Cortisol, also known as stress hormone, plays a pivotal role in the body’s response to stress. It is produced by the adrenal glands, which are located on top of the kidneys. Cortisol helps regulate various physiological processes during stressful situations, including glucose metabolism, immune function, and inflammatory responses. This is not it! Cortisol has many more bodily functions to play which include boosting metabolism, improving the sleep cycle, promoting mood, enhancing the immune system, etc. However, too high and too low cortisol levels can even lead to a plethora of health complications.

What is cortisol?

Cortisol is a steroid hormone produced by the adrenal glands in your body. It is commonly referred to as the body’s primary stress hormone, but it is vital for several bodily functions. The adrenal glands, located on top of the kidneys, produce it and they work with certain parts of your brain to control your mood, motivation, and fear. It provides energy, regulates metabolism, and increases alertness in response to stress. If your cortisol levels are too high or too low, it may cause complications over time.

What is the role of cortisol?

Cortisol is an essential hormone that plays an important role in a number of things your body does, such as:

1. Known for its fight-or-fight reaction, it mobilises energy reserves, helping in the body’s response to stress.
2. It is essential for metabolic functions, which help the breakdown of carbohydrates, fats, and proteins. This boosts metabolism as well.
3. Normal cortisol levels reduce the effects of insulin, keeping blood sugar levels under control.
4. It helps regulate blood pressure and maintains the body’s fluid balance.
5. It acts as an anti-inflammatory and immunosuppressant and helps balance immune responses to fight infections by limiting inflammation.
6. It can help you stay asleep and avoid the risk of wakefulness.
7. It boosts energy by triggering the release of glucose (sugar) from your liver during times of stress.
8. It is also a key component in several hormones, including those controlling sexual and growth functions.

Optimal cortisol levels are necessary to manage these bodily functions. Now let us understand the effect of high and low cortisol levels.

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Causes of high cortisol levels

Here are 5 common reasons that can cause high cortisol levels, also known as hypercortisolism or Cushing’s syndrome:

1. Stress

Chronic stress may trigger adrenal glands to release hormones, which include adrenaline and cortisol. Long-term exposure to cortisol and other stress-related hormones may negatively affect your body, increasing the risk of heart disease, anxiety, depression, and more.

2. Pituitary gland issues

The pituitary gland is located at the base of your brain. Pituitary conditions such as hyperpituitarism (overactive pituitary gland), benign pituitary tumors and cancerous pituitary tumors can stimulate the adrenal glands to overproduce cortisol.

3. Adrenal gland tumors

The adrenal gland is just above each kidney. Adrenal gland tumors, which can be benign (noncancerous) or malignant (cancerous), can increase the level of cortisol. You may also notice symptoms such as a feeling of fullness in your abdomen, even if you are hungry.

4. Medication side effects

Taking large amounts of corticosteroid medications, such as prednisone, prednisolone, or dexamethasone, for a long time can raise cortisol levels.

5. Cushing’s syndrome

This condition can be caused by either excessive production of cortisol by the adrenal glands (adrenal Cushing’s syndrome) or by excessive secretion of adrenocorticotropic hormone (ACTH) by the pituitary gland (Cushing’s disease).

Signs of high cortisol levels

High cortisol causes several symptoms. However, they mostly depend on the cause of high cortisol levels. Read common signs and symptoms of too much cortisol:

• Weight gain, especially in your face and abdomen.
• Acne
• Muscle weakness
• High blood pressure (hypertension)
• Stretch marks on abdomen (belly)
• Excessive hair growth (hirsutism)
• Weak bones (osteoporosis) and fractures.
• Slowed healing
• Severe fatigue and irritability
• Difficulty concentrating and headache

Causes of low cortisol levels

Low cortisol levels, known as hypocortisolism or adrenal insufficiency, can occur due to various conditions affecting the adrenal glands or the pituitary gland. Here are some common causes:

1. Autoimmune disorder

Autoimmune conditions such as autoimmune adrenalitis (also known as autoimmune Addison’s disease) cause the body to mistakenly target and attack healthy cells. This results in insufficient cortisol production, causing a decrease in cortisol.

2. Infections

Certain infections, particularly those affecting the adrenal glands directly, such as tuberculosis or fungal infections, can impair their function and lead to adrenal insufficiency.

3. Traumatic brain injury

Severe head injuries or trauma affect the pituitary gland, which can disrupt the production and regulation of cortisol by the adrenal glands.

4. Addison’s disease

When the adrenal glands do not produce enough cortisol and other hormones, you may develop adrenal insufficiency or Addison’s disease. There are two types of it: primary and secondary.

5. Hypoglycemia

Severe or prolonged episodes of low blood sugar (hypoglycemia), especially in individuals with diabetes who are using insulin, can suppress cortisol production and lead to adrenal insufficiency.

Signs of low cortisol levels

Low cortisol levels can result in symptoms such as:

• Fatigue and weakness
• Unintentional weight loss
• Low blood pressure (hypotension)
• Poor appetite
• Nausea
• Abdominal pain
• Hyperpigmentation, or dark patches of skin

How to manage cortisol?

Cortisol levels can be both high and low. Both can be problematic and lead to several complications.

Tips to reduce high cortisol levels

If you have high cortisol levels, you need to follow these 9 tips to manage it:

1. Practise yoga: High cortisol levels can cause stress. To reduce stress try deep breathing, meditation, or yoga to calm the mind and body.
2. Exercise: Engage in moderate exercise such as walking, jogging, or cycling to reduce cortisol levels and promote overall well-being.
3. Eat healthy: Consume a diet rich in fruits, vegetables, whole grains, and lean proteins.
4. Refrain from certain foods: Avoid excessive caffeine and refined sugars, as these can contribute to cortisol spikes.
5. Say no to alcohol and smoking: Alcohol and smoking can elevate cortisol levels so quit both.
6. Regulate sleep pattern: Poor sleep cycle can cause high cortisol levels so make sure you sleep for at least 7-8 hours each night.
7. Reduce stress levels: If stress is causing high cortisol, engage in activities that bring joy and laughter, such as dancing, playing games, watching movies, etc.
8. Surround yourself with loved ones: Spend some time with friends and family to form healthy relationships and stay happy.
9. Avoid sedentary lifestyle: Whether you are studying or working, taking short breaks between work can help lower cortisol levels associated with prolonged stress.

Apart from these tips, you require medical attention to treat Cushing’s syndrome and manage other symptoms.

Tips to manage low cortisol levels

Cortisol deficiency can cause severe harm to your body, such as Addison’s disease or damage to the adrenal glands. This may need medical attention, which involves hormone replacement therapy. Your doctor may also prescribe medicine to treat low cortisol levels in your body.

When to check with a doctor?

If you experience symptoms indicating excessive or insufficient cortisol levels, consult a healthcare provider. Seek immediate medical help if you experience these symptoms:

• Abdominal pain
• Dizziness or feeling lightheaded
• Low blood pressure
• Decreased consciousness
• Difficulty breathing

Your doctor can run some simple tests to see if your adrenal glands or pituitary glands are responsible for your symptoms.