PEAK TESTOSTERONE

How To Lower Cortisol

STEP 2B. How to Lower Cortisol If You Are High:.

One of the very common issues that I see on the The Peak Testosterone Forum is men with high morning or evening cortisol. I think that a 3-point cortisol test is usually the most useful and predictive, because it corresponds so well to symptoms that a man is experiencing. For example, high evening cortisol often leads to sleep issues and difficulties falling asleep, and high morning cortisol to generalized feelings of anxiety and lowered mood during the day. Elevated cortisol levels can also contribute to acclerated visceral (belly) fat and prediabetes along with an increased risk for depression,  lower testosterone and libido. Worst of all, high cortisol is hard on the cardiovascular and neuronal systems and appears to even shorten telomeres, i.e. accelerate aging.

The obvious point is that we need to pay attention to this hormone and find natural ways to reduce inflated levels.  Below are 10 Great Research-Backed Ways to Lower Cortisol Significantly.  I start out with lifestyle solutions - because these will generally really get at the root of the problem and are side effect free and then follow with supplement (nutraceutical) based solutions:

NOTE:   Of course, if you self-test and find you have high cortisol, I highly recommend that you talk to a physician and make sure that there is not some type of serious underlying medical condition.

1. Mindfulness Meditation (Baseline and Peak).  In modern, industrial cultures cortisol and stress are generally related to perceived psychological and social issues.  Mindfulness meditation is a fantastic tool to combat the chronic stress that we so often face.  One example was a study on PTSD victims.  Results were very impressive: [5]

--The mindfulness group dropped cortisol area unde the curve (AUC) by about 15%

--Peak cortisol levels were dropped by about half!

Mindfulness meditation will help you in a dozen other key ways that I outline in my page on The Benefits of Mindfulness Meditation. One of the things that many men struggle with is something called "ruminative thinking," which is the psychological term for getting stuck thinking about one thing over and over.  Men with depression or high anxiety often struggle with this issue and mindfulness meditation is a fantastic tool to get partially reverse it.  Mindfulness meditation trains you to passively observe things that enter your mind or your perception without strong emotional reactions .

2. Progressive Muscle Relaxation.  One study grabbed a bunch of male and female psychology students and taught them Abbreviated Progressive Muscle Relaxation (APMR). They then measured cortisol and pulse immediately before and after the students actually practed the APMR.  The results were very impressive: [6]

--Heart rate dropped from ~72 to about 66.1-66.7

--Cortisol dropped from 16.96 nmol/l to 14.11 nmol/l. (The controls did not change.)

That's a drop of about 8% in pulse and 17% in cortisol by making a simple lifestyle change that has absolutely no side effects and costs nothing. That's what we call a "no brainer" in the health and fitness world!

Another study from three years prior had found even more profound cortisol reduction from the same Abbreviated Progressive Muscle Relaxation technique. Participants did a 20-25 minute session and lowered their cortisol before and after the session from 18.96 to 10.45 nmol/l (day 1) and 19.31 to 11.31 nmol/l (day 8).  These are cortisol reductions of 45% and 42%, respectively!  As in the first study, pulse was also substantially reduced as well.

NOTE:  See my page on The Benefits of Progessive Muscle Relaxation for more information.  On that page I also describe how to actually do PMR.

3.  Low Carb Diets (Baseline).  Low carb diets work by raising stress hormones such as cortisol and adrenaline.  Most low carb men do not even notice, but that is certainly not always the case.  In my mind the obvious thing to do if you are high cortisol and on a low carb diet is to add in some carbs and then see if your cortisol improves.  If so, then you may need to go more "classic Paleo."

4. Phosphatidylserine (Post-Exercise Cortisol Increases and Possibly Baseline Cortisol Levels).  Hopefully, everyone reading this is doing some kind of an exercise program. If so, then I can almost guarantee you that right after exercise, you are experiencing a very significant rise in cortisol.  This is the body's natural response to a "stressor" like exercise, and some of you may even have exaggerated levels since many men push themselves to the point of overtraining.  Phosphatidlyserine (PS) can help with any such post-exercise increase in cortisol according to some research.

Now, before I discuss this supplement any more, let me mention that only recent studies on phosphatidlyserine should be considered.  For years, stellar results were achieved using bovine-based PS, but this was considered unsafe at a certain point and plant-based products - usually soy - were utilitzed thereafter.

One recent study using plant-based PS found that "mean peak cortisol concentrations and area under the curve (AUC) were lower following PS (39% and 35%, respectively) when compared to placebo. PS increased AUC for testosterone to cortisol ratio (184 5%) when compared to placebo. PS and placebo supplementation had no effect on lactate or growth hormone levels." [1]

This are very significant reductions in peak cortisol needless to say. 

Besides helping with cortisol rises during exercise, PS is used by quite a few alternative medical practitioners to lower baseline cortisol.  As far as I know, there is no study (on soy-based PS) that confirms this however. 

The biggest problem that I see is expense:  it's not a cheap supplement and the dosages generally prescribed are fairly high.  Dosages of 200 - 300 mg per day are pretty common for example. However, this seem to be the go to supplement by physicians interested in lowering cortisol naturally.

CAUTION:  Always discuss the addition of any new supplement with your physician if you have a medical condition or are on any medication.  Also, long term effects of almost all supplements are poorly understood and should generally be considered a short term solution.  TESTING IS CRITICAL: Don't just assume you are high cortisol because you have anxiety or sleeplessness. It is always important to confirm with measurements, because many things can cause similar symptoms. In addition, you can pull your measurement inexpensively at any of the following without a doctor's orders:  Testosterone Labs.

5. High Protein.  Higher protein levels can raise cortisol according to some research.  See my page on The Potential Dangers of Excess Protein for more information.

6. Vitamin C (Baseline Cortisol).  One older study examined "13 lean, healthy male volunteers aged 25 to 35 on no medications" and found a very significant lowering of cortisol with 4 grams daily of Vitamin C. [2] (1 gram was given every 6 hours to be precise.) Cortisol levels were monitored at many times during the day and participants were not put under any sort of stress, exercise of otherwise, i.e. this was a measure of baseline cortisol levels throughout the day.  The results were impressive:  cortisol was lowered from 19.6 to 14.8 ug/dl on average, a drop of approximately 25%

There are several important comments to be made about this study.  First of all, individual responses to supplements is similar to that of pharmaceuticals in the sense that there is no formula that works for everyone.  For example, a couple of the participants experienced rather profound cortisol reductions of 50% or over and a few others a cortisol rise. In addition, most participants experienced a rise in DHEA levels, another hormone that was monitored during the study.  In fact, average DHEA rose from 426  to 755 ng/dl after one week.Therefore, it would seem prudent to monitor cortisol and DHEA before and after.

CAUTION:  Vitamin C should usually be taken on an empty stomach for two reasos:  1) it increases iron absorption and 2) there is study that shows if you have fat in your stomach > ~10%, it will increase nitrosamine production.  Here are some other Potential Risks or Dangers of Vitamin C.

7. Rhodiola Rosea (Morning Cortisol).  The herb has been studied extensively with some good results in the area of athletic performance. It also has several studies behind it showing that it can lower a variety of stress markers.  It has also one study that shows it can lower baseline morning cortisol levels.  For example, one study on men and women with chronic fatigue found that morning cortisol levels were reduced by around 7% upon awakining and then around 12% for up to an hour afterward. [3]

8. DHEA?.  There is one study one senior men and women that shows that DHEA can lower cortisol. [4] It did not lower it by much in the case of the men.  The big problem is that the men took a large dose (200 mg daily) in order to achieve this effect.  50 mg is much more common from what I have seen and some experts recommend significantly less than that.  CAUTION:  I do have a few concerns about DHEA listed Here:The Risks and Potential Dangers of DHEA.

9. Testosterone Therapy (HRT / TRT).  If you are hypogonadal, going on (well done) HRT can lower your "cortisol reactivity."  Basically, this means that cortisol will likely not increase to as high of a peak during stressful situations, i.e. there is a dampening effect.  This is one of the reasons that many men, such as myself, on HRT experience substantial reductions in feelings of stress and anxiety.  (Some men have a side effect where they experience the opposite however.)  For more information, see my pages called Testosterone and Cortisol and Testosterone and the Adrenals. CAUTION:  Some men report that on TRT their cortisol falls due to a "shutdown" effect.

10. Ashwagandha (Corticosterone).  Ashwaganha has two studies behind it showing that it can lower corticosterone, a stress-related hormone. [8][9] Corticosterone is an intermediate to aldosterone for those interested.

REFERENCES:

1) Journal of the International Society of Sports Nutrition, 2008, 5:11, "The effects of phosphatidylserine on endocrine response to moderate intensity exercise"

2) Annals NY Acad of Sciences, Jul 1987, 498:487 490, "Bimodal Effects of Megadose Vitamin C on Adrenal Steroid Production in Man"

3)  Planta Med, 2009 Feb,75(2):105-12, "A randomised, double-blind, placebo-controlled, parallel-group study of the standardised extract shr-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue.

4) http://www.ergo-log.com/dhea-supplementation-lowers-cortisol-levels.html

5) Medical Care, Dec 2014, 52:S25 S31, "Reductions in Cortisol Associated With Primary Care Brief Mindfulness Program for Veterans With PTSD"

6) Applied Psycholphysiology and Biofeedback, Dec 2005, 30(4), "The Impact of Abbreviated Progressive Muscle Relaxation on Salivary Cortisol and Salivary Immunoglobulin A (sIgA)"

7) Biological Psychology, 2002, 60:1-16, "The impact of abbreviated progressive muscle relaxation on salivary cortiisol"

8) BMJ Case Rep, Sep 17, 2012, "Ashwagandha root in the treatment of non-classical adrenal hyperplasia"

9) N Am J Med Sci, 2011 Jul, 3(7):320 324, "Immune enhancing effects of WB365, a novel combination of Ashwagandha (Withania somnifera) and Maitake (Grifola frondosa) extracts"