Cortisol, known as the main stress hormone in humans, plays a variety of critical functions in the body. This hormone is produced in two ways according to our circadian rhythm: first, in supporting our activity at the highest level in the morning and noon, and, secondly, in winding down as we prepare for bed and recover from stress. Its production from the adrenal gland is controlled by our brain’s hypothalamus and pituitary glands. 

When cortisol is released as a reaction to stress, it is part of our body’s fight-or-flight response. 

The stress response is activated through the hypothalamus, pituitary, and adrenal glands—known as the HPA axis. Our fight-or-flight response helps us get enough energy to either flee from danger or fight it head on and then repair and recover from any injuries sustained in the aftermath. The response also temporarily inhibits the prefrontal cortex of our brain, which is responsible for planning and analysis. This is because in times of real danger, we need to react instinctively and not waste precious seconds analyzing the situation. Under normal circumstances, this cortisol spike induced by the fight-or-flight response soon levels off to pre-danger levels. 

Cortisol is essential in maintaining our immune system, controlling our body’s inflammation and inflammatory response to infections and injury, production of energy, and fat metabolism. All of these pathways for cortisol production are activated during fight or flight and then are lowered to typical maintenance levels. 

 

When Stress Response Goes Rogue 

Our brains have evolved in three main stages. The first is the most basic and primitive brain—also known as “the lizard brain”—which was all about the fight-or-flight response. The second stage of brain evolution developed the ability to attach emotions to actions, while the third stage saw the brain develop into the highly evolved brain, with analytical, planning, and abstract thought capacity. In a healthy, well-balanced person, the lizard brain is given a limited action time—essentially, whenever the fight-or-flight response is necessary—that ensures our basic needs are met but then is suppressed to allow us to go on with more creative portions of our lives. 

Whenever there is a life-threatening situation, a death of a loved one, a traumatic event at work or home, or any other stress-inducing event, the lizard brain is given the center stage, and the blood flow is preferentially shunted to that area of the brain and away from the frontal cortex until the stressful event is over. If you are a Masai warrior herding cattle in the African bush, you have plenty of time to process any trauma, such as the loss of a family member, and in time, the blood flow is shunted back to the frontal cortex and life is resumed at the same high level of function. 

Unfortunately, in today’s hectic world, we never really have the time to fully process trauma, and the default mode network is left shunting a bit more blood flow to the primitive brain than before. As we are continuously exposed to one stressful event after another, the lizard brain becomes more dominant, shunting more blood flow to the primitive brain and away from the highly functioning frontal cortex. This stealing of the blood shifts the balance of overall function to the primitive portion of the brain, and basic behaviors and emotions such as anger and fear are now allowed to control daily behaviors. The brain slowly enters the perpetual state of fight or flight, where one’s behavior becomes reactive and one’s mood is dominated by anxiety, depression, and antisocial tendencies. 

In such situations, cortisol levels remain elevated instead of dropping off to normal and over time become toxic to many organs in the body, including the brain and the gut. Eventually, in response to toxic cortisol levels, the brain shuts down production of more cortisol. From this point on, as long as the brain perceives the presence of stress, it keeps the body in a low cortisol state. 

In the low cortisol state, our brain and body experience higher levels of stress due to an increased level of inflammation in the gut and brain, reduced energy production, impaired sleep, and poor immune function. This state creates an endless loop, preventing the person from returning to normal cortisol production and optimal function. 

 

The Integrative Approach to Fixing High Cortisol States

Cortisol level elevation represents either external or internal stress to the body. As long as the stressor is present, the cortisol levels will continue to stay elevated. Frequently, a thorough clinical evaluation is needed to establish the source of the stress, and then a plan is formulated to reduce and, if possible, eliminate it. The sources of stress can be social, such as a dysfunctional work environment or a difficult commute to work. It can be familial due to marital issues or chronic illness in the family, or emotional due to a history of past trauma, and metabolic due to a hormonal imbalance or a hidden infection.

 Special herbal supplements called adaptogens are used to help regulate cortisol production and protect the cells from cortisol toxicity while the stressor is being addressed. Meditation and breathing exercises are prescribed as medicine, to be done at scheduled times several times a day. In cases of very high cortisol levels during the day, a 20-minute nap several times a week may be necessary to normalize cortisol production. 

Good sleep hygiene is critical in cortisol regulation and includes keeping consistent sleep hours, getting at least seven hours of sleep every night, and elimination of cortisol-activating activities (including work) 90 minutes before bed. In addition, blue light exposure before bed is very excitatory to the brain and can stimulate further cortisol production, thereby reducing quality of sleep. We recommend eliminating blue light at least an hour before bed. This can be done by avoiding the use of all electronic devices and dimming the lights to create a sense of calm. 

Using red lens blue-blocking glasses to either watch TV or read on a screened device is another very effective strategy to reduce cortisol production. 

 

The Integrative Approach to Fixing Low Cortisol States

The brain that stops sending signals to the adrenal gland to stop making cortisol is a brain that is inflamed, injured, depleted of key amino acids and nutrients, and is in the protective mode. To turn on normal cortisol production, the cycle of fight or flight has to be disrupted and brain inflammation needs to be reduced. 

Consistency is key here! The classic integrative medicine teaching is that it takes a year of consistent stress reduction and cortisol optimization strategies to normalize cortisol level production. 

As part of brain repair, stress reduction techniques such as meditation and breathing exercises need to be done frequently throughout the day. For those who do not have an existing meditation practice, I recommend starting with five minutes of breath work done three to four times per day and 15 minutes of meditation an hour before bed. This consistent disruption of stress pathways eventually reprograms the brain into a more balanced state that allows the pituitary gland to start stimulating the adrenal gland into normal cortisol production. All the sleep hygiene recommendations offered above for high cortisol states apply here as well. 

Brain Spa by OWM is a unique and powerful tool that accelerates the process of brain recovery and bucks the conventional wisdom of a 12-month normalization period for achieving cortisol regulation. Brain Spa provides intravenous supplementation of essential nutrients, amino acids, and peptides needed for reduction of brain inflammation and growth of new healthy nerve connections as the person is guided through a 45-minute virtual reality meditation session. 

Preliminary results show cortisol levels increasing after just five weekly sessions! 

Here are cortisol results of three OWM clients before and after five weekly Brain Spa sessions. The cortisol levels (mcg/dl) are taken first thing in the morning, at noon, in the evening, and before bed. 

 

Client 1 

Before Brain Spa sessions: 0.14, 0.04, <0.03, <0.03

After five weekly Brain Spa sessions: 0.18, 0.08, 0.04, <0.03

 

Client 2

 Before Brain Spa sessions: 0.34, 0.03, 0.05, <0.03

After five weekly Brain Spa sessions: 0.37, 0.14, 0.10, 0.10

 

Client 3 

Before Brain Spa sessions:  <0.03, <0.03, <0.03, < >0.03

After 5 weekly Brain Spa sessions: 0.15, 0.10, 0.05, 0.06

 

Brain Spa by OWM creates a rich experience that promotes brain health and cognitive optimization. Three main ingredients of this unique package are:

  1. Virtual Reality meditation and relaxation.
  2. Ceremonial cacao and medicinal mushrooms elixir.
  3. Intravenous infusion.
  4. Recovery leg compression sleeves by Normatec.

Learn more or schedule your appointment here: Brain Spa by OWM.