We all know that stress is a big trigger of gut unhappiness. With everything that is happening in the world right now, every virtual patient I am seeing is experiencing higher-than-normal levels of stress that can manifest in many different ways: irritable bowel syndrome, leaky gut, weakened immunity, anxiety, and other symptoms of a sick gut.
Underlying much of this stress is cortisol, the body’s primary stress hormone. When you hear “stress hormones,” you might automatically think cortisol is bad. Like any hormone, though, maintaining balance is the key. Too little or (more likely) too much cortisol can disrupt your sleep, your mood, and your overall well-being.
Your gut and immune system take a hit, as increased cortisol levels become a silent killer, paving the way for nearly every disease.
What is Cortisol?
The adrenal glands make cortisol, and the hypothalamus and pituitary gland in the brain are the control centers for this hormone, monitoring and adjusting its concentration in the blood according to how much cortisol your body needs.
This system –– the hypothalamic-pituitary-adrenal axis (HPA axis) –– produces a series of chemical messengers, including cortisol that form a feedback loop and help the body maintain balance under normal circumstances. Together, the HPA axis regulates digestion, immune function, sex drive, metabolism, and how the body responds to stress. A well-functioning HPA axis is what makes life great, dynamic, with boundless energy and motivation to get things done.
In fact, cortisol speaks to almost every cell in your body, because most of them have cortisol receptors.
Cortisol levels are generally higher in the morning and gradually taper throughout the day. A healthy cortisol curve looks like this.
Healthy Cortisol Levels:
- Manage blood sugar levels
- Regulate sleep-wake cycles
- Support how the body utilizes carbs, protein, and dietary fat
- Regulate energy levels
- Normalize blood pressure
- Help the body perform specific functions, including metabolism and reproduction
- Enhance the immune system by keeping inflammation in check
We’re even seeing how cortisol might perform as a communication highway between the gut and brain. In one study, researchers looked at the bacteria of 24 piglets. (The gut and brain development of these baby animals resembles the gut and brain of human infants). They discovered that one particular bacteria uses cortisol to communicate with, and make changes to, the brain. While the study focused on people diagnosed with autism, it reveals how the gut communicates with the brain and how neurotransmitters and even hormones, such as cortisol, can help that process.¹
So in the right amounts, cortisol is perfectly healthy and plays many critical roles in the body.
When cortisol levels becomes imbalanced, it can be “the robber that comes to steal your peace” — disrupting your mood, sex drive, sleep, and energy levels.
Because this hormone plays so many roles in the body, high levels of cortisol can wreak havoc on nearly every system, including the gut and immune system. If you want a happy gut, you need to have happy, balanced cortisol levels.
Elevated levels of cortisol –– when this hormone stays high long after it should taper down –– can make you gain weight, especially unwanted fat in the middle, and make losing weight incredibly difficult. Studies over the past 15 years have shown that even moderately high cortisol levels can also impair brain function, weaken your immune system,make you more susceptible to infections, and increase the risk of chronic diseases, including type 2 diabetes.
I’ve seen this in my patients — high cortisol levels due to stress, leading to lapses in short-term memory and word-finding difficulties to the point the person thinks they’re now losing their mind on top of the stressor.
Overall, cortisol is what I like to call the “elephant in the room”, because it is the silent menace that can ravage your health. You can ignore it, but it will still be there. For a while, it may stay silent. In fact, the symptoms of…
High cortisol may remain “silent” for months or even years before you start noticing them.
But, it’s not really silent — the problem is the person often has grown so accustomed to living with high cortisol levels that they fail to identify its damaging presence in their state of health until someone calls out that “elephant in the room”.
And in that point of acknowledgement when I look into their eyes and say — “You’re holding a lot of stress” — often a sigh of relief follows, sometimes even with tears.
Understanding the Stress Response
To understand why cortisol balance is so important, and why imbalances can become a problem, we need to look a little bit at how the stress response works. A healthy body has an intricate, interconnected system called the HPA axis, which I mentioned earlier. In a healthy body, this system releases cortisol when it is needed and stops releasing it when the body no longer needs this hormone.
Underlying this process is the autonomic nervous system, within which you have two opposing systems:
- SYMPATHETIC Nervous System – triggers a “fight or flight” response
- PARASYMPATHETIC Nervous System – helps the body calm down
Think of these two opposing systems as your “on” or “off” switch, or the gas pedal and brake in your car. When you feel stress, the sympathetic nervous system kicks in and the body moves into “fight or flight” mode, meaning you either confront or run away from whatever threat you are experiencing. Historically, this helped us survive in the wild, and it can protect us today from potential threats.
When you feel stressed out and the sympathetic nervous system gets turned on, the adrenal glands release adrenaline. The results of this hormone are immediate, and physical changes occur very quickly in the body. Your heart rate increases. Your muscles tense. Whatever doesn’t impact your short-term survival –– things like digestion and sex drive –– get put on the backburner. The primary focus of the body during this imminent threat is to either fight or run away from a problem.
If the brain continues to perceive something as dangerous after that initial activation, the adrenal glands release another stress hormone, called cortisol. This helps the body continue to deal with whatever danger it has encountered.
When that stress subsides and your body has restored its sense of harmony, the sympathetic nervous system turns off, and the parasympathetic nervous system goes on, so you stop releasing cortisol. Through a complex feedback loop, stress stimulates the production of cortisol when the body needs it and inhibits it when the body no longer needs it.²
Think of your parasympathetic nervous system as “One Big Sigh of Relief”
Unfortunately, that’s not often what happens when someone experiences near-constant, low-grade stress. Whether that stress is real or imagined, stress stays on overdrive and cortisol production stays “on” when it should be “off.” Over time, that takes its toll on the HPA axis, especially the adrenal glands, which continue to release stress hormones even when the body no longer needs them.
Let’s apply this to current events. Even during the 2020 pandemic, many of the stressors we have encountered are imagined, not real. To the body, it doesn’t matter. The same stress response occurs whether you are actually threatened by something or think that you are threatened with something. Over time, this “stress in overdrive” response creates problems throughout the body. Here, I’ll focus on cortisol’s impact on the gut and immune system, and how…
Gut balance creates hormone balance.
High Cortisol Can Lead to Leaky Gut
Stress is a huge factor in how your gut behaves or misbehaves. If you’re constantly stressed out and your cortisol levels stay high, that will manifest with gut issues ranging from indigestion, low stomach acid, poor digestive enzyme production, to problems including small intestinal bacterial overgrowth (SIBO) and increased intestinal permeability.
At the root of stress response is the fight-or-flight response, a heightened state of alertness that is controlled by stress hormones such as cortisol. As a sudden reaction that gets you to safety, this response serves its purpose, but over the long term, it can result in gut problems. For many people this adaptive response is activated for way too long without enough of its counterbalancing “relaxation” response.
When the sympathetic nervous system stays on when it shouldn’t, all sorts of things can happen to the gut, from indigestion to gas and bloating after you eat a meal to conditions like leaky gut. If you cannot digest your food properly, you will suffer from nutrient deficiencies, abdominal distress, imbalances in gut bacteria, and protein malnutrition. As a result, your risk of developing leaky gut syndrome and food sensitivities is high, along with all the symptoms associated with these conditions. In other words…
Extended stress can lead to gut distress.
Once you have a leaky gut, toxins, foreign material, infectious organisms, and partially digested food particles “leak” into your bloodstream — your good gut flora suffers too.
The stress response “in overdrive” can also alter the natural balance of healthy bacteria in our guts, causing the gut ecology to shift in favor of a more hostile group of critters.
The quality and diversity of your gut bacteria is a two-way street, which in turn can impact stress levels.
One review looked at how various forms of stress –– things like psychological stress, sleep deprivation, pollutants, and diet –– impacted gut flora among military personnel. Among their potential for damage, researchers found that unhealthy gut microbiota can increase inflammation, increasing the risk of gut-related diseases, including irritable bowel syndrome and inflammatory bowel disease.³
We’re still understanding how stress can impact specific gut bacteria, and vice versa. One animal study, for instance, found that probiotics could improve the stress response and restore tight junction integrity.4
Getting the right nutrient support is critical to maintaining a healthy, happy gut…
but so is learning to better manage the stress levels — which if left unchecked, keep cortisol high and damage the gut leaving a wake of misery for the person living with a sad gut.
High Cortisol Levels Can Weaken The Immune System
The immune system has been top-of-mind for me, as well as many of you for the last few months. And you can’t talk about how to optimize your immune system without talking about hormone balance.
As a health-regulating gatekeeper, your gut plays a key role in optimizing your immune system, while keeping out potentially detrimental substances.5
Anything that impacts the gut will also impact your immune system, because up to 70% of your immune system is housed all along the digestive tract.
When you’re stressed out and your cortisol levels stay high, you can get sick more often. Why? Cortisol isn’t the enemy of the immune system. In fact, in the right amounts, cortisol can support the immune system by lowering inflammation levels.
However, too much of this stress hormone has the opposite effect: It creates more inflammation, which can weaken the immune system. High levels of inflammation then lead to an overworked immune system that can’t protect you against viruses and other infections.6
As a result, chronic stress can increase the risk for infections.7 More specifically…
Stress lowers white blood cells called lymphocytes that are particularly adept at fighting viral infections.
Without these hardworking white blood cells, you have a higher risk for viral infections.8
I’m sure everyone who’s reading this has gotten sick at some point when they were under high stress!
One review looked at over 300 empirical articles to evaluate stress’s impact on the immune system in humans. The overall conclusion was that short, acute stressors, which usually last a few minutes, such as feeling stressed about an exam, could strengthen the immune system. Chronic stress had the opposite effect, suppressing the immune system.9
So, how do we get this runaway train under control?
Calming Down Cortisol
10 Ways to Get Your Stress Levels in Check
This is such an important conversation to be having right now.
I’ve highlighted here how elevated cortisol levels can impact the gut and immune health. The “stress in overdrive” repercussions that accompany high cortisol can also increase anxiety, depression, headaches, sleep problems, and brain function. Stress impacts your health in so many ways. The body was intended to be in mostly a relaxed, calm state, not constantly stressed out.
The best way to have healthy cortisol levels is to manage stress. By creating a relaxed state within yourself, your gut will benefit from reduced stress hormones, less muscle tension, and important vagal tone — important input from the “relaxation” portion of the autonomic nervous system — the parasympathetic nervous system — that allows you to digest and process food with ease.
When you find yourself getting wound up because of stress, you can easily access the parasympathetic nervous system to return your body to a natural state of balance. With some practical techniques, you can change your focus toward health and connection and instantly begin the process of healing and disease resolution.
A harmonious mind-body-gut connection helps restore cortisol balance and promotes overall wellness.
Getting cortisol in check is one key step in improving your digestive wellness, diminishing the effects of leaky gut syndrome, and fortifying your immune system. This is what most of us need right now.
10 Ways to Get Your Stress Levels in Check
 Meditate. One way to promote the relaxation response and manage cortisol levels is through a mindfulness practice, like meditation. Meditation is the most powerful tool for creating a sense of peace within, even when you are still surrounded by the day-to-day stressors of life. You cannot control what happens outside of you or what happens to you, but you can certainly control your internal state of mind. Ultimately, how you respond to stressful situations is really the only thing that you have control over. Worrying, getting angry, and arguing with others does not change the external events that have transpired. They may be necessary in the moment, but long-term they damage you by promoting the release of stress hormones like cortisol and putting you into that fight-or-flight response that sets your entire body, including your immune system and your gut, on high alert. Even a few minutes of meditation every day can help the body better manage cortisol levels. You’ll find a simple meditation technique here.
 Find active relaxation techniques. Relaxing mindfully is a great way to balance cortisol levels and establish calm, which will support a healthy gut and immune system. When I say active relaxation, I mean doing something constructive but calming that attenuates your health and wellbeing. For example, you can do a progressive muscle contraction-release sequence from head-to-toe, leaving your body feeling refreshed and relaxed. Another one of my favorite ways to unwind is forest bathing, a traditional practice where you visit a forest and breathe its air. Just getting out into nature is healing in and of itself. Numerous studies show that forest bathing can significantly reduce cortisol levels to reduce stress.10 But if you can get out to a park and feel the grass under your bare feet or walk on the sand by the seashore, these are other great ways to actively relax your body, mind and spirit.
 Remove sugary, processed foods. Yes, I know that grabbing a cookie or something sweet when you’re stressed out might bring a moment of relief. But the stressor will still be there after you indulge, and high blood sugar levels will keep your cortisol elevated.
Remember this: what your body feels, the mind feels. Sugar creates an internal rollercoaster, potentially raising your heart rate and blood pressure, leading to a feeling of unrest in the mind.
Cortisol imbalances, in turn, can trigger sugar and carb cravings, making you more likely to choose foods that create gut imbalances and further upset your gut health with nasty bugs like candida. If you need something sweet that will also support the gut and immune system, try my almond-hemp chocolate truffles recipe in Happy Gut.
 Eat more gut-healing foods. The right foods support gut balance and mitigate some of the effects that high cortisol levels can create. Eating foods high in dietary fiber can protect the gut. In one study, researchers looked at how short-chain fatty acids (SCFAs) might impact stress and anxiety in mice. When the gut digests dietary fiber, it makes these SCFAs. Colon cells then use these SCFAs for energy. When researchers introduced SCFAs to the guts of mice, they had a significant decrease in stress-related behavior. They found that SCFAs could reduce the risk of stress-induced leaky gut.11 Fermented and cultured foods can also support the gut. I talk more about these foods in Happy Gut.
 Get 8 hours of sleep every night. Poor sleep –– not getting enough sleep or getting poor-quality sleep –– affects your hypothalamus, the master control center in your brain that regulates all hormone secretion, including cortisol.12 Studies have shown that with poor sleep, your cortisol levels remain elevated the following evening.13 This can create a vicious cycle where you continue to sleep poorly at night and stay stressed out during the day. If you work late-night shifts, these high cortisol levels will trigger early-morning sugar cravings.
 Practice breathing with movement. Some patients have told me that accessing the breath when they are stressed out is hard to do. One solution is to combine breathing with movement to lower stress hormones, which helps to relax your gut. One study among 29 nurses (28 of them female) with post-traumatic stress disorder (PTSD) found that mindfulness-based stretching and deep breathing exercise could support healthy cortisol levels.14 I talk about a few breathing techniques in this blog. My favorite way to move with the breath is through yoga.
 Try yoga. Studies have shown that for people with depression, a regular yoga practice is more effective than medications alone to manage depressive symptoms but also lower cortisol levels.15 You don’t need an hour-long Vinyasa Flow, either. Even five minutes of sun salutations and down dogs can help. During quarantine, I made a 20-minute yoga routine part of my morning waking ritural. When you do inversion poses in yoga, the flow of blood to the brain calms the nervous system and can relieve feelings of stress that are often the source of gut-related maladies. You’ll find simple, gut-healing poses in my book, Happy Gut.
 Incorporate adaptogenic herbs. When you’re eating well, supporting gut health, and implementing the right lifestyle factors to manage cortisol, I’ve found a few well-studied herbs can provide that added nudge to help better manage the levels of this stress hormone. Two of my favorite adaptogens –– so called because they help the body better adapt to stressful conditions –– are Rhodiola rosea and ashwagandha. One study gave 80 participants either a 200-mg dose of Rhodiola rosea twice daily or no treatment for 14 days. Supplement users found that Rhodiola rosea lowered stress while significantly improving mood.16
I’m also a big fan of ashwagandha, an herb that can help the body better adapt to stress. One study gave 64 participants with chronic stress either a 300-mg ashwagandha extract or placebo twice a day for 60 days. Researchers measured serum cortisol levels before and after the study. At the end, serum cortisol levels were substantially reduced in the ashwagandha group compared with the placebo group.17
 Boost your bonding hormone. The body has a powerful hormone called oxytocin that can help balance the impact of cortisol. Basically, oxytocin puts the brakes on stress and anxiety to create a calm, collective feeling. It is the hormone that bonds mother to child. Stay tuned: In my next blog, we’ll be featuring this cortisol-balancing hormone and I’ll show you many ways that you can harness the benefits of oxytocin!
 Support liver detoxification. The liver is your body’s main organ of detoxification. One of the critical roles it plays is to help clear excess amounts of hormones, including cortisol. Without the work of your liver, hormones would stay in circulation for too long. Enzymes in the liver control the concentration of cortisol.18 When your liver becomes backed up with an accumulated toxic load, which happens often in our modern world, it fails to clear these excess hormones, leading to unhealthy levels of cortisol. You can learn more about how to avoid these toxins in this blog.
The best way to support the liver’s detoxifying abilities is by getting the correct nutrients. Protein is one of them. Without sufficient amino acids from protein, the liver cannot complete phase 2 detoxification, the phase where the liver tags metabolites with an anchor that pulls them out of the body.
As a result, your liver gets backed up much like Lucy did in the famous chocolate factory episode of “I Love Lucy,” where she was stuffing chocolates in her bra, mouth and chef’s hat. Trust me, you don’t want to get backed up like Lucy.
Some of my readers and patients have asked about an “express” program that provides everything the body requires to optimally detoxify. This is especially important if you’ve been feeling additional stress the last few months, and maybe ate a few (or more) things that didn’t support the gut and immune system.
That’s why I re-imagined the Happy Gut® 14-Day Mini-Cleanse into the new, easy-to-complete Happy Gut® Reset: 7-Day Detox. This kit offers a clean start to balance hormones, lose weight, and feel better now that the summer season is here. And since a lot of people may not have the time or be ready to commit to the more extensive, deep dive of my Happy Gut® Reboot: 28-Day Cleanse, this is the perfect alternative you’ve been patiently waiting for.
With detoxification, think of the liver as a factory with two shifts:
[Phase 1] The “first shift” receives raw materials, processes them, and sends them on to the “second shift”
[Phase 2] The problem is some of the processed products from the first shift are more harmful than the raw materials they started out as.
So the second shift, or Phase 2, needs to be functioning optimally in order to quickly get rid of these new, more damaging substances. If the liver’s detoxification pathways become overwhelmed, this can lead to an unwanted build-up of toxins in the body (think Lucy in the chocolate factory).
The great news is there is a solution that supports both Phase 1 and Phase 2 liver detoxification.
Along with Phase 2-supporting amino acids, I’ve combined all the nutrients the liver needs to detoxify in the…
HAPPY GUT® RESET: 7 Day Detox
- CLEANSE SHAKE. A gentle “gut cleanser” that serves as 2 meal replacements per day
- REVIVE. A 50-billion CFU probiotic supplement to support gut and immune health while helping the body better absorb nutrients to detoxify.
- DETOX1. A synergistic formula that combines an extensive array of nutrients that combat damaging free radicals, support the immune system, and help detoxify heavy metals and other harmful compounds in Phase 1 detoxification.
- DETOX2. A unique blend of nutrients specifically designed to support Phase 2 detoxification, the key second step that packages toxic compounds for elimination from the body.
With this program, you can rest assured you are providing your body all the nutrients it needs to detoxify healthily. And we even take the guess-work out of meal planning.
I’ve shared this program with a couple of my patients and I’ve already received rave reviews. One 37-year-old female told me that she lost five pounds doing this detox.
Another really loved the smoothie recipes we created, along with the shopping list to ensure all ingredients are used with minimal waste. And one of my male patients, who didn’t believe supplements made a difference, couldn’t believe the results he saw, including a boost in energy that motivated him to start exercising again after months of not going to the gym.
Providing the right nutrients to support liver health helps balance hormones including cortisol, which will help you lose weight, have more energy, and sleep better. Feeling constantly stressed out isn’t normal, and you don’t have to accept living with that low-grade stress, even during these crazy times. Giving your body the right nutrient support with the Happy Gut® Reset: 7 Day Detox supports hormonal balance to keep the gut, immune system, and overall health strong and resilient.
It’s time to Reflect, Reset and Renew, and you can easily begin today with my 10 tips.