How to Manage Stress and Cortisol Levels

Stress can have a negative impact on our physical health, our mental well-being, and our overall productivity. Too much stress can lead to anxiety, depression, and other mental health issues. Stress can also make weight loss efforts more difficult.

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Danielle Kelvas, MD
— Signos
Medical & Health Writer
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Updated by

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Science-based and reviewed

July 24, 2024
June 16, 2022
— Updated:

Table of Contents

Cortisol, a hormone produced by the adrenal gland, is known as the "stress hormone." When we are under stress, our body releases cortisol. When we experience chronic stress, cortisol can lead to unwanted health outcomes, which we explored in our last post, "What Is Cortisol, and Why Is Managing It Important for Health?".

Read on to learn tactics to reduce stress and manage cortisol levels.

1. Thoughtfully evaluate your schedule and work-life balance

Only you know where your work-life schedule falls on the curve. Something I used to tell my patients routinely: No one is going to make the change for you. If you’ve been overworked and stressed for years, there exists a hard opportunity cost for burning the candle at both ends. 

Researchers have found that stress and anxiety can put you at higher risk of developing type 2 diabetes.1 Stress directly impacts hormone levels, including insulin levels. Stress can also lead to unhealthy habits like drinking too much alcohol, poor food choices, and not getting enough sleep—all of which can contribute to weight gain. Being overweight, in turn, also raises the risk of developing type 2 diabetes.2

In 2018, the CDC and American Diabetes Association (ADA) showed over 10% of the entire U.S. population met criteria for some form of diabetes, with the percentage rapidly increasing.3 It can feel scary and overwhelming to change jobs, careers, or locations. As someone who personally made a monumental life shift to reduce stress-levels, I cannot stress enough (no pun intended) how incredible I felt after. I lost 15lbs and slept wonderfully for the first time in 12 years, which brings me to my next suggestion. 


2. Practice healthy sleep hygiene

Disrupted circadian rhythms and sleep cycles contribute to irregular levels of cortisol and growth hormones. This can cause blood sugar oscillations and weight gain. Here’s how to practice healthy sleep hygiene:

  • Go to bed and rise at the same time each day. 
  • Consume caffeine only in the morning, and avoid eating or drinking alcohol 2 hours before bed. This stimulates the digestive system, when you should be winding down for sleep. 
  • Create a quiet, dark, and cool place for sleep. The bed should only be used for sleep and sex - do not work, watch TV, or complete day-time tasks in bed. It may sound silly, but this is a part of conditioning the mind into knowing that once you are  in bed, it’s time to sleep.
  • Avoid bright screens 1-2 hours before bed, as this tells the mind that the sun is out, which inhibits the brain’s natural secretion of melatonin. This hormone helps our brains enter the first stage of sleep.
  • Avoid activating content such as social media content and news that might be triggering 1-2 hours before bed. 

<p class="pro-tip"><strong>Learn about </strong><a href="/blog/improving-sleep-quality-how-to-not-wake-up-tired">how to not wake up tired</a></p>

3. Protect your mind and treat mental health issues

If you suffer from depression, anxiety, eating disorders, or any other mental health illness, I encourage you to seek treatment; which includes seeing a healthcare provider and starting therapy. Living with chronic stress takes a toll on the mind. 

When depressed, it can feel impossible to eat well or exercise. Counseling can help as a form of accountability and to help you create healthy boundaries in life. For those with eating disorders, many attempt to alleviate their stress with emotional eating. Don’t get stuck in this vicious cycle.

<p class="pro-tip"><strong>Learn about </strong><a href="/blog/optimize-your-brain-health">how to boost your brain health</a></p>

person sitting cross-legged with hand in meditative position
There are many different ways to meditate, and a regular practice can improve your stress response.

4. Practice mindful meditation

Studies show that mindfulness meditation and acceptance exercises lower stress reactivity.2I recommend doing this in the morning and once again during the day. 

Find a quiet place, sit comfortably, and observe the mind for just 5 minutes; twice per day. Many excellent podcasts and videos online can guide you through meditation practices.

5. Try a ketogenic diet

Current ketogenic guidelines recommend consuming the following distribution: 55-60% fat, 30-35% protein, and 5-10% carbohydrates. Eating highly processed food that is high in sugar contributes to anxiety, stress, and weight gain. Because ketosis causes a fundamental biochemical change in metabolic fuel for the brain, ketosis results in a deeply relaxing state, which can slightly ameliorate feeling stressed.3

Talk to your medical provider beforehand to see if a ketogenic diet might be appropriate for you.

<p class="pro-tip"><strong>Learn about </strong><a href="/topics/keto">keto and low-carb diets</a></p>

6. Exercise

Extensive research demonstrates that regular exercise effectively reduces stress levels. Exercise has cardioprotective benefits, improves sleep quality, facilitates weight loss, and many other health benefits. 

Guidelines recommend exercising for 30 mins 4-5 times a week. This can include:

  • walking 1-2 miles around the neighborhood
  • Joining a gym
  • Picking up a new sport
  • Participating in online exercise videos
  • If you have joint issues or chronic pain, swimming is an excellent alternative

<p class="pro-tip"><strong>Learn about </strong><a href="/blog-category/fitness">scientifically-reviewed exercise tips</a></p>

woman kayaking
Spending time in nature and enjoying regular exercise are good ways to manage stress.

Can a CGM help?

If you use a CGM with the Signos app, it will alert you when your blood sugar or predicted blood sugar is on pace to exceed your optimal range. You may notice that on high stress days, your blood sugar is more volatile or “spiky”. Perhaps on those days you’re more likely to make poor food choices, skip exercising, or sacrifice healthy sleep. Signos helps you track these things, and it can assist in helping you understand when stress is making a negative physiologic impact on the body.

<p class="pro-tip"><strong>Learn about </strong><a href="/blog/cgm-uses">improving stress, sleep, exercise, and weight loss with a CGM</a></p>

Take Action to Reduce Stress

If you want to change your life, then change your life. If you want something you’ve never had, then you must do something you’ve never done. 

I recently downsized my career and my work hours; it initially felt overwhelming. I know that chronically high stress does a lot of harm to the body; more than increasing blood sugar levels. 

The cost of living with chronic stress ages the body—and it can take the mind with it. 

When you’re trying to lose weight, it gets more difficult with elevated cortisol levels combating your eating and exercise efforts. When you lower your stress levels, you’ll notice an improvement in: 

  • Maintaining stable blood sugar
  • Weight loss
  • Mood
  • Quality of sleep

I know I noticed these benefits, and I wouldn’t trade my health for all the money in the world.

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Topics discussed in this article:


  1. Pouwer, F., Kupper, N., Adriaanse, M.C. (2010) Does Emotional Stress Cause Type 2 Diabetes Mellitus? A Review from the European Depression in Diabetes (EDID) Research Consortium. Discovery Medicine, 9(45), 112-118. 
  2. Al-Goblan, A. S., Al-Alfi, M. A., & Khan, M. Z. (2014). Mechanism linking diabetes mellitus and obesity. Diabetes, metabolic syndrome and obesity : targets and therapy, 7, 587–591.
  3. Centers for Disease Control and Prevention, Diabetes, Prevalence of Diagnosed Diabetes. (2021) Retrieved June 17, 2022, from:
  4. Lindsay, E. K., Young, S., Smyth, J. M., Brown, K. W., & Creswell, J. D. (2018). Acceptance lowers stress reactivity: Dismantling mindfulness training in a randomized controlled trial. Psychoneuroendocrinology, 87, 63–73.
  5. Scolnick, B. (2017). Ketogenic diet and anorexia nervosa. Medical Hypotheses, 109, 150 - 152.

About the author

Dr. Danielle Kelvas, MD, earned her medical degree from Quillen College of Medicine at East Tennessee State University in Johnson City, TN.

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