Chapter 6
Supplements for Control of Cortisol
Even though cortisol comes third in the FACE acronym, it really is of primary importance because of its intimate interactions with the other three aspects of FACE. As such, we'll consider supplements for cortisol control first. Keep in mind that many of the supplements that are effective primarily for cortisol control are also effective as secondary controllers of blood sugar (and thus glycation), free radicals (and thus oxidation), and eicosanoids/cytokines (and thus inflammation).
The science regarding dietary supplements and nutrition changes rapidly, so I encourage you to visit my website www.cortisolconnection.com for frequent updates on dietary regimens and other lifestyle strategies for controlling the myriad aspects of metabolism associated with skin health.
Beta-Sitosterol
Beta-sitosterol is one of hundreds of plant-derived "sterol" compounds that are known to influence cortisol exposure, immune function, and inflammation. Plant oils contain the highest concentration of phytosterols, so nuts and seeds contain fairly high levels and all fruits and vegetables generally contain some amount. Perhaps the best way to obtain beta-sitosterol is to eat a diet rich in fruits, vegetables, nuts, and seeds (which obviously brings numerous other benefits, too), but beta-sitosterol is available in supplement form as well.
Beta-sitosterol is known to modulate immune function, inflammation, and pain levels through its effects on controlling the production of inflammatory cytokines. Much of this immune/inflammation control appears to be related to an improved interaction of immune cells (which produce eicosanoids and cytokines) with the adrenal glands (which produce cortisol). This modulation of cytokine production and activity may help control allergic skin reactions such as rosacea, dermatitis, and eczema, while also helping to promote general skin-barrier function and wound healing.
In terms of immune function, beta-sitosterol has been shown in humans to normalize the function of T-helper lymphocytes and natural killer cells following stressful events (such as marathon running) that normally suppress immune-system function. In addition to alleviating much of the postexercise immune suppression that occurs following endurance competitions, beta-sitosterol has also been shown to normalize the ratio of catabolic stress hormones (cortisol) to anabolic (rebuilding) hormones such as DHEA.
No significant side effects or drug interactions have been reported in any of the studies investigating beta-sitosterol, and the widespread presence of beta-sitosterol in the diet means that it is generally recognized as an extremely safe supplement with no side effects.
The typical daily dosage of beta-sitosterol for immune-function and cortisol-controlling benefits is 60-120 mg. A handful of roasted peanuts or a couple of tablespoons of peanut butter will contain about 10-30 mg of beta-sitosterol.
Ashwagandha (Withania Somnifera)
Ashwagandha is an herb native to India that is sometimes called winter cherry or "Indian ginseng"-to suggest energy-promoting and antistress benefits similar to those attributed to the better-known Asian and Siberian ginsengs. Herbalists and natural-medicine practitioners often recommend ashwagandha to combat stress and fatigue. In traditional Indian (Ayurvedic) medicine, ashwagandha is used to "balance life forces" during stress and aging.
Because of its relaxation and general antistress benefits, ashwagandha is commonly used to enhance mental and physical performance, improve learning ability and mental function, decrease stress, and relieve insomnia.
Most of what we know about ashwagandha comes from reports of traditional use in humans by practitioners of Ayurvedic medicine and from experimental studies in animals. In the animal studies, ashwagandha has shown benefits in treating both anxiety and depression, boosting immune-system function, enhancing the antitumor effects of chemotherapy, stimulating thyroid function, and improving memory and mental function. Many of these effects are likely due to a modulation of cortisol metabolism during periods of high stress. During stress, elevated cortisol levels can lead to depression, anxiety, suppressed immune system, reduced thyroid function, and mental decline; ashwagandha may relieve some of the stress-induced elevation in cortisol levels and help return metabolism to normal.
In terms of safety, there are no reports of adverse side effects in humans, and acute toxicity studies in rodents have shown ashwagandha to have a wide margin of safety (in excess of 3,000 mg/day). Because of the effects of ashwagandha on muscle relaxation and as a mild central-nervous-system depressant, the herb should not be combined with alcohol or other sedatives, sleep aids, or anxiolytics (antianxiety medications). Pregnant women are advised to avoid ashwagandha due to its reported abortifacient (abortion-inducing) effects and potential for causing premature labor.
General dosage recommendations for ashwagandha are in the range of 200-800 mg per day of an extract standardized to 1-2 percent withanolides (the herb's primary active components).
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