With a nickname like “the stress hormone,” it’s no wonder cortisol is often talked about with the same disdain as moldy bread; something unwanted. When feelings of stress, acne, weight changes, or exhaustion persist, many people self-diagnose themselves with cortisol levels that are “too high.”
While it’s true that high cortisol levels can result in the aforementioned symptoms (among others), cortisol’s moniker is misleading. The truth is, we need cortisol. “Cortisol, which is one of the sex hormones, is essential for life,” Harvard-educated doctor and author of Women, Food, and Hormones ($23), Sara Gottfried, MD, says. Dr. Gottfried explains that, like pretty much everything else in life, balance is key when it comes to cortisol. Too-high levels aren’t good for health, but neither are too-low levels.
Functional medicine dietitian Lacey Dunn, RD, cosigns this in her new book, The Women’s Guide To Hormonal Harmony ($30). “It’s the Goldilocks effect. We don’t want cortisol to be too high or too low; we want it to be just right,” she says. Perhaps because so many people are perpetually stressed, you may automatically assume that if your cortisol levels are out of whack, it’s because they’re too high. But both hormone experts say cortisol levels can certainly dip too low. Keep reading to learn more about cortisol’s role in the body, what can cause levels to dip, and how to bring balance to your body.
Low cortisol symptoms to be aware of
The reality is, cortisol isn’t “bad” – it plays a vital role in our health. Both Dr. Gottfried and Dr. Dunn said as much. When under stress or inflammatory conditions, cortisol is released. Stress, illness, and injury stimulate our adrenal glands, which activate our sympathetic nervous system.
According to her, this results in a domino effect of several hormones being released, including cortisol. This domino effect is beneficial in the short term: it’s part of the body’s immune response and helps reduce inflammation. People who stay in constant fight-or-flight mode for long periods of time are at risk, according to Dunn. A chronically high cortisol level can result as well as a chronically low cortisol level.
One of the main reasons it is difficult to determine whether cortisol levels are too high or too low is that the same factors can contribute to imbalances on either end of the spectrum, and they can manifest in very similar ways. Low cortisol shares many of the symptoms of high cortisol. “That’s why it is critical to have your cortisol levels checked by a doctor instead of guessing yourself,” Dr. Gottfried says. “It is also common for someone to experience both high and low cortisol levels in the same day,” she adds. “I sometimes have patients whose cortisol levels rise in the morning then drop in the afternoon. This is because if the body runs low on cortisol, it will try to make up for it by producing too much. This is a vicious cycle.”
Dr. Dunn says there are some causes of low cortisol levels that overlap with those of high cortisol levels, but some are more strongly linked to low cortisol levels. Among these are traumatic brain injury, post-traumatic stress disorder, chronic fatigue syndrome, and fibromyalgia. Checking your cortisol level is especially important if you suffer from one of these health conditions.
It is very important that you undergo blood, saliva, or urine tests at your doctor’s office in order to discover whether you have low cortisol levels (or high ones). Dunn recommends getting testes at four different times on the same day since cortisol levels can fluctuate. However, there are some signs that tell you when you should make that appointment your body uses to signal you to do so. The following are included:
1. Lack of energy
Dr. Gottfried says that feeling totally exhausted may be a sign of low cortisol levels, rather than feeling completely wired. One way this manifests is as always having very low energy, or as having very low energy during certain times of the day (like mid- or late afternoon).
2. Craving salty or sweet snacks
In general, cravings are just cravings, which is why we shouldn’t focus on these symptoms. Having a craving for sugary or salty snacks, however, may signal low cortisol. Cortisol levels fall when blood sugar levels drop, she explains.
Salt and sugar cravings can result.
3. Dizziness after standing up suddenly
Dizziness and headaches are both signs of low cortisol. This happens when blood sugar levels drop, which can lead to sudden dizziness. Standing up too quickly is especially dangerous.
4. A low level of libido
Low cortisol levels can cause you to feel completely drained, so it’s not exactly surprising that it can cause libido levels to drop. One more reason why low cortisol might cause low libido is that blood flow is reduced to parts of the body that are responsible for turning you on (when you actually have the energy).
5. Weakness in muscles
Indefeasible muscle power and inability to get through a workout you would normally complete are other signs of low cortisol levels, according to Dunn. What could be the reason for this? Again, low blood flow and low energy. The function of your muscles depends on the flow of blood.
Cortisol levels that are too low: how to restore balance
It is not pleasant to live with any of these symptoms. Fortunately, both Dr. Gottfried and Dunn say that diet and lifestyle habits can help bring your body into balance. The following recommendations are offered to anyone experiencing low cortisol levels:
1. Getting enough sleep should be a priority
Cortisol levels are affected by lack of consistent, quality sleep (about eight hours each night). When you wake up after a good night’s sleep, your cortisol levels are at their peak within 30 minutes. Having that peak sets off all your other hormones, including your thyroid and estrogen. Officially, this is known as the cortisol awakening response, a sign of a healthy stress response.”
She argues that getting poor sleep muddys this arousal response. It can disrupt the tango between estrogen and progesterone, which can impact your metabolism by slowing it down. Hence, restoring cortisol levels to balance requires regular sleep.
2. Avoid skipping meals
Nutritionally balanced and nutrient-rich meals are always important, but Dunn says they are especially essential for people with low cortisol levels. It is detrimental to your blood sugar levels to skip meals, she insists, explaining that it will cause them to fall even lower. It’s especially important to get enough protein, healthy fats, and fiber when your cortisol is low, she says.
3. Sip licorice tea or eat licorice
The studies published in JCI and M indicate that licorice raises urine cortisol levels. The general recommendation is to take 600 milligrams of root extract if you suffer from low cortisol, she says. The herb is the better choice here, not the candy. Sugar would otherwise negate licorice’s balance-restoring benefits.
4. Relax and meditate
“Meditation is a great way to relax the mind and reset cortisol levels,” Dr. Gottfried says, adding that her favorite meditation apps include Breathing Zone, Calm, and 10 Percent Happier. Meditation may also benefit from practicing diaphragmatic breathing, which ensures that stomach, abdominal, and diaphragm muscles are fully engaged. Stress can be decreased by meditation, she says, which is an impressive claim when we’re talking about balancing a hormone that is vital to the body’s response to stress.
5. Take time for yourself
In the past year, many of us were forced to work beyond our capacity. The results of that stress can be measured, says Dr. Gottfried. Incorporating self-care into daily routine is key to managing stress, even if it is small steps. If [people] track their stress levels, they are more likely to find solutions.
The solutions offered here demonstrate how the mind-body connection affects cortisol levels directly. What’s most important is to see your doctor in case you are concerned your cortisol levels are off-whether they are too high, too low, or both. If you work together, you will be able to start implementing some solutions. There are, after all, treatment options available for this medical condition. Dr. Gottfried says that cortisol is not ‘good’ or ‘bad,’ it is simply what it is. Life is all about balance, as most things are.
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