High Cortisol? The Hidden Culprit Behind Stubborn Weight Gain

Many women, particularly those in perimenopause, struggle with unexplained weight gain, particularly around the midsection. If you feel like you’re doing everything “right” but the scale won’t budge, high cortisol levels might be to blame.

The Science Behind Cortisol

Cortisol is a steroid hormone produced by the adrenal glands in response to stress. It plays a crucial role in regulating metabolism, blood sugar levels, inflammation, and the body's sleep-wake cycle. However, when stress becomes chronic—whether due to emotional stress, poor sleep, excessive exercise, or dietary imbalances—cortisol can remain elevated for prolonged periods, leading to negative metabolic effects.

How High Cortisol Contributes to Weight Gain

• Increased Blood Sugar and Insulin Resistance

  Cortisol raises blood sugar levels to provide the body with immediate energy during stress. Over time, consistently elevated blood sugar can lead to insulin resistance, where cells become less responsive to insulin. This promotes fat storage, particularly in the abdominal area.

  
  

• Fat Storage and Redistribution

  Chronically high cortisol triggers the storage of visceral fat—fat that accumulates around the organs in the abdominal region. This type of fat is associated with metabolic dysfunction, increased inflammation, and greater health risks such as cardiovascular disease.

  
  

• Muscle Breakdown and Slower Metabolism

Cortisol has a catabolic effect, meaning it breaks down muscle tissue to provide amino acids for energy. Since muscle is metabolically active and burns calories even at rest, losing muscle mass slows down metabolism, making it harder to lose weight.

• Increased Appetite and Cravings

High cortisol levels stimulate hunger hormones, such as ghrelin, while suppressing leptin, the hormone responsible for satiety. This can lead to cravings for high-calorie, carbohydrate-rich foods, further contributing to weight gain.

The Importance of Testing for Cortisol Imbalances

Testing cortisol levels can provide valuable insight into how your body is responding to stress and whether chronically elevated levels are contributing to weight gain and other health concerns.

• Salivary Cortisol Test: Measures cortisol levels at different times of the day, providing a clear picture of the body's daily cortisol rhythm.

• Dried Urine Test (DUTCH): Offers a comprehensive analysis of cortisol production and its metabolites, along with other hormone markers.

• Blood Cortisol Test: Typically measures total cortisol levels but may not reflect the fluctuations throughout the day as accurately as saliva or urine testing.

By identifying cortisol dysregulation, a more personalised and effective treatment plan can be developed, targeting specific imbalances and optimising adrenal function for better health outcomes.

Natural and Functional Medicine Approaches to Lower Cortisol

Balancing cortisol naturally involves addressing the root causes of chronic stress while supporting adrenal function.

1. Dietary Strategies

   1. Blood Sugar Balance: Avoid refined sugars and processed carbohydrates, and focus on whole foods with a low glycemic index.

   2. Adequate Protein and Healthy Fats: These help stabilise blood sugar levels and reduce stress-induced cravings.

   3. Adaptogenic Herbs: Herbs like Ashwagandha, Rhodiola, and Holy basil help modulate the stress response and support adrenal function.

   4. Magnesium-Rich Foods: Magnesium helps regulate cortisol and can be found in leafy greens, nuts, seeds, and dark chocolate.

      
      

2. Lifestyle Modifications

   1. Prioritise Sleep: Poor sleep is a major driver of elevated cortisol. Aim for 7–9 hours of quality sleep each night.

   2. Mindfulness and Relaxation Techniques: Practices like meditation, deep breathing, and yoga lower stress and reduce cortisol levels.

   3. Exercise Smartly: While movement is essential, excessive high-intensity exercise can further raise cortisol. Incorporate low-impact activities like walking, yoga, or Pilates.

   4. Daily Sunlight Exposure: Sunlight helps regulate the circadian rhythm, which in turn supports healthy cortisol patterns.

      
      

3. Targeted Nutritional and Herbal Support

   1. Phosphatidylserine: This phospholipid has been shown to blunt cortisol spikes, particularly after intense exercise. Studies have demonstrated that supplementation with 800 mg of phosphatidylserine can lower cortisol response by 30%, suggesting its efficacy in counteracting stress-induced activation of the hypothalamo-pituitary-adrenal (HPA) axis

   2. Vitamin C & B Vitamins: Both are crucial for adrenal health and can help modulate the stress response.

   3. L-Theanine: Found in green tea, this amino acid promotes relaxation without sedation and may lower cortisol.

   4. Myo-Inositol: A naturally occurring compound that has shown promise in improving metabolic profiles and insulin sensitivity, particularly in individuals with conditions like polycystic ovary syndrome (PCOS). By enhancing insulin sensitivity, myo-inositol may indirectly support cortisol balance and weight management.

If you’re struggling with stubborn weight gain despite a healthy lifestyle, high cortisol may be a hidden factor. Understanding the physiological effects of cortisol and addressing it through diet, lifestyle, and natural therapies can help restore balance and support long-term health. Testing cortisol levels can be a valuable step in identifying imbalances and creating a targeted approach to support optimal stress response and sustainable weight loss. By working with a naturopath, you can develop a personalised plan to optimise your stress response and achieve better overall well-being.