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Warning Signs of High Cortisol Levels, Plus What Causes It

6 min read

By Clarissa Vanner

  • It’s normal to have high levels of cortisol from time to time but chronic high levels can wreak havoc in the body.
  • If you have symptoms and your doctor thinks your cortisol levels are to blame, testing can be done to check your levels.
  • The type of treatment you need will depend on the root cause.

Everyone produces cortisol and it has an important role as it affects almost every organ and tissue in your body. While it’s normal to have high levels of cortisol occasionally — after all,  it’s a natural response to stress — chronic high levels can wreak havoc in the body.

So, what exactly is cortisol and how can you spot the warning signs of high cortisol levels? We’ll answer that and more in this article!

What Is Cortisol?

The Cleveland Clinic explains that cortisol is a “glucocorticoid hormone,” that is produced and released by the adrenal glands. The source says that glucocorticoids are a type of steroid hormone that suppresses inflammation in your body’s tissues. It also helps control metabolism in the muscles, fat, liver, and bones, and it affects your sleep-wake cycle.

The adrenal glands (also known as suprarenal glands) that produce and release the hormone are small, triangle-shaped glands located on top of the kidneys. The source also notes that they’re part of the endocrine system.

Is Cortisol Bad?

The short answer is no, cortisol is not bad. Even though it gets a bad reputation, it does play an integral role in your health. That said, cortisol can become a concern if the levels are too high for long periods.

So, how can cortisol benefit your health? The Cleveland Clinic says cortisol affects almost every organ and tissue in the body. It plays a vital role in the following:

  • Regulating blood sugar
  • Regulating blood pressure
  • Reducing inflammation
  • Regulating metabolism
  • Helping control your sleep-wake cycle
  • Regulating your body’s stress response.

How Does the Body Control Cortisol Levels?

The Cleveland Clinic explains that it all comes down to the hypothalamus. This is a small area in the brain that has an important role in regulating hormones. The source says the hypothalamus and the pituitary gland (located below the brain) work together to regulate the production of cortisol in your adrenal glands.

What does that process look like exactly? It’s a chain reaction. The source says, when levels of cortisol dip, the hypothalamus releases a “corticotropin-releasing hormone (CRH),” which then tells the pituitary gland to produce “adrenocorticotropic hormone (ACTH).” The ACTH then tells the adrenal glands to produce and release cortisol.

Warning Signs of High Cortisol Levels

Chronic high levels of cortisol can wreak havoc on your body. If high levels persist and symptoms develop, this can cause Cushing’s syndrome, explains Thriva. Be on the lookout for these warning signs of high cortisol:

  • Weight gain, especially around the stomach, upper back, and face
  • Fatigue
  • Acne
  • Thinning hair
  • Getting sick often
  • Bruising and slow-healing wounds
  • Weak bones
  • Muscle weakness
  • Low libido
  • High blood sugar
  • Irregular periods
  • Anxiety and depression
  • Sleeping problems
  • Difficulty concentrating

What Causes High Cortisol Levels?

Several things can cause high cortisol levels. One possible cause is physical and emotional stress. Something simple like a work deadline can trigger the stress response system. Falling ill with the common cold can also cause stress in the body. According to Thriva, other possible causes of high cortisol levels include:

  • Malnutrition (for example, suffering from an eating disorder)
  • A pituitary gland problem (for example, an overactive pituitary gland will stimulate the adrenal gland to make too much cortisol)
  • An adrenal gland tumor
  • Certain medications

Warning Signs of Low Cortisol Levels

Sometimes cortisol levels can be too low, which can present different symptoms. If this occurs, the Cleveland Clinic says it’s known as adrenal insufficiency. Though the illness is rare, the source says the following are possible warning signs of low cortisol levels:

  • Unintentional weight loss
  • Poor appetite
  • Fatigue
  • Low blood pressure (hypotension)

What Causes Low Cortisol Levels?

The Cleveland Clinic explains that there are two types of adrenal insufficiency that can cause lower-than-normal cortisol levels, including primary and secondary. Primary adrenal insufficiency is typically caused by “an autoimmune reaction in which your immune system attacks healthy cells in your adrenal glands for no known reason,” which is known as Addison’s disease. The adrenal glands may also be damaged from an infection or blood loss to the tissues.

Secondary adrenal insufficiency occurs when you have an underactive pituitary gland or a pituitary tumor. This can limit ACTH production, which in turn, can limit cortisol production. Finally, the source also notes that low cortisol levels may also occur after stopping treatment with a corticosteroid medication, especially if you stop abruptly.

When to See a Doctor

Chronically high cortisol levels can put your health at risk. Thriva says it can increase your risk of heart disease, osteoporosis, diabetes, and poor mental health. Unaddressed adrenal insufficiency can also lead to life-threatening complications. So, it’s important to contact your doctor if you’re experiencing symptoms of high or low cortisol levels.

If you think daily stress is contributing to your high cortisol levels you should also talk to your doctor. They can help you develop healthy steps to decrease your stress and keep you healthy.

How Are Cortisol Levels Tested?

If you have symptoms and your doctor thinks your cortisol levels are to blame, testing can be done to check your levels. Thriva says the most common cortisol test is a blood test. The source says the test is usually scheduled in the morning when your cortisol levels are usually at their highest.

Another possible test is a cortisol urine test. This involves collecting all of your urine over the course of a day. This test can help provide insight into how your cortisol levels change throughout the day.

How Is Cushing’s Syndrome Treated?

The Cleveland Clinic says if you have very high levels of cortisol and your doctor diagnoses Cushing’s syndrome, medical treatment is necessary. But the type of treatment you need will depend on the root cause. For example, the Mayo Clinic says if the disease was caused by medication, then your doctor may lower the dosage to see if your symptoms improve.

If the disease is caused by a tumor, then surgery will likely be necessary to remove it. The recovery process requires cortisol replacement medication until your adrenal hormone production returns to normal. However, the source notes that this can take up to a year (or longer), and in some cases, the patient may need lifelong replacement therapy. Radiation therapy may also be necessary with surgery if the surgeon isn’t able to remove the tumor completely.

Finally, the source also notes that medication may be a suitable treatment option for Cushing’s syndrome. To determine which treatment option is best for you, it’s important to follow the advice of your medical team.

Learn to Manage Stress to Lower Cortisol Levels

Stress can be a major contributor to high cortisol levels. So, learning to limit and manage your stress is a great way to keep your cortisol levels in check. The Cleveland Clinic says you can do this by being aware of your thinking patterns and learning ways to change your thoughts and behaviors. Sometimes, therapy may be necessary to help you learn healthy coping skills.

Other ways to reduce stress include practicing deep breathing exercises, mindfulness, and meditation. The source explains that controlled breathing can help “stimulate your parasympathetic nervous system,” which can help lower cortisol levels. Find what works best for you and lean on these coping strategies when you feel stressed.

Other Healthy Ways to Manage Cortisol Levels

There are other healthy habits you can start doing that can help keep your cortisol levels in a healthy range. The Cleveland Clinic says getting good quality sleep every day is a good place to start. If you have any chronic sleep problems, such as insomnia or sleep apnea, make sure you address them with your doctor. The source says these disorders are associated with higher cortisol levels.

Exercising regularly can also help manage cortisol levels. The source says exercise can help improve sleep and reduce stress, both of which contribute to more optimal cortisol levels. Plus exercise offers tons of other health benefits too.

The source also notes that laughing can release endorphins and suppress cortisol. And enjoying yourself by engaging in activities you like may also lower cortisol levels. Finally, being mindful of your relationships can also help. Stressful and unhealthy relationships may cause your cortisol levels to spike, so it’s important to maintain healthy relationships and set boundaries when you can’t resolve an unhealthy relationship.

BSN, CCRN

Patty is a freelance health writer and nurse (BSN, CCRN). She has worked as a critical care nurse for over 10 years and loves educating people about their health. When she's not working, Patty enjoys any outdoor activity that she can do with her husband and three kids.

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