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Cortisol: Symptoms, Causes, and Treatments of High vs Low Cortisol Level

by Ankur Majumder 18 Aug 2022

What is cortisol?

Cortisol, also known as the stress hormone, is a steroid hormone (specifically, a glucocorticoid) produced by the adrenal glands. It is responsible for responding to both physical and emotional stress, and plays a key role in a number of essential physiological functions such as regulation of blood pressure, sleep/wake cycle, and nutrient metabolism in the body.

stress management

How does cortisol function in your body?

Cortisol is an important hormone that has quite a few functions in our body.

  • Regulating our body's stress response 

When stressed, the body releases cortisol after releasing the “fight or flight” hormones like adrenaline so that you can continue to stay on high alert mode. Cortisol also triggers the release of glucose from the liver so that our body gets past energy during stressful times.
    • Helping in suppressing inflammation

    Cortisol helps to boost our immunity by limiting inflammation. Although if you have extremely high levels of cortisol, your body will get used to having extra cortisol in the blood, which can lead to a weakened immune system and inflammation.
      • Regulating blood pressure 

      How cortisol helps to regulate blood pressure in the human body is still unclear. Although it is known that elevated levels of cortisol can result in high blood pressure and on the other hand, lower levels can cause low blood pressure.
        • It regulates blood sugar

        Cortisol helps to counterbalance the effect of insulin which helps to regulate blood sugar levels in the body. It helps to raise the level of blood sugar by releasing the stored glucose, while on the other hand, insulin is known to lower blood sugar levels. People with chronically high cortisol levels can be more persistent with high blood sugar, which can cause type two diabetes.
          • It also controls the body's metabolism

          Cortisol helps to control how the body uses fats, carbohydrates, and proteins for energy. 
            • It helps to regulate the sleep-wake cycle 

            It has been seen that one has lower cortisol levels in the evening before going to sleep and high levels in the morning right before waking up. This suggests that cortisol plays a vital role in the initiation of wakefulness and plays a significant role in the body’s circadian rhythm.
              • Cortisol plays an important part of our survival mechanism

              It usually gets activated when our body faces any kind of stress like trauma or severe dietary restrictions. During such times, cortisol is produced from cholesterol and released by the hypothalamus to divert energy away from low-priority activities such as the immune system, or to spare brain glucose for urgent needs.

                Our body is constantly monitoring our cortisol levels. Higher or lower levels than usual can be detrimental to our health.

                What are the normal cortisol levels in the body?

                Cortisol levels change in our body with a 24 hours repeating pattern. It follows the sleep/wake cycle and the levels are usually high during the mornings, especially after 30-60 minutes of waking up. The levels gradually decline as the day progresses and reaches the lowest around midnight or 2-4 hours after falling asleep.

                Normal ranges of cortisol levels in our blood are -

                • 6 AM to 8 AM-10 to 20 micrograms per deciliter mcg/dL
                • Around 4 PM-3 to 10 mcg/dL

                Normal ranges may differ from lab to lab and also from person to person. If you want to get a test done, then your health care provider will be able to give you results and let you know if you need further testing. 

                Blood cortisol levels are best tested around 8 am, right after waking up after fasting overnight.

                Chronic stress or a genetic condition can cause cortisol levels in the blood to be consistently high over time, resulting in health consequences. Chronically high cortisol can cause the following symptoms:

                • Depression
                • Fatigue
                • Anxiety
                • Conditions like constipation, bloating, or diarrhea
                • Heartburn
                • Headache
                • High blood pressure
                • Problems with memory and concentration
                • Reproductive issues like low libido, erectile dysfunction, or irregular menstruation and ovulation
                • Difficulty in sleeping
                • Gaining weight

                Hence it is important for people to get their cortisol levels checked so that they can treat it if needed. High cortisol levels can also lead to Cushing’s Syndrome which has severe symptoms as well. So it is important to get your cortisol levels checked if you are experiencing any of the above symptoms. 

                High cortisol treatment

                It is also important to manage the stress levels since chronic stress is known to increase cortisol levels. During these challenging times, because of the ongoing COVID-19 pandemic, you must indulge in regular physical activity, mindfulness, meditation, and journaling to help you manage your cortisol levels.

                The importance of maintaining cortisol levels in your body

                Maintaining an optimum cortisol level in the body is essential as it plays a significant role in keeping the body healthy. Here are some of the important functions that are regulated by cortisol levels in the body.

                • Proper sleep cycle
                • Controlling the salt and water balance
                • Regulating blood pressure
                • Regulating growth
                • Helps with anti-inflammation
                • It also helps with memory formation
                • Helps one wake up in the morning
                • Regulates the immune system functions

                Frequently Asked Questions

                What happens when cortisol levels are high?

                When cortisol levels rise in the body because of chronic stress, then people start experiencing certain consequences. Some common symptoms include anxiety, fatigue, depression, high blood pressure, and headache.

                The severity of Cushing's syndrome depends on how high your cortisol levels are. Cortisol levels that are higher than normal can cause the following symptoms:

                • You gain weight, especially around your face and abdomen.
                • You have fat deposits between your shoulder blades.
                • Your abdomen (belly) has wide, purple stretch marks.
                • Your upper arms and thighs are weak.
                • Type 2 diabetes is often caused by high blood sugar.
                • Hypertension (high blood pressure).
                • A condition in which people born female have excessive hair growth (hirsutism).
                • Fractures and weak bones (osteoporosis).

                What does low cortisol mean?

                Low cortisol levels in the body can result in Addison’s disease. Some of the common symptoms of Addison’s disease includes-weight loss, dizziness, chronic fatigue, loss of appetite, darkening scars or skin creases, and more.

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