What Is Cortisol — and What Are the Risks if My Levels Are Too High?

Cortisol is a stress hormone — a chemical the body produces in response to stress. It can have a really negative connotation, says Raza Sagarwala, MD, chief resident in the department of psychiatry and behavioral services at Vanderbilt University in Nashville, Tennessee. “But cortisol is really important for many bodily functions.”

In a healthy body, for instance, cortisol helps regulate inflammation, adds Jeannette M. Bennett, PhD, an associate professor of psychological science at the University of North Carolina in Charlotte.

When we come into contact with bacteria or a virus, cortisol plays a role in helping our body fight off those germs and not get sick. “It really keeps the immune system in check,” Dr. Bennett says.

Our bodies produce cortisol in order to respond more efficiently to potential dangers during acutely stressful situations. “And we need our bodies to respond to threats,” says Nia Fogelman, PhD, associate research scientist at the Yale Stress Center. “A classic example is a life-threatening situation, like encountering a bear. We would want our body to be able to react quickly and appropriately to outrun the bear.” Cortisol is one hormone that helps us to do that, giving us the energy to fight or flee from the stressor — whether that’s a bear or a pressing deadline, Dr. Fogelman says.

In limited doses cortisol helps keep us healthy. When cortisol is chronically elevated, however, the immune system becomes less sensitive — and, therefore, less receptive — to the hormone’s anti-inflammatory abilities, Bennett explains. This can lead to chronic inflammation.

“And that [chronic inflammation] is linked to many chronic diseases, like obesity, type 2 diabetes, and cardiovascular disease,” she says. It also can play a role in mental health conditions, including major depression, schizophrenia, bipolar disorder, anxiety, and PTSD.

How Can I Tell if My Cortisol Levels Are Too High?

Elevated cortisol levels won’t show up in the body as some discrete sign or symptom, so it’s a little tricky to tell for yourself if yours are too high. Still, there are some tells.

Disrupted sleep has been linked to having higher cortisol levels, whether it's an inability to fall asleep or falling asleep and then waking up in the middle of the night, Bennett says. Though research is unclear when it comes to which causes which. Increased irritability may be a signal, too — as in, you find yourself snapping at people or overreacting to spilled coffee, she says.

You might also notice some differences in the foods you’re eating — namely, that you’re craving more comfort food than usual. “It may be [a way of] trying to soothe that discomfort that you’re feeling that you might not be able to put your finger on,” Dr. Bennett says. It’s also possible to experience some physical symptoms as a result of elevated cortisol, like headaches or fatigue, she added.

Certain populations may be at higher risk for increased cortisol, including people who experience chronic stress, major life traumas, or have a substance use disorder, Dr. Fogelman adds.

If I Think My Cortisol Levels Are Too High, Should I Ask My Doctor for a Test?

Most primary care doctors will not routinely administer a test for cortisol levels.

And most doctors don’t recommend testing cortisol levels unless there is a suspicion for a condition like Cushing syndrome (a serious but rare condition related to excess cortisol), says Katie Guttenberg, MD, an endocrinologist at UT Health Houston.

So, when should you be concerned about the symptoms above? And when should you advocate for yourself at your doctor’s office?

Many of these signs and symptoms — irritability, trouble sleeping, a predilection for junk food — are ones that can be linked to a variety of health issues.

Bennett offers a simple litmus test: Pay attention to the stressors in your life and how they may or may not trigger symptoms. Do the symptoms you’re noticing subside when you’re coping with fewer acute stressors? Do they ramp up when you have more on your plate? If the answers to these questions are yes and yes, take that as a reassuring signal you don’t have chronically elevated cortisol (but consider ways you can take more “breaks” from your stressors — or build in more time for self-care), Bennett says.

At that point, it may be worth advocating for your doctor to test your cortisol levels. You can ask your PCP. Or if you can get a referral to an endocrinologist, Guttenberg says they tend to be more knowledgeable on these issues.

7 Evidence-Backed Ways to Lower Cortisol Levels

The good news: Some simple, evidence-backed steps can help keep cortisol levels healthy — whether they’re elevated or not. None of them will do you any harm, and each of them will also help with general stress management.

“A lot of this is just about leading a healthy lifestyle,” Dr. Guttenberg says, which will help with stress management — which, in turn, will help lower your cortisol levels.

1. Focus on Eating Healthier Foods

Bennett suggests avoiding highly processed foods and instead choosing single-ingredient foods as often as possible. “That’s one way to help your metabolism and your digestive system, which is something cortisol can influence,” she says.

One study looked at cortisol levels and the glycemic index (GI) — a measurement of how fast a food elevates your blood sugar. (High-GI foods include many highly processed ones, like sugary drinks, refined carbs, and fast food.) Those researchers found a link between a high-GI diet and increased cortisol levels.

Other research has found a link between eating high-calorie foods and an immediate increase in cortisol.

And eating too few calories may disrupt cortisol: One study found an association between calorie restriction and increased cortisol.

2. Get Moving

Physical activity is also helpful when you’re looking to lower your cortisol levels. “And I say ‘physical activity’ as opposed to ‘exercise,’” Bennett says. “Anything that gets you moving is valuable, whether that’s walking, yoga, HIIT, or CrossFit. Find whatever your jam is and do it.”

One study, for example, assigned healthy people to either run on a treadmill for 30 minutes or not, and then take the Trier Social Stress Test — a classic experimental task requiring study participants to deliver a speech and solve a math question in front of an audience. That research found a smaller increase in cortisol among the treadmill runners as compared with the group that hadn’t exercised before the stress test.

3. Write It Down

You may want to simply avoid thinking about the event in your life that is stressing you out, but the research suggests doing the opposite may have benefits.

One study, for example, found that when people wrote about a past failure before experiencing a new stressor, their levels of cortisol were reduced when compared with those who did not first complete the personal writing exercise.

4. Try Meditating

For long-term reduction in your cortisol levels, meditation may help. Evidence supports that if you keep up the habit, you can increase your tolerance for uncertainty, anxiety, and the unexpected.

Research suggests that mindfulness meditation is an effective tool for lowering cortisol levels, and that the difference was especially stark in those the study authors deemed “at-risk,” defined here as “highly stressed people or populations with diseases that are susceptible to stress, such as mental disorders and somatic illnesses like inflammatory diseases or diabetes.”

5. Tap Into Your Community

“Being connected to other humans is really important,” says Bennett. “Just that social connection and finding yourself in a place where you know you’re valued and you value others.”

Indeed, research shows this can help with well-being and health, including when it comes to cortisol. In one study, participants were asked to engage in public speaking. Those who had a loved one nearby had lower cortisol levels before delivering the speech as compared with those who did not have that social support.

6. Get Some Sleep

In one study, participants either had a normal night of sleep or were subjected to a night of sleep deprivation. The following day, all study subjects were made to perform a stressful task — a speech and a math problem in front of a stern-looking audience. The researchers found elevated cortisol levels in the sleep-deprived people as compared with those who’d slept normally.

Other data has found that sleep loss was associated with elevated cortisol levels even on the second day after the poor night’s sleep.

7. Enjoy Art — or Try Making Some Yourself

Whether you’re losing yourself in music or works of art or making it yourself, enjoying art is a classic stress reliever.

In one study, participants either listened to relaxing classical music, the sound of rippling water, or nothing at all. After performing a stressful task, participants who had listened to music had faster reductions in their cortisol levels as compared with those who listened to nature sounds or who sat in silence.

Other research found that art-making (in 45-minute sessions) was linked to lower cortisol levels after participating in the activity compared with cortisol measurements beforehand. The projects were nothing fancy — collages, clay modeling, drawing with markers — and the participants didn’t need prior experience of making art to experience the biological benefits.

“After about five minutes, I felt less anxious,” said one 38-year-old woman who participated in the study. “I was able to obsess less about things that I had not done or needed to get done. Doing art allowed me to put things into perspective.”

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