Abstracts of the 2023 ANMS Annual Meeting Scientific Program: Advancing patient care through cutting-edge research August 11–13, 2023 Austin, Texas, USA
Should We Be Worried About Our Cortisol?
If you spend time on social media, you've probably seen lots of conversations around the hormone often associated with stress: cortisol.
"If you have bags under your eyes, a dull skin tone, and stubborn belly weight, it's because high cortisol STEALS your beauty + feminine hormone, progesterone," one influencer, @theworkoutwitch_, recently told her 1.4 million followers. She offers a solution in the form of a $147, four-course bundle that promises to teach clients to release tension and the "stored trauma" that allegedly leads to pesky high cortisol.
And she's not the only one. Many of our feeds are littered with posts selling a variety of exercise plans, diet ideas, supplements, and more to tackle this emergent problem. Quite a few influencers in this area focus on the face: Searching the #cortisolface hashtag will serve up a plethora of before and after pictures, showing visages changing from round and full to longer and narrower after "treatment." It's particularly painful to see glow-ups featuring a "before" image of a woman with a face-widening grin, followed by an "after" with an expression that's gloomier, and thus, skinnier. So, smiling makes cheeks look bigger—is that such a crime?
It's not the first go-around for cortisol as a popular wellness whipping boy. For years, frantic parents of colicky babies, scrolling for support, have encountered content warning of brain damage if they fail to protect their children from surging levels of the so-called "stress hormone:" preferably by preventing crying altogether. That trend has faded somewhat, as studies have repeatedly failed to show any lasting effects from short-term upsets like sleep training. Now, worries have shifted to cortisol in adults. Unlike the babies, we may not cry for an hour every night after dinner (hopefully?), but we still face plenty of pressures.
To be fair, the influencers are not completely out to lunch on this topic. The risks of chronic tension to everything from heart health to life expectancy are well-documented. Not so long ago, the World Health Organization labeled stress the "health epidemic of the 21st century" (apologies to COVID-19).
Given that cortisol is released by the adrenal glands to help the body react to that stress, it's perhaps understandable why some have demonized the hormone itself as part of the negative consequences of living under constant emotional strain. But that assumption over-simplifies our amazingly intricate endocrine systems.
"Cortisol is a life sustaining hormone. We cannot survive without cortisol," Dr. Anjanette Tan, an endocrinologist at the Diabetes and Thyroid Center of Fort Worth, told me via email. "It regulates our response to stress. It supports blood sugar. It maintains blood pressure. It reduces inflammation, enhances metabolism and tissue repair."
It all begins deep inside our brains, where the hypothalamus responds to stress by sending out corticotrophin-releasing hormone, or CRH. That CRH, in turn, signals our pituitary glands to make a hormone called ACTH. And finally, ACTH triggers our adrenal glands, located on top of each kidney, to release cortisol, which helps our bodies react to whatever we are confronting in our environment.
That cortisol, itself, plays a key role in terminating the cycle: It alerts the hypothalamus that the stress response is complete, and it can stop producing CRH. "It follows a circadian rhythm," Tan explains. "Circadian rhythm is our recurring, natural 24 hour sleep-wake cycle. [Cortisol] is known to be highest right before we wake up and slowly wane in the evening hours, at its lowest point at night, and during our sleep."
Like any hormone, though, it can get out of balance. Too much exposure to cortisol over a long period of time can cause a condition called Cushing syndrome. It's often an unfortunate side effect of taking steroid medications to manage auto-immune diseases. In other sufferers, it's produced by (typically non-cancerous) tumors in the pituitary or adrenal gland that disrupt normal hormonal functioning.
"There are certain symptoms or conditions that lead doctors to suspect pathologic hypercortisolism, or Cushing's," says Tan. "These include rapid weight gain, especially around the abdominal area, difficult-to-control blood sugars, [and] difficult-to-control hypertension."
The stereotypical symptom is weight gain in the face, sometimes called "moon face" (the authentic version of the so-called "cortisol face" feared by influencers). Women with Cushing syndrome also can develop unusual dark hair on their body, called hirsutism, and experience unexpected changes to their menstrual cycles.
Even outside of a Cushing scenario, stress can cause the stress response cycle to become overactive, which damages the body. When the cortisol switch gets stuck in the "on" position, its role in managing blood sugar and blood pressure for the body's benefit can instead point to Type 2 diabetes and hypertension.
"The important message is that cortisol is not the culprit," Tan says. "Cortisol is the reaction, or signal, that tells us that the body is under stress."
Indeed, as Tan notes, patients who lose their glands to surgery and no longer make their own natural cortisol must replace the hormone with oral medication if they hope to maintain healthy functioning. The mirror image of Cushing, called adrenal insufficiencey or Addison's disease, can be just as life-threatening—earlier this year, it contributed to the death of TikTok star Taylor Rousseau Grigg at age 25. Although symptoms often progress slowly and silently, signs of a sudden Addisonian crisis include severe weakness, abdominal pain, vomiting, and delirium. It can develop after tuberculosis or other infections, but most commonly, as a consequence of an auto-immune disease attacking the adrenal glands.
Since having either too much or too little cortisol is bad news for our bodies, how do we keep this critical hormone in balance? A key factor lies in protecting the stability of the circadian rhythm that moderates cortisol production. "Make sure you have a healthy sleep-wake cycle. Make sure you sleep well and get enough hours of sleep to maintain your body's circadian balance," recommends Tan.
Expensive online courses and esoteric diet regimes aren't necessary. What could help is finding ways to space out the stressful experiences of life so that they are intermittent, and not constant—though that's not something we always have control over (a girl can dream).
It's also not necessary to pay for expensive blood tests to constantly monitor cortisol levels. Unless your doctor suspects a specific condition like Cushing syndrome or Addison's disease, it's likely a waste of resources. "This will not yield anything productive," Tan says. "Why would you need a blood test to determine whether you are stressed?"
The bottom line is that cortisol makes for a poor suspect for a wellness witch hunt. Counseling followers to get more sleep and pursue moderation and balance is not a formula that pleases the algorithm, nor is such advice very saleable. But it remains true. Keep smiling widely, readers: Our adrenal glands are not the enemy.
What Is Cortisol, And What Is Its Purpose?
Cortisol is a steroid hormone that regulates a wide range of body functions, including immunity, inflammation, and metabolism. Because of its role in regulating the stress response, people also call it the stress hormone.
Cortisol production and regulation involve a complex interaction between areas of the brain and the adrenal glands, which are located just above the kidneys.
Problems with any part of this system can lead to cortisol levels that are too high or too low, which can cause symptoms.
Cortisol is a steroid hormone that affects almost every organ and tissue in the body. It helps regulate body functions such as:
Cortisol production and regulation involves a complex interaction between two areas of the brain called the hypothalamus and the pituitary gland, as well as two small glands called the adrenal glands, which sit just above the kidneys. Scientists refer to this system as the hypothalamus-pituitary-adrenal (HPA) axis.
The hypothalamus releases corticotropin-releasing hormone (CRH). This hormone instructs the pituitary gland to release adrenocorticotropic hormone (ACTH), which tells the adrenal glands how much cortisol to produce.
Once cortisol levels reach a certain level, they block the release of both CRH and ACTH. This type of self-regulating feedback loop is called homeostasis.
The HPA axis follows a circadian rhythm, in which cortisol levels are naturally high in the morning and low at night.
Cortisol works on special receptors called glucocorticoid receptors, which exist in almost all body tissues. For this reason, cortisol can affect almost every organ system in the body, including the following systems:
Cortisol regulates the following functions in the body:
Stress activates a part of the nervous system called the sympathetic nervous system (SNS).
Once activated, the SNS triggers a hormonal and physiological reaction called the fight-or-flight response, which allows a person to fight or flee perceived danger by:
A part of the brain called the amygdala processes the threat to determine whether the body needs to take further action.
If necessary, the amygdala sends a signal to the hypothalamus, which then activates the HPA axis. Once activated, the HPA axis releases a surge of cortisol. The extra cortisol provides an energy boost that allows a person to remain alert to potential danger.
Cortisol is one of several hormones that allow the body to react appropriately to perceived danger. However, chronic stress can lead to persistently high cortisol levels, which can be damaging to health.
Learn more
Learn more about stress and cortisol levels:
Chronic high cortisol levels can cause a condition called Cushing syndrome. People with this condition may notice the following symptoms:
There are two main types: endogenous and exogenous. Endogenous Cushing syndrome develops because of an issue inside the body. Exogenous Cushing syndrome develops as a result of taking certain medications.
The most common cause of endogenous Cushing syndrome is a type of pituitary gland tumor called a pituitary adenoma. This type of tumor is typically slow-growing and benign.
The most common cause of exogenous Cushing syndrome is the long-term use of high dose cortisol-like medications called glucocorticoids. This condition usually goes away once a person stops taking the medication.
Non-neoplastic hypercortisolism
Severe, persistent stress can result in increased cortisol production, which can lead to pseudo-Cushing syndrome.
This can involve symptoms similar to those of Cushing syndrome. The symptoms tend to resolve once a person has addressed the cause.
Treatments for high cortisol
Treatments for high cortisol depend partly on the cause.
If a person is experiencing high levels of stress, they may find it helpful to speak with a healthcare professional. A healthcare professional may prescribe medications and provide information on how to manage stress.
Other possible treatment options include:
Low cortisol levels can be a sign of adrenal insufficiency, a condition in which the HPA axis does not produce enough cortisol.
The most common symptoms of adrenal insufficiency include:
Treatments for low cortisol
The main treatment for low cortisol levels, or adrenal insufficiency, is hormone medication to replace the hormones that the adrenal glands are no longer producing. The hormone medication doctors usually prescribe to replace cortisol is hydrocortisone. Less often, doctors may prescribe prednisone or dexamethasone.
People with Addison's disease will also need to take a hormone medication called fludrocortisone to replace the aldosterone their adrenal glands are no longer producing. This medication helps balance sodium and fluid levels in the body.
Doctors can test cortisol levels by measuring the amount of cortisol in a person's blood, urine, or saliva.
Blood test
When testing blood cortisol levels, a healthcare professional will usually take two blood samples in 1 day. They will take one in the morning, when cortisol levels are naturally at their highest, and another at around 4 p.M., when cortisol levels are naturally much lower.
Urine test
In some cases, doctors may suggest a 24-hour urinary free cortisol test. For this test, a person collects their urine over a 24-hour period. A doctor then sends the sample to a lab for further analysis.
A urine test that shows above-average cortisol levels may suggest Cushing syndrome, while a test that shows below-average cortisol levels may suggest adrenal insufficiency.
Saliva test
Another test that can help determine cortisol levels is a late night salivary cortisol (LNSC) test. For this test, a person collects a saliva sample in the late evening, when cortisol levels are naturally at their lowest.
An LNSC test that shows high cortisol levels may suggest Cushing syndrome.
A person should contact a doctor if they experience symptoms of high or low cortisol levels or if they have risk factors for Cushing syndrome or adrenal insufficiency.
The main risk factor for Cushing syndrome is long-term use of high dose glucocorticoid medications. Risk factors for adrenal insufficiency include:
Cortisol is a steroid hormone that affects almost every organ and tissue in the body. It has a range of important functions, including regulating the body's stress response, immune response, and inflammatory response and maintaining blood pressure and blood glucose levels.
Cortisol production and regulation involves a complex interaction between the brain's hypothalamus and pituitary gland and the adrenal glands above the kidneys.
Problems in any part of this system can cause cortisol levels to become too high or too low. Problems can also result from taking cortisol-like medications for other health conditions.
High cortisol levels are a characteristic sign of Cushing syndrome, while low cortisol levels are a characteristic sign of adrenal insufficiency.
A person should consult a doctor if they experience symptoms of Cushing syndrome or adrenal insufficiency or if they have risk factors for either condition.
Should We Be Stressed About Our Cortisol Levels? I Got A Blood Stress Test To Find Out
Cortisol is known as the "stress hormone," and ironically, online discussions and videos about cortisol imbalance seem to stress people out. That includes me: I have anxiety and, as a result, I've always wondered about how my stress is affecting my cortisol levels. I finally got the opportunity to find out when Quest, a diagnostic information services provider, offered me a complimentary Cortisol Blood Stress Hormone Test.
Following my cortisol blood test, I've spoken with several doctors to better understand my "high cortisol" results and answer the question: Should we all be concerned about cortisol? Or are all these videos on social media stressing us out for no reason?
What is cortisol? Does it control stress? From talking fridges to iPhones, our experts are here to help make the world a little less complicated."Cortisol is an essential hormone produced and released by adrenal glands," said Dr. Sanjay Dixit, medical director of cardiometabolic endocrine and wellness solutions at Quest Diagnostics and medical expert for questhealth.Com, in an email. "Many people associate cortisol as being the 'stress hormone,' but it actually has many additional important functions."
In addition to managing the body's response to stress, cortisol regulates blood sugar and blood pressure, the sleep-wake cycle and metabolism while suppressing inflammation.
"It is most commonly known as the 'stress hormone' because it's released in response to stress and works to prepare the body for 'fight-or-flight,'" added Dr. Sajad Zalzala, co-founder and chief medical officer of longevity platform AgelessRx, via email. "It increases glucose availability, which supplies energy and mobilizes stored fats and proteins to provide additional fuel."
From talking fridges to iPhones, our experts are here to help make the world a little less complicated. Do you need a cortisol blood test?Dr. Dixit explained that someone could get a cortisol test to see if they have a cortisol deficiency, also known as adrenal insufficiency. Symptoms of this can include:
Another reason a cortisol test may be ordered is to see if a patient has excess cortisol, generally known as Cushing's syndrome. Potential symptoms for this include:
"[Impaired glucose tolerance is] something that can be particularly noticeable in type 2 diabetic patients who have trouble managing their glucose levels even with adherence to prescribed medication," said Dr. Dixit.
Westend61/Getty ImagesWhat happens during a cortisol blood test?Before my blood was drawn for this test, I had my yearly physical with my primary care provider. I notified her that I would be getting this test and asked to have my other preventative blood tests taken simultaneously. I want to mention this because it's important to run any health-related tests by a doctor who knows you and your health history.
According to Quest, you must be at least age 18 to buy a test, which is unavailable in Alaska, Arizona or Hawaii. For select tests, you will be asked to answer relevant medical questions. Before a test order is submitted for processing, your purchase and answers will then be reviewed by a telemedicine doctor affiliated with the national clinician network PWNHealth to ensure this test is medically appropriate for you.
You must also schedule the cortisol test between 7 a.M. And 9 a.M. "Cortisol levels naturally change throughout the day," Quest answered in an FAQ, stating that since cortisol levels usually peak in the morning, this particular level would be the best indicator of a cortisol problem.
No fasting is required. But I had to fast for the other blood tests ordered by my doctor.
According to Dr. Dixit, it is also important to note that "a blood test for cortisol can be inaccurate in some cases." Inaccurate results, for example, can happen if a person is taking oral contraceptives or steroids, such as prednisone.
Once I bought the cortisol test on Quest's website -- it ordinarily costs $89 with a $6 physician service fee -- I was sent an email with my order number and a link to schedule an appointment at a nearby Quest location. I scheduled my appointment for 8:20 a.M. At the facility closest to me.
On the day of my appointment, I was texted a link to check in when I arrived and was admitted within 5 minutes. (I highly recommend scheduling beforehand so you don't have to wait.) I get particularly anxious about blood tests, so I notified my technician and asked if I could lie on an exam table. She assured me that many people get nervous about blood tests and, after I signed off on my tests, did a great job talking to me as a distraction while my blood was drawn.
Later that night, I received the results of my cortisol test. As for the results from the tests ordered by my doctor, I received them five days later. Quest reports that processing times vary, but it generally takes up to eight business days to receive results.
My cortisol blood test resultsUnsurprisingly, my cortisol blood test results came back as "high" at 33.2 mcg/dL. Quest reports that a normal range between 7 a.M. And 9 a.M. Is 4.0-22.0 mcg/dL. To be frank, this freaked me out. I had a feeling that my cortisol levels would be high because of my general anxiety and heightened nerves around blood tests, but actually seeing that "high" result and not fully understanding it ironically increased my stress levels even more.
Quest allows you to discuss your results with an independent physician, so I took advantage of this offer. I called Quest's customer service line and was emailed to schedule my appointment with a physician at PWNHealth via Everly Health Solutions, a digital health company that acquired PWNHealth in 2021. When scheduling my appointment, I provided context about my cortisol blood test. I was then told that a physician would call me within 4 hours during business hours.
Within 4 hours, a PWNHealth physician called. I asked the doctor if my cortisol level was in line with the fact that I have anxiety and was stressed about the blood test. She said that it could be why my cortisol was acutely high, but that chronically high cortisol levels could be concerning and caused by other conditions, certain medications or pregnancy. She added that it could be related to an adrenal gland condition.
I also asked about how high cortisol levels can go and she stated that there is no "highest point," especially since it varies from person to person, depending on the condition. She added that people with adrenal gland conditions typically show higher cortisol levels, but there isn't a specific cutoff.
Though the doctor stated that my high cortisol was likely due to anxiety, she recommended that I follow up with my primary care physician. Afterward, I was able to download my Quest results as a PDF and send them to my PCP.
mapodile/Getty ImagesWhat are 'normal' cortisol levels? Why do they change?"The 'normal' reference range varies slightly with the lab that's doing the testing," said Dr. Zalzala. "Quest reports a normal a.M. (7 to 9 a.M.) blood level of 4.0 to 22.0 mcg/dL, whereas Labcorp reports normal a.M. Blood level of 6.2 to 19.4 mcg/dL."
As for why cortisol varies throughout the day: "Cortisol is very important in helping a person transition from sleep to wakefulness," Dr. Zalzala explained. "This triggers a 'morning cortisol surge' -- a rapid rise in cortisol levels within 20 to 30 minutes of waking, which jumpstarts alertness and prepares the body for the day."
Over the course of the day, our bodies will also experience mini peaks in cortisol levels to help us maintain energy and alertness. These peaks typically occur around noon and in the early evening. "Interestingly, these peaks often align with standard meal times, playing a key role in supporting our body's ability to metabolize food and regulate energy levels," said Dr. Zalzala.
Dr. Betul Hatipoglu, MD, professor of medicine at Case Western Reserve University's School of Medicine and medical director of the Diabetes and Metabolic Center at the University Hospital Cleveland Medical Center, stated in an email that there is a "normal, what we call 'circadian rhythm' for cortisol." As the day goes on, cortisol levels will gradually decrease and become lowest closer to bedtime.
How high can cortisol levels go?"Cortisol levels could go as high as or closer to 40 [mcg/dL] in individuals who are extremely ill, such as people in intensive care," Dr. Hatipoglu said. Dr. Zalzala added that a normal adult can generate cortisol levels up to 50 mcg/dL, which is about two to three times their morning surge level, during times of stress.
Dr. Zalzala also mentioned Cushing's syndrome, a rare disorder in which "the adrenal gland starts making cortisol on its own (adrenal tumor) or in response to a pituitary gland tumor that makes too much ACTH [adrenocorticotropic hormone, which regulates cortisol] and ignores the feedback cycle." For those with this disorder, cortisol levels can go as high as 100 mcg/dL.
In cases where someone is extremely ill, such as with septic shock, Dr. Zalzala stated that levels can be as high as 1,000 mcg/dL.
Maskot/Getty ImagesThe relationship between cortisol and anxietyI shared my results with all the doctors I consulted to see if I could get a better understanding of how anxiety could affect my cortisol levels -- and any other factors that may be at play.
"High cortisol in a normal individual can be a sign of stress in your case," said Dr. Hatipoglu. "However, sometimes other hormones can affect the cortisol levels. For example, if someone is taking oral contraceptives or estrogen therapy, this can increase total cholesterol, which is what you have been tested for."
Due to fasting, anxiety and being stressed about my blood draw, Dr. Zalzala said that combination could have caused my morning cortisol level to be higher than normal. He added, "Studies have shown that stress or acute anxiety can drive cortisol levels significantly higher, often to values similar to what you experienced."
Do doctors recommend a cortisol blood test? What other cortisol tests are there?"I usually would check a random cortisol before 9 a.M. In the morning to make sure the level is not low," said Dr. Hatipoglu. "If we are concerned about high cortisol, it is usually recommended that we actually do different evaluations."
To understand whether elevated cortisol levels are a normal reaction or an abnormal increase, Dr. Hatipoglu may then want to do testing such as a milligram dexamethasone suppression test (which measures whether cortisol secretion by the adrenal gland can be suppressed) or a 24-hour urine cortisol test (which measures the amount of cortisol in a person's urine over a day). However, if a patient is on birth control, stopping it for a few months and then repeating the cortisol test may help show their body's actual cortisol levels.
Dr. Zalzala, on the other hand, stated that he rarely recommends a single morning cortisol test unless a patient is believed to have Addison's or Cushing's disease. Addison's is a rare endocrine disorder caused by damaged adrenal glands that can't produce enough hormones.
"For those people who want to use cortisol levels as a tool to make lifestyle adjustments and to monitor other interventions (like therapy or sleep medications), then the saliva cortisol level is the one I would recommend," stated Dr. Zalzala. "Studies indicate that salivary cortisol levels show a reasonably strong correlation with serum cortisol."
For my "high" result specifically, Dr. Zalzala stated, "While this result aligns with the stress factors you've described, cortisol levels above 20–25 µg/dL [which is the same as mcg/dL] in the morning can sometimes prompt further evaluation, particularly if symptoms suggest additional hormonal imbalance."
If I were to take supplementary tests under less stressful conditions and my cortisol continues to be elevated, Dr. Zalzala said I should explore other factors with my healthcare provider. "They may consider repeating the test using alternative methods, like a 24-hour urinary free cortisol or late-night salivary cortisol test, which are less affected by immediate stress responses."
While this particular cortisol blood stress hormone test can be a good first step, Dr. Dixit acknowledges that it may not necessarily be the last one. He suggested that a person concerned about their health should talk to their doctor -- even if the test results don't show anything wrong.
AzmanJaka/Getty ImagesWhat happens if a cortisol blood test is abnormal?"I think the best way here would be to see a physician, a nurse practitioner or a healthcare provider to get an evaluation," Dr. Hatipoglu said. "[This is] done to understand if it is true [cortisol] elevation or is it stress-induced."
Dr. Dixit specifically recommended that in addition to a primary healthcare provider, one could see an endocrinologist, a doctor specializing in diagnosing and treating health conditions that affect the endocrine system. "That's because testing for excess cortisol is not as straightforward as a single blood test," he said, adding that a healthcare provider could perform an evaluation, recommend additional tests and consider other potential causes.
However, if additional tests remain abnormal, a trained clinician must be consulted for further diagnostic decisions. "Most conventionally trained physicians would initially evaluate for Cushing's or Addison's disease," Dr. Zalzala said. "If these are ruled out, a thorough clinician would then investigate other contributing factors affecting cortisol levels. Conversely, a less attentive approach might dismiss the patient without addressing the underlying issues."
If a doctor does determine that there are problems with excess cortisol or adrenal insufficiency, Dr. Dixit stated that the methods used to address the issue depend on the root cause. For example, with Cushing's syndrome, medication or surgery may be required since the disorder can be caused by a tumor on the adrenal or pituitary glands.
What can cause abnormal cortisol levels?"I think it's useful to talk about the ways the normal cortisol cycle can be disrupted, that could show up on salivary testing if done at the right times of day," said Dr. Zalzala, who listed the following as common causes for a disrupted cortisol cycle:
Symptoms of high cortisol or cortisol deficiency can also be connected to non-cortisol-related conditions and health issues, according to Dr. Dixit. That is why consulting a doctor about your results and symptoms is essential.
Ekaterina Goncharova/Getty ImagesAbnormal cortisol health impactsWhile social media may oversimplify all things cortisol as a means of clickbait, Dr. Zalzala said it should not be dismissed. That's because dysregulated cortisol has the following long-term health impacts:
The question that's on everyone's mind. After mentioning all of the social media videos circulating saying that people should be worried about their cortisol levels, I asked doctors if there is any legitimacy to these claims or if it's just fearmongering.
"I don't think it is fair to say people should be concerned about their cortisol levels -- as you can see, cortisol constantly fluctuates," said Dr. Hatipoglu. "The fluctuation occurs so many times that it is sometimes even difficult to know what is very normal or very abnormal." However, if you are concerned about your cortisol, she recommends seeing a doctor to see if a test is needed first instead of having it tested randomly.
While Dr. Zalzala acknowledges that there is some truth to the concept of "minding your cortisol levels," since there are medical conditions that can cause abnormal cortisol levels, he believes "social media often oversimplifies this, turning cortisol into a scapegoat for various health issues." He specifies that cortisol imbalances are typically caused by deeper issues such as poor sleep, unhealthy habits, unmanaged stress and substance abuse, in which case "cortisol is more of a symptom than the root cause."
"Cortisol levels, as a tool, should be used in conjunction with other tools like a CGM sensor or a sleep monitor," concluded Dr. Zalzala.
How to naturally reduce cortisol with lifestyle changes"I usually recommend important, basic lifestyle management, [including] nutritious meals and good nutrition; movement exercise like yoga, walking and swimming; a good night's sleep, meditation and mindfulness; good vitamin D; and stress management for day-to-day stresses of life," said Dr. Hatipoglu. "And last, as much as possible, eliminating smoking and excess alcohol."
"Minimize caffeine and sugar intake, especially later in the day," Dr. Zalzala recommended. "Both can elevate cortisol and disrupt the normal rhythm, making it harder to wind down at night." Excess sugar and starch can cause a spike in blood sugar followed by a crash. This can occur in the middle of the night, disrupting your sleep.
If you maintain a consistent sleep schedule and evening routine without screen time or intense exercise (which can elevate cortisol and disrupt sleep) but still struggle to fall asleep, Dr. Zalzala recommends mild sleep aids like melatonin or L-theanine before moving on to strong options like passionflower or California poppy. "If these aren't effective, consult a doctor about medications like trazodone or doxepin and rule out conditions like sleep apnea," he said. "Always discuss sleep therapies, including OTC supplements, with a doctor."
The takeawayWhile the results of my cortisol blood test did stress me out, I'm glad I tried it because it helped me learn more about cortisol. It also gives me even more of an incentive to increase my stress and anxiety management. While I've always prioritized my health and wellness, since getting the cortisol blood test, I've started exercising more than before, going to bed earlier, thinking up new ways to lower my stress levels and paying closer attention to having a well-balanced diet.
As for ordering the test through Quest, I thought the process was smooth, and it's nice to have control over the health tests you can get done (if approved, of course). I also appreciated having the option to speak with an independent physician about my results. However, as both Quest and the doctors I consulted advised, it is best to do any health tests under the supervision of a healthcare provider, who can then help with diagnosis and potential treatment. I'm glad I told my doctor about the test and that it was easy to send her my results. And now, I'm way more informed about what the next steps could be if further testing is needed.
Comments
Post a Comment