What Can Cause High Cortisol Levels

What Is The Best Supplement To Lower Cortisol

Ashwagandha has been shown to alleviate raised cortisol levels in stressed humans by up to 30% when taken routinely, and studies around the world have shown that adults who supplement with ashwagandha consistently over a 30-60 day period demonstrate significantly reduced stress levels compared with those who take a …

What Are The Signs Of High Cortisol

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28th Nov 2022 4 min read

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Cortisol is a stress hormone thats produced by your body. Its essential for your health, but too much cortisol can cause problems, ranging from anxiety to diabetes. When high cortisol causes symptoms and conditions, its known as Cushings syndrome. Here’s how to spot the signs of high cortisol, how to test your levels, and what you can do to lower them.

Can High Levels Of Cortisol Cause Hair Loss

Can high levels of cortisol cause hair loss? Hair loss can be caused by an imbalance in hormone levels. Cortisol is one of the hormones often identified with hair loss. Understanding how hormones and hair loss are connected and how to regulate the effects can help lead to healthier hair.

What are the symptoms of high cortisol levels?When were stressed, our adrenal glands produce this hormone called cortisol, and then the cortisone signals our hair follicles to shift from the growth phase, out of growth phase into catagen , and then hair will fall out. This is called telogen effluvium.

What does cortisol do to hair? If your daily hair fall is more than the usual 80-100 strands of hair, you might be suffering from stress-related hair loss. If you notice bald patches on your scalp, it may be a sign of Alopecia Areata. If you have had the urge to pull out your hair, it may be stress-induced Trichotillomania.

How do you know if your losing hair from stress? Too much cortisol can cause some of the hallmark signs of Cushing syndrome a fatty hump between your shoulders, a rounded face, and pink or purple stretch marks on your skin. Cushing syndrome can also result in high blood pressure, bone loss and, on occasion, type 2 diabetes.

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Will I Need To Do Anything To Prepare For The Test

The preparations will depend on the type of test you are having. Be sure to follow all the instructions that your provider gives you.

Stress can raise your cortisol levels, so you may need to rest before your test. A blood test will require you to schedule two appointments at different times of the day. Before a saliva test, you may need to stop using certain medicines. Let your provider know about all medicines you use, including skin creams. But don’t stop using any medicines without talking with your provider first.

How Your Cortisol Should Behave

When testing for adrenal fatigue, cortisol measurements need to be taken at different points in the day. Remember, cortisol follows what is called a diurnal rhythm. Meaning its activity level is more prominent during the day.

The blood tests you do with your family doctor will not pick up slightly low or high levels of cortisol. These blood tests only pick up extreme fluctuations in your cortisol rhythm. You need to have either Cushings Disease or Addisons Disease for conventional lab tests to pick it up.

Healthy cortisol levels

If youre quite healthy and enjoy relatively low-stress levels, your cortisol levels will probably look something like the below graph:

• There will be a dramatic difference between morning and evening cortisol values.
• The majority of your cortisol should drop within the first three hours after waking.
• The graph to the right illustrates a healthy cortisol rhythm.
• Each dot on the graph represents the time cortisol was measured.
• In this example, the patient woke up at 6:30 am.
• The spike in cortisol shortly after waking is called the cortisol awakening response. It should be 35-60% higher than the value at the time of waking.

Below, Ill walk you through the most common patterns found in high levels of cortisol.

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Enjoy A Healthy Diet To Lower Cortisol Levels

Foods that can increase cortisol are refined sugars, unhealthy carbs, and saturated fats. Healthy food choices such as increasing your intake of fruits and vegetables help balance your hormones better.

The journal Advances in Nutrition reported that a poor diet can affect cortisol concentrations. This can have an impact on cognitive function and affect the HPA axis. Studies have shown that supplements such as magnesium can help to decrease the concentration of cortisol if its elevated.

If you have type 2 diabetes and show signs of excess cortisol, then enjoying a healthy diet is essential to control your symptoms.

As well as eating the right foods to help control cortisol, it is essential to drink plenty of fluids. Researchers have found that your levels of hydration can affect cortisol. When the body is dehydrated, cortisol levels increase.

Cushings Syndrome And Cushing Disease

Cushing syndrome is a disorder with physical and mental changes that result from having too much cortisol in the blood for a long period of time. There are two types of Cushing syndrome: exogenous and endogenous . The symptoms for both are the same. The only difference is the causes.

Cushing disease is a rare condition, only affecting 10 to 15 people per million every year. It is more common in women and occurs most often in people between the ages of 20 and 50.

A pituitary adenoma is the most common cause of Cushing disease. An adenoma is a pituitary tumor that is almost always benign. The tumors can be hard to diagnose because they are quite small. Having an endocrinologist help with the diagnostic process can improve the chances of a prompt, successful diagnosis for patients who have symptoms of Cushing disease.

Endocrine Connection

Cortisol is a hormone produced by the adrenal glands that is directly connected to the bodys stress response. Most cells within the body have cortisol receptors. Secretion of the hormone is controlled by the hypothalamus, the pituitary gland, and the adrenal gland, a combination gland often referred to as the HPA axis. In a healthy individual, it releases adrenocorticotropic hormone , a hormone produced in the pituitary gland, and stimulates the production and release of cortisol by the adrenal glands. In normal amounts, cortisol helps the body:

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What Are The Symptoms Of Cushings Syndrome

Cushings syndrome has some unique symptoms as well as some that could point towards a variety of other syndromes. Not everyone has the same symptoms. Possible symptoms include:

Rapid weight gain in the face , abdomen, the back of the neck and chest.

• A red, round face.
• Weak muscles and thinner arms and legs.
• Libido changes and erectile dysfunction.
• Stunted growth in children.

Testing For High Cortisol Levels

To determine whether you have high cortisol levels, your healthcare practitioner would first do a physical exam to look for any of the signs and symptoms discussed. They would also rule out the use of corticosteroids. From there, they might look at doing various diagnostic tests.

The tests can help your healthcare practitioner find the cause of your high cortisol levels and rule out other health issues like polycystic ovary syndrome that mimic the condition. Consuming substantial amounts of alcohol and depression could also mimic the symptoms associated with high cortisol.

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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.

More on this topic

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 Cortisol To Rise

As your body perceives stress, your adrenal glands make and release the hormone cortisol into your bloodstream. Often called the stress hormone, cortisol causes an increase in your heart rate and blood pressure. Its your natural flight or fight response that has kept humans alive for thousands of years.

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How Does It Work

Your hypothalamus and pituitary gland — both located in your brain — can sense if your blood contains the right level of cortisol. If the level is too low, your brain adjusts the amount of hormones it makes. Your adrenal glands pick up on these signals. Then, they fine-tune the amount of cortisol they release.

Cortisol receptors — which are in most cells in your body — receive and use the hormone in different ways. Your needs will differ from day to day. For instance, when your body is on high alert, cortisol can alter or shut down functions that get in the way. These might include your digestive or reproductive systems, your immune system, or even your growth processes.

Sometimes, your cortisol levels can get out of whack.

Effects Of Chronically High Cortisol

If cortisol elevation becomes chronic, it leads to more than feeling burned out. You could be at higher risk for developing a condition called Cushings diseasewhich can include excessive weight gain, weakness, high blood pressure, and the tendency to bruise easily.

And it doesnt stop there. Mayo Clinic notes that high cortisol can affect multiple systems in your body, from brain function to gut health, putting you at increased risk for:

• Heart disease and heart attack

• High blood pressure

Dr. Messer adds that other issues related to chronically high cortisol levels are , , and .

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Can Cortisol Levels Affect Your Hair

The stress hormone, cortisol, is known to affect the function and cyclic regulation of the hair follicle. When cortisol is present at high levels it has been demonstrated to reduce the synthesis and accelerate the degradation of important skin elements, namely hyaluronan and proteoglycans by approximately 40%.

What hormone is responsible for hirsutism?

With hirsutism, extra hair growth often arises from excess male hormones , primarily testosterone.

What are the symptoms of excess cortisol?

Too much cortisol can cause some of the hallmark signs of Cushing syndrome a fatty hump between your shoulders, a rounded face, and pink or purple stretch marks on your skin. Cushing syndrome can also result in high blood pressure, bone loss and, on occasion, type 2 diabetes.

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Should I See A Doctor

If you think you might have high cortisol, its important to see a doctor for a blood test. High cortisol causes common signs and symptoms that can be caused by many other diseases, so its important to confirm whats causing your symptoms.

If youre experiencing symptoms that may be caused by high cortisol levels, your doctor may recommend the following tests:

• Cortisol urine and blood tests. These tests measure the levels of cortisol in your blood and urine. The blood test uses a sample of blood drawn from your vein. A test called the 24-hours urinary free cortisol excretion test is used to check your urine. This entails collecting urine over a 24-hour period. Blood and urine samples are then analyzed in a laboratory for cortisol levels.
• Cortisol saliva test. This test is used to check for Cushing syndrome. A sample of saliva collected at night is analyzed to see if your cortisol levels are high. Cortisol levels rise and fall throughout the day and drop significantly at night in people without Cushing syndrome. High cortisol levels at night would indicate you may have Cushing syndrome.
• Imaging tests. CT scans or an MRI may be used to obtain images of your pituitary gland and adrenal glands to check for tumors or other abnormalities.

Unmanaged high cortisol levels can have serious consequences on your health. Left untreated, high cortisol can your risk of serious health conditions, including:

• cardiovascular disease

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Symptoms And Side Effects Of Cortisol Imbalance

If you love your current workout routine, the thought of dialing it back may sound counterintuitive, but “the cost of working out at 100 percent when your mental and emotional stress levels are at 100 percent is compromised muscle mass, strength plateaus, weight gain, and generalized exhaustion,” says Molloy of the side effects of cortisol imbalance.

There are other non-exercise related symptoms, tooâmost of which are similar to the symptoms of overtraining syndrome. Some other symptoms of a cortisol imbalance are:

Because the whole endocrine system is interconnected, this is just the tip of the iceberg, says Len Lopez D.C., a chiropractor and fitness expert. For example, “your body needs progesterone to make cortisol. When there’s an overproduction of cortisol, it can cause an imbalance in your progesterone and estrogen levels, which can lead to estrogen dominance,” he says.

It’s also worth mentioning that mental health issues like anxiety and depression have a direct relationship with cortisol. Some studies have linked heightened cortisol levels with mental health issues, while others have found that chronically elevated cortisol levels increase your risk for mental illness in the future.

Because, again, cortisol touches every single system in the body, chronically elevated cortisol levels can lead to other scary health issues such as cardiovascular disease and diabetes.

Other Ways To Reduce Stress

Stress reduction isn’t all about diet. While evidence supporting the ability of stress-lowering over-the-counter vitamin and mineral supplements to reduce cortisol levels is minimal at best, per the Academy of Nutrition and Dietetics, there are other methods that can be effective.

Mindfulness practices, for example, can also help improve cortisol levels, Foroutan says, such as:

• Breathing exercises

Other way to reduce stress include:

• Getting adequate sleep, which may be as important asdiet, as cortisol helps coordinate your sleep cycle, Foroutan says.
• Exercising regularly.
• Socializing with friends and family, per the Academy of Nutrition and Dietetics.

If stress becomes debilitating, seek professional help. Counselors and other professionals are trained to help you find ways to best cope.

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High Cortisol Testing And Diagnoses

Your doctor can order a number of tests to determine if you have abnormally high cortisol levels. Both blood and urine testing help reveal a problem, but a 24-hour urine test is used more often than a cortisol blood test to diagnose Cushings disease or syndrome.

The cortisol values listed below, which can be obtained from a blood test, serve as a reference range for whats considered normal. Cortisol levels above this normal range are considered high and can be risky or problematic.

But keep in mind that values differ depending on time of day, age and the type of cortisol test preformed. Saliva tests are now also recommended and appear to be as reliable as a blood sample. Additionally, an overnight dexamethasone suppression test may also be recommended, and it involves taking a dose of a corticosteroid medicine called dexamethasone to determine how blood cortisol is affected.

Because of this, your doctor will always need to evaluate your results in light of your specific symptoms and medical history.

• Normal cortisol ranges for adults and children in the morning are between five to 23 micrograms per deciliter or 138 to 635 nanomoles per liter
• Normal cortisol ranges for adults and children in the afternoon are between three to 16 mcg/dL or 83 to 441 nmol/L
• Normal cortisol for a newborn baby is between two to 11 mcg/dL or 55 to 304 nmol/L

Final Thoughts on Cortisol Levels

How Does Cortisol Affect Female Hormones

Aside from affecting the menstrual cycle, abnormal levels of CRH in reproductive tissue have been associated with negative pregnancy outcomes, such as preterm birth. .

Cortisol actually increases the cravings for sweets.

High cortisol lowers oestrogen levels, which can result in the deposition of fat, often in the middle section of the body. When oestrogen is lowered from continuous stress and cortisol production, all the female hormone imbalance symptoms such as night sweats, sleep problems, and mood swings can get worse.

If not managed, high cortisol can cause many other important hormones to become out of balance.

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Elevated Cortisol Awakening Response

The cortisol awakening response is a large surge of the cortisol hormone generally seen shortly after waking. If you look at the above graph, an elevated cortisol awakening response would show the second value on the graph near the top of the chart or even off the chart! In this example, all other cortisol values will remain within range.

Elevated cortisol awakening response is typically indicative of high levels of anticipated daily or job stress. Some of the common symptoms associated with an elevated cortisol awakening response include:

• Sleep disturbances

The cortisol testing you do with your family doctor will not measure the cortisol awakening response. The CAR can only be measured through specific labs like DUTCH.

In the 3-stage model of adrenal fatigue, an elevation of the CAR is generally considered stage one. But remember, stress doesnt always happen in successive stages. Ive seen an elevated CAR combined with low levels of cortisol on many different occasions.

How to treat an elevated cortisol awakening response:

• Identify avoidable life and/or job stressors.
• Try to regulate sleep time, duration, and quality.
• Go to bed at the same time every night.
• Ensure youre getting 8-9 hours of sleep each night.
• Turn off lights and devices 60 minutes before bed.
• Use blackout blinds to make your room as dark as a cave.