High Cortisol Symptoms: Stress-Induced Hormonal Changes

Understanding High Cortisol: Stress, Hormones & Health Risks

Cortisol, commonly known as the stress hormone, plays a vital role in several body functions. It is obtained through the adrenal glands and used to control metabolism, blood sugar, the body's reaction to stressful factors, and inflammation.

Nevertheless, when unbalanced cortisol levels remain high over a long period of time, they may interfere with the body's normal functioning. When an underlying disorder causes this condition, it is medically known as Cushing syndrome.

This blog presents a clear and factual overview of high cortisol symptoms, focusing on symptoms of high cortisol in females, high cortisol level symptoms, and related hormonal imbalances.

Keep reading for detailed insight!

What is Cortisol, and What are its Functions?

Cortisol is a steroid hormone that is released by the adrenal glands. It plays a major role in:

• Blood pressure regulation
• Regulation of the sleep/wake cycle
• Increased energy during stress periods
• Cardiovascular support
• Supplementing glucose metabolism
• Suppressing inflammation

Cortisol levels are generally on a diurnal rhythm, with the peak early in the morning and the minimum around midnight. Nevertheless, long-term stress levels, some medications, cancerous growths, or hormonal problems can induce a long-lasting increase in cortisol levels, resulting in visible and noticeable effects that occur on both the physical and emotional levels.

What Causes High Cortisol Levels?

Many factors can cause the overproduction of cortisol:

• Chronic Psychological Stress: Challenges in work or personal life will lead to milder elevations in cortisol which may result in a chronic state of stress response in the body.
• Long-term Use of Corticosteroid Medications: Drugs such as prednisone can affect the body's normal hormonal balance, raising cortisol levels.
• Pituitary or Adrenal Gland Tumours: Conditions like Cushing’s disease can result in excessive cortisol secretion.
• Hormonal Disorders: Cortisol regulation can be disrupted by the symptoms of polycystic ovary syndrome (PCOS) and other endocrine disorders.
• Psychological Conditions: Depression and extreme anxiety disorders are linked with high cortisol production.
• Intense Physical Training or Overtraining: The increased strain on the body can activate an enhanced cortisol output.

What are the High Cortisol Symptoms?

Increased cortisol may influence various systems in the body. The most common high cortisol symptoms include:

Weight Gain, Especially Around the Abdomen and Face

In cases of severe, endogenous hypercortisolism (Cushing's syndrome), cortisol promotes a distinct pattern of fat deposition including central obesity, a rounded 'moon face', and a fat pad on the upper back and neck known as a 'buffalo hump'. These specific signs are red flags for a pathological cause.

Fatigue and Muscle Weakness

When there is weight gain, some people tend to be weak, especially in the arms and legs. A common effect of cortisol is a breakdown of muscle tissue.

Elevated Blood Pressure

Cortisol affects blood pressure by making blood vessels more sensitive to the hormones that tighten them, resulting in high blood pressure (hypertension).

High Blood Sugar and Risk of Type 2 Diabetes

Cortisol stimulates gluconeogenesis (formation of glucose in the liver) and eventually causes elevated blood sugar levels.

Mood Changes

High levels of cortisol may bring about irritability, anxiety, depression, and emotional instability.

Poor Sleep Quality

Elevated cortisol levels at night may interfere with the natural circadian rhythm, leading to insomnia or frequent awakenings at night.

Frequent Infections

Cortisol also suppresses the immune system, making one prone to frequent colds, flu or delayed healing of wounds.

What are the Symptoms of High Cortisol Levels in Females?

Both women and men may have increased cortisol, but symptoms of high cortisol levels in females may manifest differently because of hormonal differences. They are as follows:

1. Irregular or Absent Menstrual Periods

The high cortisol inhibits gonadotropin-releasing hormone (GnRH), which can cause interference in the menstrual cycle, resulting in oligomenorrhea (inconsistent period) or amenorrhoea (no periods).

2. Excessive Facial and Body Hair (Hirsutism)

In some forms of Cushing's syndrome, particularly those caused by adrenal tumors, there can be an overproduction of androgen hormones alongside cortisol. This can lead to symptoms like hirsutism (excessive hair growth in a male-pattern), acne, and menstrual irregularities.

3. Thinning Skin and Easy Bruising

Cortisol slows down the production of collagen and loosens up the skin, causing thin skin, stretch marks and frequent bruising.

4. Acne and Oily Skin

Due to enhanced cortisol levels, hormone-related changes may stimulate the production of sebum, exacerbating adult acne among women.

5. Hair Thinning or Hair Loss

High cortisol concentrations and chronic stress may interfere with the hair growth cycle, resulting in telogen effluvium by causing a higher amount of hair than usual to enter the shedding phase.

6. Reduced Libido and Fertility

High cortisol in females can decrease their sexual drive and disrupt ovulation, with effects on their fertility.

What are the Cognitive and Psychological Effects of High Cortisol?

Having increased cortisol affects mental and emotional health as well:

• Impaired Concentration and Memory: The cortisol impacts the hippocampus, a part of the brain that is involved in memory.
• Anxiety and Panic Attacks: Prolonged high cortisol can lead to sensitization of the brain's fear and stress networks, potentially lowering the threshold for anxiety and panic attacks.
• Irritability and Mood Swings: With prolonged exposure to stress hormones, emotional regulation becomes increasingly hard.

What are the Cardiovascular and Metabolic Symptoms of High Cortisol?

• The cardiovascular and metabolic symptoms of high cortisol levels are as follows:
• Central Obesity: Fat accumulation in the abdominal area with relatively thin limbs.
• High Cholesterol and Triglycerides: Due to metabolic disturbances, lipid levels can rise, thus promoting cardiovascular risk.
• Increased Risk of Atherosclerosis: Plaque accumulation restricts blood flow in arteries.
• Elevated Risk of Heart Disease and Stroke: These types of metabolic disturbances increase the chances of cardiovascular complications.

These metabolic changes increase with chronic exposure to high cortisol, even without other risk factors.

What are the High Cortisol Level Symptoms in the Elderly?

In older adults, high cortisol symptoms may be misattributed to ageing. Common signs include:

• 
  Muscle wasting and frailty
• Cognitive decline
• Bone loss and osteoporosis
• Increased susceptibility to infections
• Depressive symptoms with sleep disturbance

Because the elderly may not exhibit classic symptoms like weight gain, physicians should carefully evaluate hormonal changes in this population segment.

When to Seek Medical Help for High Cortisol Levels?

Consider speaking to a healthcare provider if you or a loved one experiences multiple signs of high cortisol, especially with accompanying symptoms like irregular periods, weight gain, or fatigue. A doctor may recommend:

• Blood and urine cortisol tests
• Dexamethasone suppression test
• Saliva cortisol sampling
• Imaging studies (MRI or CT scans) are performed if tumours are suspected.

Early diagnosis can help prevent long-term complications such as diabetes, cardiovascular disease, and osteoporosis.

What are the Treatment Options for High Cortisol Symptoms?

Treatment for high cortisol levels varies depending on the cause:

1. Lifestyle Modification

• Reduce stress through mindfulness, yoga, or meditation
• Improve sleep hygiene
• Engage in moderate physical activity
• Maintain a balanced diet rich in fibre and antioxidants.

2. Medical Intervention

• Adjusting or discontinuing corticosteroid medication (under medical supervision)
• Use of adrenal enzyme inhibitors (e.g., osilodrostat, metyrapone)
• Surgical removal of adrenal or pituitary tumours, if present

3. Psychological Therapy

If stress or depression is contributing to high cortisol, cognitive behavioural therapy (CBT) and other forms of counselling may be beneficial.

If you experience signs associated with high cortisol, it's essential to seek medical advice promptly.