If any of us are under stress, whether emotional, psychological, health stress (such as being on nothing but T4), or physical, it’s natural for the body to respond with a greater release of cortisol (and even adrenaline) to eventually equal high cortisol. But it causes problems. Here’s information for you to read about high cortisol. ~Janie, hypothyroid patient and site creator

The ultimate purpose of rising cortisol is to change amino acids into glucose, called gluconeogenesis. That extra glucose helps gives the body the right amount of energy to deal with the stress. Even those who do intense exercise will see their cortisol go up.

With straight hypothyroidism or even Hashimoto’s patients, we have noted that cortisol tends to go up when we are undiagnosed or poorly treated with Synthroid or Levo–either causing stress to the body. Hashi’s patients also tend to have inflammation which pushes cortisol up, whether from the attack on the thyroid, or the consumption of gluten. Even non-Hashi’s patients who are poorly treated can see cortisol go up due to inflammation.

Causes of elevated cortisol

  • autoimmune Hashimoto’s attack stress
  • being on T4-only
  • being underdosed on NDT or T3 and not optimal
  • working out too intensely, too often, not allowing rest between workouts (especially common with men, but can happen to women)
  • dosing with too much progesterone, which will convert to cortisol (very common with women)
  • reactivated viruses like EBV or others
  • any chronic illness
  • Lyme
  • mold exposure
  • high heavy metals
  • detoxing
  • candida
  • detoxing of metals, candida, mold
  • your current and chronic life stressors

We find that all stressors will need to be addressed, besides our hypothyroid state. (By the way, this is different from the disease called Cushings, often caused a tumor causing the excess cortisol. But that’s another thing to look into with your doctor’s help!)

And though rising cortisol has a good purpose, we run into trouble if it stays high too long. High cortisol promotes T4 to convert to more and more RT3 (reverse T3), the inactive hormone. Uncontrolled rising cortisol can also lead to weight gain, problems falling asleep or staying asleep, depression from the rise of RT3, fatigue, blood pressure problems, cortisol resistance, and even anxiety, since adrenaline goes up with cortisol. See the last chapter in the STTM II book–BRILLIANT explanation by Dr. Laura Stone.

How will I know if I have elevated cortisol??

For most of us, we have found it unwise to simply guess if you have too-high cortisol. Symptoms of high and low cortisol can be the same for many.  Additionally, we have learned we can never assume we have it because “blood results” show it. Blood is measuring both bound and unbound, which means your blood lab result can look high, when in reality, you could have normal or low cortisol results as accurately revealed by saliva testing. This has been very common!

The best way to know is order and do a 24 hour saliva test. You will test at four key times. When you get your results back, do NOT just go by their normal range graphic. Go by this page. 

What are other symptoms of high cortisol?

Elevated cortisol can create similar symptoms as having low, such as nausea in the face of stress, adrenaline surges which wire you or keep you awake (insomnia) or make you wake up 1-2 hours after falling asleep, other wakeups, lowered temp, high RT3…you name it. In fact, since excessive cortisol inhibits conversion of T4 to T3, it’s very common to see increases in your RT3 level. You can see a return of hypothyroid symptoms and a lowered temp. But again, it’s not always wise to be guessing, and instead do a saliva test to know for sure.

Another problem with long-term high cortisol–it leads to low cortisol

There comes a point in anyone’s body that the high cortisol will be forced down to low cortisol…and that is a whole another problem to treat. This is what patients see when they have saliva results which are low, high, low, high…or even low, low, high, high, or low, low, low high…or other manifestations.  Often the last high cortisol result to fall is bedtime, but there can be individual variations. It’s just the most common.

The last chapter in the Stop the Thyroid Madness II book by Lena Edwards MD does a bangup job explaining what happens with our cortisol levels, See below.

Thyroid patient Irina holding the STTM II book.

What does high bedtime cortisol do to me?

High bedtime cortisol can cause disruption of your sleep pattern, resulting in problems falling asleep, or waking up 1-2 hours after falling asleep, or both…which is the very thing you don’t need! High bedtime cortisol can also contribute to low morning cortisol…another bad issue.

How do I treat my high cortisol?

Patients have found help just around the corner at their local health food store or on the internet. The following are examples of over-the-counter products that are taken about an hour before you did the saliva spit for that particular high. So if you are high at 10 pm, these are taken by 9 pm…etc.  It may only take a week or more to get a high down if enough of the below is taken. i.e. being able to fall asleep and stay asleep, or less anxiety at any particular high time, or lowering of a high heartrate, etc). You can then decrease the supplement for a few weeks, then get off so you don’t lower it too much!  Some people take a combo of the below, but if enough of one is taken, that has worked too!

  1. Phosphatidyl serine (PS) is a fatty acid found in your immune cells and muscle tissue, as well as being prevalent in your brain cells. And as a supplement, it helps lower cortisol when its high levels are damaging–lowering it from 30% to 70% according to different literature. When you shop for it, you want simple Phosphatidyl Serine rather than Phosphatidyl Complex, the latter which will contain both PS and Phosphatidyl Choline. The “complexes” will often say 500 mg, of which 100 mg is the Phosphatidyl Serine. But the complex can give you a strange spacey feeling in the mornings for some. Recommended doses of PS range from 300 mg to 1000 mg, and you might start around 300 mg and see if you get relief, or raise until you do. If you have all day high cortisol, you can experiment with 300 mg at breakfast, another 300 by lunch, and 300 around supper…or every few hours. Note that many brands are derived from soy…which isn’t a bad thing if you aren’t already consuming it in other ways. But if you have concern, Jarrow Formulas now makes a soy-free version called PS 100, found on many websites. Another potential good alternative is Seriphos by Interplexus which contains 300 mg PS per 1000 mg capsule. Lots of good reports on its use to lower high cortisol.
  2. Zinc can also help lower high cortisol levels! (Note it says it will lower “high cortisol”. In the lower amounts, we’re not seeing it lower normal levels to the degree that it lowers “high” cortisol). Recommended dosages range from 25 mg to 100 mg, and the latter amount has been the most effective at nighttime, say patients. NOTE: It’s important to have food in your stomach when taking zinc to prevent stomach upsets. Some patients will add zinc to their PS dosage. Don’t take zinc forever–it can lower copper levels, and your body needs “some” copper for many important actions. We just use it until cortisol is lowered. Or, add copper to your supplementation, such as 2-4 mg say some experts. (Note: if you have an MTHFR mutation, you may need to check your zinc and copper levels before using zinc. If your copper is high, the addition of zinc will cause detoxing of that high copper and potential misery, say experts. So some go low and slow.)
  3. Holy Basil, which is a member of the mint family, is an adaptogenic herb which has a proven history of lowering high cortisol. It usually takes more than the bottle says as a serving. This is Janie Bowthorpe’s favorite supplement to lower high bedtime cortisol, or even the morning, if either occur. Two capsules does the trick for Janie, sometimes three. Please note that a small body of people can have allergic reactions to Holy Basil.
  4. Ashwagandha, an herb also called an adaptogen, is known to help counter the effects of stress and can eventually lower cortisol. It may be a little slower than the above, but still very worthy and can be combined with the above.
  5. Fish Oil--yes, studies report it can do a fabulous job lowering high cortisol. Here’s one. But we don’t yet know if it works as fast as the above do!
  6. Several other calming supplements, which range from lemon balm, l-theanine, chamomile, passion flower, magnesium, etc.

There are other supplements mentioned in the updated revised STTM book, shown below–the bible of worldwide patient experiences and wisdom!

You’ll want the updated revision Stop the Thyroid Madness book–the bible of worldwide patient experiences and wisdom.

Need help interpreting your lab results? Go here:

(Important note: STTM is an information-only site based on what many patients have reported in their treatment. Please work with your doctor. This is not meant to replace that relationship or guidance, and you agree to that by reading this website. See the Disclaimer.)

Important note: STTM is an information-only site based on what many patients worldwide have reported in their treatment and wisdom over the years. This is not to be taken as personal medical advice, nor to replace a relationship with your doctor. By reading this information-only website, you take full responsibility for what you choose to do with this website's information or outcomes. See the Disclaimer and Terms of Use.