Cortisol, or the “hormone of stress”, is essential for the survival of humans. It increases in times of stress, regulating the immune system. Cortisol also is controlling the body’s blood sugar levels and thus regulates metabolism, acting as an anti-inflammatory, influencing memory formation, controlling salt and water balance, influencing blood pressure and helping the development of the foetus. Think of cortisol as a substance that is needed in times of danger. What do we need in times of danger? We need less inflammation so we can move faster, we need sugar coming out of the storage in the body to be turned into energy. We need good memory and fast thinking. All of that happens fast under influence of cortisol. This function is one of the reasons why humankind survived for such a long time. 

Things go wrong with the cortisol production and management being disturbed. Imagine, you are collected and anxious when you are supposed to be relaxed and resting. Or, you start ‘preparing for battle’, hyperventilating and anxious when there is no reason to experience that. Or maybe the opposite happens, when you need to be collected, sharp and work fast – you feel sluggish and powerless. 

Low levels of cortisol may be due to a problem in the pituitary gland or the adrenal gland (Addison’s disease). The onset of symptoms is often very gradual. Symptoms may include fatigue, dizziness (especially upon standing), weight loss, muscle weakness, mood changes and the darkening of regions of the skin. Without treatment, this is a potentially life-threatening condition.

High levels of cortisol over a period of time can lead to a condition called Cushing’s syndrome. This can be caused by a wide range of factors, such as a tumour that produces adrenocorticotropic hormone (and therefore increases cortisol secretion), or taking certain types of drugs. 

The symptoms include

  • rapid weight gain mainly in the face, chest and abdomen contrasted with slender arms and legs
  • , a flushed and round face
  • , high blood pressure
  • , osteoporosis
  • skin changes (bruises and purple stretch marks)
  • muscle weakness
  • mood swings, which show as anxiety, depression or irritability
  • increased thirst and frequency of urination.

High cortisol levels over a prolonged time can also cause a lack of sex drive and, in women, periods can become irregular, less frequent or stop altogether (amenorrhoea).

In addition, there has been a long-standing association between raised or impaired regulation of cortisol levels and a number of psychiatric conditions such as anxiety and depression. However, the significance of this is not yet clearly understood.

Cortisol is a hormone of stress, part of the Adrenocortex Function test panel.

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