Often dubbed “the stress hormone,” cortisol has earned quite a reputation in wellness circles – but this molecular multitasker deserves a more nuanced introduction. While most of us know it as the instigator behind our fight-or-flight response, cortisol is actually working around the clock as one of our body’s most essential chemical messengers. But like many powerful tools, cortisol’s effects depend entirely on timing and balance. When functioning properly, it helps us spring into action during emergencies, maintains our daily rhythms, and keeps various bodily systems in check.
Tryon Medical Partners internal medicine specialist Dr. Amin shares what you need to know about cortisol, including what it does, the effects it has on the body, and how to keep cortisol levels balanced.
What is cortisol?
Dr. Amin describes cortisol as a steroid hormone naturally produced by our adrenal glands, which sit on top of the kidneys. Cortisol is a critical hormone that impacts our entire body, including the heart, and the immune and muscular skeletal systems.
Commonly known as the “stress hormone,” it’s secreted at higher levels when we are responding to stress, such as injury or sickness. It supports our body in times of stress by controlling how our bodies use fats and carbs, regulating blood sugar and metabolization, reducing inflammation, and regulating our sleep cycle. Our bodies release cortisol automatically and maintain cortisol levels at all times to ensure balance.
“As a general rule, we can’t control our cortisol levels and don’t have to worry about them,” Dr. Amin shares. “Our bodies are very good at regulating the amount we need. This is not something to be concerned about outside of unique circumstances.”
Why is high cortisol bad?
Although we generally don’t have to worry about managing our cortisol levels, there are some circumstances in which levels could be concerning. Dr. Amin says this can happen in the following situations:
- Steroid use. Taking large amounts of corticosteroids, such as prednisone, prednisolone, or dexamethasone, can cause Cushing syndrome. This is known as “iatrogenic” or exogenous Cushing syndrome.
- Tumors. Specifically tumors in the pituitary gland, adrenal gland, and in other parts of the body, such as the lungs, can cause high cortisol levels.
If your cortisol levels are unusually high due to the above conditions, you can develop specific symptoms. The symptoms often looks like:
- Weight gain – especially in the face and stomach – which is often referred to as “cortisol face” or “cortisol belly”
- Large deposits of fat between the shoulder blades
- Purple marks on the abdomen
- High blood sugar levels (diabetes)
- High blood pressure
- Weakness in upper and lower extremities
- If left untreated for a prolonged period, weak bones and excessive hair growth
“In a situation with a lot of stress, you will naturally experience a very brief rise in cortisol, but not a chronic continuation of cortisol,” Dr. Amin emphasizes. “Your feedback cycle will naturally control it. It is very uncommon to have chronically high cortisol levels and we will be actively looking for it if you’re at risk, so you don’t need to worry about it.”
How can I reduce cortisol levels?
Dr. Amin emphasizes that you can’t lower chronically high cortisol levels without medical intervention, and this would only occur in the rare circumstance of a condition like Cushing’s disease. For day-to-day stress management, Dr. Amin recommends:
- Good sleep hygiene. Your cortisol levels impact your sleep and wake cycle. You can help your cortisol out by keeping this consistent – target going to bed and waking up at the same time every day and aiming for at least 7 hours per night.
- Healthy diet. Do your best not to skip meals and to eat nourishing snacks or meals with protein, fiber, and vitamins, rather than processed foods, to support overall health.
- Consistent exercise. Regular physical activity has a multitude of positive impacts on your body, including stress management and minimizing the sudden release of cortisol.
- Healthy relationships. Unhealthy relationships are one of the biggest stressors in our lives – limit this by maintaining healthy relationships and reconsidering those that cause undue stress.
When should I go to the doctor about my cortisol levels?
Dr. Amin makes it clear: unless you are at risk due to tumors or steroid use, you likely don’t need to think too much about cortisol, aside from daily stress management.
The best way to ensure your cortisol levels are normal is by regularly seeing your doctor for a physical. At an annual physical, your weight, blood pressure, sugar levels, and kidney and liver function will all be checked – all of these labs will provide the information clinicians need. If additional cortisol level testing is required from there, your healthcare team will take that next step.
“Although it’s highly unlikely you have chronically high cortisol levels, go to your doctor if you’re nervous about some symptoms you’re experiencing,” Dr. Amin says. “It can be difficult to test for cortisol on your own, and even harder to interpret the results. Your doctor will get you the testing you need to make sure you’re healthy.”
If you’re reading to chat about cortisol and stress management, use MedChat or call Tryon Medical Partners to meet with a clinician today.