What is Cortisol and How Does it Work?

What is cortisol?

Cortisol is the body’s stress hormone produced by the adrenal glands. Hormones are chemicals that carry messages to different parts of the body. In the case of cortisol, these messages affect nearly every organ in the body and are responsible for a range of functions, including:

• Controlling the body’s response to stress.
• Reducing inflammation.
• Regulating metabolism.
• Increasing blood sugar.
• Managing blood pressure.

When you experience a stressful situation, several different changes take place in your body that prepare you to respond to it—helping you to fight, freeze, or flee from the danger at hand. For example, if you’re crossing the street and a car doesn’t stop, your body will respond to this stressful situation, enabling you to stop abruptly or to move faster to avoid being hit.

In this situation, experiencing stress is adaptive because it keeps you alive. Your body is designed to respond to stressors like these and then recover. However, when you experience chronic stress, your cortisol levels remain elevated for longer periods.

An example of chronic stress might be working under a boss who consistently berates you. Each day that you go to work you feel stressed knowing that you will have to interact with your boss and deal with their abuse. In this situation, the stressor is ongoing without an end in sight, unless you decide to quit your job.

High levels of cortisol can have a negative impact on your health. It can increase your risk of physical and mental health conditions like cardiovascular disease, depression, and anxiety.

Even though you can’t tell your body to stop releasing cortisol, you can take steps to reduce stress, which can help lower the levels of cortisol in your body. Stress management techniques and lifestyle changes, like those described below, can help you manage your cortisol levels and reduce the risk of physical and mental health conditions associated with chronic stress.

What does cortisol do?

Cortisol plays a role in several different functions in the body, including the stress response and immune response.

Cortisol and the stress response

Cortisol is involved in the body’s reaction to stress, also known as the “fight-or-flight” response. When you are faced with a stressful situation, the amygdala, a part of the brain involved in processing emotions, sends a signal to the hypothalamus (the brain’s command center). It tells the body to activate the sympathetic nervous system. This immediately triggers a release of hormones like epinephrine and adrenaline.

At the same time, your body experiences physiological changes like increased heart rate, blood pressure, breathing, and alertness. The brain can get more oxygen and release important nutrients, giving the body more energy. These changes allow the body to respond to the stressor by either getting away or facing it head on. In the example of car not stopping as you cross the street, your body’s stress response motivates you to take action by moving faster so that you don’t get hit by the car.

If the brain determines that there is still a threat, such as if there are more cars speeding down the road, it will keep the stress response going by releasing additional hormones. These hormones travel to the adrenal glands and trigger the release of cortisol. Cortisol allows the body to continue to remain in high alert until it determines that the threat is no longer present.

Once the stressful event is over—there are no more cars and it is finally safe to cross the street—the parasympathetic nervous system will activate the “rest and digest” response, which calms the body down and allows it to return to a balanced state.

Cortisol and the immune response

Cortisol also plays a role in the immune response by activating and suppressing it at different points in time. The immune response is the body’s response to anything that it perceives as foreign and harmful, such as viruses or bacteria.

When cortisol is released following a stressor, it helps to reduce inflammation, which protects the body and allows it to respond to the stressor. But when stress continues, cortisol can have the opposite effect and suppress the immune system. This causes more inflammation and increases your vulnerability to illness.

The connection between cortisol and mental health

There is a strong connection between cortisol and mental health. High levels of cortisol and exposure to prolonged stress are linked to mental health conditions like anxiety and depression.

Stress can come in many forms, including:

• Acute stress. A temporary stressor, such as running late for an important meeting, triggers the body’s fight-or-flight response. Once the stressor ends, the body relaxes and returns to normal.
• Chronic stress. A stressor is present over a prolonged period. An example of chronic stress is being in a romantic relationship where there is abuse. Because you face this stress every day, the body is not able to recover from the fight-or-flight response, causing high cortisol levels and increasing the risk of depression and anxiety.
• Traumatic stress. An event occurs that is traumatic, such as an accident, natural disaster, or abuse, either as a one-time event or an ongoing situation. Experiencing traumatic stress can put you at risk for post-traumatic stress disorder (PTSD).
• Psychological stress. Stress that is caused by your thoughts, such as worrying about something you lack control over, rumination, or self-imposed demands.

While the link between cortisol and anxiety and depression is clear, the relationship between exposure to trauma and cortisol is more complex. Studies have found that people with PTSD have varying cortisol levels. When they are calm, their cortisol levels are typically normal or lower than average. However, when they are in a stressful situation or reminded of their trauma, their cortisol levels can spike.

High levels of cortisol over time can affect your brain functioning, especially the parts of the brain involved in memory. People who experience a lot of stress show memory issues and may also be at greater risk for Alzheimer’s disease.

Chronic stress can also have negative effects on your mental health. While some stressors cannot be avoided, such as traumatic events, psychological stress is largely caused by your thoughts, fears, and projections. Taking steps to reduce your exposure to stress, maintaining healthy and balanced thoughts, and implementing coping skills can help reduce your risk of stress-related mental health conditions.

Your levels of cortisol

Cortisol levels fluctuate throughout the day and are impacted by many different factors. Levels of cortisol are typically highest in the morning shortly after waking up and decrease over the course of the day. They are typically lowest before bedtime.

Levels of cortisol can be impacted throughout the day by:

• Diet
• Sleep
• Exercise
• Smoking
• Alcohol use

Cortisol levels are measured by tests on urine, semen, or blood and used to diagnose Cushing’s syndrome and Addison’s disease.

What happens when cortisol levels are too high?

Cushing’s syndrome is a condition where your body produces too much cortisol. It is most common in adult females between the ages of 30 and 50, but can affect children too.

Cushing’s syndrome can be caused by tumors in the pituitary or adrenal glands., or taking glucocorticoids, medications used in the treatment of inflammation-related conditions, such as asthma, chronic obstructive pulmonary disease (COPD), or arthritis.

Symptoms of Cushing’s syndrome include:

• Weight gain.
• Purple stretch marks.
• Muscle weakness.
• Bruises.
• A round face.
• Thin legs and arms.
• Fat around the neck and between the shoulders.

If you are experiencing any of the symptoms listed above, you should speak with your healthcare provider.

What happens when cortisol levels are too low?

Adrenal insufficiency, also known as Addison’s disease, is when the adrenal glands do not produce enough cortisol. This means that your body does not respond effectively to stressors, and can cause a range of physical and emotional symptoms.

Addison’s disease is a rare condition. It is most common in women between the ages of 30 and 50, but anyone can develop it.

Symptoms of Addison’s disease include:

• Chronic fatigue.
• Lack of appetite.
• Muscle weakness.
• Weight Loss.
• Stomach pain.
• Gastrointestinal symptoms like nausea, vomiting, and diarrhea.
• Low blood pressure upon standing.
• Darkening of the skin.
• Low blood sugar.
• Cravings for salt.
• Changes in your menstrual cycle.
• Low libido.
• Irritability.
• Depression.

Around 80 to 90 percent of cases of Addison’s disease are caused by an autoimmune disease, where the immune system attacks its own organs. Other less common causes include infections like tuberculosis (TB) and HIV/AIDS.

If you are experiencing any of the symptoms listed above, you should speak with your healthcare provider. Addison’s disease is typically treated with medications and dietary changes.

How to manage cortisol levels

Cortisol levels can be impacted by a number of factors, including your diet, level of physical activity, and exposure to stress. If you suspect high or low cortisol levels, you should speak with a medical provider to rule out certain conditions.

You may also benefit from taking steps to manage stress and naturally balance your cortisol levels. Here are seven ways that you can help manage your own cortisol levels:

Tip 1: Adopt relaxation techniques

Cortisol is linked to the stress response, so it makes sense that using relaxation techniques can help reduce cortisol levels. Studies on mindfulness and breathing techniques have found this to be the case. These activities help activate your parasympathetic nervous system, which is responsible for calming the body after exposure to stress.

Relaxation techniques like mindfulness and deep breathing can be beneficial in moments of heightened stress, as well as used as daily practices. If you are new to relaxation techniques, you may want to try one of HelpGuide’s guided meditations.

You can also practice mindfulness and deep breathing on your own by following the instructions below:

• Find a comfortable space where you can’t be disturbed.
• Sit in a comfortable position, possibly with your legs crossed.
• Take a deep breath in through your nose for a count of four.
• Hold your breath at the top for another four seconds.
• Exhale through your mouth for six seconds.
• Repeat this cycle for several more rounds.

As you practice the exercise, you may notice that thoughts come up. This is completely normal. When this happens, notice the thought, repeat the words “Let go” to yourself, and return your attention to your breath.

Tip 2: Seek social support

There are many benefits to having good relationships in your life, including lower levels of cortisol. Research has found that when we bond with other people, we release a feel-good chemical called oxytocin, which actually lowers the release of cortisol. Not surprisingly, social isolation is linked to higher cortisol. This means that seeking connection may be an effective way to balance your cortisol levels.

If you don’t have a strong social support network, you can start building one or expanding your social circle:

• Take a class that interests you, such as pottery or writing.
• Join a team sport like soccer or softball.
• Visit your local library to see what free events they offer.
• Try a social networking app.
• Volunteer for a cause that’s important to you.

Many people struggle to make friends as a result of negative thoughts getting in the way. If you are isolated, you may have thoughts like “No one will want to be my friend,” or “I can’t trust anybody.” These thoughts then stop you from joining activities or clubs where you might meet new people.

If you’re struggling with these types of thoughts, known as cognitive distortions, there are steps you can take to reframe your thoughts. You can ask yourself questions like, “Is this thought true 100 percent of the time?” and “Are there any other ways to think about this that would better serve me?”

Tip 3: Eat a healthy diet

Cortisol levels can also be impacted by your diet. One study found that eating a diet high in saturated fats, refined carbohydrates, and added sugar was linked to higher cortisol levels. On the contrary, eating a healthy, whole food diet consisting of fruits, vegetables, and whole grains was associated with lower cortisol levels.

The following foods and beverages have been found to specifically lower cortisol:

• Dark chocolate.
• Whole grains like brown rice and whole wheat bread.
• Fruits and vegetables.
• Green tea.

Since dehydration is also linked to increased cortisol, it’s important to make sure you’re drinking enough water. The U.S. Department of Health and Human Services recommends that women drink nine cups daily and men at least 13 cups of water each day. If you are pregnant, breastfeeding, or physically active, then these numbers may be higher.

Some dietary supplements have also been found to help lower cortisol levels:

• Vitamin C, which is naturally found in many fruits and vegetables, may help to decrease cortisol released during stress.
• Ashwagandha is an herb that has been used for thousands of years to help decrease stress and improve sleep.
• L-theanine, an amino acid found in green tea, may help lower stress and cortisol.
• Magnesium is a mineral that plays a role in the body’s stress response. Stress can lower magnesium and low magnesium can increase your vulnerability to stress.
• Omega-3 fatty acids are healthy fats that are naturally found in some fish, nuts, and seeds and may help to promote healthy cortisol levels.

Be sure to speak with your doctor or a nutritionist before taking any supplements.

Tip 4: Get moving

Physical activity is another effective way to lower your cortisol levels. Exercise also releases endorphins, which help to boost your mood. This means that exercise is not just good for your physical health, but also your mental health.

Adults should aim for at least 150 minutes of vigorous physical activity each week. This can be broken up across several days, such as 50 minutes of exercise three days per week. Additionally, try to aim for at least two days of muscle-strengthening exercise each week.

Going to the gym is one way to get exercise and reap the benefits of lower cortisol, but it’s not the only way. There are many ways to incorporate physical activity into your life, such as:

• Playing team sports like soccer or softball.
• Spending time in nature by hiking or walking.
• Training for and running a 5K.
• Taking group exercise classes.
• Doing water sports like kayaking or surfing.

The way that you exercise is less important than just getting up and moving.

Tip 5: Improve your sleep

Getting good quality sleep is important for both your physical and mental health. Sleep deprivation not only makes you feel tired, but can also increase your cortisol levels.

Adults generally need seven or more hours of sleep each night. If you’re not getting enough sleep, you are at greater risk of type 2 diabetes, stroke, high blood pressure, heart disease, and motor vehicle accidents.

Here are some simple ways to improve the quality of your sleep:

• Try to go to bed and wake up around the same time each day.
• Avoid using electronic devices at least one hour before you go to bed.
• Keep your sleep environment quiet, dark, and cool.
• Limit caffeine to the morning hours.

Tip 6: Change your mindset

It is well established that stress plays a key role in the release of cortisol. If you’re constantly worrying or feeling stressed out, then your cortisol levels are likely to be higher.

Negative thoughts, especially negative anticipation of the future, is linked to higher stress and cortisol levels. If you’re experiencing a lot of negative thoughts, taking time to shift your mindset could be helpful.

The first step when it comes to changing your mindset is recognizing your unhelpful thinking patterns that are contributing to your stress and anxiety. These thinking patterns are called cognitive distortions.

Common cognitive distortions that are linked to stress and anxiety are:

• Catastrophizing: Imagining that the worst possible outcome will happen, even when there is no evidence for it.
• Fortune telling: Assuming that you know how the future will unfold.
• Overgeneralizing: Assuming an outcome based on limited evidence.

You may notice that certain thoughts are actually cognitive distortions. For example, if you think “I am going to fail this interview,” you can recognize that this is a combination of all three of the distortions above. Once you are aware of your cognitive distortions, you can ask yourself the following questions:

• Is this thought always true?
• What is the evidence for and against this thought?
• Is there another way that I can think about this that is more helpful?

Lastly, you want to come up with a new thought to replace the old one. Brainstorm thoughts that are more accurate and flexible. For example, the thought “I am going to fail this interview” may become, “I am going to try my best on the interview. I cannot predict the future. I will focus on what is within my control, including preparing as much as I can, and then hoping for the best.” This change in mindset feels much more positive than the original thought.

Tip 7: Reduce or avoid alcohol, tobacco, and caffeine

Alcohol, tobacco, and caffeine are all substances that can impact the release of cortisol. Avoiding these substances or limiting their intake may help your body regulate cortisol and prevent other health concerns associated with using these substances.

According to the United States Food and Drug Administration (FDA), adults should limit their daily caffeine intake to 400 mg, which is approximately two to three cups of coffee. Caffeine can also be found in energy drinks, soda, and even decaffeinated beverages.

When it comes to alcohol, the United States Department of Health and Human Services recommends that adults either do not drink at all or drink in moderation. Moderation is defined as one drink per day or less for women and two drinks or less per day for men. If you are having trouble cutting back or drinking in moderation, you may have an alcohol use disorder.

Unlike alcohol and caffeine, there are no recommended guidelines for moderate nicotine or tobacco use. If you are a tobacco user, there are many health benefits to quitting entirely. It can help to make a list of your personal reasons for quitting, set a quit date, and enlist support from family and friends. You can also speak to your healthcare provider about options for smoking cessation, like nicotine replacement therapy.

Quitting or cutting back on the amount of tobacco, alcohol, and caffeine you consume can provide many health benefits even beyond healthier cortisol levels.

The importance of cortisol

Cortisol is a hormone that is released when you are faced with a stressful event. It plays a key role in keeping you alert during stress and is also involved in the immune response.

If you are in a state of constant stress, then your cortisol levels will remain elevated, which can put you at risk for certain physical and mental health conditions. Taking steps to maintain healthy cortisol levels by eating a healthy diet, exercising, getting enough sleep, and managing stress are important to your overall health and well-being.

Last updated or reviewed on November 15, 2024