The Cortisol Switch: How Cortisol Makes You Fat and Angry, Plus 7 Practices to Rock Your Stress

Have you heard of the “cortisol switch?”

Here’s the scenario. When you’re stressed, you feel the positive vibe of cortisol – the rise of energy, the focus, the charge, the ascent.  Cortisol is the main stress hormone made in your adrenal glands and it’s designed to get you out of danger. It has 3 main jobs: raise blood sugar (to feed muscles so you can run or fight), raise blood pressure, and modulate immune function.

But here’s the rub…The “cortisol switch,” as I once heard articulated and reviewed by Brendon Burchard. Your body ceases to register the positive aspects of cortisol, and you switch to the negative aspects of cortisol. It’s like when you drink regular coffee and feel like a rockstar, for 20 minutes. Then you get hit the wall, get all jittery and anxious. Thoughts erode. Blood sugar drops. Acidity increases. You get heavy and dumb. Over time, high cortisol, when sustained, is linking to high blood pressure, diabetes, increased belly fat, brain changes such as atrophy of the hippocampus (where memory is synthesized), depression, insomnia, and poor wound healing. In fact, fat cells in the belly have four times more cortisol receptors compared to fat cells elsewhere, so you just keep reinforcing the muffin top as your cortisol climbs and stays high. It’s not pretty.

Cortisol is like that. It’s an impulsive little hormone that makes you feel smart and on your game one moment, and then turns on you. And the positive side of cortisol, prior to the switch, can be addictive.

I know about such things. I’m a Harvard-trained physician scientist and yoga teacher. I struggled 10 years ago with high cortisol, pre-diabetes, and a spare floating around my mid-section. I looked at a piece of chocolate cake and gained weight. Overall, I gained about 20 pounds over a few years, despite eating moderately and running 4 days per week. I was cranky. I barked at my kids and ran low on feel-good brain chemicals such as serotonin and dopamine, which excess cortisol depletes over time.

Similar to many others who struggle with a stress-crazed life and the downstream effects of the Cortisol Switch, conventional medicine had no answers for me. I went to the doctor and was told to exercise more. That was probably the worst advice a doctor could give to someone with high cortisol.

I did what Harvard taught me well: I formulated a hypothesis that it could be my hormones were out of what. I turned myself into a guinea pig. And I fixed my cortisol, lost weight, and filled my tank with energy again. It took me years, but my cortisol is now normal. And (BONUS PRIZE!) the downstream effects are much more flexibility, emotional intelligence and dexterity, and sex drive! No more fat and angry!

What can be done about the problem of cortisol, and the shadow side of this important stress hormone? I’ve got 5 practices for you. (NOT tips, because tips are things you do once and then they fall by the wayside. Practices are something you take on more fully, and integrate into your day — ultimately becoming a habit.)

1.   Eat nutrient dense food. Avoid refined carbs and sugar like the plague. Jonesin’ for sugar or alcohol? It could be a symptom of high cortisol. Don’t go there. It just keeps spiraling downward and doesn’t make you feel better.

2.   Take that fish oil. You know it’s a good idea. So why don’t you take it? 2000 mg per day lowers your cortisol level.

3.   Contempletive practice is nonnegotiable. This is especially true if you are struggling with your weight. A recent study from my ‘hood, The University of California at San Francisco, showed that obese women who began a mindfulness program and stuck with it for 4 months lost belly fat. That is radical, Baby. Just radical.

4.  Adaptive exercise. Running raises cortisol. Switching to yoga and pilates made all the difference in my weight.

5.  Rhodiola is queen when cortisol is high. Rhodiola is an herb and one of the forms of ginseng, and it’s the best proven botanical treatment for lowering cortisol. I just took mine, so I’m on the happy side of the mountain, of the “cortisol switch.”

There are many other practices I’d love to share with you (about 250, actually). Dr. Jennifer Landa, MD is a pioneering hormone expert in Florida, and she gave me 2 more juicy tips for cortisol:

6. When you are resentful, you probably need self care. I’m paraphrasing but you get the point. I love this. It shifts us out of a place of blame. In my case, my resentment is usually directed toward my darling husband or kids, whom I blame them for wanting something they probably completely deserve – such as wanting my full attention – and I need to take the feeling of resentment as a message that my self-care is not what it could be. Plus, my self care is my responsibility, not theirs. Only you can manage your self care. Don’t expect others to create the space for it. Claim it for yourself. Claim you minimally effective self care, every day. And notice that damn projections that get in the way as they are clues from your subconcious of something that needs healing.

7. Dr. Jen didn’t just create on “a-ha!” moment but many. Here’s another. No one cheers when you set a boundary. Get used to it. People love it when you overprovide. When you overpromise, and overdeliver. That may be with your spouse, kids, work, clients. Notice it. Own it. Change it. The change starts with healthy boundaries and all those people who enjoy your overproviding will not be cheering you on as you take from them the things they can do for themselves, and need to be doing for themselves. But I’m cheering you on as you set your bodacious boundaries. You go, Girl!


  1. Cindi on May 4, 2012 at 2:30 pm

    I have crazy high cortisol, I just know it. I had it tested, they said it was normal. Ugh. I am also a dancer and triathlete and so desperately–so so desperately, don’t want to change that wonderful part of my life. Can I work on 4/5 of these things and still see change? It’s such a personal dilemma.

    • Sara Gottfried MD on May 4, 2012 at 3:21 pm

      Yes! The key with adrenal dysregulation is that most of us are “pushers” and “must’er”‘s — meaning that we push ourselves too hard. Maybe start with just one thing of the 7 (I keep adding as I go along today!) and rock that for the day, rather than feeling you “must” do all of them. xo Dr. sara

  2. sara on May 5, 2012 at 1:21 am

    Running raises cortisol? How? Is it related to mileage. I love Yoga and Pilates but shouldn’t I also get some solid cardio in the schedule too? Is it something about running itself that raises cortisol, or the elevated heart rate? Does cycling also raise cortisol…?

    • Gregory Ashby on May 21, 2012 at 2:56 pm

      Exercise in general will raise cortisol, which is normal. To make your body
      more adaptable change the intensity of your exercise and learn how to relax.
      It is the constant over training that will keep cortisol elevated and damage the body.
      Here is another way to keep cortisol elevated, your mind. Ask yourself why are exercising?
      If the answer is to keep fit and healthy, this is good. If the answer is that I MUST lose
      weight so I can feel good about myself, this will send you the cortisol roller coaster.
      Negative self-talk is just as damaging as over training. Remember to Breathe and Laugh.
      These are some free ways to lower cortisol.

  3. Sophie on May 5, 2012 at 3:29 am

    What if your cortisol is low, from being burnt out…..I am doing your mission ignition course, but wonder if its low in the mornings should I be trying to raise it or stay on the path of peace?

    • Gregory Ashby on May 21, 2012 at 3:05 pm

      Thing to do are Laughing, Deep Breathing, Meditation, and Walking not quickly.
      Things not to do. No caffeine, exercise or stimulating talk before breakfast.
      Try hard-boiled eggs and yes Rhodiola. But also try Holy Basil and Ashwagandha

  4. sarah on May 5, 2012 at 11:43 pm

    How does running raise cortisol? Is it the activity itself, or the raised heart rate? Does spinning raise cortisol also? I love yoga and pilates, but isn’t cardio exercise necessary too? How much is enough without raising cortisol?

    Love your website
    Sara – nice name too, by the way 🙂

  5. Sandra on May 6, 2012 at 1:42 pm

    This all rings so true. I am also a runner, but it is not longer working for me, I run 3-4 times a week and eat well but weight seems to keep piling on. I feel very drawn to the idea of yoga as a way of reducing my cortisol but wonder how much I need the cardio from running? I don’t have time to add things to my schedule (who does?) so it would need to be a straight switch. Thoughts?

  6. Lydia Puhak on May 6, 2012 at 4:53 pm

    I just learned about you through an email from Sara Avant Stover and am so pleased to see that you’re out there doing the work that you do! In my own personal journey, it’s been the discovery of my trait as a Highly Sensitive Person (HSP) that has been my primary teacher for issues such as cortisol production and brain chemistry balance so far. There seems to be a direct correlation between being highly sensitive and having a propensity to over-produce cortisol (HSP’s are apparently prone to chronic cortical arousal). I’m curious to hear your thoughts on this. I’ve found tremendous relief through embracing my yoga practice and using it as a context for getting out of my head and into my body, thus learning to come into “right” relationship with my whole self. Tuning in this way allows me to gain better discernment about which behaviors and choices, including food, exercise, and interpersonal ways of being, are more energizing and healthily nourishing. So happy to have you and your work in my field of awareness!

  7. kimberely on May 7, 2012 at 9:20 pm

    I don’t know where to begin. This is fantastic, and I wish I had found you almost 2 yrs ago now. We think (I use that word lightly, as I can’t get straight answers from Dr at the moment, they said I”m a “zebra”) my cortisol is under control, but nonetheless I’ve been thrown into ‘severe early menopause’ at 44. Will be poking around your info for how adrenals and cortisol come together (I know they are enmeshed deeply, those rascals ;>), and how to address off the charts menopause symptoms. (They too, tell me my tests are “normal”… then why do I feel so funky, right?)

    Thank you!

  8. kimberely on May 7, 2012 at 9:28 pm

    By the way, do you not recommend active fitness (more than pilates, yoga, say)? I do shorter time spent in active fitness now, with light free wights, aerobics and combo of core work with a medicine ball (4#). Usually no longer than 40 minutes at a time. I want to do a lot more, but have heard as you noted, not to. Why is that? I gather it pushes the cortisal into action?

  9. Stacey on May 8, 2012 at 1:06 pm

    This is brilliant, and I will share widely…thank you. Just returned Monday from a yoga workshop at Kripalu with Bo Forbes (also brilliant). She raised similar points about the critical role restorative yoga plays in managing stress and depression. I’m a recovering Type A who finally gave up running and thought I found my groove with Ashtanga Yoga. Problem is that I haven’t been relieved of the chronic hip, groin, and back pain that’s plagued me for nearly 10 years. She recommends I shift away from Ashtanga. The journey continues…BTW, my favorite line from above: No one cheers when you set a boundary. Love IT!

    • Sara Gottfried MD on May 8, 2012 at 8:41 pm

      Thanks, Stacey. As one recovering Type A to another, I hear you. I went straight to Ashtanga too when I took up yoga in earnest but it was a bit to male and inflammatory for me. Shoulder injuries? Carrying too much on my shoulders and not mindfully putting stuff down? Oh, yes. Welcome to the tribe. So glad you’re here and sharing your path. xo Dr. Sara

  10. Peggy on May 8, 2012 at 4:36 pm

    Your information is wonderful and very helpful. I totally agree with what you are saying. I was wanting to sign up and download your Mission Ignition: Energy! home study course and the submit button did not work for me. Is there another option for me to submit my name and email address for the Mission Ignition: Energy! home study course? Thank you so much.

    • Sara Gottfried MD on May 8, 2012 at 8:44 pm

      Hi Peggy! Not sure why that button isn’t working – please email and we’ll get you set up for the home study! We are doing the live course right now, so the home study will ship in early June. My assistant, Aimee, should be able to help you. Thanks so much for your interest and support!

  11. Erin H. on May 8, 2012 at 7:11 pm

    Do you have a suggestion of how much rhodiola to take? I see the 2000 mg of fish oil. I know my cortisole has to be high. I have the muffin top and the belly pooch. The middle is generally where I put my weight on, right where stress puts it.

  12. Erin H. on May 8, 2012 at 7:27 pm

    And the 2000 mg of fish oil…is that of all three omega’s? Is there a particular brand of fish oil that you recommend? I was getting ready to place an order with right now for some things and there are several in there to choose from.

    • Sara Gottfried MD on May 8, 2012 at 8:47 pm

      I recommend the fish oil that’s been third party tested and found to be free of mercury and other contaminants. Here’s a list. International Fish Oil Standards – IFOS

  13. Joe Lindley on May 8, 2012 at 11:18 pm

    Hi. I picked up your website from Jimmy Moore’s New Paleo, Low-Carb & Health Blogs list for May 2012. I run a low carb/paleo blog and want to welcome you to the neighborhood! Jimmy has been a great help to me and if I can help you, just let me know. I run a news channel on my site (see below), so if you have some low carb or paleo news you’d like me to consider, please let me know at my email address: Joe at
    Put “news” someplace in your email title so I won’t miss it, please! My main site is and the news channel is
    Thanks and hope to hear from you…
    …Joe Lindley…

  14. Jeanett on May 9, 2012 at 3:50 pm

    Was wondering too about running and cortisol. A few people asked and I don’t beleive you addressed it. Can you explain why running would raise cortisol?

  15. Amy Hudgens on May 9, 2012 at 9:46 pm

    I just did the comprehensive adrenal panel through ZRT. 4 saliva samples morn, noon, 4 and before bed..They all came out normal and in the middle range. The night one was a little low..Test did showed I had a slight estrogen dominance issue,,..I feel like I did the test accurate. I feel I have some adrenal issues. In your experience, can these tests be off? Would you recommend any other test? maybe I have been repairing my adrenals and they are ok now (had a baby almost 3 years ago)..I just feel like my adrenals are sensitive…Wondering your thoughts…Thanks for all your great info..Amy

  16. Amy Hudgens on May 9, 2012 at 10:07 pm

    One more quick question…what is more common high cortisol levels or low cortisol levels in women? My understanding is that its more common to suffer from high cortisol levels first then when adrenal fatigue gets more severs then you can move to low levels? A little confuses about this…A lot of the symptoms are the same..any help would be great…thanks

    • Sara Gottfried MD on May 12, 2012 at 12:48 pm

      Yes, that is true. I’ve written quite a lot about the predictable ways that women respond to excess stess on this blog, and especially in my new book, The Hormone Cure (Simon & Schuster, 2013). Typically, chronic stress leads to high adrenaline (short acting neurotransmitter, made in the adrenal glands), and subsequently, high cortisol. When your adrenals can no longer keep up with demand, cortisol levels fall. One common pattern for women in their 40s and older is to see low cortisol during the day and high at night, which may cause insomnia and create more adrenal dysregulation, because your adrenals need restorative sleep to repair. Thanks for reading, Amy!

  17. Karen Schachter on May 11, 2012 at 6:10 pm

    This is an amazing article…I LOVE your “practices,” particularly the one about boundaries!

    I do a lot of work with women and girls around mind-body-nutrition and the psychology of eating, and see a lot of girls who are struggling with weight concerns. I “know” that their stressful lives are impacting them (both in how they are taking care of themselves with food and in terms of the stress itself affecting their weight), and I’m curious how early you’ve seen the “The Cortisol Switch” happen? Is this something you think we might be seeing in younger and younger girls?

    Thanks so much – amazing article that I will be sharing with my peeps!!

    • Sara Gottfried MD on May 12, 2012 at 1:00 pm

      Great question, Karen, and I definitely believe that the cortisol switch is affecting younger and younger girls. In fact, new evidence shows that the most profound predictor of obesity in children is their stress levels. Stressed out kids eat double the quantity of their peers, and make far more unhealthy food choices. It’s thought that the overeating is connected to high cortisol– it makes children and adults crave sugar. Thanks for writing! All the best, Dr. Sara

  18. Catharine on May 20, 2012 at 8:00 pm

    Hi Dr. Sara,
    Thanks for this post! #6 about resentment really being a reminder about absence of self-care totally resonates for me. I am currently on your Mission Ignition course so I have been learning so many gems about self-care, adrenals, energy management etc and gradually putting them into practice. (Absolutely fantastic course by the way for anyone who may be considering it!)
    As a member of society and as a woman, I really lacked these skills (probably because we don’t value and teach them). In the process of educating myself, I have had many conversations with my husband about subtle changes we could make as a family to support my self-care. From a place of innocent ignorance, he said to me that he didn’t realize that constant care of everyone else wasn’t completely fulfilling for women. At first I felt angry but then I realized, this is genuinely what he knows…his mom did that, his sisters do and until very recently his wife modelled the same behaviour.
    With so much good information from you and the resources you provided, I am creating a new pattern for myself, my daughter (and my sons!). I needed to learn that self-care is not optional (no quilt required, but it is a process 🙂

  19. Gregory Ashby on May 21, 2012 at 2:24 pm

    Please don’t a the rumor that Rhodiola is a Ginseng. It not even botanically related.
    “As an adaptogen, rhodiola is considered to be like ginseng (renshen) and eleuthero (ciwujia) in terms of effects and applications; adaptogens from numerous different plant species have the same basic actions (25). Modern promoters of rhodiola have dubbed the herb “Tibetan ginseng.” Though some herbalists object to this off hand use of the term ginseng (similarly, ashwaganda is called Indian ginseng, eleuthero is called Siberian ginseng or eleuthero ginseng), it may well represent the current intended use of the herb for consumers who are already familiar with ginseng as a general health tonic. One of the adaptogenic applications of rhodiola that has received considerable research attention recently is for aiding adaptation to high altitudes, thus, as a preventive and treatment for mountain sickness (23, 24, 25).”

  20. Sarah Clachar on May 22, 2012 at 9:00 pm

    Sara, great article on cortisol. I was just researching and writing about it for Your Healthy Home Biz. It’s such a sneaky killer of our joy and vitality.
    And so good that you noted how a little is good – wakes us up and energizes us – but it’s the chronic exposure that’s killing us. Same thing with cortisol and memory. A little helps us remember things but too much spills over into triggering receptors that interfere with memory.
    Another practice: Take a 45 minute warm bath before bedtime. Shown to lower cortisol levels dramatically.
    Glad to have found your blog.

  21. Katie Benedetto on May 22, 2012 at 9:48 pm

    LOVE these:

    When you are resentful, you probably need self care.

    No one cheers when you set a boundary. Get used to it. People love it when you overprovide. <- I needed to hear that. Thank you 🙂

    Fabulous article. Thank you 🙂

    • Sara Gottfried MD on May 25, 2012 at 4:57 pm

      I love those too! And I need to remind myself every day! Thanks for writing.

  22. Kelly Pratt on May 23, 2012 at 12:31 pm

    Dear Dr.-Sara-with-perfect-timing!!
    Thank you for this information. Everything I felt I knew intuitively but haven’t had any luck with validation from the medical community. Well, now I have!

    Curious. I’ve also had in the last 24 months a thyroid tumor and then a parathyroid (a what??) tumor – both of which I’m sure have knocked my hormones out of whack. will these practices help get me back on track??

  23. Margarete on May 23, 2012 at 1:06 pm

    How much Rhodiola is recommended? Also should there be any variation in the recommended fish oil supplement if you regularly eat foods that have high levels of fish oil?

  24. Saskia on May 26, 2012 at 3:29 am

    I love your website. Fantastic!

    About rhodiola, is there a particular time of day you recommend taking it? My salivary cortisol testing revealed high cortisol at night and low during the day, with low DHEA. Thanks.