Woman sitting on the beach - Relaxing

Cortisol Imbalance and How to Support Your Adrenals with Mast Cell Activation Syndrome (MCAS) 

MCAS / MCAS Education

Is a cortisol imbalance making your Mast Cell Activation Syndrome symptoms worse? 

If you’re dealing with Mast Cell Activation Syndrome (MCAS), you probably already know stress can be a major trigger.  

But did you know that your ‘stress hormone’, cortisol, is often mast cell calming? 

It’s true! But balance is really the key. 

Finding that balance is one area where many struggle. And it’s no surprise. In today’s world, constant stressors can keep your cortisol high. 

But cortisol balance goes beyond stress management. Especially with MCAS. 

It plays a key role in inflammation, immune response, and daily energy.

In this post you’ll learn about:

  • What cortisol is and how it functions in your body 
  • How cortisol impacts mast cells 
  • Signs and symptoms of high levels of cortisol and low cortisol 
  • How to test your cortisol levels 
  • Natural ways to support adrenal health and help restore cortisol balance 

Let’s get started!

Looking for help? Work with our clinic! Get the 1:1 support you need to get back to life.

Click Here to Work with Our Clinic

It’s important you know that this blog post is for informational and educational purposes. It’s not meant to treat any health condition or to be prescriptive for anyone.  If you have any medical condition, it is critical you work under the care and guidance of a licensed medical provider.  

Cortisol Imbalance and Mast Cell Activation Syndrome 

One of our clients, ‘Jan,’ was tired all the time.

It was a challenge to get up in the mornings and get through the day. But when it came time for bed, she struggled to sleep, tossing and turning.

She was also unable to do even light exercise without feeling exhausted for days. And Jan caught every cold that came around.  

Jan had extensive labs done through her regular doctors and everything was ‘normal.’ Despite all the symptoms, she was told she was fine.  

It wasn’t until she learned about cortisol, and found out she was low by testing, that she finally understood what was happening.  

The good news is that, with the right supports, Jan started to feel better! It wasn’t overnight but she got back to living her active life. And she no longer gets sick all the time. 

Maybe you can identify with Jan?  

In our clinic, we often see clients with symptoms like: 

  • Anxiety
  • Fatigue 
  • Low or high blood pressure 
  • Always feeling hot / cold 
  • Issues with blood sugar levels – like Hypoglycemia or Insulin Resistance 
  • Frequent infections 
  • Slow healing 
  • Easy bruising 
  • Sleep Issues 
  • Heart rate changes 
  • And more 

And many people go to their doctors only to be told that everything looks ‘normal.’ Does that sound familiar? 

With MCAS it’s fairly common to need some cortisol balancing support! And it can really help with healing. We will give you our top tips in a moment. 

First, let’s take a quick look at what cortisol is and how it works for you and your body. 

Cortisol Imbalance: Cortisol and Your Body 

Cortisol is one of the most important hormones in your body’s stress response system.  

And if you’re dealing with chronic symptoms like fatigue, anxiety, or MCAS flares it’s important to take a closer look at how cortisol affects your body. 

The HPA Axis and Cortisol Levels 

We can’t talk about cortisol without mentioning your HPA axis. We won’t get deep into the weeds here, but we do want to just give you a general idea of what it is. 

The Hypothalamic-Pituitary-Adrenal (HPA) axis is the system that regulates cortisol production.  

It begins in the hypothalamus (part of your brain), which sends corticotropin-releasing hormone (CRH) to the pituitary gland (another part of your brain). In turn, the pituitary releases adrenocorticotropic hormone (ACTH), prompting the adrenal glands (2 glands on top of your kidneys) to produce cortisol. And when cortisol levels rise, it feeds back to your brain and slows down further cortisol production. It’s an elegant system. 

But prolonged stress can dysregulate this feedback loop, contributing to dysfunction like high or low levels of cortisol.  

Why is cortisol important? Let’s take a look at what it is and does next! 

What is Cortisol? 

Cortisol is a steroid hormone produced by your adrenal glands. Your adrenals are 2 small glands that sit on top of your kidneys.  

Cortisol is often called your “stress hormone.” And it plays a critical role in helping your body respond to physical, emotional, and environmental stressors.  

These can be things like: 

  • Trauma – big T or little t 
  • General daily stress – work, relationships, traffic, etc 
  • Injury 
  • Illness 
  • Intense exercise 
  • Lack of sleep 
  • And more 

Cortisol prepares you by making more energy available for fight or flight. It influences your: 

  • Blood glucose levels 
  • Metabolism (how your body creates energy)
  • Immune system 
  • Mast cell activity 
  • Inflammation 
  • Blood pressure 
  • Cardiovascular function 
  • Bone growth / breakdown 
  • And more 

Your cortisol levels also play a big role in circadian rhythm.  

Your circadian rhythm is a 24-hour cycle that helps regulate sleep, waking, and other body functions. It is influenced by external cues and controlled by your internal clock.

During your day-to-day life, cortisol is released in pulses throughout that cycle. Typically peaking in the early morning to help you wake up and dropping in the evening to prepare for rest. 

However, chronic stress can disrupt this natural rhythm. And that can lead to imbalances that eventually affect your overall health and resilience.  

Let’s look at that next.  

Stress and Cortisol 

Cortisol is part of a normal response to stress in a healthy body.  

Acute stress (sudden and short-term) causes cortisol levels to spike.

This helps your body mobilize energy, increase alertness, and suppress inflammation temporarily. So you are prepared to fight or run away. Then it goes back to normal. 

However, chronic stress leads to ongoing elevated cortisol levels. And with too much cortisol you might have symptoms like: 

  • Insomnia
  • Slow wound healing 
  • Weight gain (especially in the face and trunk) 
  • High blood pressure
  • Muscle weakness 
  • Easy bruising 

And, over time, chronic stress can put so much strain on your adrenal glands that they can’t keep up with the constant demand.

You may no longer produce enough cortisol. This is often called adrenal fatigue or adrenal insufficiency. 

Symptoms of low cortisol can look like: 

  • Fatigue 
  • Temperature dysregulation 
  • Hypoglycemia 
  • Exercise intolerance 
  • Anxiety 
  • Thirst 
  • Low Blood Pressure 
  • Salt craving 
  • Orthostatic dizziness 
  • Lack of sweating 
  • Frequent infections 

So, you can easily see from these 2 lists that balanced cortisol levels are important for your body to function properly.

This is particularly true if you have Mast Cell Activation Syndrome (MCAS), Histamine Intolerance, or other chronic illnesses.  

Let’s take a look at how cortisol and mast cells interact next. 

Mast Cells and Cortisol 

Cortisol and mast cells are tightly connected.  

You might know that mast cells are immune system cells. And they play a key role in immune, allergic, and inflammatory responses by using hundreds of receptors that help them ‘read’ what is going on in your body.

Some of these receptors are for hormones…like cortisol! And when cortisol attaches to mast cells, your mast cells respond by calming down. 

But cortisol isn’t the only thing that controls mast cell activity.

Remember that you just read that there are hundreds of different types of receptors on each cell. And some of those receptors cause mast cells to degranulate (release inflammatory mediators). 

Related Post: Mast Cell Foundations – Mediators and Receptors 

And the HPA axis responds by making more cortisol.  

Chronically elevated cortisol levels can suppress other anti-inflammatory mediators, and contribute to ongoing immune imbalances. Which can also increase mast cell activity. 

So, balanced cortisol levels may help calm mast cell activity. But chronically high or low levels can make MCAS symptoms worse.  

Wondering whether your cortisol levels are off and how you can really know, since the symptoms often overlap with other conditions?

Let’s take a look at testing next.

When and How to Test Cortisol Imbalance

Cortisol imbalance and other adrenal hormones can be looked at through lab testing.

Testing is especially recommended if you’re experiencing things like: 

  • Chronic Fatigue  
  • Severe post-exertional malaise 
  • Feeling wired but tired 
  • Persistent insomnia 
  • POTS / Dysautonomia 
  • Fibromyalgia 
  • Persistent infections 
  • Low blood pressure 
  • Etc 

There are different kinds of cortisol tests:

  • Blood tests – only measure cortisol at one point in time. And cortisol naturally fluctuates throughout the day. Plus, getting ready, driving to the lab, and the stress of the needle can all skew your results. That’s why we typically don’t rely on blood tests to assess cortisol levels in the clinic. 
  • Saliva tests – might be a bit better since they are easier to do multiple samples and can track cortisol throughout the day. But they only measure free cortisol, so information is limited. For those who can’t limit water intake for the dried urine tests, we use a multi-sample saliva test. 
  • Urine tests (liquid) – measures the amount of cortisol over a 24-hour period. This can tell you if your overall levels are high but doesn’t give you information about patterns or metabolites (breakdown product).
  • Urine tests (dried) – shows cortisol levels throughout the day, giving a fuller picture. And it covers several metabolites. This is what we use in the clinic. And you can order the same tests yourself! 

Dutch Adrenal Test 

The DUTCH Adrenal is a dried urine test that provides a detailed map of your daily cortisol and cortisone patterns. This is our go-to for cortisol. It can help identify: 

  • Flat-lined cortisol patterns (low levels all day)
  • Reverse circadian rhythms (high cortisol at night) 
  • Chronically high levels 
  • Depleted cortisone (which shows worn-out reserves) 

>>> Click here to order the Dutch Adrenal test 

Dutch Complete Test

The DUTCH Complete test expands on the adrenal panel by including sex hormone metabolites, organic acids, and key neurotransmitters. It costs a little more, but not much. And it is ideal for a broader picture, especially if you suspect imbalances in estrogen, progesterone, testosterone, or DHEA alongside cortisol. 

>>> Click here to order the Dutch Complete test 

>>> For International orders, click here for the Dutch Complete test

So, now that you know how to test, let’s take a look at what you can do to support this important piece of the puzzle and start balancing your cortisol levels.

Watch this Live for the full discussion, including more on testing, with our Clinic team: 

How to Support Your Adrenals and Cortisol Balance 

There’s no substitute when it comes to the basics for adrenal support and stabilizing cortisol imbalance!  

Remember, go at the pace you need to. And it’s ok to just take 1 step at a time.  

Cortisol Imbalance: Lifestyle Supports 

These are lifestyle tips that may help with cortisol balance and adrenal support: 

  • Don’t overexercise or push through fatigue 
    • If you are tired, you’ve done too much and are using up energy your body needs for healing. 
    • Participate in light to moderate exercise 
  • Don’t overwork yourself. Minimize activities and commitments and focus on your top priorities. 
  • Avoid stressful or intense movies, shows, activities, and people 
    • Stick with things that make you laugh or feel good 
  • Prioritize nurturing activities, affection, fun, and laughter 
  • Throughout the day take little breaks for breathing exercises, deep breathing, guided relaxation, grounding, meditation, music, or whatever helps you relax. 
  • Make sure to get nervous system work in each day 
    • We know we say this a lot, but we can’t ‘stress‘ how important it is!

Cortisol Imbalance: Sleep and Circadian Rhythm Supports 

Many good things happen when you sleep! Your body can put all the energy that usually needs to go to being awake and moving around towards restoration and healing.  

It’s also pretty common to struggle with sleep when you have MCAS. Calming your mast cells, reducing histamine, and making sleep a priority can start to move the needle. 

Related Post: Sleep Supplements for Mast Cell Activation Syndrome & Histamine Intolerance 

Here are some tips for better rest: 

  • Get natural light in your eyes – preferably by going outside for at least 10-15 minutes without glasses or contacts 
    • Upon waking, very important
    • Around noon 
    • At sunset 
  • Practice good sleep hygiene 
    • Cool, dark room
    • Regular sleep and wake times
    • Stay off screens at least an hour before bed 
    • Have a wind down routine before bed 
  • Avoid things that add stress in the evenings 
  • Aim for at least 8 hours of sleep each night 
  • Being in bed well before midnight is beneficial 
  • Nap as much as you need, as long as it doesn’t interfere with sleep 

Cortisol Imbalance: Nutritional Supports 

Everybody knows that nutrients are important! And we understand that working on nutrition can be difficult with MCAS. It’s usually a process.  

Related Post: Low Histamine Diet Plan

If you are down to just a few foods, you may want to start with nervous system work first and stabilizing your mast cells first. 

These are some of the things that are often helpful for clients in the clinic when they are ready: 

  • Work on stabilizing blood sugar 
  • Consider eating your first meal within an hour or 2 of waking 
    • Preferably a meal rich in protein with some fat and fiber 
  • Don’t fast if you have adrenal fatigue  
  • Eat smaller more frequent meals if you need to 
  • Stay hydrated and use electrolytes 
  • Avoid: 
    • Caffeinated beverages (decrease slowly) 
    • Chocolate 
    • Alcohol 
  • Work toward improving gut health – for better nutrient breakdown and absorption 

Tip: In our experience with clients, people with adrenal fatigue also often don’t tolerate high glycemic foods. But NO carbohydrates isn’t the answer either. A better approach may be using smaller amounts of low histamine, slow-release carbs like winter squash, beans, or others based on your personal food tolerances. 

How to Support Your Adrenals with Supplements 

The foundation supports above may be enough for you. But for some people, a little extra help in the form of supplements, or even medicine, may be necessary.

These are a few of the supplements we often find helpful in the clinic. 

Balancing Cortisol  

Related Post: BeSerene Review – Nervines, Adaptogens, and Building Resiliency

Supportive Nutrients for Cortisol Balance 

Related Post: Low Histamine Vitamin C

To Lower Cortisol Levels 

And some people with very low cortisol levels may even need help with medication like hydrocortisone. 

We’ve covered a lot of different information about supporting your adrenals and cortisol imbalance! Read a few last words below.

Your Next Steps

We hope you find this information helpful. Remember that it’s ok to just pick 1 thing to work toward at a time.

MCAS is a complex puzzle. And we want you to know that you are not alone.

We also want you to know we do see people improving and getting their lives back. Hope is such an important part of healing.

Helping unravel the MCAS puzzle is what we do every day. And many of us have been on this road, too.

If you’re looking for someone to work with who understands the complexities and challenges, we’re here! 

>>> Click to read about and apply to the MC360 Clinic

More Ways to Support Your Body with MCAS 

References 

Chrousos, G. P. (2009). Stress and disorders of the stress system. Nature Reviews Endocrinology, 5(7), 374–381. https://doi.org/10.1038/nrendo.2009.106 

Silverman, M. N., & Sternberg, E. M. (2012). Glucocorticoid regulation of inflammation and its functional correlates: from HPA axis to glucocorticoid receptor dysfunction. Annals of the New York Academy of Sciences, 1261(1), 55–63. https://doi.org/10.1111/j.1749-6632.2012.06633.x 

Dong, H., Qian, Y., Bhuiyan, P., Wang, Y., & Sha, H. (2021). Neuroimmune connections between corticotropin-releasing hormone and mast cells: novel strategies for the treatment of neurodegenerative diseases. Neural Regeneration Research, 16(11), 2184. https://doi.org/10.4103/1673-5374.310608 

Theoharides, T. C. (2020). The impact of psychological stress on mast cells. Annals of Allergy Asthma & Immunology, 125(4), 388–392. https://doi.org/10.1016/j.anai.2020.07.007 

Cohen, S., Janicki-Deverts, D., Doyle, W. J., Miller, G. E., Frank, E., Rabin, B. S., & Turner, R. B. (2012). Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Proceedings of the National Academy of Sciences, 109(16), 5995–5999. https://doi.org/10.1073/pnas.1118355109 

Theoharides, T. C., & Cochrane, D. E. (2004). Critical role of mast cells in inflammatory diseases and the effect of acute stress. Journal of Neuroimmunology, 146(1-2), 1–12. 

You Might Also Like

Add A Comment

Recipe Rating