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  • Writer's pictureDr. Kogan

Cortisol Activation Response - Understanding yours may help improve your energy

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Most people are aware that cortisol is a hormone produced by the adrenal glands and that it has something to do with the person’s energy level. But did you know that cortisol is also responsible for all these essential body functions?

  • Maintaining mood and emotional balance

  • Helping us to be resilient to stress

  • Preventing excessive loss of sodium in the urine

  • Suppressing parts of the inflammatory response

  • Increasing coagulation to prevent untoward bleeding

  • Stimulating glycogen production in the liver and conversion of amino acids to glucose

With cortisol participating in so many functions, it makes sense to keep it in a perfectly balanced place. In fact, when we wake up in the morning, we are supposed to produce our highest level of cortisol within the first 30-45 minutes. This is supposed to help us to cope with the demands of the day. This “burst” production of cortisol is called Cortisol Activation Response (CAR). The cortisol is then produced at gradually lessened levels and reaches its lowest level at night.

How does the body know to carry out a perfect CAR?

This action is initiated in the brain in an area called the suprachiasmatic nucleus. This area gets activated when the light enters the eyes upon awakening. A healthy CAR is considered a sign of resiliency. Waking in the morning is like a mini stress test for the body, so an abnormally low CAR is an indication that the person is not producing enough cortisol rapidly and therefore is not mounting an appropriate physiologic response to stress. They feel sluggish upon waking, have difficulty getting out of bed, and take a long time to wake up, maybe resorting to a lot of coffee just to function.

Abnormalities in CAR have been associated with depression, metabolic syndrome, and type two diabetes mellitus to mention a few illnesses. A list of undesirable conditions.

How do we restore a healthy Cortisol Activation Response using a holistic approach?

I would recommend starting your day by getting immediate exposure to bright daylight. If you have dark shades–open them right away when you wake up. Better yet if you live in Florida–go outdoors and enjoy the natural daylight in abundance. If early mornings are very dark where you live–get a bright full spectrum lightbox that you can turn on as soon as you wake up.

Additional holistic tips for keeping your CAR healthy are to have good sleep hygiene, wake up at the same time each day, and try to incorporate movement into your morning routine (yoga, walking, tai-chi, or even just a lymphatic drainage self-massage).

Sometimes, a holistic doctor can recommend supplements to augment the CAR while you are incorporating lifestyle modifications into your daily routine.

Lastly, how do you find out what your CAR is?

There are many different labs that offer testing for it. I recommend speaking with your doctor about what would be an appropriate test for you.


Dr. Kogan is a Concierge Holistic Internal Medicine doctor in Naples. For more information, please visit or call 239.676.6883.


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