Hormones are responsible for governing many crucial systems and processes. One of the most important is cortisol, which may cause a host of problems if it rises out of its normal range. Some symptoms are well known, but doctors say there are surprising signs of high cortisol worth noting.
“Cortisol is a complex molecule manufactured by the adrenal glands, which has many metabolic functions throughout the body,” says David Cutler, M.D., a family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA. “It is essential in controlling our growth, organ development, immune functions, inflammatory response, and many other cellular activities.” Still, many people know cortisol as the “stress hormone,” rising in times of stress so that you can stay alert and deal with any potential dangers.
Meet the experts: David Cutler, M.D., a family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA; Brynna Connor, M.D., a family medicine physician in Austin, TX and the healthcare ambassador at NorthwestPharmacy.com.
Here, experts share the most common signs of high cortisol levels, plus some causes that may be behind a spike, and when you should act.
Signs of high cortisol
“The transient rise or lowering of cortisol levels is normal and in fact happens on a daily basis as cortisol levels peak upon awakening and bottom out shortly after bedtime,” Dr. Cutler explains. But cortisol levels can get stuck on high, which may lead to a host of problems. “Because cortisol is the body’s primary stress hormone, when levels are chronically elevated, it essentially means that the body is existing in a constant state of stress,” says Brynna Connor, M.D., a family medicine physician in Austin, TX, and the healthcare ambassador at NorthwestPharmacy.com. “Persistent stress and chronically elevated cortisol levels can have significant negative effects on your health.”
Here are some of the most common signs of excess cortisol.
Weight gain
“The disruption of metabolism due to chronically elevated cortisol levels is directly associated with fat storage and weight gain, especially visceral fat, which is the type of fat stored in the midsection,” says Dr. Connor. She adds that high cortisol can also reduce insulin sensitivity, further increasing the likelihood of weight gain. “When cortisol levels are elevated, the body naturally begins to store fat in the abdomen as a survival instinct designed to protect the internal organs, particularly the liver, kidneys, and intestines, as a way to protect them from shock, a.k.a. the perceived stress,” Dr. Connor explains. “This weight gain also often occurs without any changes in diet and/or exercise that would cause the increase to occur.”
Muscle weakness
Cortisol plays a key role in helping the body break down protein and fat into forms that it can use for energy, Dr. Connor says. But when cortisol is high, this can end up damaging the muscles. “When cortisol levels are chronically elevated, it accelerates the breakdown of proteins within the body, which can cause muscle weakness, thinning of the skin, and increased bruising,” says Dr. Connor.
High blood pressure
“Excess cortisol production typically causes high blood pressure,” says Dr. Cutler. While the exact link between cortisol and blood pressure is unclear, a study in the journal Hypertension found that people with high levels of cortisol and other stress hormones were more likely to develop high blood pressure and experience cardiovascular events than those with lower stress hormone levels.
Poor sleep
“Cortisol levels should be at their lowest overnight when you’re asleep. If your cortisol levels are chronically elevated, it disrupts the natural release of the hormones that cause you to fall and stay asleep,” Dr. Connor explains. If you’re not sleeping well, it may lead to a host of other problems, from fatigue and low energy to poor heart health.
Puffiness in the face
“It’s important to note that chronically high cortisol levels aren’t only caused by stress,” Dr. Connor says. “Cushing’s syndrome is a medical condition in which cortisol levels are elevated, and it requires medical attention to help regulate them.” It’s also the most likely cause behind puffiness in the face (a.k.a. cortisol face, or moon face), particularly around the cheeks and jaws and under the eyes, which Dr. Connor notes as other possible signs of high cortisol.
What causes high cortisol?
While chronic stress and conditions like Cushing’s syndrome may cause elevated cortisol levels, they are not the only possible reasons. “Cortisol levels can also be affected by physical illness, fever, sleep deprivation, inflammation, pregnancy, and emotional factors,” Dr. Cutler says. “In addition to internal factors, external factors such as diet, alcohol, caffeine, prescription medication, and nutritional supplements can also affect cortisol levels.” What’s more, Dr. Cutler notes that the above symptoms may also be caused by something other than a cortisol imbalance, especially considering that “there is a very wide range of ‘normal’ levels of cortisol.”
When to see a doctor
Ultimately, “diagnosing cortisol abnormalities can be challenging and sometimes erroneous,” he says. “Levels may seem abnormal when, in fact, there is no disease. And subtle symptoms may be found to be the result of cortisol abnormalities after more common causes have been excluded.” If you are experiencing any of the above symptoms alongside any big changes to your daily routine or your health, it may be worth asking your doctor about your cortisol levels.
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