Understanding Cortisol and Its Role
In an era where stress is prevalent, many people may wonder if their cortisol levels are affected. Cortisol, a hormone produced by the adrenal glands, plays a crucial role in regulating metabolism, blood sugar, inflammation, blood pressure, and the sleep-wake cycle. Dr. Mark Hyman, co-founder and CMO of Function Health, notes, “It’s most known for managing the body’s response to stress.” But how do you know if you have a cortisol imbalance?
What Is Cortisol?
Dr. Fady Hannah Shmouni, medical director at Eli Health, explains that cortisol is released by the adrenal glands in response to stress. It helps the body to get ready for stressful situations by enhancing energy, focus, and alertness. While this response can be beneficial in the short term, prolonged stress can lead to chronic elevated cortisol levels, which can harm various organs, including the brain. Symptoms of elevated cortisol include disrupted sleep, increased inflammation, and memory issues.
According to Dr. Andy Franklyn-Miller, a dual board-certified physician in sports and exercise medicine, cortisol functions as the body’s alarm system, often referred to as the “stress hormone.” He notes that cortisol levels peak in the morning to help you wake up and gradually decline throughout the day to aid rest.
Identifying Symptoms of Cortisol Imbalance
Dr. Hyman states that signs of cortisol imbalance can be subtle until they become disruptive. If you find yourself feeling wired at night, experiencing mid-afternoon crashes, or struggling to achieve restful sleep, your cortisol levels may be skewed. Some common symptoms of imbalance include:
- Persistent fatigue
- Difficulty sleeping
- Unexplained weight changes
Dr. Franklyn-Miller highlights that wearable technology, such as Whoop or Oura, can provide indirect indicators of cortisol dysregulation through heart rate variability measurements.
Symptoms of High Cortisol
Dr. Shmouni explains, “Under normal conditions, your cortisol levels peak in the morning to help you wake up and then gradually decrease throughout the day.” However, chronic stress can lead to excess cortisol production, resulting in disturbed energy levels. Common symptoms of high cortisol include:
- Nighttime sleep disturbances
- Energy fluctuations due to blood sugar spikes
- Constant fatigue
In addition to these, Dr. Hyman points to potential consequences of high cortisol, such as:
- Anxiety and irritability
- Increased susceptibility to illness
- High blood pressure
- Weight gain
Over time, chronically elevated cortisol can lead to more severe health problems, including cardiovascular disease and cognitive decline.
Symptoms of Low Cortisol
Low cortisol can also present distinct symptoms. Dr. Hyman identifies these signs:
- Cravings for salt or sugar
- Dizziness when standing
- Persistent fatigue not relieved by rest
- Low blood pressure
- Mood swings or depression
Dr. Shmouni notes that serious symptoms of low cortisol may indicate adrenal insufficiency, urging individuals to consult a doctor if they occur.
Causes of Cortisol Imbalance
According to Dr. Hyman, cortisol imbalance arises from a build-up of various stressors, including:
- Chronic psychological stress (work, relationships, trauma)
- Poor sleep habits
- Imbalances in blood sugar
- Overtraining without adequate recovery
- Inflammation and infections
- Nutrient deficiencies, particularly vitamin B and magnesium
Dr. Franklyn-Miller explains that the body’s HPA axis, responsible for stress responses, is designed for short-term challenges; however, prolonged activation can lead to imbalances.
Impact of Medication and Lifestyle
Chronic elevated cortisol may also stem from medications, such as steroid inhalers. Conversely, the long-term use of corticosteroids can suppress natural cortisol production, leading to low levels. Conditions like Cushing’s syndrome can result in high cortisol due to tumors or excessive steroid use, while Addison’s disease may lower cortisol production.
Moreover, lifestyle factors, including poor sleep, excessive exercise, and high-sugar diets can increase cortisol levels. Dr. Franklyn-Miller advises considering stress and sleep when planning workouts, suggesting moderation to avoid fatigue or adverse effects.
Regulating Cortisol Levels
Managing cortisol levels requires mindful lifestyle adjustments, according to Dr. Franklyn-Miller. He recommends:
- Getting adequate sunlight exposure after waking up to stimulate natural cortisol release.
- Maintaining a consistent sleep schedule, aiming for 7 to 9 hours of quality sleep.
- Practicing stress management techniques, such as mindfulness meditation or yoga.
- Engaging in moderate exercise like walking or yoga, and avoiding overtraining.
- Eating balanced meals filled with whole foods while limiting sugar intake.
- Managing caffeine consumption, especially later in the day.
When to Consult a Doctor
If you experience significant symptoms that disrupt daily activities, or if you notice extreme changes in appetite, energy, mood, or sleep, it’s important to discuss these with a healthcare provider. Dr. Franklyn-Miller adds that if lifestyle changes do not improve symptoms after a few months, or if you are on long-term steroids, seeking medical advice is crucial. The standard method for assessing cortisol levels involves laboratory tests using blood, saliva, or urine samples, so consulting a doctor is recommended.
