. The results weren’t dramatic, but prolonged sleep disruptions were thought to lead to chronic misalignment of the cortisol clock.
Time in Nature
A small cohort study of 36 people living in the city followed them over an eight-week period to see how time in nature could affect cortisol levels. Participants spent at least 10 minutes outdoors three times a week, and those sessions produced a 21.3% per hour drop in cortisol — on top of the roughly 12% hourly decline the hormone shows on its own as the day goes on.
The best results were found in those who spent 20 to 30 minutes outside; even longer than 30 minutes showed continued benefits, though the reduction slowed after the 30-minute mark.
Movement
Movement is a bit tricky because high-intensity exercise can cause acute spikes in cortisol after a workout, while low-intensity movement can reduce circulating levels. In one randomized repeated-measures study of 12 active men, researchers found that exercising at 60% or 80% of maximal oxygen uptake raised blood cortisol. At 40% the raw change was a 5.7% rise that was not statistically significant; the decrease often quoted from this study only appears after the numbers are corrected for changes in plasma volume.
That said, people who engage in more physical activity experience better cortisol balance than those who don’t, so exercise still remains important when balancing cortisol levels. One systematic review and meta-analysis gathered data from 10 clinical trials to determine how exercise affected cortisol rhythms and found that long-term, regular exercise can lower cortisol levels over time, especially in those with chronic disease or mental health disorders.
An observational, controlled experimental cross-sectional study of 56 participants found that people can adapt to heavier training, so people who regularly train heavier will raise their baseline. This means that once you build a good exercise habit, regardless of intensity, your body adapts and releases less of a spike over time as you get more physically fit. There is one caveat, however. Those who overtrain chronically and without enough rest periods do not adapt and can see more imbalance in their cortisol fluctuations.
Mindfulness and Breathing
Mindfulness and breathing have been shown to reduce cortisol levels when performed consistently over time. A meta-analysis of 58 studies with 3,508 participants found reductions in cortisol after mindfulness-based stress reduction programs, though the literature is inconsistent, with significant changes showing up more often in within-subject studies than in randomized trials. The usual explanation is that these practices engage the parasympathetic nervous system, which counteracts the fight-or-flight response, but that is a proposed mechanism rather than something a meta-analysis can demonstrate.
The analysis also found that these practices positively affected morning cortisol levels and CAR, leading to more balanced cortisol highs and lows upon waking and throughout the day. The reductions aren’t as pronounced as other methods, but still make a difference.
Caffeine Timing and Dose
Caffeine can cause a temporary spike in cortisol because of how it affects the hypothalamic-pituitary-adrenal (HPA) axis. One study looked at a small group of 96 participants and asked them to abstain from caffeine for five days while taking capsules that contained either no caffeine or 300 or 600 mg three times a day. On the sixth day, participants were told to take capsules again with no caffeine or 250 mg at 9 am, 1 pm, and 6 pm. Between 7:30 am and 7:00 pm, saliva was collected eight times to measure cortisol.
Among those who had gone five days without caffeine, cortisol rose significantly across the test day in response to the 250 mg doses they were given, rather than because of the abstinence itself. Those who did consume caffeine in the five days prior didn’t see a cortisol spike after their 9 am dose, but cortisol levels rose after the afternoon doses.
Because of this response, drinking caffeine later in the day may spike cortisol. That said, regular coffee drinkers often have a reduced response due to caffeine tolerance, meaning the results may be negligible over time. So, if you want to keep your cortisol levels balanced, you can choose between consuming caffeine regularly and only in the mornings to avoid spikes, or not at all.
Alcohol
Drinking alcohol disrupts the cortisol cycle by disrupting the body’s circadian rhythms while you sleep because alcohol activates the stress axis centrally, prompting the hypothalamus and pituitary to signal the adrenal glands rather than acting on the adrenals directly. A prospective longitudinal study looked at 200 adolescents over seven years and found that heavier alcohol use flattened cortisol patterns, meaning they didn’t rise and fall as they should but rather remained steady from morning to night.
A cross-sectional study on 3,670 participants also found that higher weekly alcohol use in males is associated with higher cortisol levels by about 3% for every unit of alcohol consumed, as well as a reduced cortisol drop to get back to baseline. In females, the results were similar, but females experienced a significantly higher spike in cortisol upon waking when compared to moderate or sporadic alcohol drinkers.
So, drinking less can help keep your body’s cortisol levels more balanced.
Social Contact and Laughter
Laughing and having fun with friends and family isn’t just for fun. It can also help to keep your cortisol levels balanced. One systematic review and meta-analysis collected data from eight studies with 315 participants and found that laughing can reduce the stress hormone by 31.9%. It didn’t mention whether laughter helped balance cortisol levels over time, but by reducing cortisol levels in the short term, you can help rebalance the stress response.
Social connections can have a similar effect. According to an observational cohort study of 456 healthy adults, people with a wider social circle experience a healthier cortisol drop throughout the day after the morning peak.
The Supplements People Ask About
People who want to lower their cortisol may also reach for supplements, but it’s important to note that many that promise to do just that aren’t well studied and have little or no evidence to support their claims.
Ashwagandha, for example, is likely the most notable, with some evidence that it reduces cortisol levels. A systematic review and meta-analysis of 15 studies involving 873 participants found that taking the supplement for eight weeks can lower self-reported stress levels and cortisol levels compared with those who took a placebo. That said, other medical literature has documented a small number of reports of liver injury in people taking ashwagandha, so it is worth raising with your own provider before you start it.
Evidence for Rhodiola and phosphatidylserine as cortisol-lowering supplements is thin, and most trials that showed success had 15 or fewer participants or were inconsistent with other studies on their cortisol-lowering effects.
When It’s Not Lifestyle
While some lifestyle changes may help certain symptoms, there are signs that you should see a healthcare provider to see what may be going on. For example, if you have unexplained weight gain or loss, easy bruising, a new onset of high blood pressure, or severe fatigue, chalking it up to high cortisol without seeing a doctor could prolong the symptoms or even lead to them getting worse.
You want to address these symptoms with a healthcare provider first before trying to tackle it on your own, because these non-specific symptoms could arise from a number of conditions.
Balancing your cortisol levels matters for overall health and wellbeing, so knowing what you can do at home and what needs a healthcare provider’s attention will help ensure you get the care you deserve, whether it be through lifestyle changes or medical intervention.
Angelica Bottaro is a medical writer and researcher with a background in psychology and journalism.
Is your neighborhood healthy?
Get a free report on your tap water, air quality, walkability and more
