Cortisol is a steroid hormone that produces the body’s stress response. If your levels are too high, it can cause conditions such as Cushing syndrome and chronic stress to develop.
Medically reviewed by Alisha D. Sellers, BS Pharmacy, PharmD
Your body naturally releases cortisol to help respond to stress and also to regulate a number of important factors, such as blood sugar levels. It follows a regular cycle, with the highest levels occurring right after you wake up.
However, prolonged periods of stress can cause your cortisol levels to go up and down, which can lead to negative health effects, such as Cushing syndrome. This is where the body creates too much cortisol.
You can take steps to reduce cortisol levels through stress management. If you have a diagnosis of Cushing syndrome, a healthcare professional can work with you to treat the underlying cause. They may also recommend medications to help reduce your cortisol levels.
Sex and gender exist on spectrums. This article uses the term “women” when discussing people assigned female or male at birth to reflect language that appears in source materials.
While gender is solely about how you identify yourself, independent of your physical body, you may need to consider how your personal circumstances will affect diagnosis, symptoms, and treatment. Learn more about the difference between sex and gender here.
What is cortisol?
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Cortisol is a steroid hormone released by your adrenal glands. It can affect most of the body’s organ systems and plays an important role in regulating significant body processes, such as your:
immune system
metabolism
blood sugar levels
inflammation
stress response
Due to its activity during the body’s natural stress response, cortisol is commonly known as the stress hormone.
When your body feels as though it is under threat, it activates its natural stress response. The amygdala is the part of your brain involved in managing emotions. During stress, it sends a signal to the hypothalamus, which activates the sympathetic nervous system (SNS).
The SNS controls your fight-or-flight response. When turned on, it releases adrenaline, leading to physiological changes such as increased breathing and heart rate.
If the feeling of threat continues, the brain signals a mechanism that causes the release of cortisol. This hormone allows your body to remain attentive to the perceived threat. It also helps regulate the immune response and gives the body energy during a stressful event.
Our bodies can sometimes perceive a stressful or anxiety-inducing situation, such as having to give a presentation at work, as a threat. This can cause our fight-or-flight response to overreact and our bodies to produce higher levels of cortisol.
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While cortisol is important for your body to protect itself, experiencing high levels over a long period can lead to chronic stress, which can negatively affect your health.
Chronic stress can cause a breakdown in communication between the natural stress response and the immune system. Over time, this might lead to conditions such as:
chronic fatigue
diabetes
depression
immune system disorders, such as rheumatoid arthritis
It can also cause people to develop Cushing syndrome, where the body creates too much cortisol. The syndrome can also develop from long-term use of glucocorticoid medications, which are a type of corticosteroid used to treat inflammation.
Symptoms of Cushing syndrome can vary from person to person. A prolonged period of high cortisol levels can lead to:
engaging in quick physical activity, such as push-ups or weightlifting
making a short list of things you’re happy or grateful for
The following activities have also been found to reduce cortisol levels directly:
Followinga healthy diet: A 2018 study of 242 adolescents found lower cortisol levels among those who ate a Mediterranean diet.
Getting quality sleep: Insomnia is associated with higher levels of cortisol. The CDC recommends adults get at least 7 hours of sleep each night.
Exercising regularly: Exercise can improve your mood and cognition, and can also help to decrease cortisol levels. However, exercising too much can increase your levels. Consider doing low impact exercises to keep your cortisol at a healthy level.
Making art: A 2016 study of 39 adults found cortisol levels decreased after a 45-minute session of making visual art.
Certain supplements might also help reduce cortisol levels. A 2019 study involving 60 people found ashwagandha (Withania somnifera) reduced morning cortisol levels over 60 days. Consider speaking with a healthcare professional before beginning any herbal supplements.
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If you have a diagnosis of Cushing syndrome, a doctor might recommend tapering off any glucocorticoid medications you are taking. They might try to bring you down to the lowest possible dose or switch you to a non-glucocorticoid medication.
Several other medications can help bring down cortisol levels. Most of these medications are of the steroidogenesis enzyme inhibitor class. They include:
A doctor can discuss these options with you if you have a Cushing syndrome diagnosis. They might prescribe these medications as part of a larger treatment plan for the condition.
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Summary
Cortisol is a steroid hormone that helps your body respond to stress. If you experience high levels of cortisol for a long period of time, it can disrupt the communication between your body’s stress and immune response systems. This can lead to health conditions like chronic fatigue, depression, and immune disorders.
High cortisol can also lead to Cushing syndrome. You can manage this condition with medication to reduce cortisol levels.
To help manage your stress levels, you might want to consider regular exercise, eating a healthy diet, and getting enough quality sleep.
Chen C, et al. (2017). The exercise-glucocorticoid paradox: How exercise is beneficial to cognition, mood, and the brain while increasing glucocorticoid levels. https://pubmed.ncbi.nlm.nih.gov/27956050/
