The signs of high cortisol levels and how to manage

What is cortisol?

Cortisol is a hormone that plays a key role in how you respond to stress.

For example, if you’re in danger, your body releases adrenaline and cortisol hormones. These increase your heart rate and energy levels so you can quickly react if you're in danger.

Additionally, cortisol also helps:

• regulate your blood pressure
• regulate the metabolism of carbohydrates, fats, and proteins 
• regulate the effects of insulin, a hormone that controls your blood sugar levels
• manage inflammation
• maintain your sleep-wake cycle

While cortisol gets a bad rap, it’s important for your health and survival. It only becomes problematic if your cortisol levels are chronically elevated.

What are the signs and symptoms of high cortisol levels?

Your cortisol levels fluctuate throughout the day, which means that having high levels for brief periods of time is completely normal. Brief moments of stress during work, your commute, or when picking up kids cause temporary spikes in cortisol that are quickly resolved.

However, prolonged exposure to high cortisol levels can cause problems. Over time, consistently elevated cortisol levels can contribute to hypothalamic-pituitary-adrenal (HPA) dysfunction.

This can cause a myriad of issues, including:

• weight gain
• fatigue
• acne
• thinning hair
• bruising and slow wound healing
• muscle weakness
• low sex drive
• high blood sugar
• irregular periods
• anxiety and depression
• sleep problems
• difficulty concentrating

Over time, chronically elevated cortisol can increase your risk of heart disease, osteoporosis, diabetes, and poor mental health. Chronic exposure to high cortisol, usually from steroid medications, can cause a condition called Cushing's syndrome.

What causes high cortisol?

Temporary increases in cortisol are completely normal. However, having consistently elevated levels may be a sign that something's wrong.

Possible causes include:

• Physical and emotional stress: Your body can't gauge the seriousness of a stressful situation, meaning a simple traffic jam can spike your levels and keep them there.
• Medication: Certain medications, like corticosteroids and oral contraceptives, may increase your cortisol levels.
• Oestrogen: High oestrogen levels in women (e.g. during pregnancy) are linked to elevated cortisol levels.
• Pituitary gland dysfunction: An overactive pituitary gland stimulates your adrenal glands to make too much cortisol.
• Adrenal gland tumour: While very rare, your adrenal glands produce cortisol, so any issues with them can affect your cortisol levels.

Additionally, mental health conditions, diabetes, and PCOS are also linked to high cortisol levels.

How to test your cortisol levels

A blood, saliva, or urine test can be done to measure your cortisol levels.

Cortisol blood test

In most cases, a blood test is used to diagnose the conditions Addison's disease (where the body doesn't produce enough cortisol) and Cushing's syndrome (where it produces too much cortisol).

Cortisol urine test

Cortisol levels vary significantly throughout the day, being at their highest in the morning and lowest in the evening. If you're testing your cortisol, you may be asked to take multiple samples throughout the day.

Treatment and management for high cortisol

If your cortisol levels are high, how you lower them will depend on the underlying cause.

For example, if it’s because of a medication you're taking, you'll need to work with your GP or health professional to lower them. If it’s because of chronic stress, lifestyle changes can help yoy manage your levels.

You can try to:

• Practise mindfulness: Mindfulness practices are an evidence-backed way to reduce your stress. Try a daily meditation app or yoga classes.
• Make sleep a priority: Getting enough good quality sleep really matters for your stress levels. Do your best to get at least seven hours of sleep per night.
• Break a sweat — Research shows that regular physical activity can reduce stress levels. We think the best way to exercise is to pick something you really enjoy, whether that's running outdoors, lifting weights in a gym, or going to your favourite fitness classes.
• Fill your plate with colour: Nutrient-dense, Mediterranean-style eating patterns have been shown to benefit your overall health and cognitive function. Try adding more fruits, vegetables, whole grains, nuts, seeds, and oily fish.

Takeaway

Chronically high cortisol can cause issues like fatigue, anxiety, weight gain, and increase your chances of heart disease and diabetes.

If stress is the culprit, you can manage your levels through lifestyle changes like meditation, prioritising sleep, regular exercise, and eating a nutrient-dense diet.