What supplement can help with cortisol levels?

Supplements for Managing Cortisol Levels

Ashwagandha root extract is the most effective supplement for reducing elevated cortisol levels, with high-concentration extracts (300-600 mg daily) showing significant reductions in cortisol and improvements in stress-related symptoms.

Evidence-Based Supplements for Cortisol Management

Ashwagandha (Withania somnifera)

• Dosage and Form: 300-600 mg daily of high-concentration full-spectrum root extract, divided into two doses
• Evidence: Multiple randomized controlled trials demonstrate significant cortisol reduction:
  • High-concentration full-spectrum extract (600 mg/day) showed substantial reduction in serum cortisol (P=0.0006) compared to placebo 1
  • Dose-dependent response with both 250 mg/day (P<0.05) and 600 mg/day (P<0.0001) reducing serum cortisol levels 2
  • Standardized extract with 2.5% withanolides (500 mg daily) significantly reduced morning salivary cortisol levels 3
  • Ashwagandha appears to work primarily through modulation of the hypothalamus-pituitary-adrenal (HPA) axis 4

Other Evidence-Based Approaches

Sleep Optimization

• Maintain consistent sleep schedule and bedtime routine
• Avoid screen use before bedtime
• Consider low-dose melatonin (0.5-5mg) 30 minutes before bedtime if sleep onset is difficult 5
• Create a cool, dark, and quiet bedroom environment

Stress Reduction Techniques

• Daily mindfulness practice (start with 10-15 minutes daily, gradually increase to 20-30 minutes)
• Progressive muscle relaxation and guided imagery
• Regular physical activity (moderate intensity)

Implementation Algorithm

1. Start with Ashwagandha:

   • Begin with 300 mg standardized root extract twice daily
   • Continue for at least 60 days to assess full benefits
   • Monitor for mild side effects (digestive discomfort, drowsiness)

2. Combine with lifestyle modifications:

   • Implement sleep hygiene practices
   • Add daily mindfulness practice
   • Maximize morning natural light exposure
   • Reduce evening screen brightness

3. Monitor effectiveness:

   • Assess subjective stress levels after 2-4 weeks
   • Consider salivary cortisol testing at baseline and after 8 weeks if available

Important Considerations and Cautions

• If cortisol abnormalities are severe or accompanied by symptoms like weight gain around midsection, fatigue, muscle weakness, or mood changes, medical evaluation is essential to rule out Cushing syndrome or other medical conditions 6
• Diagnostic tests including 24-hour urinary free cortisol, late-night salivary cortisol, or dexamethasone suppression tests may be indicated if an underlying medical condition is suspected 5
• Ashwagandha should be used cautiously in patients with autoimmune conditions, thyroid disorders, or those taking medications for diabetes, hypertension, or immunosuppression
• Pregnant or breastfeeding women should avoid ashwagandha due to insufficient safety data

Conclusion

Ashwagandha root extract stands out as the most evidence-based supplement for cortisol management, with multiple high-quality studies demonstrating significant reductions in cortisol levels and improvements in stress-related symptoms. For optimal results, combine with evidence-based lifestyle modifications targeting sleep quality and stress reduction.