The Connection Between High Cortisol Levels and Cognitive Function

Cortisol, the primary stress hormone released when your body perceives a threat, is essential for survival. In small doses, cortisol has beneficial effects, like waking you up in the morning, supporting energy, and helping the body deal with stress.

The problem is that high cortisol levels over a prolonged period can lead to adverse health consequences, both physically and mentally. Hormone imbalance, weight gain, and blood sugar imbalance are just a few of the physical effects of too much stress and elevated cortisol. But cortisol also plays a huge role in brain health, from mood and memory to learning and decision-making.

In fact, the connection between cortisol and cognitive function is so strong that chronic stress and high cortisol levels have been linked to cognitive decline and dementia. This makes sense because cortisol crosses the blood-brain barrier and binds to various receptors in your brain, especially areas that control memory, learning, and emotional processing.

Let's take a closer look at how cortisol affects the brain, signs your brain is struggling, and what you can do to keep your cortisol levels in check.

What Gland Produces Cortisol?

Cortisol is produced by the adrenal glands that sit on top of the kidneys. The adrenal glands produce various hormones, including cortisol, adrenaline, and noradrenaline. These hormones are essential for regulating the body's stress response.

The release of cortisol is controlled by the hypothalamic-pituitary-adrenal (HPA) axis. This complex system starts in the brain and involves several different hormones.

Adrenal Gland Health

The HPA axis is activated in times of stress, triggering the release of cortisol from the adrenal glands. Cortisol then works to help the body cope with the stressor. Once the stressor is gone, the HPA axis should return to its normal state.

However, for some people, the HPA axis becomes dysregulated, and cortisol levels remain high even when there is no longer a stressor. HPA axis dysregulation is what is often called adrenal fatigue in conversation. While it's not exactly correct to say the adrenals are fatigued, it is a common language used by patients who are trying to explain the symptoms they experience when the whole HPA axis system is thrown off.

Nourishing the adrenals (which we will discuss later in the article) can support a healthy stress response, lowering how much cortisol your brain is exposed to daily.

Signs That Your Brain is Struggling

The tricky thing about brain-related changes is that they don't always present themselves in obvious ways. It's not like a broken bone, where you can see the physical damage, and it's evident that something is wrong.

Cognitive decline, dementia, and brain fog often manifest as subtle changes in behavior or thinking patterns. For example, you might notice that you're having more trouble remembering names or where you put things. Or maybe you're feeling more forgetful than usual and having difficulty concentrating.

Brain fog isn't an actual medical diagnosis, but that doesn't make it any less serious and it can manifest in many ways.

Symptoms of Brain Fog

Difficulty concentrating
Trouble remembering things
Feeling forgetful
Poor decision-making
Trouble multitasking
Brain fatigue (feeling brain-tired but not necessarily body-tired)

How Can Cortisol Affect Brain Health?

The science behind how cortisol affects the brain shouldn't be ignored (and adverse outcomes can start younger than you think).

First, it's worth noting that occasional situational stress, like a work deadline or giving a presentation, doesn't have the same effect on the brain as chronic stress. Brief surges of stress can actually improve your performance and keep you more alert in these situations. It's only when cortisol levels stay elevated for extended periods that problems can occur.

But here's what we know: changes in the function of the HPA axis and consistently high cortisol levels are linked to an increased risk for brain-related disorders like dementia and Alzheimer's.

This has been repeated in various studies that link high cortisol with brain-related issues for people without dementia like:

Poor cognitive function
Memory issues
Language
Spatial memory
Processing time
Social cognition
Faster cognitive decline

A study following a famous cohort called the Framington Heart Study found that higher cortisol levels (especially for women) were linked to poor performance in memory, organization, visual perception, and attention. The study comprised over 2000 participants, primarily in their 40s. Those with higher cortisol levels also were associated with physical alterations to the brain linked to dementia and Alzheimer's disease.

Several other studies have noted that cortisol impacts brain volume in regions known to affect cognition, including gray matter, which is vital for processing information, and the hippocampus, which is essential for memory (stay tuned for more on why the hippocampus is so important).

@drjolenebrighten Symptoms or high cortisol bleed into symptoms of period problems, thyroid issue, fertility struggles, and more because they are all connected. Sleep is when your adrenals recover. Your cortisol dips while melatonin rises and it needs this time so they can rally the cortisol spike for the next morning. 😴Sleep in a dark, cool room 😴Set up a bedtime routine 😴Try to maintain a consistently sleep schedule #highcortisol #highcortisollevel #adrenalfatigue #adrenalhealth #adrenalhealingjourney #hormone ♬ Anxiety Is My Boyfriend – Haven

What Does the Hippocampus Do?

The Hippocampus is a seahorse-shaped region in the brain that's important for learning and memory. It's located in the temporal lobe, just behind the ear. The hippocampus has a significant amount of cortisol receptors, which makes it especially vulnerable to the effects of stress.

Hippocampus-Dependent Learning and Memory

The hippocampus is essential for forming new memories and recalling old ones. It's also involved in navigation, spatial memory, and declarative memory, the kind of memory we use to remember facts and events.

This part of the brain is constantly active, even when we're not consciously thinking about memories. It's continuously encoding new information and making connections between different memories.

Hippocampus and the Stress Hormone Cortisol

High cortisol appears to significantly impact the hippocampus, to the point where very high cortisol levels may cause atrophy (shrinkage) of the hippocampus.

Here's where it gets complicated—you learned the HPA axis regulates the stress response, but the hippocampus can also inhibit the HPA axis. So when the hippocampus is impaired by stress, it can worsen the stress response. This dangerous cycle can further damage the hippocampus and cause even more stress.

Studies have found that both directly administering hydrocortisone, a synthetic form of cortisol, and exposing healthy younger subjects to stressors that increase cortisol negatively impacts working memory. Chronic stress may also accelerate apoptosis (cell death) in the hippocampus, although this was seen only in animal studies.

Signs and Symptoms of High Cortisol Levels

Clearly, stress isn't good for the brain or the hippocampus. So what signs should you watch for that may indicate you have high cortisol levels? Here are some of the most common signs and symptoms:

Anxiety
Depression
Irritability
Fatigue
Muscle weakness
Weight gain or unexplained weight loss
Skin problems, such as thinning skin, easy bruising, and stretch marks
Digestive issues, such as diarrhea, constipation, and nausea
Sleep problems, such as insomnia and night sweats
High blood pressure
Headaches
Memory problems
Cloudy thinking or “brain fog”

Stress can look different for each person, and we all have different thresholds for stress. You may be able to handle a lot of stress before it starts to impact your health, while someone else may begin to feel the effects of stress at much lower levels. Take a closer look at how stress affects you mentally and physically, and pay attention to any changes that may indicate high cortisol levels.

How to Lower Cortisol Levels and Improve Adrenal Function

Nutrition, lifestyle, and supplements are my go-to approach for supporting adrenal health and lowering cortisol levels. Here are some of the best things you can do to protect your brain from the harmful effects of stress.

Foods that Lower Cortisol

Insulin resistance and inflammation are closely tied to brain health. Diet patterns like the Mediterranean or Mind Diet have been shown to help protect cognitive function and reduce the risk of dementia. These diets are full of nourishing anti-inflammatory foods like fruits, vegetables, olive oil, fish, and nuts. You’ll find these types of foods in our free hormone balancing recipe guide and meal plan.

High cortisol also increases blood sugar levels, so eating to support stable blood sugar can help. This means eating regularly spaced meals and including protein, healthy fats, and fiber at every meal.

And of course, you can't forget about your gut health. The gut-brain axis is a two-way street, meaning that what's going on in your gut can affect your brain and vice versa. So a healthy microbiome may influence your stress response and brain health.

Supplements to Lower Cortisol

Adaptogenic Herbs. Adaptogenic herbs help the body adapt to stress and normalize cortisol levels gently yet effectively. Some of my favorite adaptogens for lowering cortisol include ashwagandha, Rhodiola, shavarti (asparagus racemosus) and holy basil.

Magnesium. Magnesium is a mineral involved in over 300 functions in the body, including the stress response. Low magnesium may exacerbate stress, but stress can also increase magnesium losses.

Vitamin C. Vitamin C is a powerful antioxidant that helps protect the body from stress. In one study, people who took a vitamin C supplement had lower cortisol levels and blood pressure.

B-Complex Vitamins. B vitamins contribute to the enzymatic reactions involved in the stress response. Taking a B complex could help improve the impact of stress on your body.

Phosphatidylserine. Phosphatidylserine is a type of fat found in cells, including those in your brain. It's vital for brain health and cognitive function. Phosphatidylserine has also been shown to lower cortisol levels and improve the stress response.

I've created a comprehensive, all-in-one Optimal Adrenal Kit that includes all these essential nutrients, botanicals, and more to support optimal stress and hormone balance in the body.

Lifestyle

Stress resilience takes a whole-person approach, so in addition to diet and supplements, lifestyle habits can also make a difference in your stress resilience and adrenal health (and just make you feel better from the inside out).

Exercise. Exercise is one of the most effective ways to lower cortisol levels. Not only does it help mitigate stress, but it also boosts endorphins, which are hormones that have mood-elevating effects.

The tricky thing is to not overdo it, as over-training can exacerbate cortisol. So, mix in a few rest days to stretch too.

Meditation. Meditation is a mindfulness practice that helps you focus on the present moment and let go of stress. Research shows that meditation can help lower cortisol levels and improve the stress response.

If you're brand new to meditation, it can feel a little intimidating, but there are plenty of apps and free resources to get you started.

Sleep. Getting enough sleep is essential for adrenal health. Poor sleep interferes with the normal function of the HPA axis, impacting stress, adrenal health, and so much more.

I won't pretend that sleep struggles are an easy fix. All of the above tips for the adrenals are also important for adequate rest. Also, ensuring you have a quiet, cool sleep environment with a calming bedtime routine can help. You can read more sleep tips in this article.

@drjolenebrighten Cortisol is like that. #hormones #hormoneimbalance #hormonehealth #hormonetiktok #hormonas #casatiktok #insomnia #sleepover #cortisollevels #cortisol ♬ original sound – Marler9⚾️

Take Steps Now to Limit the Effect of Stress on Your Brain

Sometimes reading these articles can sound a little scary, especially if stress is a significant factor in your life. But my hope is that you can take this information and use it as motivation to make a few changes.

Small steps can add up, even if it's one or two changes to get you started. Supplements, nutrition, and lifestyle-focused habits like sleep and stress are all essential for managing stress.

If you need extra support, you can check out my free Hormone Balancing Starter Kit, which includes a 7-day plan and recipe guide to help you feel confident as you start your journey.

References

About The Author

Dr. Jolene Brighten

Dr. Jolene Brighten, NMD, is a women’s hormone expert and prominent leader in women’s medicine. As a licensed naturopathic physician who is board certified in naturopathic endocrinology, she takes an integrative approach in her clinical practice. A fierce patient advocate and completely dedicated to uncovering the root cause of hormonal imbalances, Dr. Brighten empowers women worldwide to take control of their health and their hormones. She is the best selling author of Beyond the Pill and Healing Your Body Naturally After Childbirth. Dr. Brighten is an international speaker, clinical educator, medical advisor within the tech community, and considered a leading authority on women’s health. She is a member of the MindBodyGreen Collective and a faculty member for the American Academy of Anti Aging Medicine. Her work has been featured in the New York Post, Forbes, Cosmopolitan, Huffington Post, Bustle, The Guardian, Sports Illustrated, Elle, and ABC News. Read more about me here.