What Is Cortisol?

Most people are familiar with hormones like estrogen and testosterone. But the body produces a lot of hormones that aren’t as well-known. One of them is cortisol.

What Is Cortisol?

Cortisol is a stress hormone produced by the adrenal glands, which are two small glands at the top of your kidneys. It is one of the two main hormones your adrenal glands produce.

Cortisol belongs to a class of hormones known as glucocorticoids. It helps regulate a person’s motivation, mood, fear, and fight-or-flight response.

Stress causes the body to produce an abundance of cortisol, which can slow some bodily functions. Stress may adversely affect a person’s immune system, digestive system, or reproductive system. In children, too much cortisol can disrupt physical growth and also cause obesity.

What Is the Function of Cortisol?

Cortisol is a multitasking hormone that’s key to overall health. Cortisol levels fluctuate depending on a person’s circumstances. To flourish, your body needs to have the right cortisol level at the right time.

While the main function of cortisol is to help your body respond to and manage stress, cortisol also:

  • Prevents inflammation.
  • Controls sleep-wake cycles.
  • Regulates blood pressure.
  • Raises blood sugar as needed.
  • Boosts energy during a stressful period.
  • Controls metabolism by managing the body’s use of protein, fat, and carbohydrates.

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How Is Cortisol Produced And Adjusted?

While the adrenal glands produce cortisol, other areas of your brain also help adjust your blood’s cortisol levels. This includes the hypothalamus and the pituitary gland (a pea-sized gland at the base of your brain). Sometimes called the master gland, the pituitary gland regulates growth, reproduction, and blood pressure. Your hypothalamus is a region of the brain just above the pituitary.

Signs of High Cortisol

Cortisol levels that are either too high or too low can be harmful. Chronic stress keeps cortisol levels continuously high. Signs of high cortisol include:

Cushing’s Disease

Cushing’s disease is when a tumor or mass in the adrenal or pituitary glands causes cortisol overproduction. Cushing’s is a rare disease. It occurs most often in those between ages 20 and 50, and women make up more than 70% of cases.

Symptoms of Cushing’s disease include:

  • Rapid weight gain.
  • Thin skin that bruises easily and heals slowly.
  • A round, swollen face.
  • Muscle weakness.
  • Extra facial and body hair.
  • Hair loss in women.
  • Purple, stretchmark-like streaks across your chest or belly.
  • Large amounts of belly fat and upper back fat.
  • Getting tired easily.
  • Irregular menstrual cycles in women.

Addison’s Disease

Too little cortisol could indicate Addison’s disease. It occurs when the adrenal glands become damaged and can’t make enough cortisol. Addison’s disease is rare. Women are more likely than men to develop it. It occurs most often in those between ages 30 and 50.

Symptoms of Addison’s disease often appear slowly and include:

  • Fatigue and weakness.
  • Weight loss or appetite loss.
  • Skin changes.
  • Nausea and vomiting.
  • Diarrhea.
  • Abdominal pain.

Adrenal Crisis

When cortisol levels are extremely low, it can cause adverse effects. Low cortisol levels can trigger adrenal crisis, a condition that requires immediate attention. Symptoms of adrenal crisis include:

  • Extremely low blood pressure.
  • Severe vomiting or diarrhea.
  • Dehydration.
  • Confusion.
  • Sudden and severe pain in the abdomen, legs, or lower back.
  • Loss of consciousness.

Testing Cortisol Levels

To check your cortisol levels and diagnose a cortisol-related disorder, your doctor can order a cortisol test. This measures levels in your blood, urine, or saliva.
While blood tests are the most common way to test cortisol levels in your body, other tests include:

High cortisol levels suggest that you may have Cushing’s disease. Low cortisol levels suggest that you may have Addison’s disease.

Abnormal cortisol levels don’t always mean that you have a cortisol disorder or a health condition that needs treatment. Several factors can affect your cortisol test results, including pregnancy, infection, stress, and medications (such as birth control pills).

Tips for Managing Stress

Because stress can affect your cortisol levels, it’s important to get your stress under control. To best manage stress, be sure to:

  • Get regular exercise.
  • Focus on the present by practicing yogaguided imagery, or meditation.
  • Get 7 to 9 hours of sleep each night.
  • Do something you enjoy, such as a hobby or volunteer work, to help you relax.
  • Eat a healthy balanced diet.
  • Avoid smoking and limit alcohol use.

Treatment Options

Treatment options for adrenal gland disorders include:

  • Medication to stop the excess production of cortisol.
  • Hormone replacement for low cortisol levels.
  • Minimally invasive surgery to remove tumors in the pituitary glands. Doctors perform this surgery through the nostrils.
  • Surgery to remove tumors on the adrenal glands.
  • Surgery to remove one or both adrenal glands.
  • Radiation therapy to treat tumors on the adrenal glands.

When Should I See a Doctor About Stress?

If you can’t manage stress on your own, your doctor can help. A licensed counselor or other mental health professional can help you find ways to reduce stress in your life. They can also screen you for other disorders related to stress, such as anxiety, depression, or insomnia.

Cortisol can affect many parts and systems in the body. If you have any questions about the definition of cortisol or if you have a cortisol-related health issue, contact your UPMC doctor. You can find a UPMC doctor by calling 1-800-533-UPMC.

Editor's Note: This article was originally published on , and was last reviewed on .

About UPMC

Headquartered in Pittsburgh, UPMC is a world-renowned health care provider and insurer. We operate 40 hospitals and 800 doctors’ offices and outpatient centers, with locations throughout Pennsylvania, Maryland, New York, West Virginia, and internationally. We employ 4,900 physicians, and we are leaders in clinical care, groundbreaking research, and treatment breakthroughs. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside as one of the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. We are dedicated to providing Life Changing Medicine to our communities.