Think you might have high cortisol?

Cortisol, often dubbed the "stress hormone," has become a hot topic across social media platforms. With influencers promoting various supplements and quick fixes, the conversation around cortisol is often more confusing than clarifying. To separate fact from fiction, endocrinologist Scott Lee, MD, explains the true impact of high cortisol levels, backed by scientific research.

Recognizing the Signs: How Cortisol Impacts Daily Life

Cortisol plays a critical role in the body's response to stress, but chronic elevation can lead to serious health problems. Lee says key symptoms of high cortisol include difficulty rising from a seated position, easy bruising, and notable physical changes such as a reddened face and large, bright stretch marks. These stretch marks often appear on the abdomen, thighs, and arms. Other symptoms include significant weight gain, particularly around the abdomen and neck, and psychological effects like increased anxiety, agitation, and restlessness.

These symptoms can severely disrupt daily life, affecting physical mobility and emotional stability. The cumulative impact of these symptoms emphasizes the need for accurate diagnosis and effective management.

Other Possible Causes of These Symptoms

While high cortisol levels can cause a range of symptoms, it's essential to recognize that they can be associated with other medical conditions. Lee emphasizes that experiencing signs like weight gain, anxiety, or fatigue doesn't automatically mean you have elevated cortisol levels.

For instance, weight gain around the abdomen and neck might also be related to metabolic disorders such as hypothyroidism, where the thyroid gland doesn't produce enough hormones, leading to slowed metabolism and weight gain. Similarly, anxiety, restlessness, and difficulty sleeping can be symptoms of generalized anxiety disorder (GAD) or even a side effect of certain medications. Easy bruising might be due to a vitamin deficiency such as vitamin C or K, or it could be related to blood disorders like thrombocytopenia, which affects blood clotting.

"While social media can be a useful platform for raising awareness, it can also lead to misinformation and unnecessary panic," Lee says. "Just because you recognize some of these symptoms in yourself doesn't mean you should self-diagnose or start treatment on your own."

Instead, Lee stresses the importance of consulting a healthcare professional for a thorough evaluation.

"A doctor can help determine whether your symptoms are due to high cortisol levels or something else entirely. They can then guide you toward the appropriate tests and treatments based on a comprehensive understanding of your overall health."

The Importance of Accurate Diagnosis

For those who suspect they may have high cortisol levels, Lee recommends the dexamethasone suppression test, widely regarded as the most reliable method for diagnosing hypercortisolism. In this test, a patient takes a dexamethasone pill at night and has their blood tested the following morning to assess cortisol suppression, revealing whether the body produces an abnormal amount of cortisol.

The Dangers of Self-Treating with Supplements

In the age of quick fixes, many people turn to over-the-counter supplements marketed to balance cortisol levels or combat "adrenal fatigue." However, Lee strongly advises against this practice.

"Supplements targeting cortisol are not only unregulated but can also pose significant health risks when used without medical supervision," he says.

The dangers of unsupervised supplementation include potential interactions with other medications and the possibility of masking underlying health conditions that require professional treatment.

The lack of scientific backing for these supplements is another concern. A review found little evidence supporting the efficacy of many over-the-counter supplements, highlighting the need for caution when considering such options.

Proven Lifestyle Interventions for Managing Cortisol

Rather than relying on supplements, lifestyle modifications offer a safer and more effective approach to managing cortisol levels. Lee says regular aerobic exercise, like walking for 20-30 minutes three times a week, can significantly reduce cortisol levels in both men and women. Similarly, adequate sleep and stress management techniques like mindfulness and yoga have lowered cortisol levels and improved overall well-being.

"Diets high in fiber and low in refined sugars and saturated fats are associated with lower cortisol levels and improved metabolic health," Lee says. "Prioritizing a balanced diet rich in whole grains, fruits, and vegetables supports hormone balance."

The conversation around cortisol and other trending health topics can be overwhelming, but relying on credible sources and expert guidance is essential. Video visits let you see your provider from the comfort of your home. To schedule, visit lluh.org/videovisits.