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No, you can’t blame all your health issues on ‘high cortisol’. Here’s how the hormone works


Have you developed an appetite for certain foods and gained weight? You may be tired and unable to concentrate, waking up in the middle of the night. The last TikTok wellness trend would have you believe that high cortisol levels are to blame.

It is true that cortisol affects our weight, energy balance, metabolism and sleep. But so are thyroid hormones, appetite hormones, and sex hormones, as well as diet and exercise.

Cortisol also does more than this and regulates many other biological functions. It affects almost all cells of our body and is essential for survival.

Why is cortisol portrayed as bad?

Part of what is attributed to cortisol is symptoms of chronic stress or depression – which makes sense since they are interrelated.

Cortisol is the body’s main “stress hormone”. This might make people think that cortisol is bad for them, but that is not the case.

Stress is an inevitable part of life and our response to stress has evolved as one survival mechanism so that we can react quickly to dangerous situations. Both psychological and physical tensions provoke the stress response.

Cortisol is essential for a healthy stress response

Our immediate response to a sudden threat is the fight-or-flight response. Adrenaline is released from the adrenal glands into our bloodstream. This immediately increases our heart rate and breathing so we can act quickly to escape or avoid danger. However, the adrenaline response is only very short-lived.

When a threat or stress lasts for minutes instead of seconds, cortisol is released from the adrenal glands. Its main role is to raise blood glucose (sugar) for energy.

Read more: Three reasons to get your stress level under control this year

Cortisol affects the liver, muscle, fat and pancreas to increase glucose production and mobilize stored glucose. This increases glucose to the brain so we are mentally alert and to the muscles so we can move.

In a healthy and normal stress response, cortisol rises rapidly in response to the stress and then rapidly drops back to baseline after the stress has passed.

However, chronic stress and persistently elevated cortisol secretion are not healthy. Chronic stress can cause dysregulated cortisol secretion: when cortisol remains high even when there is no immediate stress.

It can take weeks for cortisol disruption to occur back to normal after chronic stress.

What is the link with depression?

New evidence suggests that chronic stress and dysregulated cortisol may contribute to the development of depression. Our research team has shown that people with depression have on average more cortisol than people who don’t have depression. We also found that higher cortisol was associated with more negative thinking and lower quality of life.

The symptoms described on TikTok as being due to high cortisol levels can be caused by stress, depression or anxiety. Depression is also possible cause insomnia, increased appetite and weight gain or loss.

Fatigue and cravings can be caused by a number of different things.

The relation between cortisol, weight changes and depression are complex. High cortisol also increases the activity of adrenaline. This explains why, when you’re stressed, you can be extra reactive and quickly shoot into fight-or-flight mode.

However, some of the symptoms described on TikTok as due to “high cortisol” may reflect low cortisol. Low cortisol can be caused by chronic stress and high cortisol during childhood or earlier in life. This is why some people with depression, especially those with a long history of depression, tend to have low rather than high cortisol.

Low cortisol causes fatigue and weight gain. This is more often in women and we found that this was related to leptin, a satiety hormone.

How do you know if your cortisol is too high or too low?

Despite claims on TikTok, we can’t tell if our cortisol is balanced or high or low.

The only way to find out is to have your blood, urine or saliva analyzed in a laboratory. This is not done routinely and would be a waste of resources. A doctor would only check for this if they suspected you had a cortisol production disorder, but these are rare.

In addition, your cortisol levels vary significantly at different times of the day and night.

Cortisol affects your body clock

One of the most important roles of cortisol is in the body’s circadian system. The hypothalamus in the brain sets the circadian (about 24-hour) rhythms of our biological functions to match the light-dark cycle. Cortisol communicates these signals from the brain to the rest of the body.

Read more: Chemical messengers: How hormones help us sleep

The secretion of cortisol by the adrenal glands increases in the early morning hours, peaks around 7 a.m., and then is lowest from about noon to early morning.

Cortisol is our body’s natural alarm clock. Higher cortisol in the morning or at the end of the sleep period stimulates wakefulness, more energy and physical activity. Lower cortisol during the night promotes sleep and restorative functions.

How do you ensure a healthy cortisol level?

You can try to maintain healthy cortisol levels by addressing the underlying causes of cortisol disregulation.

Meditation, mindfulness, and cognitive behavioral therapy can reduce stress response reactivity.

Excercise daytime and good sleeping habits also help to reduce chronic stress and high cortisol.

Finally, a healthy, balanced diet gives your body the building blocks for good hormone health.

If this article has raised any issues for you, or if you are concerned about someone you know, call Lifeline at 13 11 14.

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