Stressed Out? The Natural MD’s One-Day Plan To Balance Your Cortisol

If there’s one thing we’ve lost in our 24/7 go-go-go way of life, it’s rhythm. I don’t mean whether you can bust a move. I’m talking about the healthy internal rhythm that flows when your body’s inner clocks are aligned with the natural rhythms that protect our health. Called circadian (from the Latin circa which means around, diem meaning day) and diurnal (the cycle happens in 12-hour shifts) rhythms, they allow us to adapt to the daily and cyclic demands of our environment, and are critical for keeping weight, mood, metabolism, digestion, detoxification, hormones, thyroid, immunity, sleep, and energy healthy. They are an ancient, inherent part of our biology. As we’ve evolved, our biological wiring has not changed, however the demands on our time have, leading to sleep deprivation, irregular eating patterns, and with it, chaos in our health.

What Are These Internal Clocks You’re Talking About, Dr. Aviva?

Each of us possesses a central internal clock, located in our brain in an area of the hypothalamus called the suprachiasmatic nucleus (SCN). The SCN coordinates our body’s functions around a 24-hour clock that coincides with the 24-hour rotation of our planet around the sun. It evolved so that functions and behaviors most appropriate for daytime, for example, being awake when there’s natural light, eating, digesting, and eliminating, and being immunologically primed to neutralize the viruses and bacteria we’re more likely to encounter while we’re awake, and those that occur at night, for example, sleep and higher levels of cellular repair and detoxification, occur respectively during the daylight or nighttime hours.

Our daily exposure to cycles of light and dark largely determine these rhythms, which also vary according to seasonal light. Other influences on your rhythm include the timing of when you eat and sleep, and your stress level.

In addition to this central master clock, every organ and cell in your body, from your brain, heart, liver, spleen, your fat cells, and adrenal glands, for example, to specific immune tissues and cells including your lymph glands, your T cells, B cells, lymphocytes, and Natural Killer (NK) cells, each has its own individual clock. These are known as peripheral clocks, and their timing and functioning are entirely specific to the optimal timing for the actions of those organs and cells to occur. In order to keep your overall healthy functioning coordinated, however, they all have to remain synchronized, or “entrained” to your master SCN clock.

An internal clock that’s lost its rhythm is like an orchestra that’s lost its conductor, and as a default, each member has decided to come up with her own rhythm, tune, and timing. When this happens in your body, the results are more than just a lot of noise – you can end up with

  • Hormonal imbalances
  • Blood sugar and metabolic problems (including sugar cravings, metabolic syndrome, PCOS, and diabetes)
  • Sleep problems (insomnia, waking in the night, waking up tired in the morning)
  • Weight challenges
  • Decreased memory, focus, and willpower
  • Immune system imbalances leading to more frequent infections, reactivation of old viruses, allergies, inflammation, and even autoimmune disease.

Most chronic health imbalances can be traced to circadian rhythm problems. In fact, obesity, digestive problems, diabetes and even breast cancer have been linked to disturbances in the circadian rhythm, as shown in studies of nurses and others who work night shifts.

Did You Say the Hypothalamus and Adrenals?

As the author of The Adrenal Thyroid Revolution, you’ve gotta’ figure the adrenals come in here somewhere! And they do, in a major way. The central clock of this whole internal clock system is located in the same gland that control the adrenal stress response – the hypothalamus, and the primary messenger of communication between your central clock and your peripheral clocks appears to be none other than the adrenal hormone cortisol along with a nerve signaling pathway directly between the hypothalamus and the adrenal glands. Each organ and cell responds to the messages from cortisol, which means for the peripheral clocks to be keeping time and keeping you healthy, your cortisol rhythm follows a predictable waveform like you see in the picture below, when healthy.

The relationship between the adrenal stress system and the alignment of all these systems is so important, which is why finding your inner rhythm is all the more important if you’re struggling with any of the symptoms I list below – because they are also symptoms of your adrenal stress system being out of sync. 

How Do I Know If My Master Clock is Out of Sync or My Internal Clocks are Playing Their Own Tune?

If you’ve ever experienced jet lag, you’ve experienced the impact of your internal clock being out of sync. Your mind feels foggy, you’re tired but can’t seem to get normal hours of sleep, you crave sugar, and may wake up at 4 AM ready for a meal, and your digestive system is often too far ahead or too far behind where you need it to be. Jet lag is an example of an acute disruption in your circadian rhythm.

11 Signs That Your Master Clock Need a Reset

These are not the only signs that your circadian and diurnal rhythms are off, but they are amongst the most common.

  1. Trouble falling asleep; waking in the night; not feeling rested when you wake
  2. Cravings for caffeine, sugar, carbs, or fat
  3. “Adrenal fatigue;” fatigue around 3-4 most afternoons, cravings at this time
  4. Slow metabolism; weight gain, especially your middle; trouble losing weight even with diet and exercise
  5. Anxiety; depression; depression when you wake in the morning; low motivation during the day
  6. Chronic colds, respiratory, or sinus infections; recurrence of old infections, for example, Epstein Barr Virus (EBV) or herpes
  7. Irregular or poor digestion
  8. Hormonal imbalances of any kind
  9. Autoimmune disease, including Hashimoto’s
  10. Decreased memory or concentration, making mistakes at work
  11. Blood sugar problems including low or high blood sugar; metabolic syndrome; insulin resistance or diabetes

Can I Reset My Internal Clocks? How?

Yes, with rare exception (i.e., rare traumatic brain injury with damage to the hypothalamus), you absolutely can reset your internal clocks. Resetting your central clock will usually lead to an automatic resynchronization of the peripheral clocks once they start to get a steady cortisol signal over time. It doesn’t require any fancy foods, crazy diet plans, supplements, or dance steps. It’s actually shockingly simple. It does, however, require a commitment to reclaiming some balance in your life. But who doesn’t want that.

How Long Does it Take?

It all depends on how far off track your clocks have gotten, and the severity of symptoms you’re having as a result. If you’re just a little bit out of rhythm, for example you’ve been traveling, going through stress for a few weeks or months, and aren’t having significant symptoms, you might feel reset after just a week or so of doing the following. If you’ve had more serious disruption over a longer period of time, or have developed more chronic symptoms or resultant medical conditions, think of this as a process that will happen over weeks to months.

How Do I Know When I’ve Reset My Rhythms?

Simple. Your symptoms will improve. You’ll feel better. You’ll have energy when you wake up, steady energy throughout the day, and when nighttime comes, you’ll feel ready for sleep and it will come easily and will be refreshing. You won’t crave caffeine, sugar, carbs, or other quick energy foods. Aches and pains will go away, inflammation will go down, your blood sugar will reach healthy levels and so will your weight. Your mental clarity, focus, and memory will improve; so will your moods. You’ll notice improvements in your hormones, and if your libido has been low, it might just fire up.

6 Important Ways to Reset Your Rhythm – Do All

Reset Your Sleep Schedule

Our schedules lay waste to the normal circadian rhythms that regulate cortisol. And cortisol in turn, regulates the production of melatonin, which is important not only for sleep, but for detoxification and immunity. Elevated cortisol, in fact, suppresses melatonin, increasing your risk not only of sleep problems, but also inflammatory conditions ranging from diabetes to dementia and cancer.

Sleep is the ultimate pause you need at the end of the day; it’s impossible to reset your internal clocks without good quality – and enough quantity – sleep. Further, when your sleep is disrupted, it tends to exacerbate other symptoms of disrupted rhythm – your sugar and carb cravings go up, your energy and focus go down, and so does your immunity. Here’s the magic number: you need at least 7 hours of good sleep every night to reset your natural clock – and cortisol rhythm – dump the chemical toxins that accumulate in your brain and body all day, and for your brain to do the work of sorting and filing new information from that day.

Especially important is a regular sleep cycle that has you waking and going to bed at roughly the same times each day, preferably waking by about 7 am and getting to bed between 10 and 11 pm.

Follow the Light

Your circadian cycle is anything but colorblind! In fact, light spectrum is part of what helps keep your master clock regulated. Bright natural morning light, which is in the blue spectrum, through light receptors in your eyes (interestingly, most blind people remain sensitive to these signals), gives your central clock a wake up call. Getting 30 minutes of bright sunlight in your eyes in the morning can regulate your energy, mood, mental clarity, all day long. Can’t get natural light in the morning because of your work schedule or where you live? Try light box therapy instead. It can help reset your internal clock and has been shown to bust through depression, too. Throughout the day, try to get natural light exposure by sitting near a window when you work.

One of the biggest factors impacting most American’s sleep is the use of electronic devices close to bedtime. A “digital detox” (no electronics) in the hour before bed, can reset your natural cortisol and melatonin cycles. It’s a great place to start resetting your rhythm. If you have trouble winding down at night, also consider dimming the lights in your home in the evening, and if you must be on an electronic device at night, get a dimmer program that progressively turns down the blue light.

Eat the Right Foods, at the Right Time

While a low carb diet may sound like a weight loss winner, interestingly, and particularly in women, a very low carb diet actually increases your cortisol and likelihood of putting on, not taking off belly fat. In fact, eating a small healthy carbohydrate choice 3-5 hours before going to sleep has actually been shown to create a healthier cortisol pattern while improving sleep – a win-win. Healthy choices include a serving of a whole grain, for example brown rice or quinoa, and/or a serving of sweet potato, winter squash, or potatoes – baked or roasted and cooled almost to room temperature before eating. Eating within 3 hours of bedtime can impair both sleep and cortisol, and skipping meals also has a negative impact on cortisol.

Reset After Work/Before Dinner

Studies have shown relaxing and rebooting mentally and emotionally after a hard workday leads to healthier cortisol levels and better sleep. Make it a weekday end-of-work habit to decompress for 15 minutes with a favorite activity when you get home from work. My personal favorite is a solo dance party!

Avoid Caffeine Later in the Day and Alcohol

While a great cup of coffee can be one of life’s pleasures, caffeine, including from green tea, chai, and chocolate, can keep you up at night. If you’re super sensitive, do a caffeine detox for 3 weeks while you reset your central clock; if caffeine doesn’t make you jittery and wired, enjoy a small amount, but not after 12 noon to prevent it from jacking up your afternoon and even energy and keeping you from getting sleep. Similarly while you might love an evening glass of wine, almost all of my patients report that their sleep improved dramatically, particularly their ability to stay asleep and feel refreshed in the morning when they stopped drinking alcohol.

Root Out Inflammation

If you also have physical health symptoms, getting to the root causes of chronic inflammation is an important part of getting out of SOS and preventing/reversing longer term health consequences. The most common root causes are food intolerances, processed foods, poor quality fats, and a high sugar diet, environmental toxin exposure and overburdened endogenous detoxification systems, gut disturbances including leaky gut and microbiome disruption, certain medications, including commonly used ones like ibuprofen and Tylenol, and even hidden infections. In my book, The Adrenal Thyroid Revolution, I walk readers through a comprehensive self-assessment to root your root causes and reverse SOS. 

If You Have to Work Nights

This is a tough situation – because working nights is inherently harder on your Stress Response System. But there are things you can do to protect yourself:

  • Get extra sleep before your shift. I know that sounds wonky, but a phenomenon called sleep banking – sleeping ahead to store up on rest – really is scientifically proven to help prevent exhaustion and physiologic consequences from missed sleep.
  • Eat well on the job. It’s so tempting to nosh out at night, but keeping only to nutrient dense foods overnight can keep your cortisol sane and the unhealthy calories off.
  • Use adaptogen herbs  which have been shown to offset the stress on body and brain of night shift work.
  • Make time to decompress when you get home (see above).

How Can I Learn More?

In my new book The Adrenal Thyroid Revolution  I outline a clear blueprint to rescue your metabolism,hormones, immunity, mind, and mood from cortisol imbalances.

Using this plan, in as little as two weeks you can recover your energy, improve your sleep better, and reverse the root causes that throw our important rhythms out of balance, as well as their impact, so you can feel better and live better.

Click here to order your copy of the book.

Have a question about adrenal health? Resetting your cortisol rhythm and circadian clock? Drop me note in the comments section. And please make sure to LIKE and SHARE this article so I know it was helpful to you.

To your health!




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Chan. Sharon and M Debonno. Replication of cortisol circadian rhythm: new advances in hydrocortisone replacement therapy. Ther Adv Endocrinol Metab. 2010 Jun; 1(3): 129–138.

Chung S et al. Circadian rhythm of adrenal glucocorticoid: its regulation and clinical implications. Biochim Biophys Acta. 2011 May;1812(5):581-91.

Gold, P., & ChrouSOS, G. (2002). Organization of the stress system and its dysregulation in melancholic and atypical depression: High vs low CRH/NE states. Molecular Psychiatry, 7(3), 254-275.

Romm, A. The Adrenal Thyroid Revolution. San Franciso: Harper One, 2017.

Rutters, F., S. L. Fleur, S. Lemmens, J. Born, M. Martens, and T. Adam. 2012. “The hypothalamic-pituitary-adrenal axis, obesity, and chronic stress exposure: Foods and HPA axis.” Current Obesity Reports 1 (4): 199–207. doi:10.1007/s13679-012-0024–9.

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Read or leave comments 6 Comment

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Mary Koronis

Thank you for this Article. So very interesting as all of your Articles. Thanking you again.

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Fatima Costalaurent

Hi! I've become a huge fan of your work in recent months. I read the book about baby health and I use that knowledge on my child whenever he gets sick. Now I'm struggling with hormonal issues. I believe it is a combination between adrenal fatigue (lack of sleep with an infant/toddler) and the removal of an IUD(I don't do good with synthetic hormones). My question is: what do u do when u can't avoid night waking because you have babies to take care of? I'm not a sleep training believer, so I go with my child's rhythms. Sometimes he sleeps amazing for weeks and sometimes he wakes up to 4-5 times for weeks. Does the protocol in your book work for us moms? Or do we need to tweak it? I would love to get my energy back and lose the last bit of weight I gained after having my baby (which doesn't budge with diet and excercise)

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    Aviva Romm

    Hi Fatima, Thank you. Yes- lack of sleep in early motherhood can leave us super exhausted. The gentle adaptogens can help, but importantly, trying to sleep when the kids do during the day - as hard as that is - can help - not so much can up on sleep but because of something called sleep banking a phenomenon that let's us preemptively store rest. It's weird but it words. For toddlers, sometimes just having some nights where you sleep in a separate room and aren't on waking duty can make a huge difference. And yes, the protocol in the book is totally ok for moms - if you're still breastfeeding you might not want to take out the grains - you'll need the energy- and pay attention to which supplements say they aren't safe while preggers and BF'ing - those are marked throughout. Warmest wishes and hang in there - it keeps getting easier :)

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      elisa carson

      I ordered your book "The Arenal Thyroid Revolution" and I am looking for a few of the enhancements from the book. However on audible, I am not sure how to get the enhancements. I have been through your website, and I am unable to find all the things I need. Can I get access to those things?

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Kathrine Davis

I am a 54 y/o nurse and have worked night's for 30 years. I do take Levothyroxine 50mcg. I haven't had my levels checked in a long time but after reading your article I have all of the symptoms of SOS and an extreme case of it. I have tried everything and nothing seems to work. I need RELIEF and I need something that works FAST! Thank You