The Hidden Dangers of High Cortisol Levels

Because cortisol amps up the release of glucose in your system, chronically elevated cortisol levels can result in high blood sugar levels and weight gain. It can also lead to physical symptoms such as hypertension, a weaker immune system, and muscle weakness. Cortisol rings an alarm in your body and slows bodily functions that aren't essential in fight or flight situations. High levels can thus affect the digestive and reproductive systems. They also lead to emotional and cognitive symptoms such as anxiety, depression, and memory problems.

Symptoms like weight fluctuations and fatigue may result from other conditions, so it's important to make an appointment with a healthcare professional to confirm a diagnosis before jumping to conclusions.

In addition to chronic stress, medical conditions like Cushing's syndrome can cause high cortisol levels. Cushing's syndrome is a rare hormonal disease that is typically benign but can be fatal without treatment. It presents more often in young women, and symptoms include a red, puffy face, more body fat around the stomach and upper back, thin limbs, bruises, and stretch marks. The comedian Amy Schumer revealed she had Cushing's in 2024 as a result of high doses of steroid injections.

When it comes to medications, corticosteroids in certain anti-inflammatories, asthma, allergy, and autoimmune drugs can increase cortisol levels, as can stimulants prescribed for ADHD and sleep disorders. Opioids, tricyclic antidepressants, and some HIV treatments can have similar effects. It's best to chat with your doctor if you have concerns about your meds. Finally, lifestyle factors such as poor diet, inadequate sleep, and a lack of exercise play a significant role in high cortisol levels.

Don't let social media channels like TikTok convince you that a cortisol imbalance is at the root of health issues such as acne or insomnia. If you suspect you have high cortisol levels, consult a doctor. Your physician may refer you to an endocrinologist. Saliva, blood, or urine tests can confirm whether or not your cortisol levels are elevated. Blood and saliva tests reflect cortisol levels at the time of testing, but levels go up and down over the course of a day.

Urine samples cover a longer period and are more common. At-home testing with finger pricks and saliva swabs aren't ideal, and while hair samples are useful, they're mostly used in research settings.

Generally, cortisol is anti-inflammatory and keeps the immune response in check. But if cortisol is chronically too high, the immune system can become "resistant" leading to longer wound healing times, for example. Studies also link high cortisol levels to an increased risk of cardiovascular events, including heart attacks and strokes.

Because stress has an impact on glucose levels, there can also be metabolic consequences such as type-2 diabetes or insulin resistance. Beyond anxiety and issues with cognition, chronic stress's impact on the brain can extend to mood swings and addiction.

Firstly, consider how you sleep. Are you getting enough sleep, about 6 to 8 hours a day? Is it good quality, uninterrupted sleep that leaves you feeling refreshed? If not, prioritize creating the right environment and implementing behaviors that promote restful sleep.

Secondly, doing activities that reduce stress, like yoga or as little as three minutes of mindfulness exercises that incorporate the five senses, deep breathing, or guided meditations, can also make a difference. It's easy to dismiss these strategies, but they're powerful and can help even those who experience intense stress.

The third pillar in the trifecta is exercise. Moderate exercise like jogging or cycling is great for regulating cortisol because it conditions the body to activate and deactivate the stress response appropriately. So, for example, if you go running or cycling, your heart rate increases, and when you're done, it decreases.

The Mediterranean diet, which cuts down on ultra-processed foods and includes veggies and fruits, whole grains, lean proteins, and healthy fats, is a balanced one and has been shown to lower cortisol levels. Foods containing omega-3 fatty acids, such as salmon, walnuts, and pumpkin seeds, can have a positive effect, and so can foods rich in magnesium and vitamin C. Limit alcohol, nicotine, and caffeine, which can cause stress and inflammation.

Skipping meals puts stress on the body, but stress can also lead to overeating comfort foodsthat are high in fat and sugar, so don't make these foods readily available in your pantry.

In the event of a Cushing's diagnosis, your doctor will likely help you safely taper glucocorticoid medicines. It's not common, but if Cushing's syndrome is determined to be caused by a tumor in the pituitary or adrenal glands, this may necessitate brain surgery or the removal of the adrenal glands. If surgery and radiation aren't an option, medicines may be prescribed to manage the condition. These can have side effects such as an upset stomach or swelling.

Adaptogenic herbs like ashwagandha and rhodiola rosea are popular for lowering stress and improving sleep. Before you take any vitamins or herbal supplements, ask a qualified health professional whether they are suitable for you and whether there are potential contraindications with the medications you're taking, if relevant.

Be wary of dietary supplements, herbal or animal-derived, that claim to manage cortisol levels or help with adrenal fatigue. They can contain steroids like dexamethasone and thyroid hormones that may stop the production of cortisol, which is dangerous.

There are numerous causes of high cortisol levels, and some, such as night shift work, may be out of your control. Managing high cortisol comes down to making sustainable lifestyle changes wherever possible. Schedule laughter-filled meet-ups with friends and family members to decompress, or book a therapy session with a mental health counselor to establish techniques to deal with stressors.

If you frequently fly for work, become more cognizant of the time differences between home and your destination so you can change your sleep schedule in the lead-up to trips to avoid jet lag. If you're going through a hectic period at work or home, keep healthy snacks on hand rather than resorting to unhealthy foods that compound the stress on your body. And if your daily life is sedentary, get moving.

Regular health check-ups are crucial to maintaining health and well-being, particularly in older adults. Responsibilities such as caregiving, coupled with chronological aging, take their toll on the body, and a trusted doctor can help you figure out what's going on and how to move forward if you have symptoms of high cortisol levels.

Don't underestimate the effects of behaviors like doom scrolling and excessive screen time. Nature is sometimes the best tonic for stress, so prioritize time outside in green spaces like your local park.

Stress is natural—simply being alive in the world means that you will experience stress. Cortisol spikes are an evolutionary boon for humans to react to real or imagined dangers and survive. But if it feels like you're constantly in survival mode, you need to make changes, or your health will take a beating. High cortisol levels are not something you can feel—testing is key to giving doctors a clearer picture of how cortisol ebbs and flows in your system.

If you have symptoms such as brain fog, fatigue and irritability, sleep disorders, increased thirst and urination, and an increased appetite and weight gain, don't play guessing games. Schedule an appointment with your GP for a safe treatment plan.