Cortisol: What It Does and the Signs of High Cortisol

Could your tiredness, poor sleep or weight gain be down to cortisol? When days become exhausting, it’s an understandable question. This hormone is often talked about as if it explained every effect of stress on its own.

Cortisol is essential for the body to work. Its level varies naturally. A lasting excess, however, may need medical care. Some physical signs can guide a doctor, but no single feeling is enough to make the diagnosis.^{[1, 2]}

Here’s how to recognise the situations worth getting checked, and what tests can really tell you.

What are the signs of high cortisol?

Looking for a list to understand what’s happening to you? Several signs can come with a prolonged excess of cortisol. Not everyone has all of them, and they can have other causes.

How they combine, how they progress and their context matter more than any single symptom. Your doctor relates them to your history, your treatments and their examination.^[3]

Which physical signs deserve particular attention?

Noticing several unusual changes that are settling in? These are the signs described by medical sources:

Why aren’t tiredness and stress enough for a diagnosis?

Sleeping badly and feeling worn out: does that prove a hormonal excess? No. These symptoms are common and can’t tell you your cortisol level.

The aim of an appointment is to explore what’s bothering you, without deciding in advance that this hormone is to blame for everything. Likewise, recognising some of the signs on a list doesn’t mean you have Cushing’s syndrome. This condition needs a precise diagnostic process.^[3]

What is cortisol and what does it do?

Why does your body make this hormone? Cortisol is produced in the outer part of the adrenal glands, which sit on top of the kidneys.

It helps regulate metabolism and blood sugar, blood pressure and the body’s response to challenges. It also influences inflammatory and immune responses. Its nickname, the “stress hormone”, describes only part of what it does.^[1]

The goal is not to get rid of cortisol. Your body needs it to be well regulated, and too little can also cause disease.

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Why does its level change during the day?

Is a higher reading on waking necessarily worrying? Cortisol usually follows a daily rhythm: it is higher in the morning and falls as the day goes on.^[1]

The time of the sample is therefore part of the interpretation. Sleep patterns and some treatments can also influence which tests are chosen. A value can’t be read correctly without this information.

How is it linked to inflammation?

Is cortisol simply a hormone that “causes inflammation”? On the contrary, it helps regulate the inflammatory response and has anti-inflammatory effects.^[1]

The links between stress, hormones and immunity are complex. You can’t infer a particular kind of inflammation from a cortisol level, nor claim that lowering this hormone would automatically improve your health. To go further, read our feature on stress and cortisol.

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What causes a lasting excess?

Why look for the cause before trying to bring a value down? The possible mechanisms are not treated in the same way.

Cushing’s syndrome means prolonged exposure to too much cortisol, or to medicines that act in a similar way. In particular, a medicine-related cause has to be distinguished from overproduction by the body itself.^[5]

Can corticosteroids be the cause?

Taking a corticosteroid treatment? Under certain conditions of use, these medicines can lead to Cushing’s syndrome. Your doctor needs to know about all your treatments and every way you take them.^{[3, 5]}

Exposure to a medicine in this family is not the same as your own glands producing too much cortisol.

What is the difference between Cushing’s syndrome and Cushing’s disease?

Do these two terms mean exactly the same thing? Cushing’s syndrome describes all the effects of excessive exposure to glucocorticoids.

Cushing’s disease refers to one specific cause: a usually benign tumour of the pituitary gland makes too much ACTH, a hormone that stimulates the adrenals. Other causes can lie in the adrenal glands or involve ACTH being made elsewhere in the body.^[6]

These explanations help you understand the medical approach. They don’t allow you to identify a cause from your appearance or from where you have gained weight.

How do you know if your level is really too high?

Is a blood test enough? A single measurement cannot, on its own, diagnose Cushing’s syndrome. Your doctor chooses tests based on the signs observed and the factors that can affect results.^{[3, 7]}

Which tests might your doctor suggest?

Heard about saliva, urine or dexamethasone tests? These tests answer different questions.

Several measurements or tests may be needed. An abnormal result has to be put in context and sometimes confirmed. Looking for the cause comes next, if the excess is established.^[7]

A blood sample taken at a random time is not the recommended screening test for Cushing’s syndrome. That doesn’t mean every blood cortisol test is useless: its value depends on the medical question being asked.^[3]

Is there a normal value that applies to everyone?

Your doctor also takes into account medicines and sampling conditions. Use the reference ranges on your lab report, then ask the prescriber to explain the result.^{[3, 7]}

When should you see a doctor, and how do you prepare?

Are physical changes adding up, or is tiredness stopping you from living normally? Make an appointment with your GP. They can look for different causes and refer you to an endocrinologist if needed.

What happens if an excess is confirmed?

Is there a single solution? Treatment depends on the cause. A supervised change to a medicine, surgery or specific medicines may be considered, depending on the situation.^{[8, 9]}

Follow-up also looks at blood pressure, blood sugar, bones and other possible consequences. It is part of a specialist care pathway.^[8]

A relaxation programme or a change of diet does not replace treatment for pathological hypercortisolism.

What role for lifestyle and supplements?

Want to feel better day to day already? Some habits support your wellbeing, without claiming to correct a hormonal excess:

To take this further, see our advice on easing stress and fatigue.

If you’d like to learn about the brand’s products, you can discover AISA Moleculum Capsules. This article does not show that they lower cortisol or treat Cushing’s syndrome. Any supplement should be considered in light of its composition, your needs and your treatments.

Sources

1. Society for Endocrinology, You and Your Hormones, “Cortisol”. yourhormones.info
2. NIH, NICHD, “What are the symptoms of Cushing syndrome?”. nichd.nih.gov
3. Endocrine Society, “Diagnosis of Cushing’s Syndrome”, 2008 clinical practice guideline. endocrine.org
4. NIH, NIDDK, “Cushing’s Syndrome”. niddk.nih.gov
5. NIH, NICHD, “Cushing’s Syndrome” fact sheet. nichd.nih.gov
6. Endocrine Society, “Cushing’s Syndrome and Cushing Disease”. endocrine.org
7. NIH, NICHD, “How do healthcare providers diagnose Cushing syndrome?”. nichd.nih.gov
8. Endocrine Society, “Treatment of Cushing’s Syndrome”, 2015 clinical practice guideline. endocrine.org
9. NHS, “Cushing’s syndrome”. nhs.uk