You’ve probably heard of cortisol, which is sometimes called the body’s main “stress hormone.” Although it’s key in determining our response to stressful situations, cortisol’s role is much more complex — and essential to day-to-day health. Learning about cortisol — what it does in human physiology, what occurs when levels are askew, and how you manage it — is essential to understanding your general state of health. This article uses expertise in medicine to provide a succinct overview of this important hormone.
What the Heck is Cortisol?
Cortisol is a steroid hormone of the glucocorticoids class. It’s made and secreted by your adrenal glands, which sit on top of your kidneys. Consider cortisol the body’s home alarm system, but also a manager of so many important background processes that your body does. Its production is tightly controlled by a communication network between your brain (specifically the hypothalamus and pituitary gland) and your adrenal glands.
The Multifunctional Role of Cortisol: More Than Just the Stress Response
And while stress management is its primary function, cortisol affects nearly every organ system. Here’s a look at its key duties:
Regulating The Stress Response Of Your Body
Your body releases high amounts of hormones like adrenaline during short-term or long-term stressful events for immediate reactions, such as “fight or flight.” Cortisol joins in, keeping you alert and mobilizing energy by causing glucose (sugar) to be released from your liver. This is to provide the energy required to drag the stressor.
Handling Metabolism and Blood Sugar
Cortisol is key to metabolism — how your body utilizes energy. It also regulates how insulin and glucagon are produced and how fat, muscle, and liver tissues use glucose, and thereby helps control blood sugar levels.
Controlling Inflammation
In short bursts, cortisol can help put a lid on inflammation, functioning as a natural anti-inflammatory agent. But when levels remain elevated over a longer period, that can paradoxically increase inflammation and potentially, over time, weaken the immune system.
Managing Blood Pressure
While the mechanisms are not fully understood, cortisol also plays a role in blood pressure regulation. High and low cortisol levels also correlate with low and high blood pressure, respectively.
Affecting Your Circadian Rhythm
Cortisol levels rise and fall naturally over the course of the day, peaking just before you get out of bed in the morning and falling to their lowest during the evening hours when you go to bed. This rhythm is important for healthy sleep cycles and waking up feeling alert.
What Happens When Cortisol Is Too High? (Hypercortisolism)
Excessively high levels of cortisol all the time (a condition diagnosed in people as Cushing syndrome) can have deleterious effects on health. Everyday stress alone probably isn’t what causes this, but the most likely culprits are:
- Medications: Long-term use of high doses of corticosteroid medications (such as prednisone).
- Tumors: Tumors on the pituitary gland or adrenal glands that cause excess production of cortisol or the hormones that stimulate production (ACTH).
Elevated Cortisol: Common Symptoms
Those with chronically high cortisol might find the following:
- Excessive weight gain, particularly in the face (“moon face”) and abdomen, occasionally with slender arms and legs.
- Fatty deposits behind the shoulder blades (“buffalo hump”).
- Wide, purplish streaks, especially on the stomach.
- Muscle weakness.
- High glucose levels, which can lead to Type 2 diabetes.
- High blood pressure.
- Easy bruising.
- Bones that become fragile (osteoporosis).
- In women, male-pattern baldness (hirsutism) or irregular periods.
What If Cortisol Levels Drop Too Low? (Adrenal Insufficiency)
Adrenal insufficiency is indicated by abnormally low cortisol levels. That means the adrenal glands are not making sufficient cortisol. Major causes include:
- Primary adrenal insufficiency (Addison’s disease): Usually an autoimmune process in which the body destroys the adrenal glands. Infections or other damage, too, can be the culprit.
- Secondary Adrenal Insufficiency: Problems in the pituitary gland (such as tumors or underactivity) restrict the release of ACTH, the signaling hormone for cortisol release. It can also be triggered by suddenly stopping long-term corticosteroid medication.
Signs & Symptoms of Low Cortisol:
Low cortisol: People with low cortisol may see:
- Fatigue and weakness that last a long time.
- Unintentional weight loss.
- Decreased appetite.
- Low blood pressure (can cause dizziness if you stand up).
- Nausea, vomiting, or abdominal pain.
- Muscle or joint pain.
- Generalized bronzing of the skin (Addison’s disease).
Regulate That Cortisol? Lifestyle Indication vs. Medical Indication
It’s important to make a distinction between managing normal cortisol fluctuations related to daily stress and treating medical conditions that cause cortisol levels to behave abnormally.
Balanced Cortisol: Lifestyle Measures to Take
For otherwise healthy patients seeking stress management and balanced cortisol support:
- Get Sleep Priority: You need to get sleep at regular quality. Chronic sleep deprivation raises cortisol.
- Motion in Nature: Physical activity is a proven stress reliever and a means to maintain our bodily rhythms.
- Practice Relaxation: Deep breathing, meditation, or yoga can stimulate the body’s “rest and digest” mode, which counteracts stress hormones.
- Forge Strong Relationships: Positive social connections are a buffer against stress.
- Prioritize Fun: Laughing and having fun releases endorphins that can reduce cortisol.
Medical Treatment for Cortisol Imbalances
If you have Cushing syndrome or adrenal insufficiency, lifestyle changes won’t suffice. Medical treatment is important and may consist of:
- Medication: To inhibit cortisol production, block its effects, or replace it (if deficient).
- Surgery: To excise tumors which produce excess cortisol.
- Tapering Off Corticosteroids: If medication is the cause of high cortisol.
When to Seek Medical Advice
Enduring symptoms linked to either elevated or decreased cortisol should be presented to a doctor. If you’re experiencing unexplained weight fluctuations, chronic fatigue, muscle weakness, blood pressure issues, or any of the other symptoms above, speak to your doctor. They can do tests (blood, urine, saliva) to quantitatively assess your cortisol levels and evaluate the reason. Self-diagnosis or unverified “adrenal fatigue” tests can be misleading and delay appropriate treatment.
Reliable Information About Cortisol
Cortisol is a critically important, potent hormone. Learning its functions and the warning signs when it goes out of balance enables you to support your health better.