Cortisol is a vital hormone for immune system function, says Marcelle Pick. Here’s how to keep your levels balanced and ward off colds, flu and seasonal burnout
Angie came to me in early November one year and declared, “I’m not going to survive the holiday season!” When I asked her to explain, she said she was already exhausted from trying to be in a million places at once.
She had to prep for the holidays, and with a huge extended family and two young children of her own, there was a lot to do: shop for gifts, decorate for their annual gathering, bake and prep all the holiday favorites, and take her kids to see Santa at the mall.
On top of that, she had a major work project due by January 1 and she had to prepare for winter weather. Then came the last straw—she caught a cold, and it just wouldn’t go away.
That’s what brought her to me. She said she simply couldn’t be sick for the next two months.
I told her it was no coincidence that she’d gotten sick now, when there was so much to worry about already. That’s because stress and adrenal function have a huge impact on the immune system.
Research shows that life stressors, such as high job stress, divorce or relationship struggles, and bereavement, lead to decreased immune function and increased vulnerability to viruses and infections. And when stress is chronic and adrenal function suffers, the problem can get even worse.
Every winter, I see a flurry of resources dedicated to how we can support immune function and ward off viruses. But one thing I don’t see mentioned nearly enough is how to support adrenal health.
Adrenal fatigue (dysfunction) is, in my experience, one of the most common reasons the immune system is struggling.
An immune system problem related to adrenal fatigue can mean more frequent viruses and infections and a harder time recovering from them. It can also lead to an increased likelihood of developing certain kinds of chronic disease (more on this later).
Moreover, if adrenal fatigue is interfering with immune system function, it’s a solid bet that other areas of your health, including hormonal balance, mood regulation and metabolism, are out of whack too.
We know the adrenal glands, located atop the kidneys, are responsible for producing hormones related to our stress response. One of the key players is cortisol, often referred to as the “stress hormone.”
Levels of cortisol that are too high or too low are an important indication that adrenal dysfunction is present. And when cortisol levels are out of balance and adrenal function is compromised, your immune system suffers too.
Since we often call cortisol the stress hormone, it can be easy to think it doesn’t impact other areas of our health. But nothing could be further from the truth.
Cortisol is crucial to regulating the immune system. Let’s take a basic look at how the immune system works.
When the body detects an intruder—called a pathogen—the immune system gets to work on attacking it and protecting us from it. This involves creating inflammation, in part to signal that defense and repair are necessary. The inflammatory response leads to those common cold symptoms, like a stuffed-up or runny nose, sore throat, or fever.
Because of its many links to chronic disease, we often think of inflammation as a dirty word. In truth, it’s an essential component of a healthy immune response. But it can’t be left to run wild—something must regulate it to keep it from becoming excessive, overreactive or chronic.
This is one of cortisol’s jobs. When you have healthy adrenal function, balanced cortisol levels and a healthy immune system, cortisol helps to reduce inflammation and keep levels in check during an immune response without eliminating it entirely.
Cortisol levels that are too low lead to an underactive immune system and insufficient inflammation to protect us against viruses, infections and other pathogens. When they’re too high, it leads to an overactive immune system and too much inflammation (which can lead to issues like autoimmunity and allergies). Of course, neither situation is good.
Usually, in the earlier stages of adrenal fatigue, our stress response system is very busy (just like us). Our adrenals are working overtime to combat a heavy load of stressors, from the emotional to the physical to the environmental, and this includes producing a ton of cortisol.
When cortisol levels are too high, inflammation is reduced too much, and the immune system is suppressed to the point of not really functioning properly.
Basically, when we encounter stress, cortisol and the rest of our hormonal team are thinking, Something really challenging is going on, and we need all hands on deck. Let’s just move some of our resources away from the immune system (and the digestive system, and the reproductive system) for a bit while we take care of this problem.
This may seem reasonable, but when high stress becomes chronic, and stressors are ever-present rather than being dealt with and then disappearing, our stress hormones don’t have the chance to return everything to normal. With all the modern stressors we face, it’s common for cortisol levels to stay high, which means immune system function stays low.
This makes us more susceptible to colds, flu and bacterial infections. It also helps to explain why we often get sick at the “worst” times—stress itself is making us more vulnerable to illness.
High cortisol levels can also make it more difficult for us to recover from viruses and infections. Just like Angie, my patients often tell me that their colds seem to linger on forever.
As adrenal dysfunction progresses, certain things start to change. While you may have once been producing way too much cortisol to battle high levels of stress, your adrenal glands and the rest of your stress response system might now be exhausted and unable to even produce the amount you need.
We know high cortisol levels suppress the immune system. So wouldn’t low cortisol levels boost immune function?
The answer is . . . kind of. But here’s the rub: When cortisol levels get too low, we’re actually removing the watchman that keeps an eye on inflammation during an immune response. Basically, the immune system and inflammation are left to run amok.
When nothing is monitoring the immune system and it’s left to its own devices, new problems can arise. This is when inflammation becomes a dirty word again.
Inflammation can become problematic and chronic, which can lead to a number of illnesses, including fibromyalgia, chronic fatigue syndrome, mood disorders, obesity, autoimmune disease (when the immune system attacks the body’s own healthy cells and tissues) and the development of allergies.
Adrenal fatigue is one of the most common problems I see in my practice, and it often comes with symptoms and concerns related to faulty immune system function. Some patients feel like they’re just getting sick all the time, many have illnesses like Angie’s that linger on and on with no relief, or they have infections that keep coming back.
I also see a lot of autoimmunity, food allergies or sensitivities that were not present earlier in life, and digestive concerns including leaky gut and dysbiosis (an imbalance in gut bacteria). All of these issues are related to issues with the immune system caused largely by adrenal dysfunction.
What bothers me is hearing about how many of these patients have been treated for these issues with no resolution. Doctors prescribe medication after medication—or dole out antibiotics like they’re candy—which just creates more stress and inflammation and doesn’t get to the root of the problem.
When we see signs of immune system dysfunction of any kind, we should start thinking about and supporting adrenal function. Adrenal support should also be included when we talk about immune-boosting protocols during the colder months.
The suggestions below are a great start to supporting the adrenals and immune system. Also see my column Fixing Fatigue for how toxins and trauma can contribute to adrenal fatigue.
Adaptogens. Supplementing with adaptogens can help support the immune system and adrenal function. Adaptogens are a category of powerful herbs that have been found to help regulate the stress response and manage cortisol levels. The adaptogens below may help with adrenal fatigue.
Eleuthero helps to reduce stress, improve cognitive function, boost the immune system, increase energy levels and lower inflammation.
Suggested dosage: 200–400 mg daily
American ginseng has been used for thousands of years to help the body withstand mental and physical stress.
Suggested dosage: 50–100 mg daily
Ashwagandha is a relaxing adaptogen that reduces cortisol, improves brain function and combats anxiety.
Suggested dosage: 200–400 mg daily
Rhodiola is a powerful herb known for its energy-boosting effects.
Suggested dosage: 200–400 mg daily
Vitamins and minerals. Vitamin C is essential for both adrenal and immune system function, and its levels in the body have been shown to decrease during stress. B vitamins are crucial too. Vitamin B5 (pantothenic acid) is often called the “anti-stress vitamin” for its crucial role in producing stress hormones in the adrenal glands, and B10 (para-aminobenzoic acid, or PABA) helps regulate cortisol levels.
A well-rounded multivitamin also includes minerals and can help your body, including your adrenal glands, function at its best. As with all supplements, it’s smart to consult with a practitioner and determine what specific protocol is best for you.
Suggested dosages: Up to 10,000 mg (10 g) daily vitamin C; choose a high-quality vitamin B complex supplement and multivitamin supplement and follow the label instructions
An anti-inflammatory diet. Eating a healthy, balanced diet packed with whole, fresh, anti-inflammatory foods is vital. Here are some quick tips for healthy eating:
Targeted stress reduction. Although many herbs, nutrients and other supplements can be helpful for adrenal and immune system function, you can’t supplement or even eat your way out of adrenal fatigue. It requires really digging into your stressors and finding ways to reduce stress levels so you can heal.
Stress is everywhere, but we don’t have to just accept the consequences and live with it. It shouldn’t be “normal” to be so stressed out that your body, hormonal system and immune system can’t function properly. Consider this a prescription for self-care. See below for nine simple ways to reduce stress.
I highly recommend working with a functional medicine practitioner who will help you to get to the root of your adrenal dysfunction, hormonal imbalances and immune system dysfunction and support true healing rather than offering you a band-aid “solution.”
Angie tried my advice—including taking some time to think about what was truly important during the holiday season. She realized she needed to scale back on the decorating and baking, decline an invite or two, and focus on her family.
She made a conscious effort to eat better (avoiding many of those holiday “treats” made a real difference for her). She also added a high-quality multivitamin and some targeted supplements.
When she came to see me in the new year, she looked like a completely different person. Not only had she survived the season, she’d thrived.
With this deeper understanding of how the immune system, the adrenal glands and hormones like cortisol are intertwined, you can too. And, like Angie, you’ll know what areas of stress to attend to so you can move forward, keep illness away, heal your adrenals and truly enjoy your life.
Try aromatherapy
Using aromatic essential oils to boost well-being can help ease stress. Lavender aromatherapy has been found to reduce cortisol levels measured in saliva.1 And combined with massage, it has been reported as beneficial for work stress and burnout.2
Go outside
Spending time outdoors, especially in green spaces, appears to relieve stress.3 Pairing it with exercise may bring even bigger benefits.
Research is showing that “green exercise,” exercise done in nature, may be associated with better mental well-being than exercise done indoors, with immediate positive effects.4 So go for a walk in your local park, field or forest as much as you can or take up gardening to keep stress levels in check.
Prioritize self-care
Really take the time to think about what you want and need. Say no to things you don’t want to do, and build time into your schedule for the things you do want to do. Keep a gratitude journal and acknowledge that you matter just as much as anyone else.
Lighten the load
Make a list of stressors you’re currently dealing with. Can you make small changes to relieve any of them? For instance, if morning fights with your teenager are leaving you exhausted, buy them an alarm clock and let them know they need to manage their own mornings.
Try mind-body exercise techniques
Yoga, tai chi and qigong are all science-backed ways to reduce stress and anxiety.5 Look online for a class near you, or for a virtual course.
Meditate
Meditation is another way to ease stress and burnout.6 It can also reduce anxiety and depression and improve sleep quality.7
Laugh daily
Laughter therapy is great medicine. Norman Cousins, who first identified it, overcame his “incurable” connective tissue disease by watching Marx Brothers movies and the TV show Candid Camera, as he detailed in his 1979 book Anatomy of an Illness as Perceived by the Patient.
Consider acupuncture
This traditional Chinese technique can reduce stress, depression and anxiety.8 To find a qualified acupuncturist near you, visit acunow.org.
Tackle trauma
Ignoring previous trauma and hurt from childhood means letting your body keep hanging on to that stress. Talk to a counselor or trusted friend, find a support group, or try methods like the Emotional Freedom Technique (tapping) to release old emotional baggage.
Interestingly, a single online group EFT session was recently found to reduce stress, anxiety and burnout levels in nurses treating Covid-19.9
Also check out editor Bryan Hubbard’s Time-Light method of overcoming trauma: time-light.co.uk.
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