Learn about Cortisol: Function and Health Effects

You’ve probably heard the word “ cortisol .” Some say it’s the body’s main “stress hormone.” But cortisol does much more than just respond to stress, it’s a hormone that’s essential to our daily health. Understanding how cortisol works—what it does in our bodies, what happens when its levels are out of whack, and how to control it—can help you better understand your health. In this article, we’ll take a look at this important hormone from a medical perspective.

What is cortisol?

Cortisol is a steroid hormone in the group of glucocorticoids. It is produced and secreted by the adrenal glands, which are located above your kidneys. Cortisol acts like the body’s alarm system. It also helps manage many important processes that occur regularly in the body. Its production is controlled by a complex network of communication between the brain (specifically the hypothalamus and pituitary gland ) and the adrenal glands.

The various functions of cortisol: beyond the stress response

Although stress management is a major function, cortisol actually affects almost every organ system in the body. Here are some of its main functions:

1. Controlling the body's stress response

When a short-term or long-term stressor occurs, the body quickly releases hormones like adrenaline to respond (e.g., “fight or flight”). Cortisol joins in, helping to keep the body alert and provide the necessary energy. It does this by releasing glucose – aka sugar – from the liver. This is what provides the energy needed to deal with the stress.

2. Metabolism and blood sugar control

Cortisol is essential for metabolism – the way the body uses energy – and it also helps regulate blood sugar levels by regulating the production of insulin and glucagon, and the use of glucose by fat , muscle and liver cells.

3. Controlling Inflammation

In the short term, cortisol acts as a natural anti-inflammatory, helping to reduce inflammation . However, if cortisol levels are high for a long time, it can have the opposite effect. That is, it can increase inflammation and weaken the immune system over time.

4. Managing blood pressure

Although the exact mechanism by which this happens is not fully understood, it is known that cortisol also plays a role in regulating blood pressure. High and low cortisol levels are associated with low and high blood pressure, respectively.

5. Affecting the circadian rhythm

Cortisol levels naturally rise and fall throughout the day. They peak just before you wake up in the morning and drop to their lowest levels at bedtime. This circadian rhythm is important for both good sleep and waking up refreshed.

What if cortisol levels are too high? (Hypercortisolism)

Having high cortisol levels all the time (a condition called Cushing's syndrome) is not good for your health. It is rarely caused by everyday stress alone. The most common causes are:

• Medications: Long-term use of high doses of corticosteroid medications (e.g. prednisone).
• Tumors: Tumors in the pituitary gland or adrenal glands cause excessive production of cortisol or the hormones that stimulate its production (especially ACTH – Adrenocorticotropic hormone).

Common symptoms of high cortisol levels:

People who have had high cortisol levels for a long time may experience these symptoms:

• Significant weight gain, especially in the face (“moon face”) and abdomen. There may also be thinning of the limbs.
• Fat deposits behind the shoulders (“buffalo hump”).
• Wide, purple stretch marks, especially on the stomach.
• Muscle weakness.
• Increased blood sugar (glucose) levels (this can lead to type 2 diabetes).
• High blood pressure (Hypertension).
• Easy bruising.
• Fragile bones (osteoporosis).
• In women, hair follicle growth (hirsutism) or irregular menstrual periods, similar to men.

What if cortisol levels drop too low? (Adrenal Insufficiency)

Adrenal insufficiency is an abnormally low level of cortisol. This means that the adrenal glands are not producing enough cortisol. The main reasons for this are:

• Primary adrenal insufficiency (Addison's disease): This is usually caused by an autoimmune condition. This means that the body's own immune system attacks the adrenal glands. Infection or other damage can also cause it.
• Secondary Adrenal Insufficiency: Problems with the pituitary gland (such as tumors or underactive pituitary gland) cause a decrease in the production of ACTH (Adrenocorticotropic hormone), which signals the body to make cortisol. It can also occur after suddenly stopping long-term corticosteroid medication.

Symptoms of low cortisol levels:

People with low cortisol levels may experience these symptoms:

• Persistent severe fatigue and a feeling of weakness.
• Weight loss for no reason.
• The food is tasteless.
• Low blood pressure (hypotension) (may cause fainting upon standing).
• Nausea, vomiting, or stomach upset.
• Muscle or joint pain.
• Browning of the skin (hyperpigmentation) (in Addison's disease).

Cortisol Control: Lifestyle or Medical Treatment?

There is something important we need to understand: managing normal cortisol levels, which vary with the activities of the day, is one thing, and treating medical conditions that cause abnormal changes in cortisol levels is another.

Lifestyle tips for balanced cortisol levels:

A person who is not suffering from any major illness and is trying to manage stress and balance cortisol levels can do the following:

• Prioritize sleep: Get enough, quality sleep every day. Consistently lacking sleep increases cortisol levels.
• Exercise: Exercise that involves moving your body helps reduce stress and maintain body rhythms.
• Practice calming practices: Deep breathing, meditation, and yoga stimulate the body's "rest and digest" (parasympathetic) system. This works against stress hormones.
• Maintain good social relationships: Good relationships with loved ones act as a buffer against stress.
• Make time for fun: Laughing and having fun release endorphins, which help reduce cortisol.

Medical treatments for cortisol imbalances:

If you have a condition like Cushing's syndrome or adrenal insufficiency, lifestyle changes alone aren't enough. Medical treatment is essential. These may include:

• Medications: Reduce cortisol production, block its effects, or (if low) provide it externally (replacement therapy).
• Surgery: If there are tumors that are producing too much cortisol, remove them.
• Tapering corticosteroid medication: If the increased cortisol is due to medication.

When should you seek medical advice?

If you continue to have symptoms related to high or low cortisol levels, be sure to see a doctor. If you have unexplained weight changes, persistent fatigue, feeling lethargic, blood pressure issues, or any of the other symptoms mentioned above, tell your doctor. They can then perform the necessary tests (blood, urine, saliva) to check your cortisol levels and find the cause. Self-diagnosing yourself or going after things like “adrenal fatigue” (not a formally recognized medical diagnosis) can delay getting proper treatment.

Reliable information about cortisol

Cortisol is a very important and powerful hormone. Understanding how it works and the symptoms of imbalances can help you stay healthy.