What is cortisol: function and side effects

Hormones are signalling chemicals that our body produces to control functions from digestion to reproduction. You might have heard of insulin, estrogen, testosterone, thyroid-stimulating hormone and adrenaline—these are just five of over 50 hormones that use our bloodstream to travel to different parts of the body and regulate functions that are vital for supporting life.

Cortisol is one such hormone that controls a wide variety of activities in humans as well as many other animals.

Cortisol is a steroid hormone that is naturally produced by the body to regulate different processes including immune response to foreign invaders as well as metabolism, both of which are performed by the hormone through a process called gluconeogenesis which helps in increasing blood sugar in the body.

Produced mainly in the adrenal glands located above the kidneys—other tissues of the body produce it in much lower quantities—cortisol is also known as the stress hormone as it controls feelings of fear, motivation and the body’s fight-or-flight response. Cortisol levels rise in response to these feelings and return to normal once the threat is over—you can feel this as the heartbeat slows down gradually. Your blood pressure also returns to your usual, as cortisol levels drop.

If you feel stressed, tired or fatigued despite consuming a balanced diet and leading a physically active lifestyle, chances are that there may be a disturbance in the cortisol levels in the body.

Cortisol function in the body
How is cortisol regulated in the body?
Side effects of cortisol imbalance in the body
- High cortisol effects on the body
- Low cortisol effects on the body
Cortisol diagnosis and test
How to reduce cortisol levels

Cortisol function in the body

While it is more popularly known as the stress hormone, cortisol is known for regulating a wide range of physical functions, including:

Regulating blood pressure
Increasing blood sugar or glucose
Lowering inflammation (inflammatory disease) in the body
Energising the body by controlling stress levels
Controlling the sleep cycle
Regulating the body's use of proteins, fats and carbohydrates

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How is cortisol regulated in the body?

Cortisol is part of the glucocorticoid (steroid hormone) family. It works as the body's in-built alarm system: whenever we feel fearful, stressed or in danger, cortisol kicks in. As this happens, many other bodily functions are shut down to send blood and energy to the muscles of the legs, arms and heart (to enable you to run or stand your ground and fight).

Cortisol levels in the blood are usually higher when you wake up in the morning and reduce as the day progresses. However, for those who are used to working at night, cortisol levels are higher at the beginning of the night and decline as daylight approaches.

Three regions of the body are responsible for releasing cortisol: the hypothalamus (H) and pituitary (P) gland in the brain are able to assess the levels of cortisol in the blood and adjust the flow of the hormone. Whenever the body needs an additional supply, they send a signal to the adrenal (A) glands which in turn produce more cortisol and release it in the blood. This network of glands controlling the secretion of cortisol is also known as the HPA axis.

Most cells in the body contain cortisol receptors. Our physical reaction to stress—one of the many functions related to the cortisol hormone—is to shut down several other bodily functions. Along with cortisol, the body also releases the hormone adrenaline in response to stress or a perceived threat. The digestive system, the reproductive system, and even the body's growth functions are suppressed when we are affected by stress of any kind.

Side effects of cortisol imbalance in the body

The body should produce the hormones based on what it needs, when and how much. In some cases, though, there may be overproduction or underproduction of cortisol in the body, which may lead to some disorders. This can happen due to the continuous presence of stress or stressful situations that keep the body in constant fight or flight mode.

The genetic make-up of a person, their lifestyle and life experiences (for example, childhood trauma or domestic abuse) could make them more vulnerable to stress and the negative health effects of (excess) cortisol.

A study published in the journal Neuropsychopharmacology in 2003 analysing 24 women with a history of sexual and/or physical abuse with lifetime PTSD (post-traumatic stress disorder) found they had 122% higher cortisol levels when revisiting the traumatic incidents, and 69% higher cortisol levels in recovery. Even during the period leading up to exposure to the episodes, they had 60% higher levels of cortisol.

Constant stress can take a toll on the production of cortisol in the body, which can affect a person in the following ways:

Unexplained weight gain, especially in the stomach region and neck
Acne
High blood pressure
High blood sugar
Muscle weakness
Digestive issues
Headaches
Heart disease
Affects memory and makes it difficult to concentrate
Fertility problems

High cortisol effects on the body

High levels of cortisol in your blood levels can be due to various reasons.

One of them is the presence of a mass or nodule in the adrenal gland. Tumours in the adrenal gland can be malignant (cancerous) or benign (non-cancerous), but both can result in high levels of cortisol and other hormones produced by the gland. A similar growth in the pituitary gland can also affect the production of cortisol in the body. Both situations—a growth in the adrenal or pituitary glands—can lead to a hormonal disorder called Cushing's syndrome, which is marked by symptoms such as weight gain, digestive disorders, diabetes or bruising of the skin.

Chronic stress that leads to the overproduction of cortisol can also lead to mental health disorders such as anxiety, depression, frequent headaches, insomnia or even affect the memory of the patient.

Low cortisol effects on the body

The underproduction of cortisol in the body can also lead to its own set of problems. Consistently low production of cortisol in the body is known as Addison's disease, whose symptoms begin to show gradually on the body. The symptoms include:

Darkening of scars or folds of the skin
Fatigue
Diarrhoea
Muscle weakness
Loss of appetite
Weight loss
Nausea and vomiting
Low blood pressure

Addison's disease is also rare and is considered to be a type of autoimmune disease, as it causes the immune system to attack the body's own healthy tissues.

Medications, especially corticosteroid treatments used in the management of conditions such as asthma or other respiratory diseases, cancers or others can also lead to high cortisol levels in the body. Oral contraceptives are also known to increase the level of cortisol in the body.

Cortisol diagnosis and test

Apart from the above-mentioned signs and symptoms which could lead you to visit a doctor, the specialist may also recommend some tests to ascertain the level of cortisol in your body. A cortisol level test requires a blood sample and can help in measuring the level of cortisol in the blood, which helps in accurately diagnosing the problem.

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How to reduce cortisol levels

You should consult with a doctor for proper treatment if you have high cortisol levels. Additionally, any activity that helps you reduce stress could also help to reduce the levels of cortisol in the body. You could try a combination of these to begin with:

Exercise
Meditate or do yoga (read more: how to begin meditation for stress relief)
Do deep relaxation exercises (read more: Savasana: benefits and how to do it)
Fix a bedtime routine so that you can get a minimum of seven hours of sleep daily. Avoid caffeine or alcohol before going to bed
Eat a balanced diet