Cortisol, a question of balance

Stress is probably one of the greatest evils of our time, and we hear a lot about cortisol as the enemy to be defeated. While it's true that its presence in excessive quantities has many negative effects, at its core, cortisol is a necessary and desirable hormone. Indeed, as with almost everything related to health, the goal is not to completely eliminate it, but rather to balance it. So let's see how cortisol is useful to us, but also what impacts an imbalance could cause and how to help us better manage this stress hormone.

What Cortisol Does in Our Body

Cortisol is linked to the concept of allostasis, that is, the mechanisms by which the body modifies its physiological functions to maintain its homeostasis (balance) in response to or even in anticipation of real or perceived stress. For example, moderate to intense physical activity can generate a release of adrenaline and cortisol that will create an increase in blood pressure; this is a healthy adaptation mechanism. On the other hand, constant high blood pressure, which would be due to a chronic excess of cortisol, is now rather pathological and undesirable.

Here are some other examples of the effects of cortisol in the body:

• Immunomodulation : Normally, cortisol plays a role in the immune system in response to inflammation to help modulate the immune response and control inflammation. However, under chronic stress, cortisol remains consistently elevated and cells appear to become accustomed to it, leading to resistance to its action. This obviously affects the effectiveness of the immune system and may contribute to the state of low-grade systemic inflammation.¹

• Circadian cycle : Cortisol levels follow a 24-hour cycle that helps regulate our circadian rhythm with the help of melatonin. When it is at its lowest, melatonin will be at its highest, allowing us to sleep. In the morning, when we wake up, cortisol will be at its highest, and this peak allows us to wake up properly and activate our metabolism. However, since cortisol begins to rise around 2-3 a.m., if it is already high due to a period of stress or chronic stress, this could cause nighttime awakenings in addition to affecting the quality of sleep. Also, if the peak occurs at the wrong time or there is no peak in the morning, this could be linked to difficulty waking up and feeling ready to start the day upon waking.²

• Metabolic functions : Cortisol affects metabolic health through several mechanisms. It is known to increase blood pressure by causing blood vessels to constrict. 3 High blood pressure, one of the diagnostic criteria for metabolic syndrome, has several recognized adverse effects on overall health. Cortisol also acts on the pancreas and liver to increase blood sugar (among other things via glucagon) and contributes to insulin resistance. As a result, increased blood sugar will subsequently lead to an increase in insulin, which causes cells to store excess glucose, particularly as fat. However, cortisol will tend to direct this storage to visceral fat rather than subcutaneous fat. This visceral fat surrounding our organs will further increase inflammation in these organs and contribute to the release of pro-inflammatory cytokines, further contributing to the state of low-grade systemic inflammation.⁴⁻⁵

• Hormonal system : Initially, the increase in cortisol is proportional to the increase in thyroid hormones since the thyroid regulates metabolism. However, chronic stress related to cortisol will lead to a change in the hypothalamus that will lead to a decrease in thyroid hormones in addition to impairing the effectiveness of thyroid hormones and the sensitivity of cells to them. At the level of sex hormones, cortisol could decrease GnRH (gonadotropin-releasing hormone) in addition to disrupting carbohydrate metabolism, which affects the levels of sex hormones. In women, there may be more estrogen and testosterone, which can be linked to polycystic ovary syndrome, among other things. In men, it seems that these disturbances instead lead to a decrease in testosterone, causing various problems such as erectile dysfunction.⁶

• Neuroinflammation : Cortisol is linked by several mechanisms to systemic inflammation, which in turn contributes to neuroinflammation. Inflammatory states disrupt the blood-brain barrier and activate microglia, the brain's immune cells. These cells release inflammatory cytokines, chemokines, and reactive oxygen species, causing disruptions in neurotransmission and neuroplasticity. Neuroinflammation, a phenomenon that is increasingly being studied, appears to be linked to several neurological pathologies, including depression.⁷

• Mood and memory : : According to some studies, chronic stress causes hippocampal atrophy and an enlarged amygdala, which are linked to depression, as is neuroinflammation. Furthermore, these brain changes may also be linked to problems with memory, concentration, and learning.⁸

• Leaky gut and dysbiosis : Cortisol, and more specifically corticotropin (cortisol-releasing hormone), affects the intestinal epithelium and microbiota in several ways. Corticotropin appears to weaken the tight junctions between enterocytes, contributing to what is called intestinal permeability. When the integrity of the intestinal epithelium is compromised, many antigens or immunogenic particles can cross this barrier and lead to inflammatory reactions and activation of the immune system, which is widely present in the intestine. In addition, chronic stress, which is associated with the release of cortisol, is associated with disruptions in the mucin layer (protective mucus of the mucosa), the function of mitochondria in intestinal cells, the composition of the microbiota, intestinal transit, and more. Gut health plays a central role in overall health through several axes. Gut permeability and dysbiosis are being linked to a growing number of health conditions, which can affect both the gut and the rest of the body.⁹

What can be done to help rebalance cortisol

To manage stress effectively, you must first know how to recognize it. Stress is not only emotional; it can be:

• PSYCHOLOGICAL: emotions, abuse…
• PHYSICAL: exercise (too much or not enough), injury, lack of sleep, surgery, lack of oxygen, pregnancy…
• BIOLOGICAL: infections (viruses, bacteria, yeasts, parasites)...
• ENVIRONMENTAL: extreme temperature, electromagnetic fields, noise, sun/UV rays, changes in atmospheric pressure, altitude, radiation, etc.
• NUTRITIONAL: deficiencies, sugar (pro-inflammatory), significant blood sugar fluctuations, alcohol, intolerances/allergies, fried foods and trans fats (pro-inflammatory)...
• CHEMICAL: pesticides, food additives, heavy metals, PFAS, drugs, plastics, fragrances, smoke, dust, etc.

Obviously, some acute stresses are known to be beneficial and stimulate the body to adapt and increase its resilience. The goal is therefore not to completely eliminate stress from our lives and remain comfortable and secure at all times. On the contrary, the search for comfort is aging, according to some longevity specialists. So, although challenging ourselves and stepping out of our comfort zone can, in fact, cause us to experience what is called acute stress, the body is normally well equipped to cope with it. The problem is when stress becomes chronic. This is why it may be relevant to identify the stressors we face and try to eliminate those that do not bring us benefits. Adopting different techniques and lifestyle habits can also promote better stress management. Here are a few:

• Abdominal breathing : The vagus nerve, involved in the autonomic nervous system, is activated by abdominal or diaphragmatic breathing. Inhalation is said to be more activating of the sympathetic nervous system ("fight or flight") while exhalation is said to be more activating of the parasympathetic nervous system ("rest and digest"). For this reason, when we try to regain a state of relaxation, it is recommended to adopt a breathing pattern with a longer exhalation than inhalation. This technique has proven effective in numerous studies and one way to assess the state of the autonomic nervous system is by measuring heart rate variability (HRV). In one study, a single 5-minute breathing session with 4 seconds of inhalation and 6 seconds of exhalation was effective in participants of all ages in achieving better HRV and reduced feelings of anxiety.¹⁰

• The use of calming essential oils such as lavender, chamomile, bergamot, or neroli, among others, has been shown to be effective in reducing feelings of stress and anxiety. These contain different molecules capable of acting on certain mechanisms such as the regulation of GABA, a calming neurotransmitter.¹¹

• Adaptogenic plants are increasingly being studied, and their effects on the hypothalamic-pituitary-adrenal axis, among other things, are well recognized and even scientifically demonstrated. They work, among other things, by increasing the stress resistance phase and helping to achieve a state of adaptation rather than a state of exhaustion. They therefore allow for greater resilience in daily life and provide better reserves to cope with various stressors.¹²

• Cognitive Behavioral Therapy: There's often a fine line between excitement or restlessness and stress or anxiety. In fact, they're similar physiological processes, but they don't have the same associated emotion. So, take the time to analyze the situation to see which emotion is more accurate. For example, it can be normal to feel anxious about a job interview. However, it can also be perceived as exciting or as a challenge to overcome that will make you proud. Additionally, it seems that repeating out loud that it's excitement and not anxiety can help convince yourself. 13 Stress is often a matter of perception according to the principles of cognitive behavioral therapy, so our thoughts are very important and therapists are best placed to support you in managing this if anxiety takes up too much space in your daily life.¹³

• Slow down, take the time to rest and why not also practice relaxation or mindfulness activities.

• Take care of yourself, learn to prioritize yourself and respect your limits.

• Implement techniques to improve the quality of sleep (see the article Who sleeps well, lives well).

• Expose yourself to sunlight early in the day to promote the cortisol spike that helps us wake up and balance the circadian cycle.¹⁴ Also, the sun's rays in summer allow you to benefit from the benefits of vitamin D and nitric oxide which are produced when the skin is exposed, without burning of course.

• Breathe good air, free as much as possible from pollutants.

• Choose good foods and drinks, as little processed as possible, and why not include foods rich in tryptophan (precursor of serotonin) and magnesium (mineral known for relaxation).

• Taking care of our microbiota: include foods rich in fiber, prebiotics and fermented foods, probiotics.

• When we feel an adrenaline rush, we can also use all that energy to do physical activity, for example. Physical activity is a very good technique for increasing our resilience to stress.

• Limit our exposure to media that may use sensationalism to generate greater reactions

• Limit cell phone use and perhaps even set it to black and white to limit overstimulation. It may be a good idea to keep it out of reach as much as possible to avoid the FOMO reaction (an acronym from English that can be translated as the fear of missing out), which always puts us on the lookout, in a state of hypervigilance.

• Spend time with people you love and who make you feel good. Laughter releases endorphins and lowers cortisol.

As you may have noticed, cortisol has its place, as do stress and anxiety, which push us to push ourselves, adapt, and improve. The important thing is to find balance!

References

1. Alotiby A. Stress immunology: a review article. J Clin Med. 2024 Oct 25;13(21):6394. doi: 10.3390/jcm13216394. PMID: 39518533; PMCID: PMC11546738.

2. Peel Yates, Victoria. “Why you wake up at 3am - And how to go back to sleep”. OURA. September 19, 2023. (Consulted March 5, 2025). https://ouraring.com/blog/fr/why-do-i-wake-up-at-3-am/

3. Bourdua-Roy, Èvelyne. “How sleep can help you stay slim or make you diabetic.” Vitalité Québec . September 12, 2023. (Accessed December 30, 2024). https://vitalitequebec-magazine.com/comment-le-sommeil-peut-vous-aider-a-rester-mince-ou-a-vous-rendre-diabetique/

4. Peredes S, Ribeiro L. “Cortisol: The villain in metabolic syndrome”. Rev Assoc Med Bras 60 (1), Jan.-Feb. 2014. https://doi.org/10.1590/1806-9282.60.01.017

5. Cleveland Clinic. "Cortisol." Revised February 17, 2025. (Accessed March 5, 2025). https://my.clevelandclinic.org/health/articles/22187-cortisol

6. Bourbeau, Véronique. "The Impact of Lifestyle Habits on Your Hormones." Webinar. Vitoli, October 17, 2024.

7. Hassamal, Sameer. “Chronic stress, neuroinflammation, and depression: an overview of pathophysiological mechanisms and emerging anti-inflammatories”. Forehead. Psychiatry . May 10, 2023. https://doi.org/10.3389/fpsyt.2023.1130989

8. Moisan MP, Le Moal M. “Stress in all its states”. Med Sci (Paris) . June-July 2012; 28(6-7):612-7. doi: 10.1051/medsci/2012286014. PMID: 22805137.

9. Rodiño-Janeiro BK, Alonso-Cotoner C, Pigrau M, et al. “Role of Corticotropin-releasing Factor in Gastrointestinal Permeability”. J Neurogastroenterol Motil. 2015 Jan 1;21(1):33-50. doi:10.5056/jnm14084. PMID: 25537677; PMCID: PMC4288093.

10. Magnon V, Dutheil F, Vallet GT. “Benefits from one session of deep and slow breathing on vagal tone and anxiety in young and older adults”. Sci Rep 11, 19267 (2021). https://doi.org/10.1038/s41598-021-98736-9

11. Fung TKH, Lau BWM, Ngai SPC, Tsang HWH. “Therapeutic Effect and Mechanisms of Essential Oils in Mood Disorders: Interaction between the Nervous and Respiratory Systems”. Int J Mol Sci. 2021 May 3;22(9):4844. doi:10.3390/ijms22094844. PMID: 34063646; PMCID: PMC8125361.

12. 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.

13. Brooks A.W. “Get excited: reappraising pre-performance anxiety as excitement.” J Exp Psychol Gen. 2014 Jun;143(3):1144-58. doi:10.1037/a0035325. Epub 2013 Dec 23. PMID: 24364682.

14. Huberman A. “Using light for health.” Huberman Lab . January 24, 2023. (Accessed March 5, 2025). https://www.hubermanlab.com/newsletter/using-light-for-health

Maison Jacynthe disclaims all liability. All information contained on this page is not intended to replace justified allopathic treatment or to disregard the expertise of the medical profession. It is up to each individual to take charge of their own health, to inform themselves, and to make the necessary changes to improve their condition. Therapeutic supervision by a qualified health professional is obviously recommended.