What is cortisol? How to manage the stress hormone.

It’s 3:00 AM and you are wide awake. Your mind races from one stressful topic to the next. Your heart is racing too, and your muscles are tight. Just when you think you’re about to finally drift off to sleep, your phone buzzes with another notification. If this feels familiar, you’re not alone. 

Stress can keep you up at night. In fact, stress can make you feel sick, depressed, hungry and more. When you are stressed, a hormone called cortisol floods your bloodstream and impacts nearly every system in your body. With constant stress comes the harmful effects of heightened cortisol on the body. Let’s talk about what cortisol is and how it works in your body. Then let’s explore ways to manage it. 

What is cortisol? 

There’s a reason why they call cortisol “the stress hormone.” When you feel physical symptoms of stress, chances are cortisol is involved. 

But despite being “the stress hormone,” cortisol isn’t inherently bad for you. The release of cortisol is part of a larger stress response called “fight or flight.” The human body developed fight or flight to keep us safe from danger. When you are confronted with a threat, chemicals like adrenaline and cortisol help you stay alert and agile enough to either fight or flee from the threat. How? Below are ways that healthy amounts of cortisol help you in dangerous situations:

• Blood sugar management—cortisol tells your liver to produce more glucose, giving you a boost of energy and fuel to act quickly.

• Inflammation—cortisol is a powerful anti-inflammatory agent. It helps keep your immune system from overreacting by suppressing inflammation.

• Blood pressure—cortisol helps with vasoconstriction—when your blood vessels get tighter, which increases blood pressure. The temporary increase in blood pressure helps blood flow to more vital organs during stressful situations.

• Circadian (sleep/wake) rhythm—cortisol helps you wake up in the morning. About 30-45 minutes before you wake up, your cortisol levels are at their highest. Throughout the day, they should decline as part of a healthy rhythm of wakefulness and sleep.

How does too much cortisol impact the body?

As with most things, moderation is key. Cortisol becomes a problem when your body constantly perceives a threat when there isn’t one. Your body doesn’t know the difference between a life-threatening situation and a modern-day stressor like an argument or an email from your boss. So everyday stress can easily keep your body in a state of chronic stress. 

When this happens, your blood is constantly flooded with cortisol. Let’s take a look at how too much cortisol can negatively impact your health:

• Weight management—elevated cortisol promotes fat storage, especially around your belly. It can contribute to excess visceral fat. Visceral fat is associated with many serious health conditions like heart disease and certain cancers. Read more about visceral fat here.

• Blood sugar management—elevated cortisol can raise your blood sugar. Over time, higher blood sugar can contribute to insulin resistance, which can set the stage for developing type 2 diabetes.

• Cardiovascular health—when cortisol is elevated all the time, you may develop high blood pressure, elevated cholesterol levels and a faster heart rate. These metrics may increase your risk of developing or worsening cardiovascular diseases.

• Sleep—too much cortisol can impact your sleep quality and natural sleep rhythms. Sometimes, elevated cortisol can lead to insomnia.

• Mental health—elevated cortisol can lead to increased anxiety and depression. 

How do you know when your cortisol is high?

Care providers don’t usually test for cortisol levels during your annual exam. Your care provider may suggest a blood or urine test for cortisol levels if they believe you may benefit from it. Reasons your provider might suggest a cortisol test may be if:

• They believe you may have an adrenal gland disorder 

• They want to investigate a set of symptoms you’ve been experiencing   

• They want to monitor medication side effects

Sometimes high cortisol levels can be an indication of an underlying medical condition, like Cushing’s syndrome. Let your care provider know if you develop any of the following symptoms associated with high cortisol:

• Weight gain

• Hair loss in women 

• Stretch marks, often red or purple, on the belly

• High blood pressure 

• High blood sugar

• Muscle weakness in your arms and legs 

If your care provider confirms that you have high cortisol, they may do additional tests to see what’s causing it. They may prescribe medication or suggest surgery, depending on the root of the issue. 

If your provider doesn’t believe you need a cortisol test or your levels are within range, it’s OK. Living with chronic stress, even when you don’t know your cortisol levels, can be harmful to your health. The good news is that even if you don’t have a diagnosis, you can still find a healthy balance of stress and relaxation, which impacts your cortisol levels. Keep reading to find ways to help improve your stress management.

How do you manage elevated cortisol? 

Lowering your cortisol depends on what’s causing it to be elevated. Let’s explore some methods and tips to help you balance your cortisol.

Medication—depending on your diagnosis, your provider may prescribe medication. Some medications reduce the production of cortisol while others block your body from using it. 

Stress management—managing stress is one of the best things you can do for your overall health. But how? Check out “Recognizing and managing stress” for helpful tips.

Regular exercise—exercising on a regular basis trains your body to better handle cortisol in the long run. 

Prioritize sleep—sleep helps you recover from all types of stress throughout the day. Make some time to wind down before bed. Create a consistent sleep schedule that you can stick to. Check out these 7 ways to get the best sleep of your life.

Breathe deeply—breathing exercises help trigger “rest and digest.” Think of rest and digest as the opposite of fight or flight. Slow deep-breathing exercises help your body become relaxed, counteracting the effects of stress. Learn more about how deep breathing reduces stress here.