Meet Cortisol, the Hormone You Can't Ignore

Different types of stress can impact cortisol levels. About 15 minutes after the onset of acute stress, cortisol levels rise, and they stay high for several hours. Higher cortisol levels lead to increased glucose levels. The body USS the increased glucose for fuel. Elevated cortisol also suppresses non-vital organs and decreases inflammation to prepare the body to deal with the stressor. As the stress passes, cortisol levels and bodily functions slowly return to normal.

Stressful events are inevitable, and the body's short-term stress response allows us to work through it. While the body's short-term stress response can be considered adaptive, a chronic stress response can cause significant problems. Chronic or frequent stress leads to repeated surges of cortisol and can result in cortisol dysfunction, including depletion of cortisol, impaired cortisol secretion, cortisol resistance, or hypersensitivity.

Cortisol acts as a potent anti-inflammatory, and when it is depleted or not used effectively, it can lead to many problems, including muscle and bone breakdown, depression, fatigue, pain, and memory impairments.

Normal cortisol levels depend on the time of day. Generally, cortisol will be low when falling asleep and rise throughout the night, peaking in the morning when the person wakes up. Normal cortisol levels for blood taken at 8 am are 5 to 25 mcg/dL or 140 to 690 nmol/L. Cortisol levels also tend to increase with age and are generally higher in women than men.

Imbalance cortisol levels can have a variety of symptoms. Symptoms of high cortisol levels depend on how high they are but can include weight gain, fat deposits between the shoulder blades, hypertension, diabetes, osteoporosis, and muscle weakness. Signs of low cortisol levels include weight loss, hypotension, fatigue, and hyperpigmentation of the skin.

High cortisol levels can have a variety of causes. A tumor or growth in the pituitary gland, called Cushing disease, can cause excess cortisol production, as can tumors in the adrenal glands, lungs, or thyroid. Steroid medications, including oral medications, injections, nebulizers, and creams, can also increase cortisol. Chronic stress, insufficient sleep, working night shifts, and a lack of exercise may also contribute to elevated cortisol.

A variety of things can cause low cortisol levels. Addison's disease is a condition where the adrenal glands do not produce enough cortisol. It is usually caused by an autoimmune disease where the body attacks and damages the adrenal glands.

Other causes of Addison's disease may include certain infections, like tuberculosis, HIV/AIDS, or anything that weakens the immune system. Anything that affects the pituitary gland can also affect cortisol production, including tumors, genetic diseases, surgical removal of the pituitary gland, or traumatic brain injury.

Another possible cause of low cortisol levels is suddenly stopping steroids after taking them for an extended time. High levels of corticosteroid medication in the blood cause the body to make less cortisol. If the medication is stopped suddenly, the adrenal glands may take some time to begin producing cortisol normally again. For this reason, doctors usually prescribe a slow taper where the dose is slowly lowered over time to give the adrenals time to start producing cortisol again.

There are multiple ways to test for cortisol imbalances. Blood tests are effective, but they have to be done by a qualified healthcare provider. Blood samples are usually taken twice a day, once in the morning when levels are high and again in the later afternoon when they are lower.

Other options include urine tests and a saliva test. A cortisol urine test typically requires a 24-hour urine sample. The person collects their urine in a special bottle at home for 24 hours. In some cases, a cortisol urine test can be done with a single sample of urine collected in the morning. A cortisol saliva test can also be done at home. These tests are typically done at night before going to bed when cortisol levels are lower.

When a cortisol imbalance is detected, additional testing may be needed to determine the source of the imbalance. For example, CT scans and MRIs can detect tumors in the adrenal glands or pituitary glands. If you think you are displaying signs of a cortisol imbalance, talk to your doctor.

Cortisol affects the body in many ways. In short spurts, cortisol can boost immunity, but over time, the body gets used to elevated levels of cortisol, which can lead to increased inflammation and a stressed immune system, which can lead to increased sicknesses. Studies also suggest that increased cortisol can contribute to some mental health disorders, including anxiety and depression.

One way to help manage cortisol levels is stress management. Techniques to lower stress can include:

• Deep breathing exercises
• Exercising
• Listening to claiming music
• Taking breaks
• Getting enough sleep
• Talking to friends and family
• Some research has found that diets high in refined grains, saturated fat, and added sugar led to higher cortisol levels than those high in fruits, vegetables, whole grains, and polyunsaturated fats

Cortisol levels can also be managed with medication. Those with high cortisol due to Cushing's syndrome may take medication to control cortisol production in the adrenal gland or help the body use cortisol more effectively. Addison's disease usually involves steroid replacement for life to replace cortisol and other hormones affected by the condition.

Research has found some herbal supplements may be effective at reducing cortisol levels, including ashwagandha, Rhodiola, and lavender. These supplements have been shown to be generally safe, and they are easy to use and readily available, but they may interact with other medications. There is also not a lot of data available on whether these supplements are safe to take for people who are pregnant or nursing, so people in these groups should exercise extreme caution. Talk to your doctor before starting any herbal supplements.

There are several approaches to maintaining balanced cortisol levels, including:

• Eating a diet high in fruits, vegetables, healthy fats, lean protein, and whole grains
• Getting between seven and nine hours of sleep every night
• Establishing a regular exercise routine
• Learning stress management techniques, like yoga, mindfulness meditation, or breathing techniques
• Limiting caffeine intake
• Maintaining a healthy lifestyle can help maintain cortisol levels and lower risk factors for several other health conditions.
• Regular check-ups and lab work are important parts of staying healthy and can help identify problems early so treatment can begin as soon as possible.

Cortisol is commonly known as the stress hormone. While it regulates the body's stress response, it is also involved in many other body functions, including suppressing inflammation, regulating blood sugar and blood pressure, controlling metabolism, and controlling the sleep-wake cycle. Both high and low cortisol levels can have significant effects on a person's health, but regular check-ups and routine lab work can help identify problems early and ensure appropriate treatment.