Cortisol Confusion
We often hear that stress and anxiety are caused by too much cortisol, the body’s primary stress hormone. While that’s true in some cases, the story is much more complex. Cortisol isn’t the villain it’s often made out to be. It’s essential for survival, mental focus, blood sugar regulation, inflammation control, and overall resilience. The real problem is imbalance: cortisol that’s too high for too long or too low when you need it most.
In this article, we’ll explore how cortisol works, what happens when its levels are out of balance, how to properly test it, and which natural remedies for stress help restore balance, whether your cortisol levels are too high or too low.
What Cortisol Actually Does
Cortisol is produced by your adrenal glands, small yet powerful organs located on top of your kidneys. It’s often referred to as the “stress hormone,” but its role extends far beyond that. Cortisol helps:
- Maintain stable blood sugar during fasting or between meals
- Support alertness and focus
- Regulate inflammation and immune response
- Influence blood pressure and circulation
- Work with adrenaline to respond to stress and danger
Think of cortisol as your body’s built-in survival tool. It helps you wake up in the morning, stay focused under pressure, and recover after physical or emotional strain.
Too Much of a Good Thing: High Cortisol and Chronic Stress
Short bursts of cortisol are healthy and necessary. The problem arises when your body perceives constant stress, whether from deadlines, sleep deprivation, infections, financial worries, or even overexercising. Prolonged activation of the stress response can lead to chronically high cortisol, which may cause:
- Anxiety, irritability, or panic attacks
- Weight gain (especially around the abdomen)
- Poor sleep or waking up at 3 a.m.
- Brain fog or difficulty concentrating
- Suppressed immune function
- Irregular periods or low libido
- Elevated blood pressure or blood sugar
In this phase, your body is essentially stuck in a state of “fight or flight”. The adrenals keep pumping out cortisol to help you cope, but over time, that demand becomes unsustainable.
The Other Side: When Cortisol Becomes Too Low
After months or years of chronic stress, the adrenal glands can struggle to keep up. This state is sometimes described as “adrenal fatigue” in natural medicine, although conventional medicine refers to it as HPA axis dysfunction (hypothalamic-pituitary-adrenal). In simple terms, your brain and adrenals stop communicating effectively, leading to low cortisol output.
Low cortisol can cause:
- Fatigue that doesn’t improve with rest
- Low blood pressure or feeling dizzy when standing
- Salt cravings
- Difficulty waking up in the morning
- Afternoon crashes
- Depression or lack of motivation
- Low resilience to stress or illness
Ironically, many people with low cortisol think they’re too stressed and need to “lower their cortisol,” when in fact their cortisol is already too low. Suppressing it further with natural remedies for stress can make symptoms worse.
Why You Shouldn’t Assume You Have High Cortisol
Online wellness spaces are full of advice for “lowering cortisol,” but without proper testing, this can be counterproductive. Two people can experience identical symptoms like anxiety or insomnia for completely opposite reasons.
For example:
- Person A might feel anxious because cortisol is too high at night.
- Person B might feel anxious because cortisol is too low, causing blood sugar drops and adrenaline surges.
That’s why testing is crucial before starting any natural remedies for stress or an herbal regimen.
What’s the Best Test for Cortisol?
There are several ways to measure cortisol, and each provides different insights:
- Blood Test (Serum Cortisol):
Usually tested first thing in the morning, when cortisol should peak for the day. This is useful for ruling out extreme disorders like Addison’s disease or Cushing’s syndrome, but only reflects one moment in time. - Salivary Cortisol Test:
Measures cortisol levels at four key times during the day (morning, noon, afternoon, and bedtime). This reveals your daily rhythm, which is often the best way to assess stress-related imbalances. - DUTCH Test (Dried Urine Test for Comprehensive Hormones):
The most advanced option provides information on cortisol and cortisone, as well as how your body metabolizes them. It’s beneficial for understanding complex patterns, such as “wired but tired” or “flatlined cortisol.”
For most people struggling with fatigue, anxiety, or suspected adrenal imbalance, a 4-point salivary cortisol test or DUTCH test gives the clearest picture. Still, these tests can be pricey and are not covered by OHIP. OHIP would cover a first morning cortisol blood test if your MD orders it.
How to Know if You Have Too Much Cortisol
If your cortisol is high, you might notice:
- Feeling “tired but wired” at night
- Trouble falling or staying asleep
- Racing thoughts
- Cravings for salty or sweet foods
- Muscle weakness
- Midsection weight gain
- Elevated blood pressure or glucose
- Frequent infections (from immune suppression)
A salivary or urine test showing elevated morning or nighttime cortisol confirms this.
Natural Remedies for Stress to Support Healthy Cortisol Levels
Natural medicine offers powerful tools for regulating cortisol, either calming it down or gently lifting it when it’s too low. These are called adaptogens, herbs that are natural remedies for stress that help the body adapt to stress and restore cortisol balance.
If Your Cortisol Is Too High
The goal is to calm and regulate your stress response without making you feel sedated.
1. Ashwagandha (Withania somnifera)
- Reduces cortisol and improves resilience to chronic stress
- May improve sleep quality and reduce anxiety
- Shown in multiple studies to lower serum cortisol by up to 30%
- It can make some people feel sleepy if they take it during the day
2. Rhodiola rosea (in low doses)
- Enhances energy and focus while preventing cortisol spikes
- Useful for “burnout” or high-pressure work periods
3. Holy Basil (Tulsi)
- Calms the nervous system and reduces the physiological effects of stress
- Supports immune balance and mental clarity
4. Phosphatidylserine
- A nutrient that helps reset the body’s cortisol rhythm, especially when levels are high at night
- Shown to lower evening cortisol and improve sleep
5. Magnesium
- Supports the adrenal glands and relaxes the nervous system
- Low magnesium can worsen anxiety and cortisol dysregulation
- Magnesium bisglycinate is the best form of magnesium. It is well absorbed, works well, and won’t induce other mineral deficiencies. Magnesium supplements should not be taken by anyone with impaired kidney function.
Lifestyle strategies also help normalize high cortisol:
- Reduce caffeine, especially after 10 a.m.
- Prioritize sleep – even one week of sleep deprivation increases cortisol
- Practice breathwork, yoga, or meditation daily
- Eat regular meals to prevent blood sugar drops
If Your Cortisol Is Too Low
Here, the goal is to rebuild and nourish your adrenal function rather than suppress it.
1. Licorice Root (Glycyrrhiza glabra)
- Slows cortisol breakdown, helping it stay active longer
- Can raise low cortisol levels naturally
- Not for use in people with high blood pressure or sodium retention
2. Ginseng (Panax ginseng or Eleutherococcus senticosus)
- Gently stimulates the adrenal glands and increases stamina
- Improves energy, motivation, and resilience
- Siberian ginseng (Eleuthero) is particularly useful in chronic fatigue
- Ginseng is more appropriate for men than women
3. Vitamin C and B Vitamins
- Both are crucial for adrenal hormone production
- Chronic stress depletes these nutrients quickly
- B5 (pantothenic acid) and B6 are particularly vital for adrenal recovery
4. Mineral Support
- Sodium, potassium, and magnesium are often low in people with low cortisol
- Adding sea salt or electrolytes to water can help stabilize blood pressure and energy
5. Adaptogenic Combinations
Some people do best with balanced adaptogen formulas that contain both calming and energizing natural remedies for stress, as these help smooth out fluctuations and restore resilience over time.
When to Seek Professional Guidance
If you’re unsure whether your cortisol is high or low, or if your fatigue, anxiety, or insomnia don’t improve with lifestyle changes, it’s time to test and work with a qualified naturopathic doctor. Hormone balance is rarely a matter of black and white. Cortisol interacts with thyroid hormones, sex hormones, blood sugar levels, and inflammation, making individualized care essential.
The Bottom Line About Cortisol
Cortisol isn’t your enemy; it’s your body’s built-in stabilizer. Too much or too little can both cause fatigue, anxiety, or burnout, but the key is understanding which direction you’re off balance. Testing provides clarity, and targeted herbs, nutrients, and lifestyle changes can restore your natural rhythm.
Supporting your adrenal health isn’t about suppressing cortisol; it’s about helping your body respond to stress in a balanced, resilient way.
References for Natural Remedies for Stress
- McEwen, B.S. & Akil, H. (2020). Revisiting the stress concept: Implications for affective disorders. Journal of Neuroscience.
- Dirk H. Hellhammer, Stefan Wüst, Brigitte M. Kudielka, Salivary cortisol as a biomarker in stress research, Psychoneuroendocrinology, Volume 34, Issue 2, 2009, Pages 163-171, ISSN 0306-4530, https://doi.org/10.1016/j.psyneuen.2008.10.026.
- Panossian A, Wikman G. Effects of Adaptogens on the Central Nervous System and the Molecular Mechanisms Associated with Their Stress-Protective Activity. Pharmaceuticals (Basel). 2010 Jan 19;3(1):188-224. doi: 10.3390/ph3010188. PMID: 27713248; PMCID: PMC3991026.
- Bornstein SR, Allolio B, Arlt W, Barthel A, Don-Wauchope A, Hammer GD, Husebye ES, Merke DP, Murad MH, Stratakis CA, Torpy DJ. Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016 Feb;101(2):364-89. doi: 10.1210/jc.2015-1710. Epub 2016 Jan 13. PMID: 26760044; PMCID: PMC4880116.
- Armanini, D. et al. (2014). Licorice: From pseudohyperaldosteronism to therapeutic uses. Front. Endocrinol., 17 July 2019 Sec. Molecular and Structural Endocrinology, Volume 10 – 2019, https://doi.org/10.3389/fendo.2019.00484
