The holidays are almost here, and for many of us that means a fuller calendar, less sleep, extra sweets and a few more glasses of wine. It’s also when patients tell me they feel puffy, wired and exhausted all at once. Two systems are usually behind that feeling: inflammation and your main stress hormone, cortisol.
Both are built to protect you. The trouble starts when they stay switched on. The good news is that small, everyday choices move both in the right direction, and you can start most of them today.
Inflammation and cortisol, in plain terms
Inflammation is your immune system’s repair crew. When you sprain an ankle or catch a cold, it rushes in, does its job and then settles down. Chronic inflammation is different. It’s a low, steady simmer that can last for months or years without obvious symptoms, and it’s linked to heart disease, type 2 diabetes, joint pain, fatigue and faster aging.
Cortisol follows a daily rhythm. It’s highest shortly after you wake up, to get you moving, and lowest at bedtime, so you can sleep. Short bursts are healthy. Ongoing stress, poor sleep and constant stimulation can keep it high or flatten that rhythm. That can show up as trouble falling or staying asleep, cravings, weight around your middle, higher blood sugar and feeling wired but tired.
The two are closely connected. Cortisol normally helps keep inflammation in check. But research from Carnegie Mellon University found that chronic stress makes immune cells less responsive to cortisol, so inflammation can run unchecked. That’s why the five habits below work on both at once.
1. Protect tonight’s sleep
Sleep is when your body resets. A review of 72 studies with more than 50,000 people found that poor sleep quality and short sleep were linked to higher levels of C-reactive protein (CRP), a key marker of inflammation. Regularly sleeping more than 8 hours was also linked to higher inflammation, so more isn’t always better. Sleep loss affects cortisol, too. In one study, a single night of restricted sleep raised cortisol levels the next evening by 37%, right when they should be falling.
Keep the same bedtime and wake time, even on weekends. A steady schedule supports your natural cortisol rhythm.
Get outside in the morning. Daylight early in the day helps set your body clock, which makes it easier to fall asleep at night.
Make your bedroom dark, cool and quiet, and put your phone away 30 to 60 minutes before bed.
Aim for 7 to 8 hours. If you snore, wake up gasping or feel unrefreshed no matter how long you sleep, let us know. Sleep apnea is common and treatable, and it’s worth checking.
2. Take a 20-minute walk, outside if you can
You don’t need an intense workout to calm inflammation. In a UC San Diego study, a single 20-minute session of moderate walking reduced the number of immune cells making an inflammatory protein called TNF by about 5%. Regular activity also builds muscle and improves blood sugar, which both help keep inflammation low.
Walking outdoors adds another benefit. In a University of Michigan study, a break in nature lowered cortisol about 21% per hour beyond its normal daily decline, and 20 to 30 minutes gave the most benefit for the time spent. Participants left their phones alone, and that matters. Here in Scottsdale, November is the perfect month for a trail, a park or a quiet stroll along the canal.
3. Add color, fiber and fermented foods to your plate
What you eat can fuel inflammation or help cool it. A Mediterranean-style diet has the strongest evidence. In an analysis of 17 trials with about 2,300 people, it lowered CRP by about 1 mg/L compared with other diets. That’s a meaningful change for a marker where under 1 is considered low risk.
Eat fermented foods every day. In a Stanford study, adults who ate several servings a day of foods like yogurt, kefir, kimchi, fermented vegetables and kombucha for 10 weeks had lower levels of 19 inflammatory proteins, including IL-6. Bigger servings had bigger effects.
Have fatty fish twice a week. The American Heart Association recommends two 3.5-ounce servings a week, especially omega-3-rich fish such as salmon, sardines and mackerel.
Fill half your plate with plants. Vegetables, berries, beans, nuts, seeds and extra-virgin olive oil are the backbone of a Mediterranean diet.
Cut back on sugary drinks, refined carbs and ultra-processed snacks. You don’t have to be perfect, especially during the holidays. Start by adding more of the good stuff.
4. Give your nervous system five minutes
When you’re stressed, your breathing gets fast and shallow, which keeps your body on alert. Slowing it down is one of the quickest ways to tell your body it’s safe. In a Stanford study, people who practiced five minutes a day of “cyclic sighing” for a month had bigger improvements in mood and a larger drop in their breathing rate than people who did five minutes of mindfulness meditation. Here’s how to do it:
Breathe in slowly through your nose until your lungs feel full.
Take a second, shorter breath in to fill them completely.
Exhale slowly through your mouth until all the air is out. Let the exhale take longer than the inhale.
Repeat for five minutes. Try it in the car before you walk into work, or in bed before sleep.
If breathing exercises aren’t your thing, prayer, meditation, journaling or a call with a good friend can help, too. The key is doing something calming every day, not only when you’re already overwhelmed.
5. Rethink your afternoon coffee and evening drink
Caffeine raises cortisol, and regular coffee drinkers don’t fully adapt to it. In one study, even daily coffee drinkers still had a cortisol rise after an afternoon dose. Caffeine also lingers. In another study, 400 mg of caffeine (about two to three cups of coffee) taken six hours before bed cut sleep by more than an hour, and people didn’t even notice.
Alcohol works differently. It can make you sleepy at first, but as your body processes it, sleep becomes lighter and more broken, especially in the second half of the night. Sleep experts recommend stopping alcohol at least three hours before bed.
Enjoy your coffee in the morning, and switch to decaf or herbal tea after about noon.
At holiday parties, alternate each drink with sparkling water and set a cutoff time.
A note on “adrenal fatigue”
You may have read that stress “burns out” your adrenal glands. The Endocrine Society says adrenal fatigue isn’t a real medical condition. Under stress, your adrenal glands typically make more cortisol, not less. Your exhaustion is real, though, and it deserves a real answer. Thyroid problems, low iron, sleep apnea, perimenopause, depression and blood sugar swings can all look like “adrenal fatigue.”
Be careful with “adrenal support” supplements, too. When Mayo Clinic researchers tested 12 of them, every one contained thyroid hormone and seven contained steroid hormones, often without listing them on the label. Check with your provider before starting any supplement like this.
When to look deeper
If you’ve worked on these habits and still feel off, it’s time to test rather than guess. Depending on your symptoms, labs that can help include:
hs-CRP, a sensitive marker of inflammation. For heart disease risk, under 1 mg/L is considered low, 1 to 3 is average and over 3 is high. Because it can spike with a cold or injury, a high result is usually rechecked a couple of weeks later.
A1c and fasting insulin, since blood sugar problems and inflammation often travel together. You can read more in my article on insulin resistance.
Thyroid, vitamin D and iron (ferritin), which are common and very fixable causes of fatigue.
Cortisol testing, when your symptoms point that way. This might be a morning blood test or a test that tracks your cortisol rhythm across the day.
See a provider soon if you notice weight gain in your face and belly with thinner arms and legs, wide purple stretch marks, easy bruising or new muscle weakness. These can be signs of Cushing’s syndrome, a condition where the body makes too much cortisol. Persistent fevers, swollen joints or unexplained weight loss also deserve a prompt visit.
How we help at Lovena
Routine labs through primary care. Tests like hs-CRP, A1c, thyroid and vitamin D are billed to your insurance when covered.
A root-cause plan through functional medicine. We look at sleep, stress, hormones, gut health, nutrition and your labs together, then build a plan that fits your real life.
Specialty testing when it adds something, such as a full-day cortisol rhythm test, at 25% off the lab’s standard price.
Follow-up to make sure it’s working, with repeat labs and adjustments along the way.
Founding 100 members get the Foundations Evaluation for $399 (standard $695) and keep founding rates for as long as their membership is continuous.
Start with one
You don’t have to do all five at once. Pick the one that feels easiest and start tonight. If you’d like help figuring out what’s driving your inflammation or stress, call or text (602) 894-8398 or book online. You can start with a free 15-minute functional medicine discovery call.
Sources
Leproult et al., Sleep loss results in an elevation of cortisol levels the next evening, Sleep 1997
UC San Diego: 20 minutes of exercise can act as anti-inflammatory, Brain, Behavior and Immunity 2017
American Heart Association science advisory: eat fish twice a week, Circulation 2018 (summary)
Endocrine Today: Endocrinologists confront the myth of adrenal fatigue, 2018
This article is for general education and isn’t medical advice. Talk with your own provider about your situation.