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Have you given any thought to your cortisol levels lately? The so-called “stress hormone” has become a popular scapegoat, blamed for everything from exhaustion and bloating to anxiety, brain fog, muscle cramps, and lack of focus. But as with any health “issue” that gains traction on social media, it’s hard to know who to trust or what information is actually worth your attention.
Here’s the thing: Our bodies have been dealing with cortisol since the earliest humans ran from tigers and bears to stay alive. So why is this ancient hormone suddenly getting so much attention? Here’s what you need to know.
What Is Cortisol?
Cortisol is a hormone made and released by your adrenal glands, two triangle-shaped organs that sit on top of each of your kidneys. It’s known as the “stress hormone” because it’s a primary player in your fight-or-flight response, or your body’s reaction to stress.
But cortisol does much more than handle stress. It also helps your body with many other essential functions, including controlling blood sugar levels, regulating blood pressure, and reducing inflammation.
Your brain constantly monitors cortisol levels in your bloodstream and communicates with your adrenal glands to adjust production based on what your body needs. For example, cortisol is woven into your sleep-wake cycle: Your brain signals your adrenal glands to release it to help you wake up. Cortisol levels peak in the early morning and then gradually taper throughout the day.
The key point: Your body relies on cortisol to carry out many vital functions, and your brain is constantly fine-tuning your levels.
How Cortisol Drives Your Stress Response
When you’re met with a physical or psychological threat, cortisol and other hormones spring into action, priming your body to face the threat or flee from it. The physiological reaction—mental alertness, higher blood pressure, a faster heart rate, rapid breathing—is designed to give your muscles the energy you need to get through a stressful scenario. That’s why nonessential body functions like digestion also slow down.
The problem? Your brain is a “really old machine,” says Kate Hanselman, a board-certified psychiatric mental health nurse practitioner at Thriveworks. It’s built to respond to life-or-death situations, like surviving in the wilderness. But our stressors look completely different now.
“When we think about stress today, we’re not talking about being hunted by a pack of wolves. We’re talking about running late or feeling overwhelmed,” Hanselman says.
Millions of years ago, the fight-or-flight response helped humans hear cracking twigs, spot the wolves, and run or hide for safety. “In modern life, we don’t have as many opportunities to expel the impacts of cortisol,” Hanselman says. You don’t actually run when your boss sends an anxiety-inducing email (as much as you’d probably like to). The email might cause a temporary cortisol spike, and that’s normal. Levels of the hormone naturally fluctuate, so once the tense moment passes, your body goes back to baseline.
High Cortisol Levels: When Is It a Problem?
It’s impossible to know if your cortisol level is a concern without seeing a primary care doctor or endocrinologist. Only a blood test can indicate if your cortisol levels are abnormally high. If that happens, your doctor will likely screen you for a condition like Cushing’s syndrome (also called hypercortisolism), a rare disorder that occurs when your adrenals pump out too much cortisol for a long period. Cushing’s is usually triggered by long-term, high-dose use of oral steroid medications or benign tumors on the pituitary gland at the base of the brain.
Signs of High or Low Cortisol
Physical symptoms of Cushing’s syndrome are pretty distinct, Hanselman explains. Not everyone with the condition shows these signs, but they can include:
- Weight gain
- A fatty hump between the shoulders
- Increased fat around the neck
- Easy bruising
- Purplish stretch marks
- Hair loss, particularly in women
- High blood pressure
- Muscle weakness
- A rounder face
Experts sometimes see higher-than-normal cortisol levels in other hormone-related conditions as well, like polycystic ovary syndrome, which has been linked to an increased risk of depression, anxiety, and other mental health conditions.
On the flip side, it’s also possible to have low cortisol levels, leading to conditions like:
- Addison’s disease, when the adrenal glands don’t produce enough of the hormone
- Hypopituitarism, when the pituitary gland fails to tell the adrenals to produce the hormone
These conditions can lead to symptoms like fatigue, dizziness, low blood sugar, muscle cramps, weakness, and stomach upset. Again, a blood test is required to diagnose any conditions associated with high or low cortisol levels.
Common Misconceptions About Cortisol
When people post about cortisol on social media, they’re generally not pointing to a diagnosable condition. Rather, they’re talking about stress itself and wrongly blame “high cortisol” for every negative health consequence they experience.
Here’s the reality: If you’re chronically stressed—which happens when any type of stress goes on for weeks or months—you’ll feel physically and mentally unwell.
When you’re working nonstop, dealing with a life transition, or recovering from a health scare, there’s often a cascade of mental and physical effects, Hanselman says. You might have achy muscles, trouble sleeping, or brain fog, among other symptoms—but these don’t all come down to a single hormone.
Stress can cause you to freeze up as much as it can rev you up. You may be so drained that all you can do after work is lie on the couch and watch TV. So when you notice physical changes—like weight gain if you used to be more active—it’s natural to look for a culprit. “Is it cortisol keeping weight on you, or is it your response to stress, regardless of what the hormone is doing, keeping weight on you?” Hanselman asks.
The bottom line: While higher cortisol levels are linked to chronic stress, cortisol levels are not entirely within your control, nor are they a single problem to solve—especially not with the latest “hormone-balancing” supplements promoted on TikTok.
What to Do if You Think You Have High Cortisol
If you’re so stressed that you’re worried about your cortisol levels, speak with your doctor about your symptoms. “I recommend primary care first because that’s the place where they can rule out a lot,” Hanselman says. “They can run tests to tell you if it’s something diagnosable and treatable.”
Next, turn your efforts toward what you can control: reducing stress in general. If it’s bad enough that you’re seeking medical attention, connecting with a mental health professional might be more helpful to you than trying to figure it out alone. They can help you pinpoint the source of your stress, make lifestyle changes, and set attainable goals that support your mental health.
“I can’t tell you how many people come to me and say, ‘I’m stressed and I don’t know why,’ or ‘I’m stressed but I think I should be able to handle this,’ and we can actually recalibrate your expectations,” Hanselman says.
The Bottom Line on Cortisol
Here’s what you need to know: Having abnormally high or low cortisol levels is rare and tied to specific medical conditions that require blood tests to diagnose. What social media calls “high cortisol” is usually just chronic stress—which absolutely deserves attention, but not the kind you’ll find in a supplement bottle.
If you’re feeling overwhelmed by stress and wondering about your cortisol levels, skip the online rabbit holes. “Talk to your primary care provider and a mental health specialist,” Hanselman says. “We can help you figure out what it is, what it isn’t, and what to do about it.”
