SGHS6939_72One month ago, I wrote about my Achilles heel, which is the wayward, dysregulated hormone called cortisol. I wrote about “cortisol switch” which I’ll define again in a moment, but first up… let’s talk about how cortisol, the main stress hormone produced by your adrenal glands in your mid-back, brings you down and ramps up your risk of serious disease, and more importantly, what you can do about it.

When stress is not managed skillfully, and becomes chronic and repetitive, cortisol rises too high. Cortisol has 3 main jobs in your body, as I described in Part 1: raise blood sugar (as fuel); raise blood pressure (so you can run from the tiger your body thinks is chasing you); and modulate your immune system.

Here are some of the problems linked with excess cortisol.

  • Diabetes/Pre-diabetes. Cortisol’s main job is to raise glucose levels, and even small bumps in cortisol, such as when drinking a cup of regular coffee, can raise blood sugar and increase insulin resistance (another major topic I’ll tackle soon for you, and I promise to make it stunningly simple).
  • Sucky mood. Persistent stress causes your body to increase the production of brain chemicals, and initially you make too many “excitatory” neurotransmitters, such as epinephrine and norepinephrine. Over time your backstock runs dry, and you begin to run out of epinephrine, norepinephrine, and serotonin. Then you find yourself mildly depressed, unable to focus, and wondering what happened to your battery charge. Maybe sleep and motivation start to worsen. Not pretty, but also not a good time to start a prescription antidepressant (unless severe or you/your doctor decide it’s needed) — you need to work on more effective stress management and correcting your cortisol (see tips below), not crank up your serotonin with a happy pill! (BTW, the “happy” pill was recently shown to increase breast and ovarian cancer, which you can now add to the list of side effects including weight gain, stroke, and libido hijack.)
  • More body fat. Too much cortisol makes you fat, especially at your belly. Hello, spare beach floaty? Unfortunately, the belly fat has 4 times the number of cortisol receptors, so you get into a vicious cycle of excess cortisol creating more body fat, which gets stimulated by persistently high cortisol levels.
  • Slow wound healing. When cortisol is high, it takes you longer to recover from injury, like a cut or even a sports injury. Your immune system is too jacked up to work effectively.
  • Lousy Sleep. If you measure the cortisol levels of insomniacs, they are way increased.

Ok, Ok, enough of the doom and gloom. Let’s turn this ship around before it hits the iceberg. I mentioned last time that I have 250 tips for right-sizing your cortisol. Here are 5 more.

1. Get a massage. You’re probably thinking, “Duh!” but there was just a rigorous, randomized study showing that massage lowers your cortisol. Now if we could just get all insurance to pay for it!

2. Alternate nostril breathing. I do this 3 times per day. The Sanskrit term is “Nadi Shodhana” or channel clearing breath. If you need to learn how to do it, click here. This is not woo woo — there’s is robust science showing that when you breath in this way, your breath crosses the center line, builds synapses, leverages neuroplasticity, helps you see the bigger picture, and increases problem solving. And, by the way, it’s shown in a randomized trial to lower blood pressure and heart rate, which means it reverses signs of stress.

3. L-Theanine. Shown to calm down the sympathetic nervous system (“fight or flight”. The idea is that we need sacred balance between the sympathetic nervous system and parasympathetic nervous system (“rest and digest”).  Dose of L-theanine is 250 to 400 mg per day.

4. Lock into aromas that trigger the “calm response.” I learned this one from genius Lisa Byrne over at She taught me that certain scents can help you calm down, such as cedar wood, frankincense and sandalwood. These scents travel from your nose straight into your brain, and tap into your hypothalamus to trigger a calm response. This is crucial, because you can’t be in both a calm and a stress response. It’s like a toggle switch, Lisa taught me. If you can increase the flip of the switch to the calm response, by any means necessary, you can linger there and lower cortisol when it is excessively high.

5. Wean off coffee. It’s like a high-interest loan that you need to pay back. Don’t become a debtor. Use coffee medicinally or not at all. It’s very hard for your adrenal glands to be the full “repair” conversation if you are taking out a daily loan against them. There’s no chance to heal.

What are your favorite ways to lower cortisol when it’s crazy high? Another favorite of mine is oxytocin, but that’s a conversation for another time. Leave me a comment and let me know what works for you.

Recap of Cortisol Switch

Just a reminder, for those of you who also have high cortisol and, as a result, you’ve fried your hippocampus which integrates memory, and can’t remember this from last time. “Cortisol Switch” is when you “switch” from the cortisol love, which is where cortisol is helping you be productive, helping you focus, helping you feel on top of the world and capable of anything, similar to the first 20 minutes after drinking a cup of regular coffee… to the cortisol hate. You hit the wall. It takes 18 minutes, on average. You get irritable, jittery and anxious. Blood sugar drops. You get dumb. Click here to read more about what it feels like, and leave me a comment about how the cortisol switch happens in your body.


  1. Darlene on June 1, 2012 at 2:20 pm

    Which cortisol test do you recommend?

  2. Bebe Meredith on June 3, 2012 at 1:39 am

    I am SO confused about cortisol! have been to various docs…..some who wrote the books. The one black hole that no one can EVER give me clear answers on is cortisol. How to figure out if you are in need of supplementation……how much is enough…… How much is too much……how to avoid bad side effects even when supplementation is needed……how to test once on supplementation… long to take …..and is it my adrenals or my thyroid or lack of balance of all other hormones….etc…etc…etc. Never have gotten good answers!

  3. katie on June 3, 2012 at 3:47 pm

    DR. Sara,
    What about issues with low cortisol?

    • Sara Gottfried MD on June 3, 2012 at 3:53 pm

      People who have chronic stress, and longstanding high cortisol, burn out their ability to produce cortisol in their adrenals. The extreme, and only low cortisol state universally recognized in mainstream medicine, is Addison’s disease (adrenal failure). Chronically low cortisol is linked to Post Traumatic Stress Disorder, fibromyalgia, and chronic fatigue. There are many ways to boost low cortisol (and to initiate adrenal repair)–I’ll focus on this in a future blog topic if you’d like. It’s also a major part of my new book, The Hormone Cure (Scribner/Simon & Schuster), which will be published March 1, 2013. Thanks for writing!

  4. Claudia Welch on June 3, 2012 at 5:18 pm

    Dr. Sara!

    Wonderful, and wildly familiar, to hear what you are teaching and advocating. I wrote Balance Your Hormones, Balance Your Life: Achieving Optimal Health and Wellness through Ayurveda, Chinese Medicine, and Western Science, published in 2011 and say a lot of the same things–though possibly not always with as much wit and charm. Was alerted to your post via a fb friend. So glad you are out there 🙂

    Warm wishes,

    • Sara Gottfried MD on June 3, 2012 at 6:00 pm

      Dr. Claudia: I LOVE your book! So glad to know you. I think we should teach workshops together and change the world one hormone at a time! Thanks for writing and let’s keep in touch! All the best, Dr. Sara

  5. Alexis Smart on June 3, 2012 at 6:16 pm

    Hello Claudia,
    Great post! I am a flower remedy practitioner and I see this syndrome frequently in my practice. Flower remedies are really effective at turning off the cortisol switch. Vervain for stress and tension and for those who tend to overwork, Rock Rose for intense fear and panic and Cherry Plum for stress that reaches the level of freaking out. I also use Olive for my clients who have the adrenal exhaustion that follows long periods of stress.
    I look forward to reading more of your work.
    All the Best!
    Alexis Smart

  6. Cindy on June 4, 2012 at 12:14 am

    When I’ve overdone it on the cortisol side, I take epsom salt baths with lavender, orange and or cedar wood oils….chills me right down.