“Cortisol” is a popular wellness buzzword, and there’s a newfound tendency to blame it (or “cortisol imbalances”) for a bevy of health-related matters — from acne to stress to sleep issues. But there’s nuance in these claims that deserves unpacking. While “cortisol imbalance” sounds legitimate, it has no scientific or medical basis. While it’s true that cortisol is tied to stress, the hormone affects nearly every body organ, and we need it — pretty desperately — to function properly. Here’s the cortisol hormone explained, along with some tactics for engaging or calming down our body’s fight-or-flight response.
What is cortisol?
Cortisol is a steroid hormone produced in the adrenal glands that mediates our stress response. To zoom out a bit wider, hormones are chemicals that coordinate different bodily functions by carrying messages through our blood to our organs, skin, muscles, and other tissues. These signals tell our bodies what to do and when to do it.
Cortisol and epinephrine (also known as adrenaline) are the two hormones that dominate the processes of having enough energy and a properly functioning immune system. Think of them as gifts from evolution that make energy more freely available when confronting or fleeing a tangible threat, like seeing a snake on the trail or getting a “Can you call me, please?” text from your boss. The more threatening we perceive something to be, the more cortisol we tend to produce. This complex alarm system is pretty good at self-regulation and self-timing. In other words, cortisol should taper off once the snake is gone or the boss has what they need, but we all react to stress differently.
Cortisol is essential to the body and brain.
Its moniker as a stress hormone “should not stress you out,” says Andrew Huberman (neuroscientist and tenured associate professor in the Department of Neurobiology, Psychiatry, and Behavioral Sciences at Stanford University School of Medicine) in his thorough lab lesson on cortisol. Instead, Dr. Huberman urges us to consider cortisol an energy hormone. Aside from motivating us to get out of the burning building or away from a bear, cortisol regulates our metabolism (breaking down fats, proteins, and carbohydrates), our immune system (anti-inflammatory functions that fight off infection), memory formation, and other facets of physical and mental well-being.
One of cortisol’s most important roles in day-to-day life is found in our sleep-wake cycle. Proper cortisol levels are high in the morning and low in the evening to accompany our circadian rhythm and tell our bodies when to be awake and when to rest. Cortisol should increase upon waking and decrease throughout the day to be lowest at bedtime.
But too much cortisol at the wrong times = BAD
This integral link between cortisol and sleep is where things can get topsy-turvy. We need the hormone level to decrease so we can fully rest at night. People with high evening cortisol often struggle to fall and stay asleep. The ability to down-regulate or “turn off” this fight-or-flight response we so often feel in our bodies and overactive brains is much harder for people with chronic stress (like from a high-pressure career) or traumatic stress (like after a life-or-death event).
While we expect fluctuation in cortisol throughout the day, the blips need to be brief. Sitting in afternoon traffic or reading a triggering comment on social media can elicit bursts of cortisol, but this isn’t necessarily harmful in most people. We just don’t want to be in a state of chronic cortisol elevation. Excessive or chronically high cortisol can undo the hormone’s positive effects and turn them into harmful ones, like insulin resistance, reduced immune function, elevated blood sugar levels, and high blood pressure. It can exacerbate the stress it causes, leading to anxiety, depression, insomnia, and more.
Chronic stress and cortisol
Chronic stress is one of the biggest culprits in elevating our baseline cortisol levels over time. Icky relationships, stressful jobs, and big moves can contribute to this fight-or-flight feeling we cannot shake. Luckily, there are lots of tools and a growing body of research on calming our nervous systems down and ensuring that cortisol goes from high to low throughout the day.
How to properly produce cortisol throughout the day.
There’s one essential and relatively easy thing you can do every morning to regulate cortisol. Many peer-reviewed studies show that getting outside in morning sunlight is imperative to regulating cortisol. Morning sunlight also massively helps your sleep later that night by signaling it’s time to sleep at the proper time. Soon after waking, while the sun is still going up to its highest point, get outside and view some sunlight without sunglasses for two to 10 minutes — a little longer if it’s overcast. Don’t look directly into the sun, of course!
Timing cortisol release early in the day improves focus, mood, energy, learning, and memory. If certain stressors pop up throughout the day that make you feel that surge of adrenaline, try:
- Breathing exercises, meditation, and other NSDR (non-sleep deep rest) methods
- Trading alcohol and caffeine for water, water, water
- Spending time outdoors and exercising consistently (even 30 minutes a few days a week)
- Petting or playing with animals
- Eating healthy meals that prioritize hearty whole grains, vegetables, and fruit
- Upping time with family and friends and talking with someone about life stressors, whether that’s a mental health professional or a close friend
- Sticking to a regular sleep schedule and spending more time in bed
- Saying “no” to stressful people, tasks, and events
- Indulging in hobbies to bring you joy
Curious about your cortisol levels? Talking to a doctor is best.
It’s hard to feel or self-diagnose a hormone imbalance, and your levels naturally change throughout the day. That’s why the at-home tests that use saliva and blood samples can be problematic. They cannot paint a complete picture of your cortisol levels over time. Cushing syndrome can happen when cortisol levels are too high, and Addison’s disease can occur when they’re too low.
A relatively new metric called HVR (heart rate variability) measures your body’s resistance to stress. While they won’t tell you your cortisol levels, wearables like WHOOP and the Aura ring give you access to HRV and a half-dozen other data points about your body’s functions. You can also see detailed sleep analyses and suggested lifestyle shifts to help you manage stress and sleep better. As a WHOOP wearer for three years, I cannot overstate its positive effects on my sleep and stress.
According to the Mayo Clinic, the following can be signs of high cortisol, among other diagnoses:
- Rapid weight gain, mainly in the face, chest, and abdomen
- Osteoporosis
- Skin changes such as thinning skin, acne, bruises, purple stretch marks
- Muscle weakness
- Increased thirst and frequent urination
- Tension headaches, chronic fatigue, and a struggle to recover from physical activity
- Mood shifts such as irritability, depression, or anxiety
- Difficulty concentrating
- Digestive issues, including constipation, diarrhea, or bloating
- Weight gain, particularly in the abdomen, face, and chest
- Diminished libido
- High blood pressure
If you think that your levels are out of whack, consult your primary care physician for an assessment.
Read and listen to these to learn more about cortisol:
- BOOKS: The Mind-Gut Connection by Emeran Mayer, M.D and The Body Keeps The Score by Bessel Van Der Kolk, M.D. (this one dives into the body’s response to severe trauma)
- ARTICLES: This one in The New York Times, and this one in Health
- PODCAST: Huberman Lab’s Episodes “Boost Your Energy & Immune System with Cortisol & Adrenaline” and “Master Your Sleep & Be More Alert When Awake”
Other sources for this article include Examine, Mayo Clinic, and Johns Hopkins.
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