The stress response is an indispensable part of human physiology; however, modern lifestyles are not well adapted for this ancient system. Stress can impact cognition, influence behavior, affect eating and sleep habits, and dysregulate hormone secretion. (1)(22) All of these factors significantly impact how you feel and can lead to long-term health concerns when left unaddressed.

What is stress?

Put simply, stress is the body’s response to a perceived threat. In times of danger, the body has learned exactly what to prioritize and what to ignore. Hormones, such as cortisol, send a signal to the body that there is an immediate threat, turning off any and all “non-essential” processes (e.g., digestion, growth) and preparing the body for action. This results in the characteristic sensations of stress, including increased blood pressure, heart rate, and breathing rate. Stress is a healthy response when faced with an immediate threat; however, long-term (chronic) stress can cause or exacerbate several health concerns. (3)

What is cortisol?

Cortisol is a key signaling hormone that is released from the pituitary gland during periods of physical or psychological stress. It has a number of rapid-response functions, including changes to cognitive behavior, metabolism (e.g., glucose regulation), and our immune system. (1)(12) While these changes can be helpful under very specific circumstances, chronically elevated levels of cortisol can have a direct impact on our day-to-day well-being and have been linked to increased sick days, migraines, and poor sleep. (9)(12)

 

A man and a woman kayaking in a lake
Balance your cortisol levels by staying active.

 

How to balance cortisol

When it comes to managing cortisol, balance is key. Luckily, there are several evidence-based steps we can take to help manage our stress responses and promote normal cortisol levels.

Engage in regular exercise

Physical activity is one of the most effective strategies for balancing cortisol levels. Exercise has been widely studied for its anti-anxiety and anti-stress benefits. (19) Not only does exercise help improve mental health and mental outlook, but it directly counters many of the negative impacts of hypercortisolemia (prolonged excess cortisol levels). Even a single bout of aerobic exercise (e.g., brisk walking, biking, dancing) can counteract the stress response, after which the blood vessels are signaled to relax and blood pressure lowers. (16)

Exercise releases a cascade of signaling molecules and hormones that directly counteract many of the most pervasive aspects of stress. For example, exercise is known to reduce inflammation and improve metabolism. (16) These effects are found across a range of exercise intensities and durations, meaning that you don’t have to be a triathlete to procure these benefits. (16) Even small bouts of exercise can make a big difference in countering an overactive stress response. A recent study found that moderate-intensity exercise was actually slightly more effective at improving mental health and reducing inflammation than high-intensity training. (16)

Get enough quality sleep

Research has demonstrated that sleep is one of the most important factors for balancing cortisol levels. Unfortunately, when your sleep is disrupted, so too are many key recovery pathways, including cognitive health and endocrine function. Conversely, a chronically activated stress response can cause further disruptions to our circadian rhythm—the body’s natural sleep-wake cycle. (15) Practicing good sleep hygiene is one of the best approaches you can use to improve your circadian rhythm. Avoiding blue light exposure (e.g., smartphones, computers, televisions), avoiding food consumption for two hours prior to bedtime, and trying your best to follow a consistent sleep schedule are effective strategies. These actions signal the body that it is time to slow down, promoting restful and restorative sleep. (4)(14)

Practice mindfulness and minimalism

Whether it’s reading an engaging book, playing an instrument, or learning to paint, there is something inherently enjoyable about feeling focused and undistracted. Contrast that with the all too familiar feeling of overstimulation. If you find that your attention is constantly pulled in multiple directions or you’re often distracted by social media, finding time to unplug can do wonders for bringing a sense of calm to an otherwise overactive mind. Establishing a daily meditation practice is a great place to start.

Practicing meditation and mindfulness can help us better focus our attention on the items that we find to be meaningful and valuable. The exact mechanisms by which meditation influences cognitive function is an active area of investigation. Mindfulness meditation has been found to lower overall anxiety and reduce serum cortisol levels, which researchers suggested may be a result of increased prefrontal cortex activity and improved regulation of the amygdala. (7)(23)

 

 

Mediterranean-style spread of food
Consuming a Mediterranean-style diet can help improve your mood and reduce stress levels.

 

Consume a healthy diet

The foods you eat (and do not eat) play a crucial role in how you may feel on a day-to-day basis. While this likely comes as no surprise, it is often understated just how connected your diet is to your mental well-being. Studies have shown that adaptogenic herbs, such as Rhodiola rosea and Withania somnifera (ashwagandha), can effectively reduce cortisol levels and improve symptoms of stress. (13)(15) Research has also demonstrated that a diet rich in dietary fiber and phytonutrients (health-promoting plant compounds) can have a positive effect on perceived mood, stress, and overall quality of life. (2)(6)

Consuming a diet rich in a variety of plant foods can ensure you’re getting the phytonutrients, vitamins, and minerals necessary for optimal health. Fruits and vegetables contain an array of nutrients that have been shown to fight oxidative stress, control inflammation, improve blood flow, enhance cognition, and encourage a healthy gut microbiome. (17) Diets high in refined sugars and carbohydrates can negatively impact levels of oxidative stress and cortisol, while healthy eating habits such as adherence to the Mediterranean diet have been shown to counteract these effects. (5) Not only can diets like the Mediterranean diet, rich in fruits, vegetables, seafood, nuts, and olive oil, help with stress management, but they’ve also been linked to improved overall mental health attributed to their role in regulating inflammation throughout the body. (5)

Focus on the gut

Finding ways to encourage a healthy and robust microbiome can have profound downstream impacts on your well-being. Supplements such as probiotics and prebiotics have been shown to help reduce stress and improve mental outlook. (8)(24) Unfortunately, modern lifestyles mean that people are spending more time indoors and consuming greater amounts of processed foods, which are directly harmful to the microbiome. These poor lifestyle habits can shift the balance of microbes in the gut, leading to a greater prevalence of pro-inflammatory “bad” bacteria and fewer “good” microbes in the gut, producing chronic levels of low-grade inflammation. (11)(21)

Like any ecosystem, a healthy gut thrives on balance. Too many harmful microbes can be highly disruptive, resulting in significant health consequences. Among their many responsibilities, microbes work hand-in-hand with the brain through both the production of neurotransmitters and direct signaling across the vagus nerve. While the research continues to evolve, animal studies have shown a direct link between the microbiome and the regulation of the stress response. (20) Recent human research has added further credibility to these findings, demonstrating a direct connection between particular harmful gut microbes (e.g., Bacteroidetes) and depressive symptoms. (10) Further understanding the complex relationship between us and our microbes promises to be a crucial step in promoting mental wellbeing.

The bottom line

While stress may feel unavoidable, it is important to remember that we are not powerless against it. Taking active steps to manage our cortisol levels can do wonders for our physical and mental health and wellness, and we are fortunate to have an abundance of research highlighting the most effective strategies. It is important to remember that these findings are not all or nothing! Taking even small actions in any of these areas is a great step to take in fighting back against some of the more pervasive influences of our modern lifestyles.

Fullscript simplifies supplement dispensing

Create your dispensary today I'm a patient

Disclosure: This article was written in partnership with Genuine Health. All supplier partnerships have been approved by doctors on our Integrative Medical Advisory team, and this content adheres to all guidelines outlined in our content philosophy. Fullscript has not been compensated financially for the publication of this article.

  1. Adam, E. K., Quinn, M. E., Tavernier, R., McQuillan, M. T., Dahlke, K. A., & Gilbert, K. E. (2017). Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis. Psychoneuroendocrinology, 83, 25–41.
  2. Antonopoulou, M., Mantzorou, M., Serdari, A., Bonotis, K., Vasios, G., Pavlidou, E., Trifonos, C., … & Giaginis, C. (2020). Evaluating Mediterranean diet adherence in university student populations: Does this dietary pattern affect students’ academic performance and mental health? The International Journal of Health Planning and Management, 35(1), 5–21.
  3. Berger, F.K. (2020). Stress and your health. Medline Plus. https://medlineplus.gov/ency/article/003211.htm
  4. Burkhart, K., & Phelps, J. R. (2009). Amber lenses to block blue light and improve sleep: a randomized trial. Chronobiology International, 26(8), 1602–1612.
  5. Carvalho, K. M. B., Ronca, D. B., Michels, N., Huybrechts, I., Cuenca-Garcia, M., Marcos, A., Molnár, D., … & Carvalho, L. A. (2018). Does the Mediterranean diet protect against stress-induced inflammatory activation in European adolescents? The HELENA study. Nutrients, 10(11).
  6. Govindaraju, T., Sahle, B. W., McCaffrey, T. A., McNeil, J. J., & Owen, A. J. (2018). Dietary patterns and quality of life in older adults: A systematic review. Nutrients, 10(8).
  7. Greenberg, T., Bertocci, M. A., Chase, H. W., Stiffler, R., Aslam, H. A., Graur, S., Bebko, G., … & Phillips, M. L. (2017). Mediation by anxiety of the relationship between amygdala activity during emotion processing and poor quality of life in young adults. Translational Psychiatry, 7(7), e1178.
  8. Hirotsu, C., Tufik, S., & Andersen, M. L. (2015). Interactions between sleep, stress, and metabolism: From physiological to pathological conditions. Sleep Science (São Paulo, Brazil), 8(3), 143–152.
  9. Inoue, K., Hashioka, S., Takeshita, H., Kamura, M., & Fujita, Y. (2019). High serum cortisol levels as a potential indicator for changes in well-regulated daily life among junior high school students. The Tohoku Journal of Experimental Medicine, 249(3), 143–146.
  10. Jiang, H., Ling, Z., Zhang, Y., Mao, H., Ma, Z., Yin, Y., Wang, W., … & Ruan, B. (2015). Altered fecal microbiota composition in patients with major depressive disorder. Brain, Behavior, and Immunity, 48, 186–194.
  11. Konturek, P. C., Brzozowski, T., & Konturek, S. J. (2011). Stress and the gut: Pathophysiology, clinical consequences, diagnostic approach and treatment options. Journal of Physiology and Pharmacology: An official journal of the Polish physiological society, 62(6), 591–599.
  12. Lippi, G., & Mattiuzzi, C. (2017). Cortisol and migraine: A systematic literature review. Agri: Agri Dernegi’nin Yayin Organidir: The Journal of the Turkish Society of Algology, 29(3), 95–99.
  13. Lopresti, A. L., Smith, S. J., Malvi, H., & Kodgule, R. (2019). An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine, 98(37), e17186.
  14. Markwald, R. R., Iftikhar, I., & Youngstedt, S. D. (2018). Behavioral strategies, including exercise, for addressing insomnia. ACSM’s health & fitness journal, 22(2), 23–29.
  15. Olsson, E. M., von Schéele, B., & Panossian, A. G. (2009). 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. Planta Medica, 75(2), 105–112.
  16. Paolucci, E. M., Loukov, D., Bowdish, D. M. E., & Heisz, J. J. (2018). Exercise reduces depression and inflammation but intensity matters. Biological Psychology, 133, 79–84.
  17. Peirce, J. M., & Alviña, K. (2019). The role of inflammation and the gut microbiome in depression and anxiety. Journal of Neuroscience Research, 97(10), 1223–1241.
  18. Romero, S. A., Minson, C. T., & Halliwill, J. R. (2017). The cardiovascular system after exercise. Journal of Applied Physiology, 122(4), 925–932.
  19. Stubbs, B., Vancampfort, D., Rosenbaum, S., Firth, J., Cosco, T., Veronese, N., Salum, G. A., & Schuch, F. B. (2017). An examination of the anxiolytic effects of exercise for people with anxiety and stress-related disorders: A meta-analysis. Psychiatry Research, 249, 102–108.
  20. Tetel, M. J., de Vries, G. J., Melcangi, R. C., Panzica, G., & O’Mahony, S. M. (2018). Steroids, stress and the gut microbiome-brain axis. Journal of Neuroendocrinology, 30(2).
  21. Tomasello, G., Mazzola, M., Leone, A., Sinagra, E., Zummo, G., Farina, F., Damiani, P., … & Carini, F. (2016). Nutrition, oxidative stress and intestinal dysbiosis: Influence of diet on gut microbiota in inflammatory bowel diseases. Biomedical papers of the medical faculty of the University Palacky, Olomouc, Czechoslovakia, 160(4), 461–466.
  22. Tomiyama, A. J. (2019). Stress and Obesity. Annual Review of Psychology, 70, 703–718.
  23. Turakitwanakan, W., Mekseepralard, C., & Busarakumtragul, P. (2013). Effects of mindfulness meditation on serum cortisol of medical students. Journal of the Medical Association of Thailand: Chotmaihet Thangphaet, 96 Suppl 1, S90–S95.
  24. Vitellio, P., Chira, A., De Angelis, M., Dumitrascu, D. L., & Portincasa, P. (2020). Probiotics in psychosocial stress and anxiety. A systematic review. Journal of Gastrointestinal and Liver Diseases: JGLD, 29(1), 77–83.