Everything to Know about Cortisol and How to Keep it in Balance
By
Dr. Gabrielle Francis
Naturopathic Functional Medicine Doctor
If you've ever felt exhausted in the morning, wired at night, prone to anxiety, or like your body is holding onto extra weight despite your best efforts—your cortisol levels may be out of balance. Cortisol is often misunderstood, but in truth, it’s a vital hormone that, when in harmony, gives you the energy, resilience, and focus to thrive.
In my practice, I’ve seen time and again how balancing cortisol can transform everything—from sleep and energy to hormones and mood. Let’s explore how this powerful hormone works, how it becomes imbalanced, and what you can do to restore harmony in your body, mind, and spirit.
What is Cortisol?
Cortisol is a glucocorticoid hormone made by your adrenal glands—small glands that sit atop your kidneys. It’s part of the hypothalamic-pituitary-adrenal (HPA) axis, the intricate communication network between your brain and adrenal glands that governs your body’s response to stress.
Cortisol is released in a circadian rhythm—naturally highest in the morning (to help you wake up) and lowest at night (to help you wind down). But when life gets overwhelming, this rhythm can go haywire.
What Does Cortisol Do in the Body?
Cortisol is essential for survival—and when it’s balanced, it helps you feel energized, focused, and strong. It plays several key roles:
- 🧠 Energy & Focus: Cortisol helps you feel alert and energized. It boosts mental clarity and keeps you motivated under pressure.
- 🍬 Blood Sugar Regulation: Cortisol works closely with insulin to regulate your blood sugar. If cortisol is chronically high, your cells may stop responding to insulin properly, increasing your risk for insulin resistance or Type 2 Diabetes.
- 🔥 Inflammation Control: Cortisol is a natural anti-inflammatory. In the short term, it suppresses inflammation and supports healing. But if cortisol levels are chronically high or low, it can contribute to chronic inflammation and pain.
- 🦴 Bone & Muscle Health: Excess cortisol over time can lead to bone loss (osteoporosis) and muscle breakdown.
- 🧬 Hormone Harmony: Cortisol affects and is affected by other hormones:
- Thyroid Hormones: Chronic stress and high cortisol suppress thyroid function, leading to sluggish metabolism, weight gain, and fatigue.
- Estrogen & Progesterone: Cortisol and progesterone share a common precursor, so chronic stress can deplete progesterone, worsening PMS, fertility issues, and perimenopausal symptoms.
- Estrogen Dominance: High cortisol can increase aromatization (the conversion of testosterone to estrogen), potentially contributing to estrogen dominance symptoms like weight gain, mood swings, and fibroids.
The Difference Between Good and Bad Cortisol
Cortisol itself is not the enemy. We need it to survive and thrive. The real issue is when cortisol becomes imbalanced due to chronic stress or lifestyle factors.
✅ Healthy Cortisol Patterns ("Good Cortisol"):
- High in the morning to help you wake up and feel energized
- Gradually declines through the day
- Lowest at bedtime, helping you sleep and repair
❌ Dysregulated Cortisol ("Bad Cortisol"):
- Too high all day = anxiety, insomnia, cravings, inflammation
- Too low all day = fatigue, depression, brain fog
- High at night/low in the morning = insomnia, burnout, poor immunity
The Benefits of Balanced Cortisol
When cortisol is well-regulated, you’ll experience:
- 🌞 Natural energy in the morning
- 😴 Restful, deep sleep at night
- 🍽️ Stable appetite and fewer cravings
- 😌 Calm mood, emotional resilience
- 🔥 Lower inflammation and less pain
- 💪 Stronger immunity and muscle strength
- 🔁 Hormonal harmony with estrogen, thyroid, and insulin
What Causes Cortisol to Become Imbalanced?
We are not just dealing with stress anymore—we’re dealing with chronic micro-stressors that chip away at our resilience day by day. These can include:
🌍 Modern Lifestyle Factors:
- Long work hours, poor boundaries, endless notifications
- Constant exposure to news and digital stimuli
- Over-scheduling and lack of rest or play
🛌 Poor Sleep Hygiene:
- Inconsistent sleep/wake times
- Exposure to blue light at night
- Insomnia or disrupted sleep from worry or pain
🍩 Blood Sugar Imbalances:
- Skipping meals, fasting too long, or eating high-sugar, high-carb diets leads to cortisol surges to rescue your blood sugar.
🔥 Chronic Inflammation and Infection:
- Ongoing inflammation from gut issues, autoimmune disease, or hidden infections like EBV or Lyme can keep cortisol elevated.
💭 Mindset and Perception:
- Your body doesn’t differentiate between a lion chasing you or a stressful thought loop. Negative self-talk, worry, and perfectionism can trigger cortisol the same way physical danger does.
💊 Medications:
- Corticosteroids, birth control pills, and certain antidepressants can disrupt the HPA axis and adrenal function.
Symptoms of Cortisol Dysregulation
Cortisol imbalance affects every major system in your body. Symptoms may include:
- 🌜 Poor sleep – trouble falling asleep or waking up too early
- 🧠 Mental fog, poor focus, anxiety, or depression
- 💥 Low energy, especially in the morning or after meals
- ⚖️ Weight gain, particularly around the abdomen
- 🍬 Blood sugar issues – cravings, crashes, shakiness
- 📉 Low libido, menstrual irregularities, or hot flashes
- 🦴 Osteoporosis or joint pain
- 😷 Weakened immune system – frequent colds or viruses
- 🌡️ Thyroid dysfunction – cold hands/feet, sluggish metabolism
- 🔥 Chronic pain or inflammation
How Do You Know If Your Cortisol Is Out of Balance?
Testing the Adrenal Glands and Cortisol Levels
Symptoms can be clues, but the most accurate way to understand what your body needs is through testing. At my clinic, we use a variety of tools to assess your adrenal health and cortisol rhythm. This gives us the insight needed to create a treatment plan tailored just for you.
Types of Cortisol Testing:
✅ Salivary Cortisol Testing (Adrenal Stress Index)
- Collects saliva at four points during the day (morning, noon, afternoon, and evening)
- Shows your diurnal cortisol pattern—whether you have high cortisol in the morning (as you should), and whether it's falling appropriately throughout the day
- Ideal for identifying patterns like adrenal fatigue, nighttime cortisol surges, or a flat-line response
✅ DUTCH Test (Dried Urine Test for Comprehensive Hormones)
- Provides a complete picture of hormone health, including cortisol, cortisone, estrogen, progesterone, testosterone, DHEA, and melatonin
- Measures cortisol metabolites as well as free cortisol—offering insight into how your body is using and clearing cortisol
- Useful for complex hormone cases and when other systems are involved
✅ Blood Testing (AM Cortisol + ACTH)
- Offers a snapshot of your cortisol level at one point in time (usually in the morning)
- Helpful for ruling out extreme adrenal conditions but doesn’t show the full rhythm or daily fluctuations
Why Testing Matters
Everyone’s stress response is different. Some people run on chronically high cortisol and others are running on empty, with flatlined levels. Without testing, it’s difficult to know whether to support, lower, or rebuild your cortisol.
Testing helps us answer key questions like:
- Are you producing too much or too little cortisol?
- Are your levels rising and falling at the right times?
- Is your cortisol interfering with your thyroid, blood sugar, or sex hormones?
- What phase of adrenal dysfunction are you in—early stress response, adaptation, or burnout?
Once we have these answers, we can create a personalized plan that may include nutrition, lifestyle changes, adaptogens, targeted supplements, and mind-body practices—all tailored to your specific cortisol pattern.
Lifestyle Tools to Balance Cortisol Naturally
You have more control than you think. Small, consistent choices can create big shifts. Here’s what I recommend:
🛌 1. Prioritize Deep, Restorative Sleep
- Aim for 7–9 hours per night
- Go to bed before 10 p.m. to align with your natural cortisol curve
- Keep the room cool, dark, and screen-free
🧘 2. Practice Daily Stress Resilience
- Breathwork, meditation, or prayer even for 5–10 minutes
- Nature time—walk barefoot on grass, soak in the sun
- Limit exposure to toxic news and social media
🍳 3. Eat for Blood Sugar Stability
- Include protein at every meal (especially breakfast)
- Avoid high-sugar, high-carb meals that spike and crash your energy
- Eat regular meals—don’t skip!
🏃♀️ 4. Move Intelligently
- Gentle exercise like walking, yoga, Pilates, or strength training
- Avoid overtraining, especially if you’re already exhausted
💗 5. Cultivate a Positive Mindset
- Focus on what’s working
- Practice gratitude journaling
- Engage in uplifting conversations and community
Supplements and Adaptogens for Cortisol Balance
These natural remedies help your body adapt to stress and regulate cortisol:
🌿 Adaptogenic Herbs:
- Ashwagandha: Calms high cortisol, supports thyroid, helps sleep
- Rhodiola: Boosts energy and mood in low-cortisol states
- Holy Basil (Tulsi): Balances mood, blood sugar, and inflammation
- Eleuthero (Siberian Ginseng): Supports stamina, immune strength
- Schisandra Berry: Helps restore balance in both high and low cortisol
🔬 Targeted Nutrients:
- Vitamin C: The adrenals use it to make cortisol
- B Vitamins: B5, B6, and B12 help adrenal hormone production
- Magnesium: Calms the nervous system and supports sleep
- Phosphatidylserine: Helps reduce nighttime cortisol and promote calm
Always check with your healthcare provider before starting supplements, especially if you are on medications or managing other health conditions.
Empowering Your Healing Journey: Body, Mind, Spirit
You don’t have to be at the mercy of stress. When you understand cortisol and how it affects your health, you can begin to work with your body, rather than against it.
Whether you’re recovering from burnout, seeking better sleep, or simply looking to feel more grounded and resilient, remember healing is possible.
Every step you take—whether it’s a nourishing meal, a deep breath, or an early bedtime—is a message to your body that it is safe, supported, and ready to thrive.
Your body is wise. Your hormones are listening. Let’s bring them back into harmony—together
Take Charge of Your Cortisol—and Your Life
Cortisol is not just a stress hormone—it’s your body’s way of helping you survive. But in today’s world, survival isn’t enough. You deserve to thrive.
If you’ve been feeling off and aren’t sure why, don’t guess. Let’s test. Once we know your cortisol pattern, we can craft a healing path that’s as unique as you are.
Your body is not broken—it’s talking to you. Testing helps us listen. Healing helps us respond.
I invite you to reach out and schedule a consultation and adrenal test. Together, we can bring your cortisol—and your health—back into balance.
In healing,
Dr. Gabrielle Francis
Naturopathic Functional Medicine Doctor
Phone: 646-596-8215
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