Cortisol: How this stress hormone may affect your well-being

Cortisol is a hormone that is made by the adrenal glands; these glands help control functions in your body. Your cortisol level changes during the day. It is usually highest in the morning and drops in the evening. It’s high in the morning as a natural way of getting your body ready for the day.

Other things can make your cortisol level spike. Things like stress, working out, caffeine and some medications e.g. corticosteroids like prednisone can raise it.

Experiences that commonly activate your body’s fight or flight response, or your body’s way of preparing for an unexpected issue, may increase it, too. For example, do you find your heart beating rapidly if something surprising happens when you’re driving? Or if you accidentally step off a curb that you didn’t see? That physical response is cortisol in action.

“Cortisol is designed for short bursts of activity, such as responding to immediate threats, not for constant, low-level stress,” says Aleksandra Sliwinksa, a PeaceHealth endocrinologist in Eugene, Oregon.

What’s the big deal if it’s high throughout the day?

Living in a constant state of fight or flight may have long-term effects. “When the body is under prolonged stress, it continually signals the adrenal glands to release cortisol. This sustained elevation of cortisol can lead to a variety of health issues,” says Dr. Sliwinksa. 

If cortisol stays high, it can affect your immune system, digestion, heart and metabolism. "Over time, this can increase the risk for more serious conditions, including cardiovascular disease and metabolic syndrome.” says Dr. Sliwinksa.

If you’re experiencing high cortisol, it could cause symptoms in many areas of your body. Examples include:

• Acne
• Weight gain in the midsection, upper back or face
• Bruising easily
• High blood pressure
• Headache
• Irritability
• Trouble sleeping

Cortisol is central to your body's overall response to stress, Dr. Sliwinska says. "It influences nearly every organ system because it helps the body manage energy."

Essentially, cortisol controls how your body breaks down the carbohydrates, fats and proteins you eat. It also interacts with your immune system, helps manage inflammation, and can influence your sleep patterns. "Its widespread effects illustrate how interconnected our bodies are, where one system can easily influence others," Dr. Sliwinska adds.

Cushing Syndrome

If your cortisol levels are high for an extended amount of time it could be something rare called Cushing’s syndrome or hypercortisolism. Some symptoms of this may be diabetes, depression or osteoporosis. You may want to make an appointment with your primary care provider if you feel you may be experiencing this.

What about low cortisol? 

It’s possible that your body may not be making enough cortisol. This is something known as Addison’s Disease. This is pretty rare, but symptoms may include: low appetite, low blood pressure, fatigue and diarrhea.

How can I manage cortisol?

There are many things that you can do to help manage your cortisol levels, including:

• Getting regular physical activity. Exercise helps to improve the quality of your sleep which can lower cortisol.
• Finding a stress relaxation technique that works for you. Whether that’s meditation, walking in nature or box breathing, where you inhale/hold your breath and exhale/hold your breath for equal counts.
• Play or cuddle a pet. If you don’t have a pet of your own, consider walking with a neighbor and their dog, or try volunteering at an animal shelter.

When should I see a doctor?

If you feel like you may be over- or under-producing cortisol, you may want to make an appointment with your primary care provider. They can run tests including blood tests and CT scans or an MRI to check your levels.

“Cortisol levels fluctuate naturally throughout the day, but consistently high levels, along with persistent symptoms, can indicate the need for evaluation. "Keep track of things like unexpected weight gain, extreme tiredness, changes in your mood or difficulty sleeping. If these symptoms persist and get in the way of your daily activities, Dr. Sliwinska recommends checking in with your doctor. "They can determine whether testing is warranted." She adds that getting a diagnosis and treatment early on can help you avoid the more serious long-term effects of high cortisol.