Our hormones are tiny, naturally occurring substances that play a role in virtually every aspect of our health and well-being, including mood, metabolism, and how our bodies respond to stress.
One such pivotal hormone is cortisol. It’s known as the ‘stress hormone’ for a reason, but how does it work? And when can it cause issues? In this article, we’ll explore the vital role of cortisol in your body’s function and shed light on what happens when it gets too high or low.
What is Cortisol?
Cortisol is a hormone that your body naturally produces, and its production is regulated by your adrenal glands. It’s referred to as the “stress hormone” because cortisol is released in your body as a response to stress. You’ll also see an increase when you’re feeling anxious or fearful.
Although it has a bad reputation, cortisol is vital for several essential functions in your body. For instance, it regulates metabolism, blood pressure, and blood sugar, helps with memory formulation, and suppresses inflammation. It’s important, but too much of it can be problematic.
What are Normal Cortisol Levels?
The level of cortisol in the body exhibits a peak during the early hours of the morning and gradually decreases throughout the day, with the lowest level being observed around midnight. However, this natural pattern can be disrupted if you have an irregular sleep schedule due to working night shifts.
The standard cortisol level ranges for most blood tests are 10 to 20 micrograms per deciliter (mcg/dL) between 6 a.m. to 8 a.m. and 3 to 10 mcg/dL around 4 p.m. However, the normal ranges may differ drastically depending on what lab you use and when you do your blood test. Every person is different, so no one number can determine normality.
What Causes Abnormal Cortisol Levels?
Before we get to ways to improve your cortisol levels, such as choosing between therapy and psychiatry, we need to look at what causes abnormally high or low levels in the first place.
What Causes High Cortisol Levels?
Having a high level of stress can cause you to maintain an abnormally high level of cortisol (hypercortisolism), but once the stress diminishes, these cortisol levels will reduce. However, there are conditions that cause hypercortisolism regardless if the patient is undergoing stress.
The causes of higher-than-normal cortisol levels include:
- Cushing’s syndrome (a condition where you produce too much cortisol)
- Taking large amounts of corticosteroid medications for treatment of another alignment
- Tumors that produce ACTH or neuroendocrine tumors found in the lungs
- Adrenal gland tumors that are experiencing a high level of growth
The above conditions are rare, so more than likely, your cortisol level is high due to stress.
What Causes Low Cortisol Levels?
Low cortisol levels are less common than high levels but can cause similar problems as high cortisol. Also known as hypocortisolism, lower-than-normal cortisol is almost always the cause of another condition that causes either primary or secondary adrenal insufficiency.
There are many causes of both adrenal insufficiency:
- Primary Adrenal Insufficiency: Often caused by an autoimmune reaction where healthy cells attack your adrenal gland. This condition is called Addison’s disease.
- Secondary Adrenal Insufficiency: Often caused by an underactive pituitary gland or a tumor that limits ACTH production. Both conditions are considered rare.
You could also have a low cortisol level if you stop taking corticosteroid medications too early.
What Are the Symptoms of Abnormal Cortisol Levels?
The symptoms of abnormal cortisol levels depend on your condition. Since you’re most likely suffering from high cortisol levels due to stress, we’ll focus on these related symptoms first.
The symptoms of long-term stress include:
- Emotional Symptoms: Easily frustrated, agitated, or moody, feeling overwhelmed, having a hard time relaxing, low self-esteem, feeling lonely or worthless, avoiding others.
- Physical Symptoms: Low energy, headaches, upset stomach aches, tense muscles, chest pain, insomnia, frequent colds, loss of libido, nervous shaking, dry mouth.
- Cognitive Symptoms: Consistent worrying, racing thoughts, poor judgment, inability to focus, forgetfulness, disorganized thinking, being more pessimistic than positive.
- Behavioral Symptoms: Changes in appetite (not eating enough or eating too much), procrastinating, overuse of alcohol or drugs, and increase in nervous behaviors.
The symptoms of higher-than-normal cortisol levels (caused by Cushing’s syndrome) include:
- Weight gain
- Purple stretch marks
- Muscle weakness
- High blood sugar and pressure
- Excessive hair growth
- Weak bones
The symptoms of lower-than-normal cortisol levels include:
- Unintentional weight loss
- Poor appetite
- Low blood pressure
Prolonged low or high cortisol levels can cause a number of consequences, including mental health problems, cardiovascular disease, obesity, sexual dysfunction, gastrointestinal problems, skin and hair issues, and menstrual problems. It’s important to seek help if you have symptoms.
How Can I Improve Abnormal Cortisol Levels?
Improving abnormally high or low cortisol levels, if they aren’t caused by stress, almost always involves medical intervention. In the case of Cushing’s syndrome; chemotherapy, medications, radiation, and surgery can help minimize or prevent symptoms from causing further damage.
In the case of low cortisol not caused by stress, a doctor will need to address the direct cause. For example, if low cortisol is caused by Addison’s disease, the doctor will treat said condition. If low cortisol is caused by a tumor, a surgeon will remove it to prevent worsening symptoms.
If high cortisol is caused by stress, you can try the following lifestyle interventions:
- Get 7-9 hours of quality sleep each night
- Exercise at least 30 minutes a day
- Limit stressful events or thinking patterns
- Try deep breathing or meditation exercises
- Do something you enjoy or that makes you laugh
- Maintain healthy relationships with loved ones
If your stress progresses to the point it’s unmanageable, you may need to see a psychiatrist or therapist. Cognitive-behavioral therapy and anti-anxiety medication may help you.
Understanding your body’s intricate workings, such as the function of cortisol, can be a powerful tool in maintaining optimal health. Remember, while stress can’t always be avoided, managing how you react to it can make all the difference. From modifying lifestyle habits to seeking medical advice when needed, you have control over your wellness and health journey.