High Cortisol Symptoms, Diagnosis & Treatment

Cortisol, often referred to as the "stress hormone," is produced by the adrenal glands and plays a crucial role in various bodily functions, including metabolism, immune response, and blood pressure regulation. While cortisol is essential for survival, excessive levels — referred to as hypercortisolism — can have detrimental effects on health. High cortisol levels can be caused by chronic stress, medication use, or underlying medical conditions such as Cushing syndrome. Individuals who are experiencing persistently high cortisol levels may notice a range of symptoms affecting their physical and mental well-being. Proper diagnosis and treatment are necessary to restore hormonal balance and improve overall health. In this article, we explore the symptoms, diagnosis, and treatment options for high cortisol levels.

Symptoms of High Cortisol

High cortisol levels can show up in various ways and impact different systems in the body. Common symptoms include:

Weight gain, particularly around the abdomen and face (often called "moon face")
Fatigue and muscle weakness due to protein breakdown in muscles
High blood pressure from the hormone’s role in cardiovascular regulation
Mood changes, such as anxiety, depression, and irritability
Insomnia or poor sleep quality, as cortisol disrupts normal sleep cycles
Frequent infections, as cortisol suppresses the immune system
Slow wound healing due to impaired tissue repair
Osteoporosis caused by calcium depletion from bones
Increased blood sugar levels, leading to an increased risk of diabetes

If left untreated, high cortisol can contribute to serious long-term health problems such as heart disease and metabolic disorders.

Hypercortisolism Diagnosis

The process of diagnosing hypercortisolism involves performing a series of tests to measure cortisol levels and identify the underlying cause. Common diagnostic methods include:

Salivary Cortisol Test – This is a non-invasive test that measures cortisol levels in saliva, often taken at night when cortisol should be at its lowest.
Blood and Urine Cortisol Tests – These measure cortisol levels throughout the day and can help detect abnormal hormone production.
Dexamethasone Suppression Test – A low dose of dexamethasone (a steroid) is administered to determine whether the adrenal glands are overproducing cortisol.
Imaging Tests – CT scans or MRIs may be used to identify tumors in the adrenal glands or pituitary gland, which could be contributing to excessive cortisol production.

Early diagnosis of hypercortisolism is essential for preventing complications and guiding appropriate treatment.

Cushing Syndrome

One of the more common medical conditions associated with high cortisol levels is Cushing syndrome. This condition occurs when the body is exposed to high levels of cortisol for an extended period, either due to medication use (exogenous Cushing syndrome) or overproduction by the body (endogenous Cushing syndrome).

Symptoms specific to Cushing syndrome include:

Round, puffy face (moon face)
Purple stretch marks on the abdomen
Excessive hair growth in women (hirsutism)
Weakness and thinning skin that bruises easily

Treatment for Cushing syndrome depends on the cause. If the condition is caused by medication (such as corticosteroids), doctors may gradually reduce the dosage. If the condition is caused by a tumor, surgical removal, radiation therapy, or medication may be necessary.

Remedies for High Cortisol

Lifestyle modifications can help people with this condition manage high cortisol levels. Here are some remedies for high cortisol:

Stress Management Techniques: Meditation, deep breathing, and yoga can help regulate stress response and lower cortisol levels.
Regular Exercise: Engaging in moderate exercise, such as walking, swimming, or strength training, can help reduce stress-induced cortisol spikes.
Balanced Diet: Consuming a diet rich in whole foods, lean proteins, healthy fats, and complex carbohydrates can stabilize blood sugar and support adrenal health.
High-Quality Sleep: Prioritizing good sleep hygiene, such as maintaining a consistent bedtime and avoiding screens before bed, helps normalize cortisol production.
Limited Caffeine and Sugar: Reducing stimulants like caffeine and refined sugar can prevent unnecessary spikes in cortisol levels.

Incorporating these remedies into daily life can contribute to better hormonal balance and overall well-being.

Medical Treatment for High Cortisol

If lifestyle modifications alone don't lower cortisol levels, medical treatment for high cortisol may be required. Common treatments include:

Medications: Drugs such as ketoconazole, metyrapone, and mitotane can help reduce cortisol production in cases of Cushing syndrome.
Surgery: If a tumor in the adrenal or pituitary gland is the cause, surgical removal may be necessary.
Radiation Therapy: If surgery is not an option, targeted radiation may be used to shrink tumors contributing to cortisol overproduction.
Hormone Replacement Therapy: After adrenal gland surgery, hormone replacement therapy may be needed to maintain proper endocrine function.

It’s essential to work closely with a healthcare provider to determine the most effective treatment plan based on individual circumstances.

High cortisol levels can have widespread effects on the body, influencing metabolism, immune function, and emotional well-being. Recognizing hypercortisolism symptoms, obtaining a proper hypercortisolism diagnosis, and implementing appropriate remedies for high cortisol or medical treatment for high cortisol can help restore balance and improve overall health. If you suspect you have high cortisol, consult a healthcare professional for guidance on diagnosis and treatment options.