“Doctor, my cortisol is acting up.” It is a sentence I hear often. A patient recently came to see me with fatigue, disturbed sleep, and some weight gain. Searching the internet, she was convinced that her “cortisol was too high” and had discovered a bewildering array of advice on how to “lower cortisol naturally”.

Cortisol has become one of the most talked-about hormones on social media. It is blamed for abdominal obesity, poor sleep, anxiety, ageing, and lack of energy. Numerous websites and holistic practitioners promote coconut water, apple cider vinegar and rhodiola as ways of reducing cortisol. However, there is no good evidence that these remedies reliably lower or manage cortisol.

The irony is that cortisol is not a bad hormone. We cannot live without it.

Produced by the adrenal glands, two small glands above the kidneys, cortisol is essential for maintaining energy, blood pressure and the ability to respond to physical and psychological challenges. One of its major functions is in glucose metabolism-the process by which the body produces, maintains and uses glucose, its principal source of energy. Cortisol helps ensure that sufficient glucose is available to the brain and other vital organs, particularly during stress.

Cortisol also follows a precise daily rhythm. Levels are normally highest in the early morning, helping us wake up and become alert, and gradually decline during the day, reaching their lowest levels around midnight. Thus, it is not simply the amount of cortisol that matters; its timing and pattern are important too.

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