Why Constant Stress Hits Your Metabolism, and Why the Miracle Root Can Hit Your Liver

About a hormone that can quietly push your metabolism toward fat and diabetes while you keep on functioning, about the miracle root that may lower the cortisol level and in rare cases takes a liver apart, and about the only substitution that holds in the end, the jump out of the wheel

I was out on the road, alone with my thoughts, somewhere between two appointments, and I was thinking about the last piece and about the flood of messages it set off. Almost all of them came down to the same question. „Is there not a pill for this? Is there not some remedy you simply swallow, so that this cortisol finally drops and you can keep functioning the way you always have?”

And while I read that one question, over and over, something struck me. Over the past weeks I have talked with a lot of people, not in conference rooms, but where life actually happens. With the woman at the supermarket checkout, whose smile near closing time was only a movement of muscle. With the man in the workshop, lying under a car and sweating, who told me between two turns of the wrench that he cannot go on. Not one of them looked as though they would hold out much longer. Every single one was close to dropping out of the hamster wheel, simply because the strength runs out.

Fine, you get your piece about cortisol. But you get the honest version, with everything attached, including what no brochure tells you. The first thing is uncomfortable, so it stands right here at the top. This permanently derailed stress regulation, the one that the constant now-now-now breeds in you, can push your metabolism toward insulin resistance, belly fat and type 2 diabetes, and that is no character flaw, it is biochemistry. It is not the only cause, but it can be a powerful part of the problem. The pill you ask about, usually people mean ashwagandha, can lower the cortisol level measurably in small short-term studies, yet in rare cases it can take your liver apart. I back up both sentences in this piece, with a source, without exaggeration.

I am no family doctor, and I am selling you nothing. I write here out of human biology and out of decades of forensic practice, not as a treating endocrinologist, and that is exactly why I separate cleanly between published findings, personal experience and my own social judgment. I speak to you from that vantage point, not from the glossy pamphlet of a maker who is pushing a root on you as salvation.

And because we go in deep in a moment, here is my thesis for this whole piece, in one sentence. Most of us do not simply fall ill out of nowhere, struck by bad luck. We fall ill systemically, because we live in a state Homo sapiens was never built for, in constant alarm, around the clock, with no pause and no way out.

What cortisol does to you when it never switches off

Let us start with the truth that stands in your defense. Cortisol is not your enemy. It is the hormone that pulls you out of bed in the morning before the alarm even rings, and in real danger it is the hormone that keeps you supplied with energy over the following minutes. When a car comes racing at you, in the first seconds it is mainly adrenaline and noradrenaline that shoot up, the heart speeds, the muscles get their blood, and you jump aside without a thought. Cortisol follows a little slower and then keeps the energy supply stable. That whole machinery was built over hundreds of thousands of years for exactly this, for the short fright and the fast rescue.

Homo sapiens was built for the saber-toothed tiger. A short fright, a sprint, then quiet, then recovery by the fire. He was never built for an inbox that fires hundreds of little saber-toothed tigers at you a day, every one of them urgent, every one of them now, not one of them real. And this is where the system that is meant to protect you breaks. It knows no difference between the tiger and the payment reminder for 100 euros. To your body both are a threat, and to both it answers with the same substance.

The controller behind this carries an unwieldy name, the HPA axis, a chain from the hypothalamus in the brain over the pituitary gland down to the adrenal cortex. You do not need to memorize the name, you only need to grasp what it does. It is a control loop with a brake. Cortisol rises, the brain signals back, enough, wind down, and the level sinks again, so it should run. Under chronic stress this loop can fall out of step. Some people then show raised cortisol values, others a flattened daily profile or a dampened response to new demands. A large meta-analysis has gathered exactly these contradictory patterns. So the problem is not always a permanently high level, it is a stress axis that no longer switches cleanly between alarm and recovery.

And now comes the part that concerns you when you look in the mirror. Cortisol drives the liver to build new sugar, so that fuel stands ready in an emergency. A fine mechanism when the emergency is over in 5 minutes. A catastrophe when the emergency lasts 5 years. Because then there is constantly too much sugar in the blood, the pancreas constantly pumps insulin against it, and at some point your cells simply stop responding to the insulin. That is called insulin resistance, and it is the antechamber of type 2 diabetes. The insulin-producing beta cells work against a wall until they can no longer sufficiently cover the rising demand for insulin.

The fat comes on top, and it comes in one particular place. Cortisol does not spread it evenly over hips and arms, it stores it deep in the belly, around the organs, as so-called visceral fat. This belly fat is no dead store, it is an active organ that itself gives off inflammatory messengers and stokes the whole circulation further. A review gathered these connections under the deliberately provocative title „Cortisol: the villain in metabolic syndrome?”, with a question mark, because cortisol is one factor among several, not the sole culprit. An enzyme called 11-beta-HSD1 makes it worse still, because right there in fat and liver tissue it turns inactive cortisone back into active cortisol, a little resupply plant at the scene of the crime.

Whoever wants to see the extreme case looks at Cushing’s syndrome. There the body produces pathologically too much cortisol permanently, diagnostically detectable and often on a completely different order of magnitude, and the result is a textbook of horror. Belly fat, trunk obesity, high blood sugar, high blood pressure, muscle wasting. Everyday stress is not Cushing’s syndrome, I say that plainly, but individual mechanisms and their metabolic consequences can overlap. And that is exactly what is bitter, because the creeping pattern spreads over years, so quietly that you look for the blame in yourself, in your supposed lack of discipline, while in truth a whole hormone system is running the show.

And out there the Otto Sapiens walks around and explains the HPA axis to you at the bar, because he heard half a podcast, and he tells you that you should just pull yourself together. Pull yourself together, of all things, as though you could order your adrenal cortex by willpower to please produce a little less. The very same adrenal cortex that reacted to the reminder before you had even read it to the end.

And here is the part where I stay honest

In the last piece I took apart the serotonin legend for you, the story of the empty tank you top up with a pill. With cortisol the same temptation lurks, and I do not fall into it. One would love to say now, high constant stress means high cortisol, high cortisol means depression, done, here is the clean chain of cause, here is the next pill. And that is exactly what I do not tell you, because it is simply not that simple.

What is proven is impressive enough. Especially in severe, melancholic or psychotically colored depressions the HPA axis is often overactive, the brake no longer works properly, and the body no longer reacts normally to its own stress hormones, which the field calls glucocorticoid resistance. Other forms of depression can show entirely different patterns. Such changes can be shown in studies with cortisol profiles and pharmacological function tests, there are decades of research on it, but it is no routine single test with which a depression could be diagnosed. Under effective treatment this pattern often normalizes again.

But, and this but matters to me, the same research also shows the other direction. There are works showing that high glucocorticoids do not always make you depressed, and that lowering them does not always help. The link is real, yet it is no one-way street, no simple cause with a simple effect. And here I separate openly for you what is proof and what is my opinion, the way I always do.

Proof is that the stress axis falls out of step in many depressions. Opinion is what I make of it, and that I tell you plainly as opinion. I believe that a body held in alarm for years reaches a point at which it says, „I no longer want to play this character”. I believe that most of the illnesses that kill us today are systemic, grown from a life led against every logic of one’s own biology. That is my conviction, propped up by the proven side, and I am not selling it to you as an established fact.

And now comes a second opinion, marked unmistakably as such, and it will not please a few people. I believe that many doctors took away little of all this. The HPA axis, the cortisol, the interplay of the systems, it does stand in the textbook, but in their studies it is crammed for the wave of exams and forgotten afterward. You ask a fellow student, „what did the professor ask last year”, you learn exactly that by rote, you survive the wave, and by Friday half of it is gone again. What remains is the reach for the prescription pad, because that is faster than the question of why this person’s body is fighting back. I do not say this to mock doctors, many of them work at the limit in a broken system. I say it so that you stop handing every judgment about your own body to someone who will never come to know it in a few minutes of consultation time.

What actually helps, and what they only sell you

Let us come to the question it all began with. What can you actually do? I start with what helps most and costs least, and it is uncomfortable, because you cannot swallow it. You have to get out of the wheel. You have to turn the noise down, shut off the constant barrage of other people’s disasters, sleep, move, get into daylight, give the body back what was self-evident for Homo sapiens and is being stolen from him today piece by piece. That lowers the cortisol level more lastingly than any capsule, and it has no side effect except that you get your life back.

And because that sounds so general, let me make it concrete. Cortisol follows a daily rhythm, it lies low around midnight, climbs again in the second half of the night and reaches its peak usually 30 to 60 minutes after waking. Good sleep is what lets this rhythm settle in the first place, and whoever scrolls through other people’s outrage at 2 in the morning disturbs exactly this pattern. Regular movement improves the regulation of the stress axis over the long run, even if a single intense session can raise the cortisol level for a while. Daylight in the early morning sets your inner clock, and for a walk in the forest there are at least small studies that observed a short-term lowering effect. None of that can be patented, none of that earns a maker money, and that is exactly why you hear so little of it, while the next miracle capsule jumps at you out of every feed.

Only after that comes the root all of you want to know about. And because I do not want to lie to you, I say it straight out. Yes, I take ashwagandha too. I supplement a lot anyway, from a B complex to vitamin C, and I see to it that I have no gross gap in the important micronutrients. But I take ashwagandha only when needed, in short courses, not permanently and not in large amounts, and in a moment you understand why I stress this caution so hard. That I take it only in short courses is my personal precaution, no scientifically secured protective scheme, because a rare idiosyncratic liver injury can occur even after a short intake.

On the effect the studies look decent, I grant the plant that much. In small controlled short-term studies a standardized root extract lowered the morning cortisol level measurably in stressed adults over about 2 months, against a dummy preparation, and the stress scores sank with it. There are several such studies, double-blind, with a control group, and they point in the same direction, even though official bodies rate the effect only as possible, given small case numbers, changing extracts and missing long-term data.

Now comes the small print that stands in no advertisement. These studies are short, they run over weeks, not years, they have small numbers of participants, and a part of them was funded close to the makers. They also test highly standardized special extracts under controlled conditions, not the cheap powder that the algorithm pushes on you between a collagen drink and a gut cleanse. Adaptogen, that is what the industry calls these remedies, and the word sounds like the gentle wisdom of nature, while behind it stands a billion-euro market that promises you would turn into a deeply relaxed bison with one capsule a day. It does not work like that, and that is exactly why the other side comes now.

The flip side of the miracle root

From here I speak coldly and without ornament, because this is about your body and a wrong sentence can do you real harm. Ashwagandha is no harmless little herb, and whoever tells you that has not read the case reports of the past years.

The biggest problem is the liver. There is a documented case series from Iceland and the US network for drug-induced liver damage, in which people developed a liver injury after taking ashwagandha, jaundice, tormenting itch, with a latency of a few weeks up to 2 months after starting. In those cases the liver recovered over months, without lasting failure, and that is the good news. The bad one comes from India. There a case series examined 8 people who had taken ashwagandha as a single substance. 5 of them already had a chronic liver disease, 3 developed acute-on-chronic liver failure, and these 3 died. They did not fall gravely ill and recover, they died.

The American reference database for liver damage classes ashwagandha as a probable cause of clinically significant liver injury and expressly advises against it where a liver cirrhosis or an advanced chronic liver disease exists. It names a second problem too, one that concerns all of you who reach for the shelf. With supplements the standardization and product quality vary considerably, and false labeling, mixed preparations and contamination in individual cases even make it harder to attribute a liver injury to its actual trigger.

Then there is the thyroid. Ashwagandha can lift the thyroid hormones, that was shown in a study of people with an underactive thyroid, and for them it can even be favorable. For everyone else it is a risk. For whoever has an overactive thyroid or already takes thyroid hormones, such as levothyroxine, this added effect can push the levels too high, with a racing heart, restlessness and sleeplessness as the result. That is no small thing, and no one thinks of their thyroid when reaching for the mood powder.

Pregnancy is a chapter of its own, and here I show you how I handle a claim that dissolved in my own research. The standard sentence runs, in pregnancy hands off, because ashwagandha might have an abortifacient effect. You find that sentence in serious reference works for doctors. When I went after the matter, I came upon a systematic review from 2025 that puts exactly this abortifacient attribution to the test and shows considerable problems in the historical citation chain. The fear goes back in good part to a citation distortion, an old report was copied on and on without a check of the original sources, until the claim looked like an established fact. This work cannot prove safety either, it only strips the dramatic claim of its apparent hardness. And yet, here comes the turn, the advice to abstain during pregnancy still holds. Not because the abortifacient effect had been proven, but because there simply are no solid safety data for pregnancy. The old warning is sloppily sourced, and abstaining remains wise anyway, because not knowing is no free pass. Almost no one makes that distinction, and on it hangs the credibility.

The rest is quickly told and important all the same. Ashwagandha interacts with thyroid medicines, with agents against high blood sugar, with blood pressure reducers, with sedatives and with medicines that dampen the immune system. It can also raise the testosterone level, even though that data is not particularly stable, and the tangible warning concerns above all men with a hormone-sensitive prostate cancer. I deliberately write you no dosage here, no plan, no instruction. What I give you is the honest package insert that the market keeps quiet.

The whole system, and not the single capsule

Ashwagandha is completely legal to buy, free on the shelf, ordered with one click, quite without prescription and quite without counsel, just like hundreds of other supplements. And that is exactly a part of the problem. There are so many people who take everything across the board that some guru holds up to the camera on Instagram, someone who himself does not understand what these remedies do in combination with one another. One substance lifts the blood pressure, the next lowers it, the third hits the liver, the fourth the thyroid, and over the years it adds up to a bill that in the end no one can cleanly divide out again. You have to see the whole system, and not the single colorful capsule.

Many people think, roots, plants, herbs, that is all nature, so it cannot hurt. Yet nature too has its poisons, and plenty of them, so take good care of yourselves. And to everyone who laughs at that sentence, go out and eat the wrong mushroom, then you understand on the spot what I mean.

To all of you who supplement a lot and permanently, take high doses, have pre-existing conditions or swallow potentially liver-toxic substances, I say this here quite directly. Have your liver values and your blood checked by a doctor, individually and at the right interval, and rethink your whole substitution in peace. Because sometimes you go to the doctor for something entirely different, and then a finding suddenly stands in the room that no one reckoned with.

It came to me too, and I tell it because it is only a single case, mine, without a control group, but an honest one. About 10 years ago I drank 2 cans of one of those caffeinated energy drinks every day, you know those narrow silver cans from every cooler shelf. The result was rather shocking. In that time I was diagnosed with a fatty liver that already showed detectable damage, and it had not been on my radar at all. Whether the energy drinks alone were responsible my single case cannot prove, but the regular consumption of sugary drinks is linked, in a dose-dependent meta-analysis, to a markedly increased risk of a fatty liver. Since then I drink only water. Alcohol, which puts extra strain on the liver, I do not drink anyway, and when I clink glasses at a birthday party by way of exception, then with an alcohol-free glass, because for parties and celebrations I am simply the wrong man. If a legal can available everywhere can do such a thing, then think hard about what a whole shelf of capsules does in you over years.

The vitamin D hype, and the bill nobody sees

One more word on the high-dose vitamin preparations, because right there you really have to be careful. Take vitamin D, around which a real hype is raging right now. I am the last one to talk down the importance of a good vitamin D status, many people do take in less than is recommended. Only, an intake below the recommendation is not automatically already a clinical deficiency, and exactly this distinction gets lost in the hype.

But do not draw the wrong conclusion from that. I see on the relevant platforms preparations with 20,000 international units of vitamin D3 and K2 per tablet, and the tolerable daily upper limit for adults stands at 4,000 units. That is no hard poisoning line, medically justified and time-limited schemes may lie above it, the real problem is long-term uncontrolled intake in self-experiment. Because a severe rise of the calcium in the blood can indeed cause kidney failure, cardiac arrhythmia and calcification in the soft tissue. That is exactly the background knowledge that no colorful feed supplies, what a lasting excess of the supposedly good can do in the body.

And yes, I supplement vitamin D too, that belongs to honesty. But I see to it that my level sits correctly, and I look at my blood regularly, instead of just swallowing blindly. That is exactly what I can only warn everyone against. I see what gets shared on Instagram, and I write Instagram here for real, by all the gurus, and you take it all in, and at some point you have a list of 30 preparations a day, swallow them dutifully and believe you are doing your body something good.

And to those who now shout, „yes, then I would rather eat fruit and vegetables”, I say, look closer, but stay sober. Rice reliably carries inorganic arsenic in it, a substance the authorities class as carcinogenic and whose intake through food the European food safety authority says should be lowered. Organic rice, by the way, does not solve exactly this problem, because the arsenic comes mostly from soil and water, not from pesticides. Strawberries and peaches belong year after year to the fruits with the most frequent multiple residues of pesticides, though the European authority has rated the estimated health risk of the residues found overall as low, and the cumulative assessment of the residue mixtures is expressly being worked on, even if it is not yet complete. Organic lowers certain pesticide residues on average, but does not make conventional fruit and vegetables broadly harmful. So I say it plainly, do not let this debate keep you from eating enough fruit and vegetables at all, because that is by far the greater lever for your health.

The only way out that no capsule replaces

And now I lean out, with warning, because what follows is my opinion, not your lab result. The only substitution that truly holds in the end is not one you buy. It is the exit from the wheel. We work ourselves up around the clock, over things that are none of our business, over other people’s disasters, over an outrage that is served to us in the morning and topped up in the evening, and then we wonder that a hormone meant for the sprint before the tiger slowly eats us from within.

You can swallow the most expensive root in the world, you can plaster yourself with adaptogens until the capsule sticks in your throat, and it will change nothing as long as the cause rings again every morning at 6. A pill against a life that does not fit is no solution, it is an anesthetic, so that you keep running in the wheel without screaming. That is the real message of this piece, and it is more uncomfortable than any side effect. The key does not lie in the pharmacy. It lies in the decision to stop running along with the others.

Just get out, that is my whole advice in a single sentence. There is no other way, you will not manage it otherwise, because the wheel never spits you out by itself. And if I do one day actually publish the book I have been writing for a long time, then in its last lines stands exactly what stands here, the hamster wheel in its pure form. Whether it ever appears I deliberately leave open, that I decide on the way and no one else.

Why no one around me holds out anymore

I am writing these last lines on a bench in the forest. The laptop on my knees, Bandit lies next to me in the leaves and does not stir, because he earned his day fair and square, and over us stands the quiet that does not exist in the wheel. In the past days I have cleared up thoroughly, in my life, in my head. I have separated the wheat from the chaff and do only what counts and what brings something. George does only the minimum from now on.

I tell you where I speak from, so you can place it. For years I have struggled with my back, an old thing I picked up in the military and carried through my whole life. I carry my share and more, and I live in a country that squeezes its working people so long that not much of the human being is left. Which particular levy rises here I deliberately leave aside for this piece, I am making no politics here. What I mean is the pattern, the steadily growing burden that wears down the individual the same way constant alarm wears down a single liver. The hamster wheel is in the end nothing other than the stress axis of a whole society, in permanent operation, without the recovery the body was built for. This constant alarm takes a single liver apart over years and a whole society over a generation, slowly and silently, only here no one takes the readings and sounds the alarm in time.

I look around and hardly see anyone left who goes to work with joy. I can still see the woman at the checkout, whose smile was only a movement of muscle, and the man under the car, who told me between two turns of the wrench that he cannot go on. I see people who merely function in the evening and are already empty in the morning, and I see how one after another quietly breaks under this burden. And I see something almost no one speaks about openly. In my own circle 2 people took their own lives in the past year. I do not write that as a statistic and not as a weapon, I write it because it is true and because I will not leave it out here just because it hurts.

Worldwide the World Health Organization counts around 727,000 suicides for the year 2021, and the number of unrecorded cases is considered high, the true figure most likely lies well above it. We finally have to talk about this openly, instead of keeping silent about it. That is exactly why my next piece will be devoted to this subject, to the signs that often precede a suicide and that one can learn to read. I know what I am talking about, because I once failed to read one of those signs many years ago, in a person who was very close to me. If that next text helps even a single person to look in time, then it has done everything a text can do.

And if you are reading this and stand at that edge yourself, then this text tells you the exact opposite of what the wheel whispers to you. There is a way out, and this way out is life, never its end. If everything is too much for you right now, then speak with a person about it. Depending on where you live, help is available around the clock: in the United States the 988 Suicide & Crisis Lifeline at 988, in Germany the Telefonseelsorge free and anonymous at 0800 111 0 111, and elsewhere through the IASP find-a-helpline directory.

And now comes my opinion, marked clearly as such. I believe that a system which squeezes its people so long that they break under the burden carries a share of the responsibility for that breaking. Not for every single despair, that is always many-layered and has many roots, but for the conditions under which mere exhaustion turns into hopelessness. A person who gives more every day and keeps less every month at some point loses not only money but meaning, and the loss of meaning is more dangerous than any figure on a bank statement. When work no longer pays and the human being runs only for the machine, then those who build and administer this machine carry a part of the responsibility for it. That is my firm conviction, and I name it here exactly so.

That is why I give you this advice, and it is advice, not an order. Cut your spending back to what you really need, because every euro you withhold from senseless consumption is a small, quiet refusal to keep running in this wheel.

The field full of hamsters, and the wheels that stay empty

I am not on this earth to run in this wheel until I one day collapse. I want to live, not merely hold out until nothing is left of me, and that is the way I have chosen for myself. How exactly I carry it out I do not yet fully know, I admit that openly. But one thing I know for certain, and this I promise you here, in this country I will not die.

Perhaps it comes easier to me than to others, and that has a reason reaching far back. I grew up poor, as a latchkey child, in the morning 2 marks lay on the table, and from that I bought myself something to eat. I learned early to get by on almost nothing and still not go under, and I taught myself everything, because there was no one who taught it to me. What was a lack back then is oddly an advantage today, because whoever never needed much cannot be blackmailed by consumption. That is exactly what I mean when I advise you to cut your spending, you lose less than the advertising wants to talk you into.

When I drive through the streets, walk through the shops, move through the cities, then I sometimes picture something rather surreal, like a Matrix you can see with the naked eye. I see a huge field, millions of hamsters, and each runs in his own little wheel. Now and then you see one who stumbles, collapses and falls out of the wheel, and he is then simply dead. Never mind, there is resupply, new hamsters are bred in the schools and move dutifully into the vacated wheels. Only the whole field gradually starts to totter, because ever fewer of them can even still run.

And now comes the part where I sit on this bench and grin quietly. Picture that one day a whole section of these wheels simply stands empty, still and run dry. I type this to the end with a smirk, in a moment I stand up and walk back through the forest, and this smirk I take with me, because I picture this image and think to myself, they will marvel, they will really marvel. The funny thing about it is only that those who administer and rent out this whole wheel today have long had their houses in Italy and overseas, over there, where they can piss off to once the field runs empty.

My back hurts, the dog sleeps in the leaves, and it smells of autumn, though it is still summer. I am out, out of the hamster wheel. I will not run one second faster in this wheel for this country, No, I am jumping out.

Disclaimer

This piece conveys general scientific information and personal assessments. It represents no medical, psychotherapeutic, pharmacological or legal advice, enables no individual diagnosis and contains no individual dosage or treatment recommendation. The cited studies depict a scientific controversy. Statements expressly marked in the text as personal opinion are personal opinion and no secured knowledge. Supplements such as ashwagandha and high-dose vitamin preparations are not harmless, they can interact with medicines and in rare cases cause serious harm, which is why any use, especially with pre-existing conditions, in pregnancy and breastfeeding or with existing medication, is to be clarified with a doctor beforehand. Whoever is in an acute crisis or has thoughts of taking their own life turns without delay to medical help or local emergency services, and depending on where they live to the 988 Suicide & Crisis Lifeline at 988 in the United States, to the Telefonseelsorge at 0800 111 0 111 in Germany, or elsewhere through the IASP find-a-helpline directory, around the clock, free and anonymous where available. For decisions that readers make on the basis of this text, no liability is assumed, as far as legally permissible.

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