Author's note: This column is intended for educational purposes only. It aims to highlight gaps in health knowledge, provide support and empower organizations to guide their members in creating …
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Author's note: This column is intended for educational purposes only. It aims to highlight gaps in health knowledge, provide support and empower organizations to guide their members in creating effective health and wellness programs.
Acute cortisol can save you. Chronic cortisol can destroy you. The difference is duration.
When cortisol levels stay elevated for weeks, months or years, the same mechanisms that protect you in an emergency start cannibalizing your body from the inside. Cortisol is highly catabolic; it eats your muscles. It breaks down muscle protein into amino acids so the liver can convert them to glucose. Short term, it is emergency fuel. Long term, it dissolves your own tissue. This is why chronically stressed people look soft even when they train hard. They build muscle in the gym for one hour, and cortisol strips it off the other 23 hours. Progressive overload cannot outrun a catabolic hormone that never stops.
Cortisol stores visceral fat around your midsection and organs. Not subcutaneous fat you can pinch — visceral fat wraps around your liver, intestines and kidneys. This is the most metabolically dangerous fat. It secretes inflammatory cytokines, produces excess estrogen through aromatase and creates insulin resistance. High cortisol gives you the “stressed belly” — lean arms, lean legs and a gut that will not budge no matter what you do.
It suppresses the thyroid. Cortisol inhibits the conversion of T4 to active T3 and shunts conversion toward reverse T3 instead. Reverse T3 is a metabolic brake — it binds to thyroid receptors without activating them, blocking the real hormone from doing its job. This is why chronically stressed people develop hypothyroid symptoms even with “normal” labs.
Cortisol redirects blood flow away from digestive organs toward muscles and the brain (survival priorities). This thins the intestinal lining, reduces stomach acid production, slows motility and increases intestinal permeability — leaky gut.
Cortisol and testosterone compete for the same precursor molecule — pregnenolone. Under chronic stress, the body prioritizes survival over reproduction. Pregnenolone gets shunted toward cortisol production instead of testosterone, DHEA and progesterone.
Chronic cortisol degrades your brain by shrinking the hippocampus — the brain region responsible for memory, learning and emotional regulation. It also affects the prefrontal cortex, which governs decision-making, impulse control and long-term planning. At the same time, it hyperactivates the amygdala — the brain’s fear center. The result: You cannot think clearly, you do not remember well, you react emotionally to everything and you cannot see the bigger picture. Your brain rewires for threat detection at the expense of higher cognition.
It destroys sleep. Cortisol and melatonin are inversely related. When cortisol is high, melatonin is suppressed. If cortisol does not drop in the evening, you cannot enter deep sleep. You lie in bed wired. You fall asleep from exhaustion but wake at 3-4 a.m. when cortisol surges to rescue dropping blood sugar. Sleep becomes shallow, fragmented and nonrestorative. Poor sleep also raises cortisol levels the next day.
It ages you. Cortisol breaks down collagen, the structural protein in your skin, joints and connective tissue. Chronically elevated cortisol accelerates skin thinning and wrinkle formation, slows wound healing and causes joint degradation. It also shortens telomeres — the caps on your chromosomes that determine cellular aging. High cortisol ages you at the DNA level.
It suppresses immunity. Acute cortisol is anti-inflammatory. Chronic cortisol becomes immunosuppressive. It reduces white blood cell production, weakens antibody response and impairs your body’s ability to fight infection. This is why people get sick when they are stressed. Their immune system runs on fumes because cortisol keeps suppressing it.
This is the part no one talks about. While cortisol does not change your core personality traits (which remain stable over time), chronic or high cortisol increases irritability and short temper. You may react with frustration or impatience over minor inconveniences.
• Emotional detachment or numbing. This can make you feel disconnected and may cause you to withdraw emotionally from others or from activities you normally enjoy.
The most effective and well-researched supplements for supporting healthy cortisol levels and managing stress include the following:
• Ashwagandha (consult your healthcare provider before starting, as it can interact with thyroid, blood pressure or sedative medication).
• Omega-3 fatty acids (fish oil).
• L-theanine. An amino acid found in green tea that can help ease racing thoughts.
• Phosphatidylserine. A phospholipid concentrated in brain tissue that helps blunt cortisol spikes, particularly after heavy physical exertion, intense exercise or sustained mental stress.
• Vitamin C. Concentrated heavily in the adrenal glands; vitamin C is rapidly depleted during stress.
Supplements are not a quick fix and do not block cortisol completely, which is good because cortisol is a vital hormone for energy and immune signaling. They help bring an overactive stress response back into balance. Although supplements are not strictly regulated like prescription medications, you can check purity and potency by looking for third-party testing, such as USP or NSF certification.
To reduce cortisol levels, focus on lifestyle habits, nutrition and stress-management techniques that calm the nervous system. Stress management and relaxation techniques include deep breathing, mindfulness and being available for joy. Prioritize sleep hygiene, diet and nutrition. Stabilize blood sugar by eating regular meals containing a balance of protein, healthy fats and high-fiber whole foods to prevent stress-hormone spikes. Include magnesium-rich leafy greens, omega-3 fatty acids and antioxidant-rich berries. Limit excess caffeine, refined sugars, processed foods and alcohol, which can tax the adrenal glands and elevate the stress response. Exercise in moderation by choosing low- to moderate-intensity workouts, like walking or swimming. Avoid overexercising, as excessive, high-intensity training without proper recovery can drive cortisol levels higher.
Dr. Cheryl Christy is a Baldwin County resident and registered nurse with nearly 30 years of experience. She holds master's degrees in nursing education and nursing practice and a doctorate in nursing practice. She is a member of Sigma Theta Tau, Phi Pi Chapter, a certified lay counselor and the author of "Voices for Healthcare," a healthcare blog.
Read her previous column titled "Moral injury: When doing what is right comes at a personal cost" on www.GulfCoastMedia.com. Her blog can be found at https://substack.com/@dnprn.
