Managing Stress

January 12, 2012 in Categories: , by

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After following a paleolithic diet, I think managing stress is probably the most important thing you can do for both your short- and long-term health.  Did I say the exact same thing about sleep?  Okay, sleep and stress are tied for second place.  They are also interlinked, so usually working on one will also help the other; and conversely, problems with one will affect the other.

What do I mean by managing stress?  Really, I mean managing your cortisol levels.  In a perfectly healthy individual, cortisol is high in the morning and decreases throughout the day.  But, when our bodies react to stressors, not only are our cortisol levels higher than normal, but also the pattern of expression changes to a spike in the late afternoon or evening.  And cortisol affect everything in our bodies:  insulin release, insulin sensitivity, hunger hormones, mood, gut health, immune system function, even libido. 

How do you know if your cortisol is high?  Do you carry much of your extra weight around your middle?  Do you have to pee in the middle of the night?  Do you have trouble sleeping?  Does your energy tank in the afternoon but then pick up again after supper?  Are you having trouble losing weight even though you should be based on what you are eating?  Are your workouts getting progressively harder rather than easier?  If the answer to any of those questions is yes, then cortisol may be to blame.

Our bodies and brains react to stressors like work, kids, relationships, deadlines, inadequate exercise, poor diet, inadequate time outside, lack of sleep, and too much caffeine.  So how do you go about regulating cortisol levels?  First, the easy stuff:  Do what you can to get more, better-quality sleep.  Give up or severely restrict your caffeine intake (at least for a little while).  Reduce your carbohydrate intake (again, at least for a little while).  Make sure you are eating a strict paleolithic diet and getting plenty of omega-3 fatty acids.  Get outside, but still take a vitamin D3 supplement.  Get more low-strain, moderate exercise (like yoga, swimming or walking).  Make time for fun, whatever it is that you find fun.  Make time to relax, especially in the evenings.

The rest is more individual.  You need to find the best way for you to manage the people/places/events in your life that cause you stress.  What small things can you add or remove from your life to help?  Can you take a minute to just breathe?  Can you take a bit longer to meditate?  Can you carve out some time for yourself?  Can you ask somebody for help? Can you take some time for something fun?  Can you just take a moment to appreciate what is good and wonderful in your life right now?  Yes, life is stressful, but you do not need to be stressed.  Your health and the health of your family are more important.  So, change what is in your power to change, and divest yourself emotionally from those things you can’t control.


Depends on the type of test you are doing (blood or saliva), which lab is doing the test, and what time of day you tested at. You really need a healthcare professional to help you interpret the results.

I know you have children so you will understand: my kids are 2 and 4, and I work mostly from home, while caring for them full time. At this age, they play well together but also battle a lot, and require me all the time. All day long, it seems like there’s only rare opportunities to breathe or relax, oe even sit down–by the time I make their breakfast and sit down to eat mine, they are done and crawling all over me. it feels like I’m always saying no, stop, get down, don’t touch that, leave him/her alone, stop yelling, quit fighting etc etc. even though they are very well behaved! As a result, I feel like my cortisol is at the max! Any tips for lowering it in the midst of chaos? 🙂

Yes, I do understand! My first tip is making sure that you get enough sleep. I know that it’s so nice when the kids are asleep after those hectic days and the’s so many things you want to do with that time, but the best thing you can do to help manage your cortisol levels is go to bed early. This is something I constantly struggle with myself, especially now that I’m writing the book. But, I do find that when I am diligent and go to bed earlier that everything else seems easier. The other tip that works really well for me is to take a moment every so often to take just three really deep slow breaths. I close my eyes and do this even in front of the kids, who seem to be partly amused and partly perplexed, but seeing me breathe will often calm down whatever is going on without me having to do anything. Then it’s easie to get them to breathe when they’re having tantrums too. 🙂 some people even set timers to remind themselves to take a few deep breaths. Ideally, I would love to do that for 5 minutes, but I rarely can spare that much time during the day.

Hi Sarah!

I just read through this study on meal frequency that I think you will find interesting:

The most interesting thing to me, as someone with an autoimmune disease, was that the group that ate only one meal per day saw significantly lowered blood cortisol concentration (as well as less body fat, but that’s just a perk I guess 🙂 ). I think for now, while I still have symptoms of my autoimmune disease, it’d probably be better to continue to eat 3 meals / day. When I am healthy do you think consistently only eating 1 meal a day would be okay?


Hi Sarah,

I really like your website, you explain everything so well. I haven’t had my cortisol levels checked, but it seems they may be out of line.

I had never read about ‘waking up in the night to pee’-sydrome being related to high cortisol. I wake up normally twice every night for this, are there other possible causes of this other than cortisol?
I am a lean 20 year old female but my weight seems to fluctuate a lot i.e. + or – 10 pounds in a few weeks. Over the last 3 weeks I have suddenly developed ‘love handles’ out of nowhere! im so upset about it – do you think cortisol is to blame? Ive seen it blamed for abdominal fat, only my stomach isn’t too bad, it’s mostly on the sides/hip area.

Do you have any reccomendations for the best tests to do? ( I like in the UK)

Many thanks

Could be. Or it could be some hormones to do with your menstrual cycle. They’re actually very linked, so it could be both. You can do a salivary cortisol test and you can have your estrogen and progesterone levels tested. Maybe before you do that, see what happens if you give up coffee for a month and go to bed 1-2 hours earlier all month. As for peeing, getting up once is probably normal for some people, twice might be normal. If you try drinking less water in the evening and that doesn’t make a difference, then it’s probably cortisol.

Here’s what I’ve noticed: really hard to get up and get going. Okay for about 2 hours and then tired again. Not really functional until after 2pm and until about 7-8pm or so… then pretty tired again. I also suffer from digestive issues and autoimmune issues (aches, pains, diagnosis of Crohns, allergies and skin issues), but wondering what can really help shift this. I am on a strict paleo diet and have been grain free for 3 months and 1005 legume free for one month. Very little improvement… just allergies have calmed down. Digestion is terrible, energy is so low adn tired all the time with aches and pains. I’d love your thoughts on this, particularly the cortisol piece!
Thank you for giving us such amazing information with your blog!!!

In terms of the wonky cortisol, the number one best thing you can do is sleep as much as you possibly can. Adding mindful meditation practise (where you sit quietly and focus on your great for 10-20 minutes every day) is also very helpful. In terms of managing Crohn’s disease with Paleo, I do suggest the autoimmune protocol. And you may wish to add digestive supplements to help speed healing (if helps you absorb more nutrition from your food so your body has the building blocks to heal).

I have recently taken up the Autoimmune Paleo diet. After three weeks I started waking up in the middle of the night, every night to go pee around 4am. A friend mentioned I am probably detoxing and that is the time of the night that the Liver kicks into action. Two weeks later, it is still happening. It is interrupting the great sleep I was getting when first starting the diet. I was wondering if anyone else has experienced this or is there a way to balance this out. i think I am drinking a normal amount of liquids but am going to try keeping it away from bed time.
Thank you!

I had a sleep study and found that I awoke every time I started into a REM cycle. No wonder I was stressed and tired. A CPAP has helped hugely. I can sleep at night now (if I do everything else right as well).

I wouldn’t say you should compare either of these: diet, stress, sleep. I think it might lead people to say, “Well, my diet’s good, so I can skip out on a couple of hours of sleep here or there.” I don’t believe this is true is you have any kind of health issue. There are some people who think managing stress is the most important thing. My endocrinologist, who encourages following a paleo diet, believes that stress is the foundation of all auto-immune problems. My feeling is that it all has to work together.

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