Cortisol, Stress and your Health

General Medical

Tammy George

A man suffering from stress and increase of cortisol in his body

Too much stress can have a negative impact on our health. Research shows that many of those negative effects are linked to one hormone - cortisol.

Elevated cortisol levels caused by chronic stress can result in weight gain, tiredness and long-term health problems. The good news is, there are proven things you can take to reduce stress and keep your cortisol levels under control.

Cortisol Definition - What is Cortisol?

Cortisol is a steroid hormone produced by the adrenal glands. Cortisol secretions peak in the early morning, gradually decreasing over the day to very low levels during the evening and at night. Stressful situations cause secretions to increase. Activities such as eating, exercising and smoking can also cause small increases in cortisol levels.

Cortisol secretions also increase as we age and, in general, higher cortisol levels are associated with aging and disease.     

A study in Sweden revealed women have higher cortisol levels than men. The morning test results in women were significantly higher than men’s morning cortisol levels. The evening test showed cortisol levels were more closely matched between the sexes.  

Cortisol is what gives us our ‘fight or flight’ response to a stressful or dangerous situation. It helps us perform better in some situations and improves focus.

When cortisol is released into the bloodstream it impacts on different parts of the body and can help to:

  • Respond to stress or danger

  • Increase the body’s metabolism of glucose

  • Control blood pressure

  • Reduce inflammation

The pituitary gland in your brain regulates the adrenal glands which sit on top of the kidneys to release the cortisol. Your body regulates the amount of cortisol released to ensure a correct balance. But in some people, the balance isn’t right. Both too much and too little cortisol can have serious consequences for your health.

Symptoms of too much cortisol include:

  • Thin, fragile skin that takes a long time to heal

  • Acne

  • Weight gain, predominantly around the abdomen and face

  • Women can experience facial hair and irregular menstruation

The reason for too much cortisol in your body could be:

  • The pituitary gland is releasing too much due to a tumour or excess growth of the glands

  • A tumour in the adrenal gland is causing an overproduction of cortisol

  • A tumour somewhere else in the body also involved in cortisol production

  • High levels of stress

Symptoms of too little cortisol include:

  • Constant tiredness

  • Nausea and vomiting

  • Muscle weakness

  • Weight loss

  • Abdominal pain

The reason for too little cortisol in your body could be:

  • The pituitary gland is not sending proper signals to produce cortisol, known as hypopituitarism

  • Addison’s disease which is a low production of cortisol by the adrenal glands.

Why is Too Much Cortisol Bad?

Too much cortisol can have the following effects on the body:

  • Impaired brain function – poor memory and a feeling of “brain fog”

  • Increase in susceptibility to viruses – cortisol dampens your immune system so you are more at risk of catching something

  • Tiredness – the interruption of hormone functions and poor sleep can make you feel fatigued

  • Weight gain – cortisol causes weight to be stored around the abdomen and face

  • Chronic health problems – constant waves of cortisol can lead to high blood pressure, type 2 diabetes, cardiovascular disease.

A fatigued woman suffering from an increase of cortisol in the body

Cortisol and Stress - The “Stress Hormone”

When you experience something stressful, part of your brain - the amygdala - sounds the alarm. Your sympathetic nervous system is alerted and put into “fight or flight” mode. Epinephrine (adrenaline) spreads through the body and increases heart rate, sends more blood to your muscles and vital organs, and opens up airways in your lungs to increase oxygen capacity and brain alertness. All of this happens almost instantaneously so that your body can react to danger. After this initial reaction period, the adrenal glands release cortisol. Typically, once the stressful situation passes cortisol levels reduce back to normal levels. When people are chronically stressed the cortisol levels remain too high for too long which can cause other health problems that could result in a trip to hospital.

Men and women release slightly different levels of cortisol and epinephrine but release very different levels of the third hormone, oxytocin from the brain.

Oxytocin promotes nurturing and relaxing emotions designed to counter the impact of the cortisol and epinephrine. Women’s levels of oxytocin are much higher than men’s. Women’s oxytocin levels combined with reproductive hormones is a possible explanation for why women are more likely to ‘tend and befriend’ during stressful situations while men take a ‘fight or flight’ response.

Men and women handle stress differently. Women could be more likely to seek support and talk about their stress while men could tend to look for an escape activity or diversion to get away from it.    

The Effects of Stress on your Health

Modern life is stressful. With so many demands on our time and pressure from work, finances, family and friends that it’s no wonder people are feeling more stressed than they ever have before.

Short-term Effects of Stress

The body responds immediately to a stressful situation. Your heart beats faster, blood vessels dilate pushing more blood into the large muscles and organs and blood pressure increases. Your liver produces more blood sugar to give you the energy for fight or flight.

You may experience appetite changes, vomiting, diarrhoea, heartburn or stomach pains.

Stress isn’t all bad. Short-term stress can help you focus, motivate you and improve your performance. It’s the constant, long-term stress that is dangerous.  

Long-term Effects of Stress

Chronic long-term stress can worsen or increase the risk of many serious health problems including heart disease, obesity, cholesterol levels, Alzheimer’s disease, metabolic disorders, diabetes, depression, gastrointestinal problems, hypertension, asthma, inflammation and poor wound healing.

Due to the heart beating faster and harder and high blood pressure, you are at an increased risk of stroke, heart attack and hypertension.

Cushing’s Syndrome

High cortisol levels over a long time can cause Cushing’s Syndrome. A sufferer can experience physical symptoms of weight gain around the abdomen and fatty deposits around the face and upper back but weight loss on arms and legs. The syndrome can be caused by a tumour in the brain or elsewhere in the body telling the adrenal gland to release cortisol. Long-term steroid medication is another cause.

Cortisol and Weight Gain

Weight gain is one of the most unwelcome symptoms of too much cortisol in the body. The excess weight usually sits around the abdomen. Cortisol increases appetite which adds to the weight gain, but it also tells the body’s metabolism to store fat. Being overweight can also lead to other health problems. Abdominal fat, known as visceral fat, can cause cardiovascular disease. Obesity is also large risk factor for developing type 2 diabetes.

Testing Your Cortisol Levels

If you have symptoms of too much or too little cortisol, visit your doctor to arrange a test to measure your cortisol levels. The test can be either a blood test or a saliva test. Other hormone levels may be analysed with the same test.

A female doctor explaining results from a serum cortisol test to her patient

Blood Test for Cortisol Levels

Also known as a serum cortisol test, a blood test for cortisol levels doesn’t require you to fast. Cortisol levels are naturally higher in the morning so your doctor may request the blood test be taken then. Normal blood test results for an 8am test range between 6 and 23 micrograms per decilitre (mcg/edL).

Cortisol Saliva Test

A salivary cortisol test is a non-invasive, accurate way of testing the body’s stress hormones, cortisol and DHEA. Some saliva tests require you to take the sample within 30 minutes of rising between 6am-8am. Other tests may require you to take four samples over a 12-hour period.

You may need to fast for eight hours and not drink, brush or floss your teeth before the test. It can take 30 minutes to collect enough saliva to fill the specimen container and complete the test. It‘s recommended that you wash and dry your hands before collection so you don’t contaminate the sample.

What Increases Cortisol?

Caffeine and alcohol stimulate the release of cortisol while a lack of sleep has the same effect.   


Studies have shown caffeine increases cortisol secretions in people who are at rest or in mentally stressful situations.  Cortisol levels after consuming caffeine can be as high as during an acute stress attack, particularly in someone who isn’t a daily coffee drinker. You can build tolerance to cortisol release.  


Heavy alcohol consumption can cause increases in cortisol secretions. Intoxication makes the body feel as though it is under stress which stimulates a release of cortisol. Research has found withdrawing from the effects of alcohol increases cortisol production.  

Sleep Deprivation

Sleep affects the release of hormones. Studies show that people who are sleep deprived with only four hours of sleep per night have elevated cortisol levels in the evening. These cortisol levels also decrease six times slower than people who aren’t sleep deprived.  

So How Do You Reduce Cortisol?

Reducing cortisol levels is important for anyone diagnosed with elevated levels.

Reducing elevated cortisol levels is important to avoid triggering other health problems. There are lifestyle changes you can make that will reduce your cortisol levels such as:

  • Get more, better quality sleep

  • Exercise daily

  • Learn ways to cope with stress like mindfulness and breathing exercises

  • Take time out regularly to relax and have down time

Some Tips for Reducing Stress and Reducing Cortisol Levels

You can use some of these techniques to fight back against stress. Here are some ways to handle particularly stressful moments when your mind is racing and your heart is beating quickly:

Use Deep Breathing

Your physiologic response to stress can be brought under control with a few minutes of deep breathing. As you breathe out, concentrate on relaxing a particular group of muscles.

Live for the Moment

Stress is often caused by something that has happened in the past or worrying about the future. If you take a break from what you are doing and bring your mind back to the present moment, the stress will subside.  

Keep Some Perspective

Think about whether you will remember the stressful situation next week and ask yourself if it’s really that bad. Remind yourself of all the things you should feel grateful about.

Stop and Think

Often we are stressed about things we can’t do anything about. Rather than getting worked up, look for a positive to concentrate on.

Reducing elevated cortisol levels long term is important for reducing the risk of serious health problems developing. There are lifestyle changes you can make that will reduce your cortisol levels.

A man having laying on the grass, resting and reducing elevated cortisol levels

Here are some other suggestions for ways to improve your lifestyle and manage stress in the long term:

Exercise More

Regular exercise has been shown to provide more energy and better moods and lowering your risk of many health problems. While exercise can reduce your stress levels, it increases cortisol production so don’t overdo the exercise. Walking 30 minutes a day is a low-impact way to get enough exercise. Owning a dog makes people more like to go for a walk every day too - just don't forget to get pet insurance.

Eat a Healthy Diet

Bingeing on sugar is one of the worst things you can do for your cortisol levels. Frequent or excessive sugar increases cortisol. If you want to indulge, have some dark chocolate. Studies have shown it reduces cortisol during a stress reaction.

Eat a healthy diet rich in probiotics including yoghurt, sauerkraut and prebiotics including bananas, pears and wheat flour. Both probiotics and prebiotics reduce cortisol. Drink plenty of water to stay hydrated and cut down on the alcohol and coffee.

Mindfulness & Meditation

There is plenty of research showing that practicing mindfulness and meditation techniques can reduce stress while improving mood and overall health.

There are plenty of free apps available on your phone or tablet that can teach you the basics of mindfulness and help you make it a regular part of your day. Try Smiling Mind or search for something similar on your device’s app marketplace.

Try Yoga

Yoga is beneficial for anyone that wants to reduce cortisol levels because it combines physical movement with mindfulness to improve overall wellbeing. Yoga will reduce muscle tension, make you feel relaxed and improve your mood. Try these four relaxing yoga moves. Two sessions of yoga per week should see a reduction in cortisol levels.  Find out if your health insurance includes extras cover for yoga and other fitness classes.

Pick Up a New Hobby or Get Back Into an Old One

A hobby or social activity allows you to switch your mind off from thinking about highly stressful situations and can provide you with more social interaction. Socialising and maintaining connections with people can have big mental health benefits.


Make sure you get a good night’s sleep, it’s essential for maintaining hormone and cortisol levels in the normal range. Sleep interruptions can also increase cortisol levels and disrupt hormone patterns. 

If you have any concerns about your cortisol levels or your mental health, see your doctor or a mental health professional.

Tammy George

Please note: Tammy's blog is general advice only. For further information on this topic please consult your healthcare professional.

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