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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. Cortisol is a vital hormone produced and secreted by the adrenal glands. The hormone 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.

Cortisol maintains steady blood sugar levels and helps provide energy to the 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.

Cortisol is also a key player when it comes to stress. Cortisol levels surge in response to physical or psychological threats; the hormone provides the energy necessary to cope with stressors or escape from danger.

The symptoms of high cortisol can have serious effects on both the body and the mind.

High Cortisol Symptoms

The symptoms of too much cortisol develop gradually and mostly overlap with many other conditions and include:

• 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 memory)
• 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

Causes of High Cortisol

Rarely, having too much cortisol is caused by Cushing 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).

Even more commonly, too much 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. 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 that damage the HPA axis and lead to high cortisol levels. These conditions, which are often associated with high cortisol symptoms, include:

• Depression
• Panic disorder
• Generalized anxiety disorder
• Posttraumatic stress disorder (PTSD)
• 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

How to Treat High Cortisol

The fortunate news for those with too much cortisol is that many effective treatment options are available. Natural cortisol-lowering therapies  may also be helpful. 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 cortisol levels are too high:

• Eat at regular intervals (every few hours)
• Follow a diet that is higher in lean protein and fiber and lower in carbohydrates that have a high glycemic index (especially sugar).
• Partake in the regular practice of relaxation or mind-body techniques such as mediation at or progressive muscle relaxation. Start by actively practicing one of these relaxation techniques just a few minutes a day and gradually increase the time to 20 to 30 minutes.
• Ask your doctor about supplements with natural compounds such as phosphatidylserine, magnolia bark extract, and ashwagandha root extract to help lower the cortisol levels or reduce stress.

RECOMMENDED FOR YOU

• Yes, You Need to Lower Cortisol Levels—In Order to Best Handle Stress
• What Is Cortisol and What Does It Have to Do with Stress?
• Cortisol: Too Much of This Stress Hormone Can Poison the Brain

Originally published in 2015, this post is regularly updated.

SOURCES

• Medscape, Pseudo-Cushing Syndrome.
• NCBI, The Diagnosis of Cushing’s Syndrome: An Endocrine Society Clinical Practice Guideline.
• NCBI, Technical and clinical aspects of cortisol as a biochemical marker of chronic stress
• NCBI, Harmful effects of functional hypercortisolism: a working hypothesis.