Combating Stress and Tackling Cortisol

Katie Guttenberg, MD

With rising costs for gas and food, 2 years of the COVID-19 pandemic, global uncertainty, and the ongoing war in Ukraine, it is hardly a surprise that more than 70% of American adults report feeling stressed. The Stress in America survey, which was conducted by the American Psychological Association in partnership with The Harris Poll, also found that a growing number of Americans report money as a source of stress, peaking at two thirds of adults in 2022, the highest reported level in 7 years.

Confronted with multiple stressors, many Americans have adopted unhealthy behaviors. More than half of Americans report weight gain, with an average of 26 pounds in the past year.

Stress affects our emotional and physical well-being. Let's examine the body's response to stress and review techniques to reduce cortisol, known as the stress hormone.

The Stress Response

In 1953, Lewis and colleagues developed the first protocol for the perioperative management of patients with adrenal insufficiency. We now have a more nuanced understanding of cortisol production and the effects of stress on the hypothalamic-pituitary-adrenal axis.

A 2020 study sought to determine the best treatment modalityfor patients with adrenal insufficiency exposed to major stress. The authors measured cortisol production in nearly 300 participants with normal adrenal function exposed to a variety of stressors, including sepsis, major trauma, elective surgery, and the war in Afghanistan.