How Much Should You Actually Care About Your Cortisol Levels?
Design: Ingrid Fowler; Source images: Getty
“Is high cortisol making you less attractive?” “Not losing weight? It’s your cortisol.” “Got cortisol face?” These are examples of actual questions you’ll find TikTokers “answering.” Again, that’s creators—not doctors!—that are obsessing over this potential harm and, oftentimes, sharing alarming advice, too. (Talk about stress-inducing.)
When you’re stressed out—which, for most of us with jobs and families and social lives isn’t exactly infrequent—it’s not uncommon to feel anxious or grind your teeth or get irritable. All can be normal physical responses to stress. At the same time, your body reacts internally: your adrenal glands, located above your kidneys, release a hormone called cortisol. Also called your fight-or-flight hormone, cortisol triggers physiological processes that help you respond to potential danger.
One example: Cortisol regulates your metabolism and keeps your blood pressure steady. “If you see an animal running toward you, and you want to run away, that rush of cortisol is needed to survive,” says Khadeen C. Cheesman, MD, a board-certified endocrinologist and assistant professor of medicine at Mount Sinai Hospital. While cortisol is necessary for helping your body respond to physical or emotional stress—whether an oncoming sabertooth tiger, a COVID-19 infection, or a deadline at work—too much of it can take a toll on your body, from causing subtle stress-driven symptoms to signifying a serious medical condition.
And though the idea of regulating your cortisol is trending on screens, “it’s one of those areas that has been floating around in the periphery for at least 20 years,” says Scott Isaacs, MD, a board-certified endocrinologist at Diabetes and Endocrinology Clinic of Georgia and president elect at the American Association of Clinical Endocrinology. But the bigger question is: Can you actually control your cortisol levels? And, if so, do you even need to?
We talked to endocrinologists to find out those answers—and to ease our minds and yours.
Meet the experts:
Khadeen C. Cheesman, MD, is a board-certified endocrinologist and assistant professor of medicine at Mount Sinai Hospital.
Scott Isaacs, MD, is a board-certified endocrinologist at Diabetes and Endocrinology Clinic of Georgia and president elect at the American Association of Clinical Endocrinology.
Marilyn Tan, MD, is a clinical associate professor of endocrinology at Stanford University School of Medicine.
What causes high cortisol?
For starters, the term “high cortisol” can be misleading, because your cortisol levels naturally rise and fall throughout the day according to your body’s circadian rhythm—the internal clock that tells you when it’s time to wake up and sleep. “Typically, for people with a regular day-night sleep-wake schedule, the levels are higher in the morning and start to decline throughout the day,” says Marilyn Tan, MD, clinical associate professor of endocrinology at Stanford University School of Medicine. Any physical stress, like a hard workout such as a HIIT class, can also cause cortisol levels to spike temporarily. And that’s not a bad thing.
In otherwise healthy people, Dr. Cheesman says cortisol levels are “usually under tight control by an organ in your brain called the pituitary gland,” which sends a signal to your adrenal glands when you experience any type of stress or when you wake up in the morning. It’s possible for cortisol to be too high and even lead to medical risk, but this is typically due to disease.
Common signs of pathological high cortisol—meaning high cortisol due to a medical condition—include weight gain in the abdominal area, facial rounding, dark purple stretch marks, and a fatty hump on the back of the neck. In one medical condition called Cushing Syndrome, cortisol levels become too high as a result of a non-cancerous tumor in the pituitary or adrenal glands, explains Dr. Isaacs. Cushing Syndrome can also cause major fatigue and muscle weakness, especially in the upper legs. High cortisol from Cushing Syndrome can also increase the risk of serious medical issues like high blood pressure and cholesterol and type two diabetes, explains Dr. Isaacs. But that’s an extreme case.
Physiological high cortisol, or high cortisol levels due to normal physical processes like stress, can also cause high cortisol levels that negatively affect your body—but likely only temporarily, and less severely (for instance, Dr. Cheesman says, high cortisol levels caused by stressful experiences might make it difficult to get a good night’s sleep) than in a medical condition like Cushing Syndrome.
Can stress cause high cortisol?
Experiencing chronic stress doesn’t mean your cortisol levels are so high that it’s dangerous, or that you even need to do anything about it. “The stress of day-to-day life does not cause chronic pathologic cortisol elevation that would show up as a positive screening lab,” says Dr. Tan.
Some companies sell cortisol tests or dietary supplements to help manage cortisol, but according to Dr. Cheesman, there’s no approved or well-studied diagnostic tool or treatment for chronically elevated cortisol levels from stress: “Don’t go and buy some crazy product or overthink about this. You don’t need them to tell you that someone under chronic stress will have abnormal cortisol levels,” he adds.
But should you stress about your cortisol levels?
All of this is to say: Try not to stress about being stressed, at least when it comes to managing your cortisol levels. Scientific evidence is clear that any kind of stress, especially in the long-term, isn’t good for your well-being—stress itself can make you feel bad physically, along with increasing your risk of coping with potentially unhealthy behaviors. “People need to care about their stress levels, but probably not their cortisol levels,” says Dr. Isaacs, who suggests taking all the easier-said-than-done steps to manage day-to-day stress, including prioritizing sleep, proper nutrition, physical activity, and getting support from loved ones or a therapist when you need it. Dr. Isaacs adds, “Stress is bad for the body; it makes people feel bad. But cortisol is not the major factor in why stress is bad.”
And keep in mind that worrying too much about this hormone, or anything else, is counterproductive if you’re concerned about taking care of your mind and body. “If you fixate on your cortisol levels every day, that can be unhealthy,” says Dr. Cheesman. “That itself might lead to more stress and higher cortisol levels.”
Read about ways to destress.
Now watch Sabrina Carpenter's beauty routine.
Don't forget to follow Allure on TikTok and Instagram.
Originally Appeared on Allure
