When most people hear the word “cortisol”, they immediately think of stress. It’s often called the “stress hormone,” and while it’s true that cortisol helps your body respond to stressful situations, that’s only part of the story.
In healthy amounts, cortisol is essential for keeping you alert, energized and balanced. It provides the motivation and focus you need to meet daily challenges and helps your body adapt to changing circumstances.
But when cortisol levels fall out of balance, whether too high or too low, you may notice changes in your mood, energy, weight and overall health. That’s why it’s so important to understand how cortisol works, what can throw it off and what you can do to keep your levels in check.
What Is Cortisol?
Cortisol is a powerful steroid hormone produced by the adrenal glands, which sit on top of your kidneys. It has a role in almost every major system in the body, including your metabolism, immune response, cardiovascular function and nervous system.
It also follows a natural rhythm, usually peaking in the morning to help you feel alert and ready for the day, then gradually decreasing in the evening to prepare your body for rest. This daily cycle, known as your circadian rhythm, helps regulate sleep, appetite, energy levels and even how your body processes nutrients.
Why Is Cortisol Important?
Cortisol is involved in:
- Controlling blood sugar levels: It keeps your energy steady throughout the day.
- Supporting memory and focus: It helps you stay sharp and attentive.
- Reducing inflammation: It helps prevent your immune system from overreacting.
- Helping control blood pressure: It ensures your heart and circulation remain stable.
- Regulating metabolism: It helps convert food into usable energy efficiently.
Beyond its role in daily rhythms, cortisol is also part of your body’s built-in survival system and is critical in emergencies. When you face stress, your adrenal glands release extra cortisol to give you a burst of energy, sharpen your focus and help you respond in a way that brings you back to balance.
For example, if you’re running late for work or avoiding danger, cortisol gives your body a boost of glucose (sugar) to help sharpen your concentration and allow you to respond.
When Does Cortisol Become Harmful?
Without cortisol, you simply wouldn’t be able to survive. The problem with cortisol comes when levels stay too high—or too low—for too long.
Short bursts of cortisol are healthy and necessary. But chronic elevation, often associated with “chronic stress,” can take a toll on your health.
Over time, constant high stress levels, whether physical, emotional or environmental, keep cortisol levels elevated and can contribute to health problems such as:
- High blood pressure and a higher risk of heart attack and stroke
- Weight gain, especially around the midsection, and a higher risk for obesity and diabetes
- Insulin resistance and a higher risk of diabetes (1 in 4 people with hard-to-control diabetes has high cortisol)
- Immune suppression, making you more prone to illness
- Sleep problems and fatigue
- Mood disorders such as anxiety or depression
On the other hand, very low cortisol levels (often from adrenal gland problems) can cause weakness, dizziness and low blood pressure.
Why Is Elevated Cortisol a Problem?
Cortisol normally helps reduce inflammation, but when levels are chronically high, it weakens the immune system and leaves you more vulnerable to infections.
Prolonged high cortisol also raises blood pressure and can increase cholesterol levels, both of which raise the risk of heart disease and stroke.
Additionally, high cortisol drives your body to store fat, especially in the abdominal area, while breaking down muscle tissue. Over time, this contributes to weight gain, insulin resistance and even type 2 diabetes.
Other ways in which high cortisol can be damaging include:
- Disrupting functions of brain structures, including the hippocampus, which is the part of the brain involved in memory and learning
- Impairing sleep and causing people to feel “wired but tired”
- Reducing calcium absorption and bone formation, increasing the risk of osteoporosis
Signs and Symptoms of High Cortisol
Some early signs that cortisol levels may be too high include:
- Persistent fatigue, even with enough sleep
- Weight gain in the abdomen, face (sometimes called “moon face”) or back of the neck
- High blood pressure
- Thinning skin and bruising easily
- Slowed healing of cuts or infections
- Mood swings, anxiety or depression
- Trouble sleeping
- Irregular menstrual cycles or fertility issues in women
If these symptoms are ongoing, it’s important to talk with a doctor.
How to Keep Cortisol Levels Healthy
Ultimately, cortisol isn’t the enemy, but when stress is constant or your adrenal glands are overworked, cortisol can shift from helpful to harmful. Paying attention to your symptoms and practicing healthy lifestyle habits can go a long way in keeping your levels in balance.
You can’t avoid stress completely, but you can support a healthy cortisol balance with everyday habits that manage stress:
- Prioritize good sleep: Aim for 7-9 hours per night. Poor sleep is one of the fastest ways to disrupt cortisol rhythms.
- Exercise regularly, but don’t overdo it: Moderate activity like walking, swimming or yoga helps regulate cortisol, while excessive high-intensity training can keep levels too high.
- Eat a balanced diet: Focus on whole foods, fiber, lean protein and healthy fats. Limit added sugars and refined carbs, which can spike blood sugar and disrupt cortisol balance.
- Practice stress management: Breathing exercises, mindfulness practices (like meditation), socializing, spending time outdoors and engaging in hobbies that you enjoy can all lower stress hormone spikes.
- Stay socially connected: Positive relationships buffer the effects of stress on the body and support long-term health.
If you have concerns about your cortisol levels, Stony Brook Medicine’s endocrinology specialists can provide testing, evaluation and treatment options tailored to your needs. Our endocrinology team treats a wide range of general and complex problems of endocrine disorders in men and women, including adrenal and thyroid gland diseases. Learn more about our endocrinology team at Advanced Specialty Care in Commack and for new appointments, call (631) 638-0597.
