Although this book focuses a great deal on controlling the stress response and cortisol levels using dietary supplements, it is important to (re)emphasize that supplements fall fourth in the whole scheme of things-behind stress management, regular exercise, and optimal nutrition. From a practical point of view, however, many of us simply do not have the ability, time, or inclination to live the "perfect" antistress lifestyle-and in these situations, supplements play a more prominent role.
So, after doing what you can do in terms of stress avoidance/management, getting adequate amounts of sleep and exercise, and eating a balanced diet, then turn your attention to using dietary supplements to help control cortisol. When you begin to focus on the supplement side of things, it makes sense to approach them step-by-step, as follows:
Avoid excessive doses of supplements that can increase cortisol levels. These tend to be ingredients that fall into the category of herbal stimulants, and they are often found in weight-loss and appetite-suppressant products. These supplements, when used at appropriate doses, certainly appear to offer a small benefit for promoting weight loss by controlling appetite, increasing energy levels, and boosting thermogenesis (calorie burning). When used in excessive doses or for extended periods of time, however, they will increase cortisol levels, disrupt blood-sugar levels, increase appetite, and sabotage efforts at long-term weight control.
Take a comprehensive multivitamin/multimineral supplement. In particular, the supplement you choose should provide adequate amounts of the most important antistress nutrients that are needed at increased levels during periods of high stress: vitamin C, magnesium, calcium, and the B-complex vitamins. Your multivitamin/multimineral supplement will provide the foundation of your cortisol-control supplement regimen, so the more comprehensive it is, providing the full range of essential nutrients, the better.
Focus on targeted cortisol-modulating supplements. This is where you'll be able to make the most dramatic gains toward maintaining healthy cortisol levels using supplements. Of the many supplements that may play a role in modulating the stress response and controlling cortisol levels, the most direct and promising benefits are likely to come from eurycoma, PMFs, magnolia bark, and theanine.
This is as far as most people will need to go in terms of using supplements to help control cortisol levels. When these are used in the context of the entire SENSE program, they help keep cortisol levels in an optimal range so that you reap the long-term health benefits. During times of particularly high stress, however, additional supplements can be used to provide a temporary "control point" designed to rebalance the stress response. The supplements addressed in Chapter 8 include a variety of adaptogens, as well as relaxation and calming supplements that can help reinforce your body against heightened stress, depression, anxiety, and insomnia on a short-term basis.
After learning about the detrimental health effects of chronically elevated cortisol, Mario joked that cortisol was his middle name-but he was serious about his desire to get his cortisol levels under control. As a long-haul truck driver, Mario experienced the quadruple threat of high stress (time pressure to deliver his loads on time), inadequate exercise, poor nutrition, and irregular sleep patterns. As a textbook case for elevated cortisol levels, Mario was certainly about as extreme as they come.
On the stress-management end of things, Mario had a heck of a long way to go. As an extreme Type C personality, his highest cortisol exposure generally occurred during traffic jams, when he sat and virtually boiled in his own stress hormones. Mario's chief problem with traffic was that it kept him from meeting his tight schedule-and consequently he felt helpless and stressed whenever the traffic slowed to a crawl. After he tried a number of stress-management approaches (breathing exercises, positive imagery, music, books on tape, and others), the solution that finally worked for Mario was to talk to his family and friends on his cell phone. As it turns out, part of the reason why traffic caused Mario to experience such high stress was because he felt that it was another obstacle keeping him from spending time with his loved ones (and it was an obstacle that he could do little to influence). As a result, when the traffic slowed, Mario's stress increased-and so did his cortisol, his cholesterol, his appetite, and his waistline. The cell phone, along with unlimited long-distance minutes and a hands-free attachment to allow him to keep both hands on the wheel, allowed Mario to stay in touch with his wife, kids, and friends-and became a significant de-stressing mechanism whenever he felt that he might be delayed. Even a conversation lasting a few minutes was enough for Mario and his family to stay mentally and emotionally connected during his frequent extended trips.
Now that the primary source of Mario's stress was identified and partially controlled, our attention turned to giving him a "supercharge" in terms of targeted cortisol control. Because his need to stay alert during the day was literally a matter of life and death (you don't want a drowsy driver behind the wheel of an eighteen-wheeler traveling at seventy miles per hour), some of the traditional antistress supplements (kava, valerian, melatonin) were ruled out because of their sedating effects. Instead, Mario started using theanine in the evening (200 mg taken as soon as he pulled his truck over for the night) as a way to relax him and help him fall asleep faster and stay asleep through the night. A significant side benefit of theanine was that he felt no "morning after" effects such as sluggishness or sleepiness, so he woke up refreshed and ready to face the long day ahead. Besides Mario's reports that he was feeling better (with more energy and clearer thinking), the increase in the quantity and quality of his sleep helped his body to better regulate its own cortisol levels (they slowly fell during the evening hours).
The second phase of supplementation for Mario was his incorporation of a daily multivitamin/multimineral along with a phosphatidylserine (PS) supplement in the morning and a beta-sitosterol (BS) supplement (also known as phytosterols) in the evening. The multi provided a general antistress foundation on which the PS and BS could begin to control cortisol levels. The morning dosing of PS took advantage of its dual effects in controlling cortisol and boosting brainpower and concentration (nice side effects for a truck driver in an unfamiliar city). The evening dosing of BS produced the dual effects of controlling cortisol and reducing cholesterol levels (Mario's largest and fattiest meal of the day was almost always dinner, which he would eat at a roadside diner). The cholesterol-lowering effect of BS occurs at a much higher level (about 3 grams per day) than the cortisol-controlling effects (60-120 mg per day), but BS is perfectly safe, and four large capsules at dinner were not much of an inconvenience to Mario-especially given the fact that BS can block a large amount of cholesterol from being absorbed.
Mario enjoyed success in controlling his primary sources of cortisol overexposure (stressing out about traffic delays and getting inadequate sleep), but what about his diet and exercise patterns? It might surprise you that Mario's strategy in these areas was to do very little at all. We learned early on that a strict diet and exercise regimen was not only unrealistic for Mario's work and travel schedule, but it would also have represented an additional source of daily stress for him to deal with. Instead, the exercise piece of the puzzle was limited to walking on as many days of the week as possible when he was at home with his family (walks around the neighborhood became a sort of family event). The nutrition part of SENSE was also quite limited in its scope; it centered on counteracting Mario's tendency to snack on convenience foods in the cab of his truck. To this end, Mario agreed to focus his snacking on balanced foods-so donuts were replaced by whole-grain bagels with peanut butter, cupcakes were replaced by energy bars containing both carbohydrates and protein, and potato chips were replaced by a handful of mixed nuts.
After just a few days on the SENSE program, Mario noticed an immediate change in how he felt; the key benefits were sounder sleep, more energy, and a clearer mind. Within two weeks, Mario's appetite and eating habits came back into balance and he was able to start focusing on getting his body weight under control. Even without a "perfect" diet and exercise regimen, the fact that Mario had regained control over his body's stress response and cortisol levels made it possible for him to lose five inches off his waistline in a little less than six months. Mario still has a long way to go to get down to his ideal body weight, but with his cortisol-control issues out of the way, he is headed in the right direction.