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Cortisol is a steroid hormone that is released by the adrenal glands; the small glands that sit on top of your kidneys. It’s a hormone most of us are familiar with due to the immediate association with stress. While stress is mostly seen as “bad” by people, having stress is an important function of the body that ensures our body takes care of us in all types of situations.
Cortisol is supposed to ebb and flow throughout the day. As much as it is thought that we want to “control our cortisol levels,” there’s a bit more to it than that. So, let’s dive into what normal cortisol levels look like, the diurnal pattern, and what cortisol actually does for the body.
Breaking It All Down…
What does cortisol actually do for you?
Cortisol is one of many steroid hormones produced and released by the adrenal glands. Its job is not just managing stress, but managing multiple systems in your body.
Cortisol is considered an essential hormone that affects almost every organ and tissue in your body. Its many roles include:
- Regulating your body’s stress response.
- Helping control your body’s use of fats, proteins, and carbohydrates, or your metabolism.
- Suppressing inflammation.
- Regulating blood pressure.
- Regulating blood sugar.
- Helping control your sleep-wake cycle.
All of this to say, we need adequate levels of cortisol (it's not evil). But it should be noted that higher-than-normal or lower-than-normal cortisol levels can be harmful to your health.
So, What Do Normal Cortisol Levels Look Like?
In healthy individuals, cortisol tends to increase significantly around 30 minutes after waking. This peak is then followed by a descent across the day, with the lowest levels being in the middle of the night.
These ranges are typically assumed to be around 10 to 20 micrograms per deciliter from 6AM to 8AM, and 3 to 10 micrograms per deciliter by around 4PM when doing a blood test. (Some ranges vary slightly from this depending on the lab.)
Cortisol can also be tested through urine and saliva, but all three of these methods show a higher peak in the morning and a low reached around midnight. The trend is always the same.
So, if cortisol is supposed to be higher in the earlier part of the day, we don’t need to go to extreme measures to be lowering it, but simply ensuring we are seeing this normal pattern.
If you have concerns about your cortisol, you can consult with a physician for some testing. However—if you’re experiencing what you believe are symptoms of elevated cortisol, there’s some things we should address first.
How Can I Ensure I Have Normal Cortisol Levels?
I’ll never tell someone to not test if they have suspicions of anything being awry amongst bloodwork, but before jumping to the conclusion that all of your problems are stemming from chronically high or low cortisol, we want to address the lifestyle changes that can help this. Like many other hormonal issues, we want to ensure that you’re controlling what you can control first, as these things are often overlooked, or will be the place you are doing work anyway if bloodwork comes back irregular.
Here are a few foundational habits to start with:
- Quality sleep is the first defense when it comes to regulating cortisol. As stated before, the diurnal pattern is helpful in regulating our sleep patterns, but this works in reverse as well—with improved sleep quality helping to improve cortisol levels over time. Think of it as a positive feedback loop. Things like working a night shift, or having sleep issues can negatively impact cortisol levels as well.
- Regular exercise: Shocker, I know! Exercise can help to actually reduce overall stress (yes, exercise itself is a stressor, but does help reduce overall stress—assuming it's exercise we can recover from), and tends to lower cortisol levels/help regulate levels to where they should be.
- Stress reduction: Another shocking bit of advice, but let’s take it a step further. Stress reduction can be lowering your overall life “load,” through saying no more, taking days off from the gym, or reducing the intensity of some sessions. It can be removing yourself from stressful work environments or relationships. It can also be swapping a high intensity workout for something like yoga, where breathwork is involved (bringing your parasympathetic nervous system into play here), or doing more things that bring you joy, releasing endorphins and counteracting the effects of cortisol.
If you are already working on all of these things and still feel like you’re experiencing symptoms of high or low cortisol, work with your physician to get testing done. And no—you don’t need an adrenal cocktail, you need some bloodwork or a urine/saliva test.
Symptoms of High Cortisol:
- Weight gain (more specifically in face and abdomen)
- High blood pressure issues
- Sudden glucose regulation issues, or type 2 diabetes diagnosis
- Excessive hair growth in females
- Osteoporosis, fractures
- Muscle weakness
- Purple stretch marks / bruising
Symptoms of Low Cortisol:
- Fatigue
- Weight loss (unintentional)
- Low blood pressure issues
- Lowered appetite
So remember—cortisol is just one of many things that your body needs to function, and it doesn’t need to always be low! What we really want is a normal cortisol pattern across the typical 24-hour day, and most times, we can achieve that through lifestyle modification.
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