High Cortisol and Hormones: The Hidden Link that’s Hijacking Your Health

Can you guess what the number one cause of hormonal imbalance is?

I’ll give you a hint - it’s not toxins and it’s not genetics. And it’s also not PCOS, hypothyroid, or birth control use.

If you guessed stress, you’re right!  Problems with cortisol and the stress-response system, also known as HPA-Axis dysfunction, are the most common triggers of hormone imbalance.

And in this post, I’m going to explain how you can get to the root of hormone issues like period problems, infertility, anxiety, fatigue, insomnia, and even weight gain by assessing and addressing high cortisol.

Once upon a time, I was told that my miserable, months-long, constant nausea was “just stress.” Perhaps you’ve experienced something similar - maybe someone in healthcare dismissed or brushed off your symptoms, telling you that the answer to your problems was to decrease or manage your stress.

While it’s true that stress can raise your cortisol levels, driving symptoms like anxiety, insomnia, digestive problems, and weight gain, it’s not always possible to avoid or minimize stress - as much as you might want to. In fact, there’s no such thing as “just stress.”

As you’re about to see, stress is a very real, very tangible biological process that alters your body chemistry in profound ways - especially in the case of chronic stress and high cortisol.

So, when I tell you that chronic stress and the cortisol that comes with it is at the root of your hormone issues, I mean it on a physiological, biochemical level - I’m absolutely not suggesting that the solution is simple stress reduction.

I prefer to think of these strategies as ways to help your body stress smarter, so that you don’t end up with cortisol and hormone imbalances.

But before we get to evidence-based, functional medicine solutions for hormone problems triggered by cortisol, I need to explain what cortisol is, which hormones it messes up, and how to assess both cortisol and reproductive hormones.

I cannot stress how important this is, because there is no way to tell if your cortisol is high or low based only on symptoms. And you can absolutely make things worse if you’re treating the wrong thing.

I see this all the time - one of my clients was actually told by a medical doctor that she had Cushing syndrome, but when we did comprehensive, functional hormone testing it revealed the complete opposite. More on that in a bit.

But first - what is cortisol? And what does it do in the body?

Cortisol is a hormone that is produced by the adrenal gland in response to stress. That stress could be mental or emotional in nature - for example, childhood trauma, a demanding workload, relationship difficulties.

But stressors can also be physical - for example, not getting enough sleep, eating junk food and lots of sweets, catching a nasty virus, or having a chronic condition like IBS, hypothyroid, or arthritis.

When we face a stressor, the brain signals to the adrenal glands to release cortisol via the HPA-Axis. And cortisol interacts with the cells of different body systems to prepare us to fight or flee from danger.

Your HPA-Axis is trying to keep you safe - and so is cortisol - and it really shines in situations of short-term or acute stress.

But too much of a good thing can become a problem. If stress becomes chronic, or we’re faced with stressor after stressor on a daily basis, cortisol can stay high for too long.

This turns the helpful, survival function of cortisol against us, resulting in weight gain, type 2 diabetes, chronic fatigue, gastrointestinal issues, elevated blood pressure, and problems with the immune system.

It also lowers your threshold for stress - meaning that it takes less stress to trigger your fight or flight response. It can feel like every little thing overwhelms you, or things that never used to bother you throw you for a loop, irritate you, or make you anxious.

And, of course, high cortisol disrupts the production and function of your reproductive hormones in several ways - first, by prioritizing hormonal pathways that lead to cortisol at the expense of other hormones like progesterone, testosterone, and estrogen.

In order to understand this concept, we need to talk about how your hormones are made in the first place.

Cholesterol is where a hormone begins its journey toward becoming a very specific chemical messenger.  The next stop on that path is pregnenolone, and after that we reach a fork in the road.

Depending on chemical signaling from the brain, environment, and rest of the body, pregnenolone can head in the direction of progesterone or a different form of pregnenolone…which eventually leads to the production of cortisol by the adrenal glands.

When you're in a stressed state, the body is focusing on making lots of cortisol. In fact, it will do just about anything to make sure that it can keep up with the demand for it - because your stress response system is all about survival.

So, when pregnenolone reaches that fork in the biochemical road, stress shifts the priority toward the pathway that makes cortisol, and away from the pathways that make progesterone, testosterone, and other reproductive hormones.

Stress pulls every pathway in the direction of cortisol, depleting progesterone and ignoring the pathway to testosterone and estrogen.

What does that look like in real life?

Well, if progesterone levels drop, it can result in infertility or miscarriage. Because progesterone has a calming effect on the brain, relatively low progesterone levels make it hard to sleep or can trigger anxiety and panic attacks.

And because progesterone helps balance estrogen, lower levels can result in estrogen dominance with symptoms like heavy periods, bloating, cramping, and weight gain - especially in the abdomen or belly area.

Likewise, if testosterone levels drop because of the body’s prioritization of cortisol, it can result in low energy and decreased libido. It can also cause a decrease in muscle mass, which negatively impacts your metabolism, leading to an increase in body fat - not to mention an increased risk of bone density loss as you age.

And if your cortisol stays high long enough in response to stress, eventually your HPA-Axis will down-regulate cortisol production, leading to low cortisol levels.

This can result in a decrease in all of your other hormones as well - including estrogens, which we’re learning are hugely important to maintain for prevention of osteoporosis, cardiovascular disease, and even dementia.

I see this coming into play a lot in menopausal women, where everything bottoms out, resulting in hair loss, insomnia, fatigue, weight gain, and frailty. Can you see how cortisol can be at the root of all sorts of hormonal problems?

So, how can you tell if high cortisol - or low cortisol, for that matter - is affecting your reproductive hormones - so that you know how to go about treating it at the root cause instead of wasting time, money, and effort on strategies that won’t work for your specific situation?

Well, like I mentioned before, you test your hormones! And I don’t mean a random blood test.

You need a comprehensive assessment that measures the entire pathway of your hormones - including free and metabolized cortisol, progesterone, all your active androgens including testosterone and DHT, and all three estrogens - yep, there are 3 of them we need to think about!

The best way to do this is with the DUTCH Complete at-home urine test. It will tell you if your cortisol is too high, too low, or spiking and crashing during the day.

It will tell you if cortisol is being cleared properly or if your metabolism is broken, if you’re making enough progesterone to counterbalance estrogen or if you’re estrogen dominant, if your androgens like testosterone are depleted or overactive, or if your hormones are depleted overall and need support.

The best part is that it can uncover hidden high cortisol in the form of cortisone - something that salivary cortisol testing misses completely.

If you’d like to learn more about DUTCH testing, check out my YouTube video that explains how it works and why I think that every woman needs to do this test.

Also, we help folks all over the world get access to DUTCH testing, so if you’d like to order your test kit, click HERE.

Alright - once you’ve figured out that high cortisol is causing chaos with your hormones, it’s time to implement evidence-based, functional medicine strategies to treat it at the root. I’m going to share my top 3 favorite, cortisol-balancing, hormone-stabilizing strategies.

My top strategy for lowering elevated cortisol is to balance your blood sugar.

The reason this is my favorite strategy is because it addresses high cortisol both directly and indirectly, so you get exponential benefit.

And you’ve got lots of strategies at your disposal to promote better blood sugar - here are a few that I’ve found particularly helpful: eat something with fiber, protein, and/or healthy fats every 4 hours during the day.

These foods digest more slowly and evenly, which helps avoid glucose spikes and crashes, which lowers cortisol’s compensatory spikes and crashes.

Avoiding simple sugars and naked carbs is another good strategy.

What do I mean by naked carbs?

I mean foods that contain only simple sugars or carbs without a healthy amount of fiber, protein, or fat.

A few examples of naked carbs are white rice, peeled white potatoes, and white bread. Simple sugars are often found in beverages like fancy coffee drinks, sports drinks, soda, and fruit juices.

You may also consider adding a targeted, blood-sugar balancing nutraceutical like Berberine to your daily routine. Berberine, a natural compound found in plants, is sometimes called “nature’s ozempic” for it’s ability to improve insulin resistance, balance blood sugar, and help folks lose fat.

According to a 2012 meta-analysis of 14 different studies including more than 1,000 people, berberine was able to help with blood sugar control as much as the common diabetes medication metformin - and with far fewer side effects.

Leptin resistance is closely linked with insulin resistance and metabolic syndrome, and Berberine helps calm cravings and improve metabolism, too. You can order my favorite Berberine supplement through my Fullscript dispensary for a really big discount - so big, that I’m literally not allowed to say what it is!  But if you click HERE, you'll see just how big it is!

Strategy number 2 is to work to regulate your circadian rhythm with healthy, restful sleep.

I’ve noticed that sleep issues are one of the early indicators of high cortisol in my clients - particularly trouble falling asleep even though you’re exhausted, or waking up between 2 and 4am, wide awake for no reason and struggling to fall back to sleep.

And these sleep issues are worsened when cortisol starts to disrupt progesterone production - because progesterone increases GABA, a calming neurotransmitter in the brain.

Some of my favorite strategies for promoting healthy circadian rhythm fall under the category of sleep hygiene - routines and habits that help prepare your brain and body for sleep.

A few examples are avoiding screen exposure for an hour before bed - that includes your phone screen. I honestly can’t think of a worse disruptor of healthy sleep rhythms than your phone.

The absolute worst thing you can do if you wake up at night and can’t fall back asleep is to scroll or watch videos on your phone - and that includes this one.

Making sure the room you sleep in is as dark as possible - especially avoiding blue light - is another way to improve your sleep hygiene.

Natural light exposure within 20 minutes of waking up in the morning is another evidence-based way to improve your circadian rhythm - but it can be difficult depending on where you live and the season.

There are about a million herbal remedies, teas, and supplements on the market to help improve sleep - but many of them cause vivid or disturbing dreams, morning grogginess, or low moods.

My favorite sleep support nutraceutical focuses more on lowering cortisol, specifically, than sedating you to sleep. It includes Ashwagandha, L-theanine, Magnolia, and Phosphatidylcholine to calm the mind and lower cortisol quickly - after the very first use.

It helps you fall asleep faster and stay asleep - and it’s non-habit forming so you can safely take it every night. The best part is that this formula also reduces stress symptoms during the day. Again, you can order it at a HUGE discount through my Fullscript dispensary.

My third favorite strategy for lowering high cortisol and rebalancing hormones is toning the vagus nerve.

One of the main regulators of cortisol and the stress-response system is a nerve called cranial nerve X or the vagus nerve - and toning or sensitizing the function of this crucial neural pathway can also help lower elevated cortisol.

The vagus nerve is also a critical part of the GLP-1 signaling pathway, which helps regulate satiety. GLP-1 or Glucagon-like peptide-1 is a compound that is made in your gut, or gastrointestinal tract, when you eat.

GLP-1 communicates to the brain, via the vagus nerve, telling you when you’ve had enough to eat. That’s how GLP-1 agonists like Ozempic and Mounjaro, as well as natural GLP-1 boosting agents like Berberine can help decrease appetite and food cravings.

Because hormone imbalances can trigger weight gain and an elevated body fat percentage, improving signaling of the vagus nerve can have double the impact.

Some of my favorite strategies for supporting the vagus nerve are humming, gargling, singing, and chanting. Deep, diaphragmatic breathing is also a very effective technique for toning the vagus.

I’m also pretty excited about the advances in at-home technology for vagus nerve stimulation - not only because of the positive impact on cortisol, but also because these devices also help treat migraine headaches, soothe anxiety, and support restful sleep.

Word of warning - only a few of these devices have robust research to back them up, so check out my vetted, recommended option in the HERE. It’s a great level-up for cortisol management if you feel like you’ve already tried all the strategies and nothing seems to help.

It’s not your fault if stress is getting to you - it’s biology!

Yes, you should work to minimize any physical stressors that you can - for example, blood sugar instability, chronic inflammation, micronutrient deficiencies, things like that.

And yes, seeking assistance for mental and emotional stressors is also very helpful - for example, working with a therapist or practicing mindfulness.

But Functional Medicine offers so many science-based, physical treatment options to help you reduce or rebalance your high cortisol - strategies that go way beyond mental health interventions.

If you’re looking for more options for treating high cortisol, check out my exclusive webinar all about how to keep going and stay healthy during times of stress - I call it the Stress Smarter Mini-workshop, and you can get instant access by joining my YouTube Membership.

Just sign into your YouTube account and tap the JOIN button to get signed up for my Exclusive Video Library - new video tutorials drop each month!