Signs Your Cortisol Levels Are Too High

Got stress? Who doesn’t these days—and it’s no surprise that an overabundance of stress, particularly when it’s chronically elevated, can wreak havoc on your body and emotions. Still, some stress isn’t necessarily a bad thing: Elevated levels of anxiety trigger the release of hormones related to the stress response, and one of those hormones, called cortisol, plays an important role in daily functioning, helping us awake refreshed, be more focused, and maintain energy throughout the day.

The key? Regulating those cortisol levels. Because when cortisol is too high, and especially if it feels stuck in that position as it can with Cushing's disease or Cushing's syndrome, there can be some serious and negative health effects as a result.

How Cortisol Works in the Body

Before diving into the signs that your cortisol levels are too high, it’s helpful to understand the way this hormone should be working.

Cortisol is a hormone produced in the adrenal glands. It fluctuates naturally during the day and night; for example, most people tend to hit their highest cortisol level in the morning—which helps get you going after waking up—and the level gradually tapers through the day until it reaches its lowest level right before bed. That’s when de-stress hormones like melatonin surge to help you fall asleep.

So what does cortisol actually do? According to Cleveland Clinic, cortisol affects almost every organ and tissue in your body, playing a major role in helping control your metabolism, regulating blood pressure, reducing inflammation, and keeping blood sugar levels steady.

Although cortisol follows a natural pattern of peaks and dips, external factors can cause cortisol to surge. If you need to leap out of the way of an oncoming car, for example, your body will spike your cortisol level to provide an energy jolt for that action, part of your “fight or flight” response. But stressors that are ongoing (relationship troubles, work issues) can keep your cortisol high, and that is often a problem.

Signs of High Cortisol

Without a lab test that can pinpoint your exact cortisol level, it’s not always easy to tell when your hormones may be dysregulated. (Normal cortisol levels range from 3 to 20 micrograms per deciliter, according to the Cleveland Clinic.) But there are some clues you can look for that indicate your levels are too high.

Insomnia

Trouble falling asleep or staying asleep is a sign of elevated cortisol levels. That’s because your cortisol levels should be at their lowest at night—if they remain elevated, it can interfere with you’re ability to feel sleepy. This can lead to chronic sleep deprivation, which causes its own set of health risks, such as cardiovascular disease risk.

Belly Fat

Can you blame your spare tire on stress hormones? Yes, actually. Cortisol directly affects weight gain and fat storage, especially around the midsection. Part of this comes from the way cortisol triggers the release of glucose from your liver for fast energy, in anticipation of dealing with a threat. When that energy isn't used, it converts to fat, especially around the abdominal region. Another factor is that cortisol surges have been linked to cravings for fatty, sweet, and salty foods—which can prompt more weight gain than healthier food choices. This can become even more problematic because abdominal fat tends to increase cortisol levels even more, leading to a constant cycle.

Frequent Colds

When it’s well-regulated, cortisol is anti-inflammatory thanks to the way it represses the expression of pro-inflammatory cytokines in the immune system, optimizing the immune response. Ironically, though, when it’s chronically elevated, cortisol can contribute to illness because of its suppressed immune reaction to viruses (cortisol temporarily dampens the immune response in anticipation of dealing with a threat). The result is that you may be experiencing colds more often, or it may take you longer than usual to get over a cold.

Irritable Bowel Syndrome

Cortisol has been associated with digestive issues, and that includes a variety of intestinal problems like irritable bowel syndrome, inflammatory bowel disease, colitis, bloating, gas, and abdominal pain, as well as ulcers in the stomach and intestines. While the exact mechanism is still being researched, scientists believe high cortisol levels may increase intestinal permeability while negatively impacting the ability of your intestinal lining to regenerate.

Muscle Weakness

Feeling lethargic at the gym? Cleveland Clinic notes that a common symptom of too much cortisol is weakness in the upper arms and thighs. That’s because cortisol affects how protein and carbohydrates are metabolized in the muscle tissue, so dysregulation can keep this process from working efficiently.

Anxiety

It’s not just your imagination: Constantly elevated stress levels mess with your head. Research suggests that elevated cortisol levels can cause “wear and tear” to the brain and body, particularly in older adults. Over time, this can lead to higher anxiety levels, as well as mood changes like irritability.

Difficulty Concentrating and Remembering

In the same way that cortisol can affect your mood, it can affect other functions in the brain as well. Mayo Clinic notes that these show up most prominently as short-term recall problems and trouble concentrating on tasks. If you feel distracted often and have a hard time focusing, that may be an indication of higher cortisol levels.

Keep in mind that even if these symptoms fit you to a T, the cause may not necessarily be high cortisol. In many patients with these symptoms, metabolic syndrome may be the true culprit, according to Caroline Messer, M.D., an endocrinologist at Lenox Hill Hospital in New York City. “This can be particularly true if you’re seeing problems like weight gain, insulin resistance, elevated blood pressure, and high cholesterol, which can all be due to either high cortisol or metabolic syndrome,” she says. “That’s why it’s important to get the right tests to find the underlying cause.”

Effects of Chronically High Cortisol

If cortisol elevation becomes chronic, it leads to more than feeling burned out. You could be at higher risk for developing a condition called Cushing’s disease—which can include excessive weight gain, weakness, high blood pressure, and the tendency to bruise easily.

And it doesn’t stop there. Mayo Clinic notes that high cortisol can affect multiple systems in your body, from brain function to gut health, putting you at increased risk for:

• Anxiety

• Depression

• Digestive issues

• Heart disease and heart attack

• High blood pressure

• Muscle tension

• Stroke

Dr. Messer adds that other issues related to chronically high cortisol levels are osteoporosis, diabetes, and blood clots.

Potential Cortisol Boosters

In addition to stress from personal or professional situations, there are other reasons your cortisol may spike and stay that way. For example, getting poor sleep can cause cortisol levels to rise, or you could be seeing elevated levels from the presence of adrenal gland tumors or pituitary gland issues—which can both cause excess production of cortisol.

Another issue may be cortisol-like medications called corticosteroids, according to Stuart Weinerman, M.D., fellowship director in the division of endocrinology at Northwell Health in New York City. These medicines are commonly used to control inflammation in conditions like asthma or inflammatory arthritis. “Higher doses of these medications can mimic the effects of excess cortisol, such as [contributing to] diabetes and osteoporosis,” he says. “The corticosteroids will generally suppress the body’s own pituitary adrenal axis, and stopping the medications after chronic exposure can cause a temporary adrenal insufficiency.”

When to See a Doctor

Determining if you have Cushing’s syndrome can be difficult, says Dr. Weinerman, since symptoms tend to non-specific to the disease—like gaining more belly fat, for example. But if you do have signs like the one above, it may be worth having a discussion with your doctor and getting a screening test to measure cortisol in the urine or saliva, he adds. If your cortisol levels look high from those tests, he says further endocrine testing may be necessary.