Table of Contents
In fight-or-flight scenarios accompanied by intense stress, the body reacts by releasing hormones from the adrenal glands, such as adrenaline. We’ve likely all felt the heart-pounding adrenaline boost that gives us extra energy in sudden scary or startling circumstances. Cortisol, which is also produced by the adrenal glands, is considered a counterpart hormone to adrenaline because it helps regulate stress so that we stay alert when our body or mind perceives a threat.
As helpful as cortisol may be when stress occurs, it can have negative effects if the body produces too much of it over time. Below, read about the effects of cortisol, as well as supplements that can help keep your cortisol levels in check for a healthier, more relaxed lifestyle.
Get 25% Off Your First Month Using Code FORBES
- Three-in-one tablet in capsule designed to optimize ingredient release for all day support
- Ashwagandha to support normal cortisol levels and reduce stress
- L-Theanine works to provide quick stress relief within the hour and a non-drowsy sense of calm
- Added Saffron may help promote a positive mood
- Gluten and major allergen free
What Is Cortisol and What Does It Do?
Cortisol is perhaps most widely known as a stress hormone, though it has many additional functions, such as regulating metabolism, inflammatory response and basic immune functionality. It’s synthesized from cholesterol, and it touches nearly every organ system in the body, including the nervous, immune, cardiovascular, respiratory, reproductive, musculoskeletal and integumentary systems.
When cortisol is released as a stress response, it may be helpful to think of the hormone as a counterpart to adrenaline: The latter increases your heart rate and respiratory system function in response to stress over the short term while cortisol helps maintain a longterm state of alertness.
“When your brain perceives any stress, it signals the adrenal gland to pump out cortisol,” explains Myles Spar, M.D., a double board-certified expert in personalized and performance medicine and a Forbes Health Advisory Board member. “This then causes the body to go into react mode—increasing blood flow to the heart and muscles, dilating the pupils and increasing heart rate. It also tells the body not to focus on sending resources to the gut or immune system, as those aren’t mission critical,” says Dr. Spar.
Dr. Spar says that continual exposure to stress, and the resulting high levels of cortisol, can have a damaging impact on the body. A 2023 study notes that conditions like Alzheimer’s disease, Parkinson’s disease, major depressive disorder and chronic pain can all be tied to abnormally high cortisol levels in relation to stress.
Conversely, it’s also possible to develop Addison’s disease, which results from an adrenal deficiency in which the body produces too little cortisol. The National Institute of Diabetes and Digestive and Kidney Diseases recognizes these as symptoms of Addison’s disease:
- Chronic fatigue
- Muscle weakness
- Loss of appetite
- Unintentional weight loss
- Abdominal pain
- Darkening skin on the elbows, knees, knuckles, toes, lips and lining of the cheek
Addison’s disease can be difficult to diagnose given the mild presentation of many of its hallmark symptoms.
“As with any hormone, balance is key,” says Jill Stocker, D.O., an osteopathic physician and hormone balance expert, as well as a Forbes Health Advisory Board member. “Cortisol dysregulation can actually cause brain damage and affect many organ systems,” she adds.
What Is a Normal Cortisol Level?
The University of Rochester Medical Center suggests cortisol levels are highest in the morning and hit their lowest point around midnight. A typical reading may be:
- Morning (6 a.m. to 8 a.m.): 10 micrograms to 20 micrograms per deciliter
- Late afternoon (around 4 p.m.): 3 micrograms to 10 micrograms per deciliter
Cortisol levels can be tested through a simple blood draw, typically taken once in the morning and again that same day in the afternoon. These estimates are a baseline and may be impacted by a person’s body chemistry and medications, such as steroids.
What Supplements Help Reduce Cortisol
While additional research is needed, some supplements may lower cortisol levels and reduce stress. Here are a few options recommended by our experts.
Ashwagandha
Ashwagandha is a plant commonly referred to as an adaptogen. Adaptogens help calm the nervous system without sedative qualities and help the body stay balanced during stress. Dr. Stocker and Dr. Spar find that ashwagandha is among the best supplements to assist with cortisol regulation.
Recent research suggests this may be true. A 2023 meta-analysis on the subject featuring nine related studies concluded that short-term supplementation with ashwagandha had a stress-reducing effect[1]. This is buttressed by a separate trial in 2023 in which participants who took 500 milligrams of ashwagandha root extract over 60 days saw a greater reduction in morning cortisol levels than those who did not, signifying the extract may have played a role in reducing stress and anxiety[2].
Tulsi (Holy Basil)
Tulsi, also known as holy basil, is an adaptogen similar to ashwagandha that is favored by Dr. Spar. While research on its use remains sparse, especially with regard to cortisol regulation, preliminary studies appear promising.
Chief among these is a 2022 trial in which select participants received 125 milligrams of holy basil twice per day. Those who took holy basil had significantly lowered cortisol counts in both saliva and hair, compared to participants who took a placebo[3].
A 2017 meta-analysis cataloging holy basil’s impact on stress noted an estimate of 31.6% to 39% reduction in stress symptoms among participants who took tulsi over longer durations, though cortisol counts were not measured[4]. Further research is required to determine the supplement’s effectiveness.
Get 25% Off Your First Month Using Code FORBES
- Gluten and Major Allergen Free, Vegan
- No Artificial Colorants, Made Traceable
- Omega-3 DHA & EPA support brain and heart health
- Omega-3 oil infused with natural citrus oil
- Get 40% off traceable essentials
Omega-3 Fatty Acids
Most research surrounding omega-3 fatty acids focuses on heart health and lowering cholesterol levels due to omega-3’s potential to reduce triglycerides, a type of fat in the blood.
However, a 2021 study concluded that participants who took omega-3 fatty acids over four months developed lower overall levels of cortisol and inflammation during stressful periods and higher levels of anti-inflammatory activity during recovery[5].”
A 2022 study featuring 80 boys and girls of adolescent age found that that omega-3 consumption through food lowered cortisol concentrations for those with depressive disorder in as little as six weeks. The effect was less pronounced among participants with mixed anxiety depressive disorder[6].
While these early analyses of omega-3 fatty acids appear promising, medical experts at the National Institutes of Health note that further research is required to determine its effectiveness in managing stress and other related health conditions.
Rhodiola
Rhodiola is a plant-based adaptogen like ashwagandha recommended by Dr. Stocker and Dr. Spar. It’s generally preferred by people who want an energy boost as opposed to a calming effect. That said, preliminary studies suggest it may have the capacity to reduce cortisol levels in some cases.
Currently, however, research on the subject remains sparse. A 2023 meta-analysis of 25 adaptogen-related studies offered three slightly different perspectives on the impact of rhodiola. While one large trial showcased promising results in cortisol regulation, another showed no measurable impact. The third study did not take cortisol measurements specifically but found rhodiola may still be an effective means of stress management.[7]
Given the mixed results, it’s especially important to consult a health care provider before adding rhodiola to your vitamin and supplement regimen.
How To Reduce Cortisol Naturally
While the supplements listed above may help regulate cortisol levels, there are ways to maintain stress hormone balance without supplements. “My go-to recommendations for cortisol regulation are mostly simple things for people to incorporate themselves, giving them more agency and involvement in their health care and life journey,” says Dr. Stocker. Both she and Dr. Spar suggest these cortisol-lowering methods:
- Meditation/prayer
- Making gratitude lists
- Humming, which may stimulate the vagus nerve to reduce the fight or flight response and cortisol
- Movement, especially yoga
- Connecting with nature
- Bodywork like massage or acupuncture
- Sleep hygiene
- Avoiding caffeine, nicotine, stressful situations
- Breathing exercises: Dr. Spar prefers the 4-7-8 breathing technique, which is accomplished by inhaling deeply for four seconds, holding your breath for seven seconds and releasing a long exhale for eight seconds.
When To See a Doctor About High Cortisol
Cortisol levels should be monitored closely by a health care professional if they’re consistently high. This is a hallmark sign of a condition called Cushing’s syndrome. The National Institutes of Health outline these possible symptoms of Cushing’s syndrome.
- Weight gain
- Obesity and stunted growth (in children)
- Thin arms and legs
- A round face
- Increased fat around the base of the neck
- A fatty hump between the shoulders
- Excess hair on the face, neck, chest, abdomen and thighs (in women)
- Irregular or no menstruation (in women)
- Easy bruising
- Wide purple stretch marks, mainly on the abdomen, breasts, hips and under the arms
- Weak muscles
- Decreased sex drive, fertility and erectile function (in men)
If you notice these symptoms, contact a health care provider immediately. They’ll determine the proper tests required to assess your condition.
