When To See A Doctor
If you are experiencing symptoms of Addisons disease or Cushings syndrome or otherwise suspect that your cortisol level is too high or too low, make an appointment with your primary care doctor and/or an endocrinologist for diagnosis.
The doctor can order tests to measure the level of cortisol in your urine, blood, or saliva. The urine test is often done over the course of a full 24 hours , since cortisol levels naturally vary throughout the day.
Depending on the results of the cortisol tests, your doctor might order further testing or imaging or start you on treatments to get your cortisol levels back to normal.
The Mayo Clinic. Chronic Stress Puts Your Health At Risk. July 8, 2021. Accessed January 5, 2022.
You and Your Hormones: An Education Resource from the Society for Endocrinology. Cortisol. Last reviewed January 2019. Accessed January 5, 2022.
Hormone Health Network . What Is Cortisol? Last updated November 2018. Accessed January 5, 2022.
Hormone Health Network . Cushing Syndrome. Last updated October 2019. Accessed January 5, 2022.
National Institute of Diabetes and Digestive and Kidney Diseases . Cushing’s Syndrome. Last reviewed May 2018. Accessed January 5, 2022.
National Library of Medicine , MedlinePlus. Cortisol Test. Accessed January 5, 2022.
What Causes Low Levels Of Cortisol
Having lower-than-normal cortisol levels is considered adrenal insufficiency. There are two types of adrenal insufficiency: primary and secondary. The causes of adrenal insufficiency include:
- Primary adrenal insufficiency: Primary adrenal insufficiency is most commonly caused by an autoimmune reaction in which your immune system attacks healthy cells in your adrenal glands for no known reason. This is called Addisons disease. Your adrenal glands can also become damaged from an infection or blood loss to the tissues . All of these situations limit cortisol production.
- Secondary adrenal insufficiency: If you have an underactive pituitary gland or a pituitary tumor, it can limit ACTH production. ACTH signals your adrenal glands to make cortisol, so limited ACTH results in limited cortisol production.
You can also have lower-than-normal cortisol levels after stopping treatment with corticosteroid medications, especially if you stop taking them very quickly after a long period of use.
What are the symptoms of low cortisol levels?
Symptoms of lower-than-normal cortisol levels, or adrenal insufficiency, include:
Regular Excess Alcohol And High Caffeine Consumption
Drinking too much alcohol on a regular basis can cause cortisol levels to rise. One study involving over 3,600 men and women found that alcohol consumption increased cortisol secretion in the body. The increased cortisol levels happen because alcohol affects the HPA axis.
Caffeine also increases cortisol secretion in people at rest or people undergoing mental stress.
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Why Too Much Of A Good Thing Is Bad For You
If your entire life is high-stress and always in high gear, your body may constantly pump out cortisol. “This has several negative effects,” says Dr. Mawri.
Get Consistently Good Sleep
This tip can be a tricky one to implement since, as Dr. Gottfried explained, there is often a vicious cycle of poor sleep-high cortisol levels-repeat that needs to be broken. But she maintains that doing what you can on the sleep front is crucial. Establish an evening routine, invest in blackout shades, find a mattress you lovewhatever will help you get those eight hours a night will help break the high cortisol-perpetually tired cycle.
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What Happens When You Have High Cortisol Levels
Before I tell you how to regulate high cortisol levels, I am going to tell you something that may surprise you: if you do nothing in order to lower the high cortisol levels, the next stage of cortisol imbalance is actually lower cortisol levels. Unfortunately, this is not as good as you would think.
As you live in stress with high cortisol levels for a while, your body recognizes that the chronic elevated cortisol levels are damaging to the body. So in order to protect you, a disconnection happens between the brain and the adrenal glands. The brain no longer signals the adrenals to produce it as much .
You would think this is good, but what happens is that now you have lower than normal cortisol levels so you struggle with energy, may feel dizzy and weak, have sugar cravings, and you may still not be able to sleep very well. Often when the cortisol is low, it will still have a higher than normal spike at night and that will make it hard to fall asleep, in spite of being tired.
Treatment Of Cushings Disease
Microsurgical resection of an ACTH-secreting pituitary adenoma is the optimum treatment for Cushings disease with cure rates of 80-90 percent if a tumor is found. Surgery is most often done through a transnasal transsphenoidal approach, which will not leave a visible scar. This type of surgery may be performed, per the surgeons preference, using either a minimally invasive operating microscope or with the use of an endoscope. Partial removal of the pituitary gland may be used in patients without clearly identifiable adenomas.
In patients to whom a remission is not obtained after surgery, the use of various medications that can inhibit cortisol production may be used, such as:
These agents are not as effective as surgery and are considered a secondline course of treatment. In some patients who are particularly resistant to all forms of therapy, removal of the adrenal glands bilaterally may be considered.
Post-surgery, with successful tumor removal, the production of ACTH drops below normal. This decrease is natural and temporary, and patients are prescribed a synthetic form of cortisol such as hydrocortisone or prednisone to compensate this change. Most patients can discontinue replacement therapy within six to 12 months, but others may require the use of oral steroids for several years to, possibly, their lifetime. Patients who need adrenal surgery may also require steroid replacement therapy.
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Reducing Excess Cortisol Levels
In general, one of the most effective ways to lower your cortisol levels is to lower your stress level. Here are some stress management tips that could help:
- Breathing exercises and meditation may be a good place to start
- Set aside time for long walks in nature where you can clear your head
- Make sure youâre eating healthy foods and are filling your body with the fuel of fresh vegetables, fruit, and hearty whole grains
- Stay connected with family and friends and find someone you can talk to about life stressors, whether thatâs a mental health professional or a close friend
- Focus on creating a regular sleeping routine and stick to it as much as possible
The Cortisol Rhythm Plays To Its Own Tune
Aside from intermittent stressors that trigger the fight-or-flight response , did you know that your bodyâs cortisol production follows its own circadian rhythm?
Normal individuals with a healthy functioning cortisol rhythm have cortisol levels that reach their lowest point at midnight, followed by a build up overnight to peak first thing in the morning. Cortisol volume is typically high when you wake up and surges for 50-60% in the first 30-45 minutes after youâve awakened. This is called the cortisol awakening response .
The cortisol load then drops rapidly past this early morning spike before gradually declining throughout the day to reach its minimum level around bedtime so you can wind down and go to sleep.
Scientists call this everyday phenomenon the cortisol diurnal rhythm or cortisol circadian rhythm. If youâre wondering who is the conductor of this rhythm, the suprachiasmatic nucleus in the hypothalamus, which is also the principal circadian clock of the brain, acts as the catalyst for cortisol production via the HPA axis.
Across 24 hours, the normal range for healthy salivary cortisol levels looks like this:
- 7 a.m. to 9 a.m.: 100-750 ng/dL
- 3 p.m. to 5 p.m.:< 401 ng/dL
- 11 p.m. to 12 a.m.:< 100 ng/dL
If your cortisol test results exceed the bracketed values above, youâre likely facing an unhealthy cortisol surplus.
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How To Lower Your Cortisol Levels
If your cortisol levels are high, how you lower them will depend on the underlying cause. If its because of issues with your pituitary gland, adrenal glands, or medication youre taking, youll need to work with your GP or health professional to lower them. If its because of chronic stress, there are lots of lifestyle changes you can make to lower your stress levels:
- enjoy yourself do something you love every day, like dancing or listening to music, to improve your mood
- practice mindfulness for example, daily meditation or yoga
- connect with your friends, family, and even your pet a strong social support system is important for your mental health
- make sleep a priority do your best to get at least 7 hours of sleep every night
- break a sweat aim for at least 75 vigorous minutes of activity or 150 minutes of moderate aerobic activity each week
- eat a healthy diet aim for a lot of fruit, vegetables, whole grains, nuts, seeds, and oily fish
- breathing exercises for example, deep nose breathing or counting breaths
- try a supplement omega-3, vitamin B-complex, magnesium, L-theanine, lemon balm, valerian root, and ashwagandha are linked to lower cortisol levels
Does Dark Chocolate Reduce Cortisol
Eating chocolate makes us happy it is undoubtedly a hero in stressful times. Some experts have revealed that the flavonoids contained in dark chocolate, which belong to the antioxidants, inhibit the secretion of cortisol and adrenaline.
In 2014 a study investigated the effects of dark chocolate on cortisol levels. One-half of study participants ate half a bar of chocolate and the other half, the placebo group, ate chocolate without flavonoids. Afterward, they all had to pass a stress test. For the participants that ate dark chocolate, the levels of the stress hormones cortisol and adrenaline increased at a slower rate. Thus, the higher the flavonoid blood levels, the smaller the increase of stress hormones.
Due to their chemical bond, antioxidants can slow down or even stop the oxidation of other substances. Antioxidants can be found in their natural form, but due to their positive health effects, they are increasingly synthetically made. The most well- known antioxidants are vitamin C, vitamin E, micronutrients such as zinc and selenium, carotenoids, and beta-carotene.
To find out more about the health benefits of chocolate, head over to our Health Portal article.
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Natural Stress Relief: How Do You Relieve High Cortisol Symptoms
Apart from successful treatment or curing the underlying disease, which help to regulate stress, there are further ways to restore low cortisol levels without drugs.
- Give your body the chance to regenerate! Sufficient high-quality sleep helps to reduce stress. There are various sleep improvement supplements you can take these days to boost the quality of your sleep.
- Do sport! Sport helps to relieve stress and can optimize cortisol levels.
- Allow time for relaxation! Bring in those stress management techniques. You can read about these techniques in our article on emotional resilience.
- Take time to spend time with important people on a regular basis! By doing this, you activate the feel-good hormone oxytocin. It is released as a result of physical contact and lets your cortisol levels recover.
How Do You Relieve Stress Quickly
For some, drinking a cup of tea and reading a book already helps to come to rest. For others, a punching bag or other sports help to relax. All of these have in common that they improve our perception of stress, but they dont tackle the source of high cortisol levels in the long run. Certain targeted relaxation techniques, often paired with exercise, have been shown to lower stress levels. This has a positive influence on not only your mind but also physiological factors such as your blood pressure, pulse, and breathing rate.
These relaxation techniques include yoga, tai chi, autogenic training, and progressive muscle relaxation, but also other types of meditation and mindfulness training. Some of these techniques are easy and quick to learn for example via online videos. Others need some practice and coaching, but the good news is that most people can benefit from them after a short time.
Studies furthermore reveal that regular physical activity can reduce stress and lower the risk of depression and anxiety. At the same time, exercise improves your cardiovascular health and thus counteracts possible long-term consequences of chronic stress.
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Natural Ways To Lower Cortisol Levels
There are several things that you can do to lower your stress levels, reduce the effects of stress on the body, and improve your overall health and well-being. Here are some common ways to help rebalance your cortisol and promote good health.
- Sleep When you sleep, how much sleep you get, and the quality of your sleep all impact your cortisol levels. We recommend keeping a consistent sleep schedule, creating an environment for uninterrupted sleep , turning off electronics an hour before bedtime, and avoiding caffeine in the evening can help you get the recommended 7 to 9 hours of sleep each night, which will help decrease your cortisol.
What Are The Symptoms Of High Cortisol
Following are some of the symptoms of high cortisol levels
Abnormal Blood Sugar
Cortisol infuses glucose into the body in case of stressful conditions. However, an increased level of cortisol continuously produces glucose. This results in an increased level of glucose in the blood. A high level of cortisol also reduces the sensitivity of cells towards insulin leading to a further increase in glucose levels.
A high level of cortisol causes weight gain, especially in the abdominal area. This may probably be due to two reasons. First, the fat cells present in the abdominal area have a high number of cortisol receptors as compared to fat cells in other areas. Further, glucose does not reach the cells and the body gets exhausted due to lack of energy. This may lead to increased hunger and sugar cravings.
High levels of cortisol narrow down the arteries. This leads to increased blood pressure and increased risk of plaque build-up. This may also cause damage to arteries.
When the body is under stress and cortisol is released, the digestive functions come to a halt until the stress gets over. However, prolonged high levels of cortisol may have a negative effect on the digestive disorder.
Various other symptoms of high cortisol levels include muscle weakness, slow healing, irritability, headache, thinning skin, irritability, acne, poor concentration, and fatigue.
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Reset Your Circadian Rhythms
We all know good sleep is paramount to good health. One reason sleep matters so much is that it involves the fluctuation of and connection between melatonin and cortisol, two hormones directly related to stress and overall bodily health. Practice healthy sleep habits by sleeping and waking at the same time each day, striving for at least 7 hours of uninterrupted rest, and limiting electronics use in the hour before bedtime. Also try to get plenty of sunshine in the morning and at midday to further stabilize your bodys circadian rhythms.
Get Enough Quality Sleep
One of the ways to prevent suffering from the symptoms of high cortisol is to get enough sleep.
The reason that not getting enough sleep impacts your health so much is that it affects the HPA axis and cortisol levels. Scientists have found that getting quality sleep is just as important as getting enough sleep to help maintain proper cortisol levels.
Excess cortisol levels are just one of the ways a lack of sleep affects your body. Find out what else happens to your health when you dont get enough sleep.
If you have trouble getting to sleep, find out which foods can help to get a better nights sleep.
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High Cortisol: Symptoms And Signs To Look Out For
When we become stressed out bodies release cortisol the stress hormone which helps us cope with challenges. Cortisols role is to convert protein into energy by releasing glycogen and counteract inflammation. When cortisol is released in the body temporarily, this is okay and wont have long-lasting detrimental effects to health as it is a natural response to a stressor. But when cortisol levels remain high chronically it can eventually begin to tear your body down thus causing health complications. This is why numerous health experts recommend the reduction of stress as much as possible because in the long run it can harm our health.
High cortisol levels over the long term can destroy healthy muscle and bone, slow down healing, impair digestion, metabolism and mental function, and weaken the immune system. Additionally, adrenal fatigue has been linked to numerous other health conditions including fibromyalgia, hypothyroidism, chronic fatigue syndrome, arthritis, premature menopause, and many others. High cortisol levels are also associated with many unwanted symptoms which we will outline below.