Cortisol is a steroid hormone produced by the adrenal glands, known for its role in the body’s stress response. It affects nearly every organ and tissue, playing a role in numerous bodily functions. Cortisol levels naturally fluctuate throughout the day, typically peaking in the morning and declining at night. When these levels become consistently too high or too low, it can impact overall health and well-being.
Cortisol’s Essential Functions
Cortisol helps regulate how the body uses carbohydrates, fats, and proteins for energy. It increases blood sugar levels by promoting glucose synthesis in the liver and reducing glucose uptake in muscle and fat tissue.
Beyond metabolism, cortisol helps regulate blood pressure and influences the immune system by reducing inflammation. It is also involved in controlling the sleep-wake cycle, contributing to the body’s natural rhythm.
Nearly every cell contains receptors for cortisol, allowing it to act on various systems, including the nervous, cardiovascular, and musculoskeletal systems. This broad influence highlights its importance in maintaining diverse physiological processes.
Signs of Elevated Cortisol
When cortisol levels remain elevated, physical and psychological changes can occur. Common physical signs include unexplained weight gain, often concentrated around the abdomen, face, and upper back, sometimes referred to as a “moon face” or “buffalo hump.” This weight distribution can be accompanied by thinning arms and legs. Skin changes may also appear, becoming thin and fragile, leading to easy bruising and slow wound healing. Purple or pink stretch marks can also develop.
High cortisol levels can lead to increased blood pressure, persistent fatigue, and muscle weakness. Bone weakness, which increases the risk of fractures, is also possible.
Mood changes are common, including increased irritability, anxiety, depression, and difficulty concentrating. Sleep disturbances, such as insomnia, can manifest. Additionally, females may experience irregular or absent menstrual periods and increased facial or body hair growth.
Signs of Depleted Cortisol
When the body does not produce enough cortisol, a distinct set of symptoms can emerge. Persistent and overwhelming fatigue is common, often accompanied by general weakness. Low blood pressure, which can cause dizziness upon standing, is another indicator. Individuals might also experience unintentional weight loss and a decreased appetite.
Muscle and joint pain or cramps can also occur. A notable sign is the darkening of the skin, known as hyperpigmentation. Some individuals develop a craving for salty foods. Mood disturbances, such as low mood, depression, or apathy, can also be present.
Steps for Suspected Imbalance
If a cortisol imbalance is suspected, consulting a healthcare professional is important. Self-diagnosis is unreliable, and a medical evaluation is necessary to determine the underlying cause and appropriate management. A healthcare provider will typically begin with a review of symptoms and medical history.
Diagnostic testing for cortisol levels can involve various methods, including blood, urine, or saliva tests. Blood samples are often collected in the morning when cortisol levels are usually highest, and sometimes again in the afternoon. Urine tests may involve collecting all urine over a 24-hour period to measure the total cortisol excreted. Saliva tests are often performed at night, as cortisol levels typically drop in the evening, and a high level at this time can signal an issue.
Additional tests may be ordered to further assess adrenal gland function. These can include the ACTH stimulation test, which measures the adrenal glands’ response to a synthetic hormone, or the dexamethasone suppression test, which assesses how cortisol levels react to a specific medication. Imaging tests, such as MRI or CT scans, might be used to examine the adrenal or pituitary glands for abnormalities. These tests help clinicians understand the body’s cortisol regulation and guide necessary interventions.