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What Is Cortisol & What Causes High Levels Of This Stress Hormone

Author:

Marygrace Taylor

Medical reviewer:

Sheeva Talebian, M.D.

February 03, 2020

By Marygrace Taylor

mbg Contributor

Marygrace Taylor is a Philadelphia-based health and wellness writer.

Medical review by

Sheeva Talebian, M.D.

Reproductive Endocrinologist

Sheeva Talebian, M.D., is a board-certified reproductive endocrinologist. She graduated from Columbia University and obtained her medical degree from Mount Sinai School of Medicine.

Getting it under control

Image by Alex Tan / Death to the Stock Photo

February 03, 2020

Stress isn't just annoying. It can also wreak havoc on your body.

For that, we can thank cortisol. The steroid hormone, which is released when you're tense or anxious, can leave you feeling lousy and put you at risk for getting seriously sick. Here's what you should know about it—and the simple things you can do to keep your cortisol levels from getting out of control.

What is cortisol?

Basically, it's a steroid hormone produced by your adrenal glands that's released into your bloodstream during times of stress.

We often tend to think of cortisol as a bad thing, but it's actually meant to be helpful. When our cave-people ancestors were faced with a stressful or threatening situation—say, being chased by a wolf—the release of cortisol activated the fight-or-flight response, explains physician and yoga instructor Monisha Bhanote, M.D., FASCP, FCAP. As a result, they could act quickly to protect themselves. (Or at least try.)

The problem? Today, there are tons of things that prompt the release of the hormone—from sitting in traffic, to emergency emails from your boss, to remembering at midnight that you promised homemade cupcakes for your kid's school party. These constant stressors mean your body ends up flooded with cortisol nonstop, which can trigger a cascade of negative health effects, says Joseph Feuerstein, M.D., Columbia University associate professor of clinical medicine and director of integrative medicine at Stamford Hospital.

How cortisol steroid works in your body.

Cortisol plays a number of roles in the body, and not all of them are bad, including maintaining healthy blood pressure levels, regulating blood sugar, and turning food into energy.

"[Cortisol is] responsible for maintaining the health of and proper communication between every cell in your body," Aviva Romm, M.D., integrative medicine doctor and herbalist, told mbg. "When it is in a healthy rhythm, cortisol is highest in the morning 1 to give us energy to get our day started, keep inflammation low, and keep immune response at its peak 2. It is naturally lowest before bed, allowing us to wind down into a rest-and-repair phase."

It also helps to keep us safe. When your body perceives a threat, your hypothalamus sends a signal to your adrenal glands to start pumping out hormones like cortisol. This release sets off physiological responses designed to help you get out of danger, pronto. Your heart rate and blood sugar levels spike, and you start to feel anxious. And nonessential systems—like your digestive and reproductive systems—temporarily shut down. That allows your body to devote more energy and focus to helping you escape the threat.

Side effects of high cortisol levels.

Normally, all of this stuff stops when the threat goes away—and you start to relax again. But when the hormone is constantly being released because of chronic stress, you can start to run into issues. Research shows that overexposure to cortisol can mess with the body's ability to regulate inflammation. And that can lead to big problems. A whopping 70 percent of diseases are related to stress, experts suspect 3. Chronically high cortisol levels can weaken your immune system 4, says Dr. Bhanote, as well as increase your risk for:

Sleep problems (insomnia, waking in the night, waking up tired in the morning)
Headaches
Digestive issues
Hormonal imbalances
Anxiety and depression 5
Blood sugar and metabolic problems (including sugar cravings, metabolic syndrome, PCOS, and diabetes)
Weight gain
Decreased memory, focus, and willpower
Immune system imbalances leading to more frequent infections, reactivation of old viruses, allergies, inflammation, and even autoimmune disease
Alzheimer's and heart disease

Health problems that can cause high cortisol levels.

Cortisol levels spike because of chronic stress. But high levels can also be caused by disorders of the pituitary gland, a pea-size organ in your brain that's responsible for making hormones.

When it comes to stress hormones, the most common pituitary gland disorder is Cushing's syndrome, where the body makes too much cortisol. Cushing's usually strikes in people who are taking high doses of steroids like glucocorticoids for asthma, arthritis, and lupus. Symptoms of too-high cortisol from Cushing's or other conditions can include weight gain (but thin arms and legs), a round face, fat around the base of the neck, a round or fatty hump between the shoulders, bruising easily, new stretch marks, and muscle weakness.

The problem most often occurs in your 30s or 40s, and women are three times as likely to get it as men, according to the National Institutes of Health. Still, Cushing's is pretty rare, affecting just 40 to 70 people out of every million.

On the other hand? It's also possible for your body to produce too little cortisol—which is also a bad thing. The culprit is often Addison's disease, in which the adrenal glands are damaged and can't make enough of certain steroid hormones.

How to regulate your level of cortisol.

Worried that stress is making your cortisol levels spike? Cortisol management is all about stress management, Dr. Bhanote explains. Some simple lifestyle changes that have been proved to help regulate cortisol levels:

Get enough sleep. Aim for seven to eight hours a night. Crummy sleep is tied to increased cortisol production, findings show. To get more sleep, consider cutting out caffeine and alcohol later in the day, suggests Dr. Romm.
Be active. Regular movement is another must for managing stress. And you don't have to go all out with intense sweat sessions. Research has actually found that lower intensity exercise (think brisk walking) is linked to lower cortisol levels.
Curb your sugar intake. Sugar overload stresses your body and can encourage the release of cortisol, Dr. Feuerstein says.
Don't cut all carbs. A very low-carb diet actually increases your cortisol. "Many of my clients benefit from eating a small, healthy carbohydrate choice (whole grain, sweet potato) three to five hours before sleep to create a healthier cortisol pattern," says Dr. Romm.
Try meditative practices. Yoga, mindfulness meditation, progressive muscle relaxation, deep breathing, and body scanning can all help you chill out, says Dr. Bhanote. Make it a weekday priority to decompress for even just 15 minutes when you get home from work.
Cuddle up with your pup. Numerous studies have found that contact with dogs specifically (but probably cats, too) during stressful situations causes cortisol levels to drop.

And if lifestyle changes don't seem to be enough? Talk to your doctor. She might recommend talking with a therapist, who can help you find other ways to manage your stress. If your doc suspects that you have a problem like Cushing's syndrome, she may recommend doing a blood or urine test to check your hormone levels, Dr. Feuerstein says.

The benefits of getting your cortisol under control.

You'll feel better, for starters. "When we're relaxed, the body lowers cortisol levels. Heart rate, respiratory rate, and blood pressure slow down, the muscles relax, circulation improves, and more blood flows to the brain," Dr. Bhanote says.

Just as important, you'll improve your health for the long haul. Getting your levels under control can have an anti-inflammatory effect and help reduce your risk for anxiety and depression—along with chronic diseases like heart disease and Alzheimer's.