How to Recognize High Cortisol Symptoms

How to Recognize High Cortisol SymptomsThe crippling effects of high cortisol are extremely common but all-too-often ignored. Cortisol is a vital hormone produced and secreted by the adrenal glands. It is released in a rhythmic fashion, with levels peaking in the morning to help wake you up and steadily declining throughout the remainder of the day.

What is cortisol?

Cortisol maintains steady blood sugar levels and helps provide energy to your actively functioning brain and neuromuscular system. It is also a potent anti-inflammatory hormone; it prevents the widespread tissue and nerve damage associated with inflammation.

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Cortisol is also a key player in the stress response. Levels surge in response to physical or psychological threats to provide the energy necessary to cope with stressors or escape from danger. However, although a stress-induced increase in cortisol secretion is beneficial in the short-term, excessive or prolonged cortisol secretion may lead to high cortisol symptoms. The symptoms of high cortisol can have serious effects on both your body and your mind.

High cortisol symptoms

The symptoms of high cortisol develop gradually and mostly overlap with many other conditions and include[1-3]:

  • Depression
  • Fatigue
  • Weight gain, especially in the face, upper back (“buffalo hump”), and torso
  • Obesity, especially abdominal obesity/central obesity
  • Back pain
  • Thin skin
  • Decreased concentration
  • Swelling in the hands and feet
  • Low libido
  • Acne
  • Impaired memory (especially short term)
  • Female facial hair or female balding
  • Insomnia
  • Poor skin healing
  • Irritability
  • Menstrual abnormalities
  • Blood sugar dysregulation/high blood sugar
  • Decreased bone mineral density
  • High blood pressure
  • Easy bruising
  • Muscle wasting and weakness of arms and legs
  • Reddish purple streaks on skin

What causes high cortisol?

Rarely, high cortisol is caused by Cushing’s disease—a hormone-secreting tumor of the adrenal gland. More often, however, high cortisol is caused by prescription corticosteroid medications (including corticosteroid injections into the joints).[4]

Even more commonly, high cortisol is caused by chronic stress. Chronic stress dysregulates the body’s stress response system (the hypothalamic–pituitary-adrenal [HPA] axis). The HPA axis is a critical physiological system that mediates responses to all types of physical and psychological stress. When that stress is chronic, the delicate feedback system that is the HPA axis becomes damaged.[5] This can result in chronically high cortisol levels and lead to high cortisol symptoms.

Certain conditions are well known to cause the types of chronic physical and psychological stress which damage the HPA axis and lead to high cortisol levels. These conditions, which are often associated with high cortisol symptoms, include[6]:

  • depression
  • panic disorder
  • generalized anxiety disorder
  • posttraumatic stress disorder
  • anorexia nervosa
  • bulimia nervosa
  • alcoholism
  • diabetes mellitus
  • severe obesity
  • metabolic syndrome
  • polycystic ovary syndrome (PCOS)
  • obstructive sleep apnea syndrome
  • shift work
  • end-stage kidney disease
  • major life stressors
  • chronic pain

What to do about high cortisol symptoms

The fortunate news for those suffering from high cortisol is that many effective treatment options are available, including many natural cortisol-lowering therapies. The correct treatment depends on the underlying cause and may involve anything from surgical removal of the adrenal glands, in the case of true Cushing disease caused by an adrenal tumor, to diet and lifestyle therapies aimed at resetting the dysfunctional HPA axis. If you’re suffering from high cortisol symptoms, eat at regular intervals (every few hours) and follow a diet that is higher in lean protein and fiber and lower in carbohydrates that have a high glycemic index (especially sugar). These dietary changes are important for lowering cortisol levels, as is  the regular practice of relaxation or mind-body techniques such as meditation or progressive muscle relaxation.[7] Start by actively practicing one of these relaxation techniques just a few minutes a day and gradually increase the time to twenty to thirty minutes.

You can also supplement with natural compounds such as phosphatidylserine, magnolia bark extract, and ashwagandha root extract to help lower your cortisol levels. These supplements have been shown in clinical studies to lower high cortisol levels in chronically high-stressed individuals.[8-10]

To start, try phosphatidylserine supplementation at 600‐800 mg per day, as this amount has been shown to lower the cortisol response to acute stress, increase performance, improve mood, and lower feelings of stress.[11,12] These and other natural therapies are sure to lessen your stress response and lower your cortisol, helping you beat high cortisol symptoms for good.

Originally published in 2015, this post has been updated.


[1] J Clin Endocrinol Metab. 2008 May; 93(5): 1526–1540.

[2] Stress. 2015 Aug 13:1-9. [Epub ahead of print]

[3] Medscape Drugs and Diseases. Pseudo-Cushing Syndrome. Updated Oct. 2014. Accessed Aug. 22, 2015.

[4] Endocrine. 2015 Mar;48(2):410-6.

[5] BMB Rep. 2015 Apr; 48(4): 209–216.

[6] Endocrine. 2014 Aug;46(3):370-86.

[7] Stress Health. 2014 Feb;30(1):65-70.

[8] J Int Soc Sports Nutr. 2013 Aug 7;10(1):37.

[9] Indian J Psychol Med. 2012 Jul-Sep; 34(3): 255–262.

[10] Lipids Health Dis. 2014 Jul 31;13:121.

[11] Sports Med. 2006;36(8):657‐69.

[12] J Int Soc Sports Nutr. 2008 Jul 28;5:11.

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Comments
  • I am constantly hungry…no matter what I eat or how much I eat…I feel starved, dizzy, confused, light headed….dehyrdated….then burning up with hot flashes….due to menopause…cannot stay sleeping for more than a hour or two….feel disoriented…what could be happening.

  • Estrogen regulates the level of cortisol in your blood, without it you can end up having high cortisol which can in turn give you high blood sugar/low insulin which can cause a feeling of being constantly hungry and be a cause of some of your other symptoms too. Some of your symptoms could just be due to the hormones fluctuations. First thing, eliminate all caffeine, which spikes cortisol, and contributes to hot flashes. Like this article says sugar, simple carbs (white flour, pasta, white rice) and alcohol affects your cortisol and blood sugar. If you can, quit caffeine, sugar and alcohol and then eat whole grains and brown rice, and focus more on protein, fruits and veggies. Moderate exercise is very helpful too, can help regulate your hormones and blood sugar. Try these things first and then if you need additional help you can try one of the herbal supplements the article suggests (but check WebMD for all of them to find out if there are side effects/drug interactions etc), I do well on Rhodiola Rosea by Gaia Herbs (I tried a bunch of different kinds of Rhodiola and this was the best by far) without any side effects. However after awhile my body adjusted and I just need to take Rhodiola during the parts of my cycle when my hormones are lowest (here’s a link to a 28 day menstrual cycle hormone graph: https://womeninbalance.org/wpcontent/blogs.dir/36/files/2012/10/HormoneCycle.jpg) When your hormones are low, you’ll have higher cortisol issues, and would need to supplement; when your hormones are higher, if you take Rhodiola or another cortisol-lowering supplement, you could actually end up with your cortisol being too low which will make you tired and not feel like doing much of anything). Another option is to go to your ob gyn to either get a low dose birth control pill or HRT, if you put hormones back into your body, your cortisol/blood sugar should go back to normal. I personally can’t take birth control/HRT (makes me crazy and so tired I can’t even drive) but if I could take it, I definitely would, its the best option to get you through perimenopause. Good luck, I know how hard it is.

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