Cortisol is a hormone that the body produces in excess during stress. What are the consequences and how can you lower the cortisol level? Why does the human body need the stress hormone anyway?
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What is cortisol?
Cortisol is a hormone that is made in the adrenal cortex and broken down in the liver. It influences growth and metabolism, in particular blood sugar, lipid metabolism, protein turnover as well as water excretion and blood pressure. In higher concentrations, cortisol also slows down the immune system and thus has an anti-inflammatory effect.
Synthetically produced, cortisol is available as cortisone in the form of ointments, injections or tablets. Cortisone is a well-known medicine used to suppress the immune system and treat inflammation.
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Treatment: How to Lower Cortisol
If the cortisol level is too high, it is important to restore the balance between tension and relaxation and thus lower the cortisol content in the body. If the hormone concentration gets out of hand in the long term, a cortisol deficiency often occurs.
This helps lower cortisol in the body:
- Avoid stress, use relaxation techniques
- Get enough sleep, preferably consistent sleep times
- regular and healthy, low-fat and low-sugar diet
- Avoid coffee and alcohol if possible
- Integrate sport, exercise and relaxation into everyday life
If there is a significant excess of cortisol, drugs can inhibit the synthesis of the hormone. If hormone-producing tumors are the trigger for a too high level, they are treated with medication or removed surgically.
What to do if there is a cortisol deficiency
If there is only a slight lack of cortisone, changes in the person’s lifestyle often help to reactivate the production of the hormone. If there is a pronounced cortisol deficiency, hormone replacement therapy can be useful, with medication containing precursors of cortisol. Doctors often choose hydrocortisone or similar substances for this. It is important to have a precise diagnosis, to adapt to the living situation and thus to the hormone requirements of those affected and to regularly check the hormone level.
What does cortisol do in the body?
Cortisol is supposed to activate the metabolism in the body and thus release more available energy when required. Therefore, the body usually produces the hormone mainly in the second half of the night in order to be prepared for the increased energy requirements in the morning. Body temperature and blood pressure rise, the blood sugar level increases in order to provide energy for physical and mental stress.
Stress is a very stressful situation for the body and consumes a lot of energy. The body adapts to this, produces more cortisol, increases the heartbeat and sweats more easily. On the other hand, the digestive system and the immune system decrease their activity under stress. However, it is important that the cortisol level drops again after the exercise and does not remain permanently high. Constant stress can cause the adrenal glands to become exhausted and unable to produce enough cortisol.
Cortisol as an antagonist to insulin
Cortisol is an important antagonist of insulin. Insulin is also a hormone produced by the body. It lowers the blood sugar level, i.e. the level of glucose in the blood, by transporting the sugar from food as energy reserves into the body’s cells. If the body needs released energy and the glucose level is too low, it produces more cortisol and the hormone glucagon to provide the sugar again. Cortisol weakens the effect of insulin, so that if there is excess cortisol, the insulin can be weakened. So-called insulin resistance is an essential basis for type 2 diabetes mellitus.
Diagnosis: determine cortisol levels with a test
Doctors determine the cortisol level in the body, for example, when a disease of the adrenal gland is suspected or during check-ups of the organ. Doctors can measure the levels of cortisol in blood serum, urine, or saliva. The body releases cortisol in bursts, which is why the levels of endogenous cortisol that can be measured with a test fluctuate throughout the day. A single measured value therefore has little informative value. Rather, repeated measurements or special stimulation tests provide reliable values.
Which cortisol levels are normal?
The results of the tests on the cortisol level depend on the time of day and the origin of the sample as well as on individual parameters such as the age of the person. The hormone content is usually highest in the morning between 6 and 8 a.m. and is lowest around midnight.
- Cortisol in blood serum or blood plasma: 5-25 µg / dl in the morning, up to 5 µg / dl at night
- Free cortisol in saliva: 0.2-1.7 µg / dl in the morning, over 0.23 µg / dl at night
- Free cortisol in the 24-hour urine: less than 62 µg / 24 hours
The normal values in pregnant women, newborns, children and adolescents differ significantly from these values. There are also saliva tests that you can do yourself at home.
Causes of too much cortisol and possible consequences
If you measure the value of cortisol directly after lunch, after exercise or during stress, it will tend to be higher. The cortisol concentration can also increase during pregnancy or when the blood sugar level is very low. Different sleep duration and quality can also lead to fluctuating measurement results. However, if the hormone imbalance persists, there is usually a pathological cause behind it.
Stress: When the level of cortisol is increased
Elevated cortisol levels often indicate that the stress is too high. The body produces more stress hormones to cope with it.
If the concentration of cortisol is permanently increased, one speaks of hypercortisolism or Cushing’s syndrome. Treatment with glucocorticoids, for example in autoimmune diseases, is often the trigger. In some cases, tumors, excessive weight or alcoholism can be the cause.
Stress can lead to a permanently high level of cortisol – and that in turn to sleep disorders and depression. At the same time, the high levels of cortisol and the associated adrenaline disrupt the balance of other hormones in the body. For example, the production of sex hormones is inhibited. The immune system also works less well, which can lead to infections, wound healing disorders or cancer. Too much cortisol also has a negative effect on the metabolism and promotes the storage of unhealthy belly fat.
Consequences of the excess of cortisol:
- sleep disorders
- high blood pressure
- depressed moods
- Fat storage
- Obesity
- Diabetes mellitus
- weakened immune system
- Wound healing disorders, very thin skin
- Connective tissue weakness
- Bones lose stability, osteoporosis
- Menstrual cycle disorders
- sexual disorders
When cortisol levels are too low
If cortisol is chronically low, it indicates a dysfunction of the adrenal cortex, also known as adrenal insufficiency.
Other causes of a lack of cortisol:
- Primary hypocortisolism or Addison’s disease: Usually an autoimmune disease or an infection weaken or destroy the adrenal cortex.
- Secondary and tertiary hypocortisolism: The damage or cause of the underfunction is located in the brain, more precisely in the pituitary gland or in the thalamus. Abrupt discontinuation of long-term therapy with cortisol, injuries or growths are possible triggers.
Persistently low cortisol can in turn lead to low blood sugar levels, persistent fatigue, a lack of sodium or nausea. Some sufferers are more cold or have to go to the toilet more often at night, while others feel pain in their muscles and joints.
Burnout and cortisol
A lack of cortisol can be the result of long-term stress. In the case of sustained exertion, the body of the person concerned initially increases the daily production of cortisol significantly. However, over time, the adrenal cortex is no longer able to maintain this high level and slowly stops producing the hormone. This disrupts the interaction of all hormones in the body – the body is no longer able to manage stress. As a result, those affected suffer from burnout.
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What can you do for healthy cortisol levels?
Stress cannot always be avoided. However, it is important that it does not become a permanent burden. Whether one acquires relaxation techniques such as meditation or yoga or takes other time-outs in peace – the body needs sufficient phases to reduce cortisol production again. Endocrinologists also recommend integrating as much exercise as possible into everyday life. Sport and physical activity break down stress hormones such as cortisol and ensure a healthy balance. Regular hobbies and contact with friends and family also reduce stress levels.
Getting enough sleep is important
Another important point with regard to the hormonal balance is the quality of sleep, because cortisol sets the pace here in interaction with its hormonal counterpart melatonin. The body releases melatonin as soon as it gets dark and gets tired. At around 3 a.m., he begins to release cortisol to prepare for waking up and getting up. The really restful sleep time is in the hours in between, especially during deep sleep. It is precisely in these phases that the body regenerates, forms new cells and recharges its batteries. If you want to contribute to a good quality of sleep, you should also go to bed at regular times and avoid alcohol, fatty food, mobile phones and television at least two hours in advance.
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