A doctor explains what people should know about the ‘cortisol cocktail' that's gone viral on TikTok
Almost half of Americans (49%) report frequent bouts of stress, and the number of people in the United States who are feeling stressed has been rising for the past two decades, according to a 2024 Gallup survey. In these uncertain times, a stress-relieving tonic feels just right as a soothing balm, but does it actually live up to the health claims?
What is cortisol and its relationship to stress? What nutrients are in these drinks and how are they purported to influence cortisol? Do they work? Who should be wary of trying this concoction?
To guide us through these questions, I spoke with CNN wellness expert Dr. Leana Wen. Wen is an emergency physician and adjunct associate professor at George Washington University. She previously was Baltimore's health commissioner.
CNN: What is cortisol and its relationship to stress?
Dr. Leana Wen: Cortisol is a steroid hormone produced by the adrenal glands, which are organs located above the kidneys. The hormone plays a vital role in many bodily functions, including regulating metabolism, blood sugar, blood pressure, sleep-wake cycles and immune responses. Cortisol is sometimes called the 'stress hormone' because its levels naturally rise when our bodies perceive a threat or stressful situation. This reaction is part of the body's 'fight-or-flight' response, helping people stay alert and react quickly when needed.
Those temporary increases in cortisol are a helpful evolutionary adaptation. Problems can arise when cortisol levels stay elevated for prolonged periods of time, which can happen when someone is under chronic stress. Persistently elevated cortisol is linked to problems such as poor sleep, anxiety, high blood pressure and even weakened immunity.
There are a number of medical conditions that can lead to abnormally high or low cortisol levels. Taking high doses of steroid medications or adrenal gland tumors are examples of conditions that can cause excess cortisol. Addison's disease, or primary adrenal insufficiency, is when the adrenal gland stops its usual function. This condition, and problems with the pituitary gland in the brain, could result in low cortisol levels.
CNN: What is in these 'cortisol cocktail' drinks, and how are they purported to influence cortisol?
Wen: Recipes vary, but they tend to have a combination of coconut water, juice (usually orange or some other citrus fruit) and some salts (commonly sea salt and/or magnesium). Sparkling water is often added to taste. Contrary to what the name may suggest, it typically does not contain any alcohol.
Each of the primary ingredients is supposed to play a role in supporting adrenal function and lowering stress. Coconut water is high in potassium, which helps maintain proper fluid and electrolyte balance. Citrus juice offers vitamin C, which plays a role in adrenal gland function. Salt and magnesium are supposed to replenish minerals depleted by stress. Moreover, some researchers believe that magnesium itself may help reduce feelings of anxiety or stress. Because of this, some versions of the cortisol cocktail include magnesium powder and/or cream of tartar, which has a high concentration of magnesium along with potassium and other salts.
CNN: Is there evidence that this drink actually lowers cortisol and reduces stress?
Wen: There is no scientific evidence that this drink has the effects it purports. While it's true that nutrients such as potassium, vitamin C and magnesium are important for healthy adrenal function, they are typically obtained in adequate amounts through a balanced diet. Bananas are the classic food high in potassium, but many others are packed with this mineral, too, such as raisins, apricots and tuna. Vitamin C can be found in citrus fruits, strawberries and peppers. And magnesium is also in many foods, including beans, peanut butter and leafy green vegetables.
True deficiencies in these nutrients can cause health problems, but such deficiencies are uncommon in otherwise healthy individuals. More importantly, there is no evidence that consuming extra amounts beyond what the body needs will provide additional benefits or that it will meaningfully lower cortisol levels.
CNN: What about the claim that the drink can treat a condition that influencers call 'adrenal fatigue'?
Wen: The claim that some influencers have promoted on social media is that there is a condition of 'adrenal fatigue' in which stress is overwhelming adrenal glands and people end up feeling tired, anxious and unable to cope with daily life. However, the symptoms could stem from a variety of causes, including poor sleep, mental health conditions, and undiagnosed diseases such as anemia, hypothyroidism and diabetes.
Importantly, there is no recognized medical diagnosis of adrenal fatigue. Outside of cases in which there are specific diseases causing adrenal insufficiency, there is no evidence that somehow the adrenal glands get overwhelmed and lose their ability to function. The symptoms often attributed to adrenal fatigue are real, but they are better explained by other, well‑studied causes. One risk I see is that people might rely on this so-called remedy instead of seeking medical evaluation for the real issues behind their fatigue or stress.
CNN: What about all the people on the internet who claim that they have had positive health outcomes as a result of this drink?
Wen: It may be that some individuals were not getting enough fluids or electrolytes before, and the additional hydration from the drink helped them feel more energized or clearheaded. There is also the placebo effect to consider: When people expect a certain treatment to work, they may genuinely feel better simply because they believe they are doing something beneficial for their health.
The ritual of making and drinking this drink could itself reinforce this sense of control and care, which can have real psychological benefits even if the drink's ingredients have no direct impact on cortisol.
CNN: Who should be wary of trying this so-called tonic?
Wen: People who should be cautious include individuals with chronic medical conditions such as kidney disease, heart disease and diabetes. Certain individuals with kidney disease need to be especially wary of food containing high amounts of potassium. Those with heart failure may be advised to restrict their fluid intake. The sugar in fruit juice may also be problematic for some people with diabetes.
Individuals interested in this drink should check with their doctor before adding this or any influencer-promoted wellness product to their diet. They should ask if any of their medications might interact with the drink's ingredients. And if they are experiencing symptoms — such as fatigue, anxiety or trouble sleeping — that prompted them to try this cocktail, they should discuss these concerns with their doctor to determine whether further evaluation is needed.
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