Stop stressing about stress: the role of cortisol in your health

Medically reviewed by Dr. Sonia Gibson and Dr. Gouri Pimputkar

Summary

There is a lot of misinformation online surrounding the role of cortisol in overall health.  Cortisol is commonly known as “the stress hormone” because the adrenal glands secrete it in response to stress. Symptoms that are often attributed to high cortisol may be caused by other underlying health conditions. If you are feeling unwanted symptoms such as fatigue, weight gain, or skin concerns, it’s a great idea to connect with an Allara provider to gain an understanding of your health.

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What is cortisol?

Cortisol is just one of the many hormones that help our body function – so how did it become such a popular topic of conversation? While cortisol plays a large role in your health, it’s not the only factor that affects how you feel.

The cortisol conversation has taken on a life of its own on social media and online - Google searches for “cortisol” have grown by more than five times since 2020. Yet, so much context around cortisol has been left behind. Blanket statements and quick fixes often oversimplify how our bodies use cortisol, and how the hormone behaves on a daily basis.  

Cortisol is an essential hormone that plays a key role in stress, as well as many other functions throughout your body (and it’s not all bad!). It is commonly known as the ‘stress response’ hormone, because the adrenal glands secrete it in response to stress. Levels rise when you experience long or short term stress, and go back down after the stress has passed. However, dysregulated cortisol levels can aggravate symptoms like anxiety, depression, digestive concerns, weight gain, and more. This can happen if someone is under constant stress, leading cortisol levels to rise, but not go back down. Chronic stressors are not just from “stressful situations”: they can be from certain medications, chronic illnesses, obesity, poor nutrition, sedentary lifestyle, and lack of sleep. If you’re struggling to manage stress or experiencing unwanted symptoms, it’s important to chat with a healthcare provider for support.

We’re unpacking some of the recent conversations surrounding cortisol. We spoke with a few of our Allara providers to help us debunk some of the most common myths about the stress hormone.

Myths and facts about cortisol

1. Myth: Cortisol is bad for your health, and you should prioritize lowering it.

‍Truth: Your body needs cortisol to function!

Cortisol plays an essential role in:

• Regulating how your body uses glucose for energy
• Suppressing inflammation
• Maintaining your blood pressure in stressful situations
• Managing your sleep-wake cycle
• Maintaining a healthy immune system

Not only is cortisol crucial – so are its fluctuations. Cortisol naturally goes up and down throughout the day - it’s usually the highest when you wake up, and slowly declines until you go to sleep. This process, called the diurnal rhythm, helps your body know when it’s time to wake up, sleep, eat, and more. It maintains your body temperature, appetite, and digestion.

“Certain events throughout the day may raise your cortisol temporarily, such as intense workouts, eating a large meal, or dealing with everyday stress,” says Dr. Sonia Gibson, our lead Board Certified Endocrinology Physician. “But don’t worry, the levels will go back down after you’re done with the activity, and return to the normal curve. That means that if you love starting the day with a long run or intense workout, that’s okay! Your cortisol may rise a little bit, but it’ll go back down when you're done.”

It’s important to remember that no one habit will set your hormones out of whack – feeling your best is about finding the balance that works for you. Cortisol helps regulate your body, with levels that change throughout the day.

2. Myth: Long term mental, emotional, or physical stress leads to “adrenal fatigue”, causing tiredness, trouble sleeping, and depression.

Truth: Your adrenal glands won’t stop working from too much stress.

The adrenal glands are small organs which produce cortisol during stressful situations. Adrenal fatigue is the idea that if someone is dealing with too much stress, their adrenal glands will no longer produce cortisol, resulting in symptoms like fatigue, salt or sugar cravings, and difficulty sleeping. This idea is not a medically recognized condition – your adrenal glands are built to withstand stress, and they won’t stop functioning because of external stressors.

Unless you have a serious medical condition, your adrenal glands will bounce back from stress.  Adrenal Insufficiency is a condition where the adrenal glands don’t make enough cortisol. This can be caused by auto-immune conditions, infections, taking certain medications, or undergoing treatments such as radiation. Also known as Addison’s Disease, the condition can cause pain in the muscles and joints, low blood pressure, symptoms of low blood glucose, fatigue, weakness, and more.

“The adrenal glands do not get ‘fatigued’, or lose function because of mental or physical stress,” says Dr. Gouri Pimputkar, a Board Certified Allara OBGYN physician. “True Adrenal Insufficiency is a rare health problem. Only an endocrinologist, an expert in hormones, should diagnose Adrenal Insufficiency using standard tests.” Your adrenal glands exist to manage stress. Trying to treat adrenal fatigue will likely be unhelpful at best, and dangerous at worst (if you take adrenal hormone supplements when you don’t need them, your adrenal glands could stop working).

If you’re dealing with unwanted symptoms like fatigue or trouble sleeping, it’s important to work with a healthcare provider – they can help you figure out what’s going on, and how to start feeling better.

3. Having a round face, or “moon face”, is a symptom of high cortisol

Truth: Face swelling can be caused by a wide range of factors that are unrelated to cortisol – true “moon face” is rare.

There’s been a lot of conversations around “cortisol face”. While it’s true that high cortisol can cause a puffy or swollen face, true “moon face” is very uncommon. “Moon face” is a symptom of Cushing's Disease - a rare condition where the body produces too much cortisol. Cushing’s Disease affects 1-10 people out of every million. Symptoms include weight gain, high blood pressure, fat between the neck and shoulders, purple stretch marks, and muscle weakness. This condition is severe and has to be diagnosed in a very specific way.

“Facial swelling can happen from a handful of normal stressors on the body, like an unbalanced diet, lack of sleep, or excess salt intake,” says Dr. Pimputkar. “It’s not always related to cortisol levels.” Sometimes, something as simple as sleeping with pressure placed on your face can cause your face to look more puffy than usual. Other times, it could be related to diet, fatigue, or alcohol consumption. The bottom line: treating “cortisol face” probably won’t help you get to the bottom of what’s going on, and as always, it’s best to connect with a healthcare provider.

4. Myth: You need to follow a strict wellness routine to manage stress levels.

Truth: Everyone is different, and you should find the routine that helps you feel your best.

“As with most things related to your health, the best way to manage cortisol is unique to you,” says Dr. Gibson. “Most people don’t need to test their cortisol, because stress management strategies don’t depend on the exact numbers of cortisol levels. How you manage stress will depend on other factors, such as your lifestyle, dietary restrictions, and health profile.”

What’s important is listening to your body. If you’re feeling overwhelmed or stressed, routines like regular exercise, eating a balanced diet, and getting sufficient sleep may help you feel better. You can also reach out to a healthcare provider, who can help you find the solutions that work for you.  The goal is to control the factors that we can control and improve our natural cortisol response, so that it can work better to do the job that it is supposed to do!

At Allara, we believe that healthcare should be personalized. Our providers get to know each and every patient, run in-depth lab tests, and engage in regular check-ins. Blanket solutions, rigid routines, or detox diets likely won’t provide long-term solutions. You deserve hormonal care that’s tailored to you.

Cortisol and your health

Stress can impact your hormones. If you’re feeling overwhelmed, it can elevate your cortisol, which can lead to hormonal imbalances over time. What’s important to remember is that you can lower your cortisol levels through lifestyle choices, and support from a healthcare provider.

We all get stressed sometimes – and that’s okay! As long as you have the tools you need to get your cortisol levels down after a spike, you don’t need to stress too much about stress.

Takeaways

• Cortisol isn’t all bad: it plays a key role in regulating glucose, suppressing inflammation, managing your sleep-wake cycle, maintaining a healthy immune system, and more.
• Routines like regular exercise, eating a balanced diet, and getting enough sleep may help you manage your stress levels.
• If you’re experiencing unwanted symptoms, reach out and start your journey with guidance from an Allara provider.