Lowering cortisol: how to bring your stress hormone back into balance

Lowering cortisol – what helps

A healthy cortisol level promotes energy, stability and a clear mind. When levels rise too high, the body reacts. The following measures are proven remedies to bring cortisol back into balance or prevent it from rising excessively in the first place:

Follow your natural daily rhythm

Cortisol follows your internal clock: high in the morning, low in the evening. Disrupting this rhythm – through late work, evening exercise or constant artificial light – can throw it off. It's better to be active in the morning and wind down in the evening.

Exercise in moderation

Regular, moderate activity like walking, light jogging or gentle strength training helps reduce excess cortisol without overwhelming your system.

Adapt your diet

Whole grains, omega-3 fatty acids (e.g. from salmon, nuts or seeds), green tea and berries help regulate cortisol. A Mediterranean-style diet focusing on protein and vegetables is preferable to carbs, sugar and processed foods.

Support through supplements

Certain supplements and herbal remedies, such as ashwagandha (an Ayurvedic herbal remedy) or Rhodiola rosea, may help lower cortisol. Magne­sium, vitamin D and phosphatidylserine – a fat-like molecule found in fish and offal, or available as a dietary supplement – can also support hormonal balance.

Stabilise your weight

Abdominal fat is linked to higher cortisol. Healthy weight management often has a double benefit: on both metabolism and hormone balance.

Reduce stress

Relaxation techniques such as yoga, meditation, breathing exercises (e.g. 4-7-8 breathing), progressive muscle relaxation or autogenic training can measurably lower cortisol.

What to avoid?

The following factors can trigger cortisol, especially when combined or long-lasting:

• chronic stress
• excessive alcohol consumption
• high caffeine intake
• excessive amounts of sugar
• lack of sleep

What is cortisol?

Simply put, cortisol is a "stress hormone" with many roles. It's essential for life and is produced by the adrenal cortex. Its production is controlled by the brain, specifically the hypothalamus and pituitary gland. Cortisol plays a key role in metabolism and stress response.

The helper in stress situations

During stress situations, cortisol mobilises energy reserves, raises blood sugar, regulates blood pressure and suppresses excessive immune responses. It follows a daily rhythm: highest in the morning, lowest at night – ideally.

How to recognise high cortisol?

An imbalance can develop gradually and isn't always obvious. Common signs of excess cortisol include:

"Moon face" and "hormone belly" – fact or fiction?

There are many rumours circulating on social media: for example, that stress alone causes a puffy face or a "hormone belly". The facts are that a "moon face" does occur in medical conditions like Cushing's syndrome or with long-term cortisone use; and an increase in belly fat can also be promoted by cortisol, but usually several factors play a role, such as diet, exercise, genetics and other hormones.

What causes high cortisol?

Chronic stress, sleep deprivation, high emotional pressure and an unhealthy diet can raise cortisol levels.

Other triggers include:

• conditions such as Cushing's syndrome (caused by tumours in the pituitary gland, adrenal gland or other tissues) or MACS (mild autonomous cortisol secretion) leading to pathological overproduction of cortisol in the adrenal gland
• long-term use of cortisone medications (e.g. for rheumatism or asthma)
• hormonal changes (e.g. pregnancy or menopause)
• alcohol abuse
• depression
• low blood sugar

What levels are normal and when are they considered too high?

Cortisol, or more precisely the body's release of cortisol, follows a daily cycle. Morning levels, usually between 6 and 8 am, are highest, peaking 30 to 45 minutes after waking. It's difficult to specify an exact normal morning level, as this depends on factors such as the type of sample (blood, saliva or urine). Persistently elevated levels, even without stress, infections or other influencing factors, may indicate a disease (Cushing's syndrome) and are then investigated using appropriate diagnostic tools.

How is cortisol measured?

Common methods include blood tests (in the morning on an empty stomach), saliva tests (spot or daily profile), and 24-hour urine collections. A full-day profile is often most informative. For suspected serious conditions like Cushing's syndrome, the dexamethasone suppression test is also used. This test checks whether the artificial hormone dexamethasone slows down cortisol production as expected – if the level remains high, this may indicate pathological overproduction. In any case, measurement and interpretation are very complex and should be left to specialists.

When does high cortisol need medical treatment?

In severe cases such as Cushing's syndrome or tumours, natural methods and lifestyle changes alone do not suffice. This is when other treatments are considered:

• Medications (e.g. osilodrostat) to inhibit cortisol production
• Surgery or radiotherapy to remove or shrink tumours

Low cortisol: also a problem?

A cortisol deficiency can also be dangerous. It occurs, for example, in Addison's disease (adrenal insufficiency). Symptoms include weakness, dizziness, low blood pressure, chills, nausea and weight loss. In situations of acute stress, very low levels can even trigger a circulatory collapse. A deficiency therefore always requires medical treatment.

Cortisol: friend and foe

Cortisol is essential for life: It helps us cope with stress and provides energy for daily activities. But if levels remain high long-term, there are steps we can and should take ourselves. When in doubt, it's always wise to seek medical advice.