What Are The Signs Of High Cortisol
28th Nov 2022 4 min read
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.
How Cortisol Impacts Mental Health
To explain how cortisol can affect mental health, let’s go back to the scenario where the antelope encountered a pack of hungry lions. Now, in this day and age, most people aren’t encountering wild animals on a daily basis. But while the circumstances around us are different from an antelope or our ancient ancestors, our brains are still trained to respond to threats. They have been calibrated to view modern fears and anxieties similar to the sight of a hungry lion. But today, the fight or flight response is more likely to come from situations such as giving a presentation, going to a party, or even just thinking about something that makes you anxious.¹
Phosphatidylserine As A Cortisol Supplement
The supplement phosphatidylserine has a positive effect on your mind and memory and can help reduce cortisol production.
One small study found that phosphatidylserine supplements of 600 mg a day can lower cortisol levels after intensive exercising. This can be an effective way for athletes or people who enjoy regular intensive exercise to avoid the effects of too much cortisol.
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What Do The Results Mean
A cortisol test alone can’t diagnose the cause of abnormal cortisol levels. If your cortisol level isn’t normal, you will usually have more tests to find out what is causing the problem.
High levels of cortisol may be a sign that you have Cushing’s syndrome. It may be caused by:
- Taking high doses of certain steroid medicines for a long time to treat conditions, such as asthma, rheumatoid arthritis, and lupus
- Tumors in your pituitary gland or other parts of your body that make too much of the hormone that tells your adrenal glands to make cortisol
- Tumors in your adrenal glands that make extra cortisol
Low levels of cortisol may mean you have Addison disease or secondary adrenal insufficiency:
- Common causes of Addison’s disease include damage to the adrenal glands from conditions, such as:
- Certain infections, such as tuberculosis and HIV/AIDS
The most common cause of low cortisol levels is suddenly stopping steroid medicines after using them for a long time.
If your cortisol results aren’t normal, it doesn’t always mean you have a medical condition that needs treatment. Cortisol levels can be affected by:
- Certain medicines, such as birth control pills
To learn what your test results mean, talk with your health care provider.
Learn more about laboratory tests, reference ranges, and understanding results.
Moderate Exercise To Lower Cortisol
Enjoying regular exercise can help to reduce your cortisol levels because it helps to cope with stress better.
The Journal of Endocrinological Investigation reported that moderate, low-intensity exercise has a positive effect on cortisol levels. However, intensive exercise increases cortisol secretion in the body.
Interestingly, sweating after exercise can cause high concentrations of cortisol in the body and these concentrations are detected in hair. Doctors can test hair samples for cortisol to help diagnose conditions related to chronic stress.
Maintaining A Good Bedtime Routine
A good bedtime routine can be a useful tool for getting longer and higher-quality sleep. This may involve a combination of relaxing activities that help a person unwind, such as:
- bathing or showering
- reading a book or audiobook
People should get into the habit of turning off all screens and relaxing before heading to bed. For example, it may help to turn off phones and any other potential distractions.
What Are Normal Cortisol Levels
The level of cortisol in your blood, urine and saliva normally peaks in the early morning and declines throughout the day, reaching its lowest level around midnight. This pattern can change if you work a night shift and sleep at different times of the day.
For most tests that measure cortisol levels in your blood, the normal ranges are:
- 6 a.m. to 8 a.m.: 10 to 20 micrograms per deciliter .
- Around 4 p.m.: 3 to 10 mcg/dL.
Normal ranges can vary from lab to lab, time to time and person to person. If you need to get a cortisol level test, your healthcare provider will interpret your results and let you know if you need to get further testing.
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Significantly Elevated Cortisol Levels Only At Night
Hello, here is information about what I have going on. Feel free to ask any questions, and I am only looking for suggestions and comments about what I should do from here.
I am 22 years old, male, and weight 195 pounds, with a muscular build.
Symptoms:-Elevated Anxiety-Depression Symptoms, mostly loss of motivation and pleasure from activities I used to enjoy-Sleep issue being that I wake up in the middle of the night gasping for breath, feeling like I had a rush of adrenaline with heart racing
I have been experiencing these symptoms my entire life and they have gotten progressively worse, with the exception for the sleep issue, which has gotten worse since I gained weight over the past few months.
I took an at home cortisol test, and my levels were extremely elevated from the 1st collection I took, immediately after waking at 8am. The 4th collection after dinner was slightly low. This was a urine test. I slept all night without issue before the test.
1st collection: 88 ug/g 2nd collection: 23.7 ug/g 3rd collection: 10 ug/g 4th collection: 15.2 ug/g
I believe I have REM-induced sleep apnea, which explains why my entire life I seemed to not dream much. I am working with a sleep doctor on this now, but progress is slow. My main question is as follows:
Thank you in advance, help is much needed.
Thank you all very much for the replies and links.
How Cortisol Works
When the adrenal glands release cortisol into your bloodstream, the hormone triggers a flood of glucose that supplies an immediate energy source to your large muscles. It also inhibits insulin production so the glucose wont be stored but will be available for immediate use.
Cortisol narrows the arteries, while another hormone, epinephrine, increases your heart rate. Working together, they force your blood to pump harder and faster as you confront and resolve the immediate threat.
If your entire life is high-stress and always in high gear, your body may constantly pump out cortisol.
Hormone levels return to normal as you swerve to miss an oncoming car, find out that your child has only a few scrapes or meet the deadline for your presentation.
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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.
What Does Cortisol Do
There are trillions of cells in your body, and a majority of them have receptors for cortisol, meaning that cortisol can bind to almost any cell and change how it functions. This is why cortisol is so importantit plays a role in essentially every system in the body.
Eva Redei, PhD, professor of psychiatry and behavioral sciences and physiology at Northwestern University Feinberg School of Medicine in Chicago, says that cortisol is “really the water of life” because, like water, cortisol goes everywhere in the body.
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High Evening Cortisol Levels
If you often find yourself in heated political arguments online at 9 p.m., or if you do heavy training at the gym in the evenings, its likely that your cortisol levels are skyrocketing at night right when you want them to be coming down. Some common indications of high evening cortisol levels are:
- Falling asleep is nearly impossible and can take hours.
- You worry in the evenings or feel especially argumentative.
- You distract yourself by spending a lot of time online, watching TV, or working out at night which can lead to self-defeating cycle of even higher evening cortisol.
How Is The Cortisol Level Test Done
A blood sample is used to measure cortisol levels. Most blood samples are collected using this process:
- The flow of blood in the arm is stopped by wrapping an elastic band around your upper arm. This also causes the veins in your arm to become more visible, making it easier to insert the needle.
- Alcohol is used to clean the site on your skin where the needle will be inserted.
- The needle is inserted into the vein. This may cause a brief pinching or stinging sensation.
- Your blood is collected in a tube thats attached to the needle. More than one tube may be needed.
- The elastic band is removed after enough blood has been collected.
- As the needle is removed from your skin, cotton or gauze is placed on the site of the needle insertion.
- Pressure is applied to the area using cotton or gauze. A bandage is used to secure the cotton or gauze.
There are few risks associated with the cortisol level test. The test is done by taking a blood sample from your vein, which may result in some bruising at the site where the needle was inserted.
In rare cases, the following risks may be associated with having blood drawn from your vein:
- excessive bleeding
- an accumulation of blood beneath your skin, which is called a hematoma
- lightheadedness or fainting
Cortisol levels are sometimes decreased by:
- drugs containing androgens
Higher-than-usual cortisol levels may indicate that:
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What Causes Low Cortisol Levels
Low cortisol levels manifest as adrenal insufficiency, of which there are three types:
- Primary adrenal insufficiency occurs when the body mistakenly attacks the adrenal cortex, causing autoimmune adrenalitis.
- Secondary adrenal insufficiency occurs when the pituitary gland fails to produce enough adrenocorticotropic hormone to stimulate cortisol production.
- Tertiary adrenal insufficiency occurs when the hypothalamus fails to produce enough corticotropin-releasing hormone to activate ACTH synthesis.
Low cortisol levels manifest as adrenal insufficiency, of which there are three types. Primary adrenal insufficiency occurs when the body mistakenly attacks the adrenal cortex, causing autoimmune adrenalitis. Secondary adrenal insufficiency occurs when the pituitary gland fails to produce enough adrenocorticotropic hormone to stimulate cortisol production. Tertiary adrenal insufficiency occurs when the hypothalamus fails to produce enough corticotropin-releasing hormone to activate ACTH synthesis.
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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How Do You Moderate Cortisol Levels
If you are experiencing high cortisol levels over time, its important to know that there are a number of treatments available that can help lower high levels of cortisol. Of course, the treatment will depend on your individual circumstances, including the cause of Cushings syndrome. Some of the most common treatments used to moderate cortisol levels may include:
- Reducing corticosteroid use
- Specific medications
If you are experiencing signs or symptoms of Cushing syndrome, its important to know more. This can be done by taking a trip to the doctor or from home with an at-home lab test.
LetsGetCheckeds at-home Cortisol Test can measure adrenal performance or stress with online results available within 2-5 days and access to our medical experts every step of the way.
You should consider taking the test if:
- You constantly feel run down
- You are body-building competitively
- You are presenting with symptoms of Cushing syndrome
- You have Cushing syndrome
- You are presenting with symptoms of Addison’s disease
- You have Addison’s disease
How Does A Cortisol Test Work
Cortisol can be measured in the blood, urine, saliva or a combination. Your healthcare provider will tell you which test they recommend for you.
- Blood test: In an office, clinic or lab, a healthcare provider inserts a thin needle into a vein in your arm. The needle collects a small sample of blood into a tube. You might feel a slight sting when the needle goes in.
- Saliva test: You or a healthcare provider puts a swab in your mouth and waits a few minutes until the swab is saturated with spit. If you do the test yourself at home, your healthcare provider will give you a special kit. Theyll tell you what time to perform the test and how to return the sample.
- Urine test: Your healthcare provider gives you a container to collect your pee. Most urinary cortisol tests collect all the pee you produce in 24 hours. Your healthcare provider may ask you to store the urine in a cold place, then return it to their office or a lab.
You may need to repeat cortisol testing twice in one day or multiple times over several days because cortisol levels vary.
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The Symptoms Of Cortisol Imbalance
In todays modern high-stress world, high cortisol has become an increasingly common health concern. When high cortisol becomes a chronic issue, symptoms can include:
- Depression, anxiety, and irritability
- Difficulty concentrating
In the most severe cases, elevated cortisol can contribute to obesity, infertility, bone loss, and insulin resistance leading to type 2 diabetes. The good news is that a combination of diet, lifestyle changes, and medication can often help get your hormones back on track. Its important to note that the remedies mentioned here are commonly recommended to those who experience symptoms from excess cortisol due to lifestyle stress rather than a medical condition.
Its also critical to mention that after prolonged exposure to elevated stress, HPA axis suppression can cause the body to produce too little cortisol, which also disrupts healthy function. Symptoms of HPA axis suppression/adrenal fatigue include:
This condition is usually mild and can typically be treated using the same strategies as you would use to address high cortisol. The goal for both conditions is to balance.
Start A Healthy Exercise Habit
Research shows that acute aerobic exercise reduces the cortisol stress response in the brain and helps improve cortisol levels. This is one of many scientific explanations for why exercise helps relieve stress and promotes overall health in the mind and body. Start a healthy habit of moving your body in a way that you enjoythrough dance, jogging, lifting, yoga, or some other practice. Still, be careful not to overdo it. Overly intense exercise without adequate nutrition and recovery time can actually result in elevated cortisol in the body.
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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.
How Long Until Your Cortisol Levels Return To Normal
“You can see some real differences within one or two weeks,” says Molloy. “But it all comes down to how out-of-whack your cortisol levels are and how much you’re able to change your lifestyle to address them.” And of course, continuing to manage your stress levels is key to keeping them from spiking too high again, he says.
If you think your cortisol levels are doing something wonky, head to your healthcare provider to chat about solutions. And even if you’re not convinced your cortisol levels are off, your health and wellness routine could probably benefit from the aforementioned lifestyle changes.
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