Written by Elizabeth Millard
For those of us who felt overwhelmed or frazzled this past year (so pretty much everyone), the symptoms associated with stress are all too familiar: a fast-beating heart, crushing headache, and maybe even insomnia.
With any of those symptoms, your body’s overproduction of cortisol (“the stress hormone”) is often the culprit. Cortisol is a hormone produced by your adrenal glands, and while it might seem like a nuisance (who needs an elevated heartbeat and an overwhelming sense of anxiety?), it has many metabolic functions throughout the body, according to David Cutler, M.D., a family medicine physician at Providence Saint John’s Health Center in Santa Monica, California.[3; 4]
Cortisol stimulates the release of epinephrine — also known as adrenaline — and norepinephrine, another chemical that plays a role in the stress response.[3; 5] When that happens, your heart rate, blood pressure, and muscle strength all increase. This is your “fight-or-flight” response. It’s your body’s reaction to any kind of serious perceived threat — something our ancestors likely relied on to survive when, say, a beast or human enemy raided a village. [3; 6]
For those ancestors, their cortisol levels would have subsided back to normal after the threat passed. But in modern times, almost any challenge can trigger that response, including work deadlines, relationship conflicts, pandemic worries, and other anxieties and fears. This can lead to chronic mild elevations of cortisol, which may have adverse health effects.[3; 6]
But dealing with threats is only one of cortisol’s essential functions, Dr. Cutler says. It’s also critical for regulating immune function and managing an inflammatory response, so it’s central to your body’s wellness. That means you don’t want to knock out cortisol completely. Still, too much for too long can be problematic.[2; 3; 5; 6] Check your cortisol levels from home now
Let’s take a look at what’s normal, some signs that you may be struggling, and how to pinpoint what’s happening when it comes to your body’s production of cortisol.
What’s Normal: The “Cortisol Curve” of Slight Ups and Downs
When your cortisol production is working optimally, you’ll experience what’s called a “natural cortisol curve.” [3; 7]
For most people, that means the hormone should be highest in the morning to help boost alertness and reduce your sleep hormones — particularly melatonin. In the evening, the opposite should happen. Melatonin surges as you prepare for bed and cortisol levels decline to help you prep for sleep.[3; 7; 8]
Normal cortisol levels rise and fall during the day—for example, if you’re rushing to a meeting or working to meet a looming deadline, cortisol will surge slightly to give you more energy for the task. But unless you’re being chased by an angry dog or facing some other serious threat, those cortisol variations should feel more like waves than a roller coaster. [1; 3; 6]
From late afternoon into the evening, there should be a gradual tapering down, with cortisol levels lowest just before you conk out.[2; 3]
“The rise and fall of cortisol is normal and happens on a daily basis,” says Dr. Cutler. “But there are many common ways for this process to change.” For example, your cortisol levels can be temporarily affected when you get sick — as well as by pregnancy, sleep deprivation, inflammation from an injury, and emotional stress.[1; 3; 5; 10]
Other factors that could throw off your cortisol levels, Dr. Cutler says, include too much alcohol or caffeine, diet choices that raise inflammation levels, and even taking some nutritional supplements, especially if they’re designed to elevate your energy level.
Signs That Your Cortisol Levels Are Off
If you’ve been stressed for a long time — for example, you’ve felt anxiety since the start of the pandemic that never really subsided — then it’s possible you may have gotten used to a certain level of cortisol elevation. Even if you were aware of your stress in March 2020, it may have become such an everyday state that you’ve stopped noticing it. But that doesn’t mean it isn’t affecting you in negative ways, says Dr. Cutler. If your cortisol is spiking, you may experience unexpected sleep disruptions or insomnia, huge energy crashes throughout the day, and feeling ill much more often than usual.[3; 11]
But those are only short-term effects. An excess of cortisol over a longer-term, like for a few months or even years, as a result of medications or underlying medical conditions, can result in higher blood pressure[3; 5; 10] and lower bone density.[2; 3; 10] Both come with considerable health risks.
Rare conditions related to insufficient or excess levels of cortisol include Addison’s disease,[2; 5; 10], or Cushing syndrome.
If you feel something is off, it’s important to talk with your provider, who can rule out (or identify) a problem with cortisol levels.
Where to Go From Here
Diagnosing cortisol abnormalities can be challenging, Dr. Cutler says, especially because there’s a wide range of normal levels of cortisol, as well as those typical variations throughout the day. Your levels may differ significantly, depending on whether the lab test is done first thing in the morning or early evening. [3; 10]
Also, cortisol levels aren’t generally checked as part of a routine exam, Dr. Cutler adds — only if there’s a high degree of suspicion that there’s a cortisol issue. Getting a home test that can measure cortisol levels can give you a good idea of your cortisol level at a point in time.
Your doctor can recommend whether medication or other treatments are needed to bring your cortisol under control, particularly if it’s discovered that you have a condition like Addison’s disease or Cushing syndrome.[10; 13]
In addition to visiting your healthcare provider, you can also start making lifestyle switch-ups today for a less-stressed you. These include:[1; 6]
- Eating nourishing, whole foods, and at regular times each day
- Moving more (walking counts!)
- Logging enough sleep by going to bed at consistent times
- Meditating or practicing relaxation techniques like yoga
- Indulging hobbies, like reading, painting, and tennis
- Connecting with friends (even via Zoom for now)
- Talking to a therapist if you need to
Understanding how your body is reacting to stress is the first step to managing it. The result is a healthier, well-rested, and generally happier you, able to steadily handle life’s daily challenges.
Chronic stress puts your health at risk
Hormone Health Network
What is Cortisol?
https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/cortisol#:~:text=Because most bodily cells have,and helps control blood pressure.
Providence St. John’s Health Center
David Cutler MD
Johns Hopkins Medicine
Harvard Medical School
Harvard Health Publishing
Understanding the stress response
Institute for Functional Medicine
Assessing the Cortisol Curve
Cameron A, Henley D, Carrell R, Zhou A, Clarke A, Lightman S.
Temperature-responsive release of cortisol from its binding globulin: a protein thermocouple
Journal of Clinical Endocrinology and Metabolism 2010 Oct;95(10):4689-95
University of Rochester Medical Center
Stress Symptoms: Effects on Your Body and Behavior
Society for Endocrinology