Maybe you can’t sleep. Maybe you sleep too much. Maybe your skin keeps breaking out or you’re always sick. Maybe you have bloating, loose skin, and feel weak. Maybe you can’t concentrate, eat, or feel tightness in your back.
If you recentlyBrushTikTokyou might be tempted to blame your cortisol levels for one or all of these problems. Over the past year or so, users have taken to TikTok to tell their stories of what they believe is an imbalance of cortisol causing a host of health issues — and to advise viewers to get their own cortisol levels checked.
Cortisol, sometimes calledStress hormonesa chemical that helps regulate the way our bodies respond to stress. “It’s a hormone that connects the mind and body,” says Martin Picard, associate professor of behavioral medicine at Columbia University. Nearly every organ has a receptor that responds to cortisol. It plays a vital role in how we function on a daily basis, whether by regulating blood pressure or fighting inflammation.
Nia Fogelman, an assistant researcher at the Yale Center for Stress, said this doesn’t necessarily mean that the various ailments people post on TikTok are due to cortisol imbalances. “People want to: A. figure out what’s going on in their bodies, and B. want to do something about it. I think that’s natural and understandable,” she said. But it’s not that simple.
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What does cortisol do?
When we are stressed, the pea-sized pituitary gland in our brain – sometimes calledMain gland—signals the adrenal glands, located above the kidneys, to secrete cortisol and deliver it into our bloodstream.
Janet M. Bennett, a health psychologist at the University of North Carolina at Charlotte who studies the effects of stress on health, says our bodies release the chemical when we face a challenge, whether it’s psychological or physical, real or imagined. We release cortisol when we encounter a tangible threat, like a bear on a hike, but we also release it when we get an unwanted work email. The more threatening we perceive an event to be, the more cortisol we typically produce, she adds. When researchers study cortisol levels, they often look at people’sPublic speechas a research tool, because any situation that exposes us to social evaluation will cause a rapid rise in cortisol.
“The mind and body react as if we are in danger of dying, when in reality it is our sense of self that is threatened,” Picard said.
It’s a gift from evolution: Cortisol helps us mobilize the energy we need to fight or flee danger, in part by boosting the levels of glucose in our blood. It also regulates our metabolism. Our cortisol levels fluctuate throughout the day, rising when we first wake up and falling as we drift off to sleep, says Dr. Gregory Fricione, vice chair of psychiatry at Massachusetts General Hospital and professor of psychiatry at Harvard Medical School.
“Cortisol is your friend,” Fricione said, “but too much of it is bad.”
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What happens when your cortisol levels are high?
We function best when we have the right balance of cortisol. “Our bodies are such harmonious units,” Fogelman says. But chronic stress raises our baseline cortisol levels over time, leading to a host of consequences. Sustained high levels of cortisol can weaken the immune system, Fricione says, and can also raise blood sugar levels and blood pressure. There’s also an integral connection between cortisol and sleep: We need to lower levels of the hormone in order to get adequate rest. People with high cortisol levels often have trouble falling asleep and have restless sleep, Fricione says.
Imbalance can also lead to fatigue and irritability, Bennett says. “That’s the hard thing about cortisol,” she says. “Because it’s a hormone that’s so important for daily functioning, even in the absence of stress, any time that daily rhythm is disrupted, it can cause behavioral problems.”
Several mental health conditions — including depression and post-traumatic stress disorder — are linked to an imbalance in cortisol, said Dr. Raza Sagarwala, a resident physician in the department of psychiatry at Vanderbilt University Medical Center. He has studied the effects of non-drug treatments on cortisol levels.Research.
In rare cases, people with too much cortisol develop a cluster of symptoms known as Cushing’s syndrome. Sufferers may develop a mass of fat at the back of their neck; some gain weight, feel fatigued and have trouble sleeping. Some bruise easily, and their blood sugar and blood pressure levels may also rise. People with the condition may need medication or surgery, but first they need to be diagnosed by a doctor, said Dr. Pratibha P.R. Rao, medical director of the Cleveland Clinic Adrenal Center.
Without testing cortisol levels and consulting a doctor, it’s almost impossible to determine whether problems like acne or poor sleep are definitively linked to a hormonal imbalance – and when people can’t find any other clear explanation for their health issues, cortisol can be an easy culprit to point to. “People will say their cortisol is elevated – and I’ll tell you, you can’t feel it,” says Bennett. But experts say if people are really concerned about their cortisol levels, they can talk to their GP about whether they need to get tested.
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Can You Measure Your Cortisol?
You can test blood or saliva for cortisol levels at a specific moment, but a one-time test is unlikely to be particularly useful because cortisol levels vary throughout the day, Picard said. Urine or hair samples can show cortisol levels over a longer period of time, although hair samples are used primarily in research settings.
Some companies offer at-home cortisol tests, which usually require a finger prick of blood or a saliva swab. But experts recommend seeing your primary care doctor, who may refer you to an endocrinologist. “I’m not a big fan of these at-home tests,” Rao said. “My advice is don’t do them.”
One reason is that doctors try to get a comprehensive picture of how your cortisol levels ebb and flow before deciding if there’s a problem, says Mikhail Zelberminter, assistant professor of clinical medicine at the Johns Hopkins School of Medicine who specializes in endocrinology.
“It’s easy to measure cortisol levels, but it’s hard to interpret what they mean,” he added.
Can cortisol levels be brought down?
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Some small studies suggest that mindfulness interventions like yoga and meditation may help lower cortisol levels, Sagarwala says, and even taking just five minutes a day to relax and reset your mind can be beneficial. He suggests a “five senses” exercise to ground you when you’re stressed: List five things you can see, four things you can touch, three things you can hear, two things you can smell and one thing you can taste.
Exercise also helps regulate cortisol, Bennett says, especially moderate physical activity like jogging or biking. Such exercise allows your body to mirror the stress response, raising your heart rate, then bringing it back down when you stop exercising. This cycle effectively trains our bodies to properly turn our stress response on and off.
Everyone should find the stress-relief method that works best for them, Fogelman said.Grid BreathingSome people can calm down, while others can’t. Once you find ways to relieve stress, your cortisol levels will hopefully become more stable, she adds; this also applies to people who deal with high levels of stress for long periods of time.
“Stress is not a disease,” Fricione said. “Every living thing has stress.”