The Cortisol Connection: How Stress Affects Your Sleep, Weight, and More

In the constant rush of modern life, stress feels like an ever-present companion. At the center of our body's response to stress lies a key player: cortisol, often nicknamed the "stress hormone."

M.B.
Dr. Manuela Băbuș, MD
The Cortisol Connection: How Stress Affects Your Sleep, Weight, and More
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Cortisol is a steroid hormone produced by the adrenal glands, which are on top of each kidney. These glands are part of the endocrine system.

Cortisol earns its "stress hormone" title because it is released in response to stressful situations. It belongs to a group of hormones called glucocorticoids. The adrenal glands produce cortisol. The hypothalamus, pituitary gland, and adrenal glands regulate its production.

Often seen as the body's multi-tasking marvel, cortisol significantly impacts nearly every aspect of our bodily functions. Its vital roles include managing the body's stress response, controlling metabolism by regulating fats, proteins, and carbohydrates, reducing inflammation, keeping blood pressure in check, maintaining blood sugar levels, and even orchestrating the delicate balance of our sleep-wake cycle.

Any imbalance, whether high or low cortisol levels, can have detrimental consequences for our health.

The Good and Bad of Cortisol:

Positive Effects:

  • Energy Boost: Cortisol helps provide a quick burst of energy by increasing blood sugar levels, enabling the body to respond to stressors effectively.
  • Anti-inflammatory Properties: In the short term, cortisol can help reduce inflammation, aiding in the body's recovery from injury or infection.

Negative Effects:

  • Suppressed Immune Function: Prolonged exposure to high levels of cortisol can suppress the immune system, making individuals more susceptible to infections and illnesses.
  • Metabolic Imbalances: Chronic stress and elevated cortisol levels have been linked to metabolic disorders such as obesity, insulin resistance, and type 2 diabetes.

Hypersecretion of Cortisol:

When the body produces too much cortisol, it can lead to a condition known as Cushing's syndrome. This can occur due to various factors, including:

  • Chronic Stress: Prolonged exposure to stressors can cause the adrenal glands to overproduce cortisol.
  • Adrenal Tumors: Tumors in the adrenal glands or pituitary gland can lead to excessive cortisol production.

Certain medications, such as corticosteroids used to treat inflammatory conditions, can also cause hypersecretion of cortisol.

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Excessive levels of cortisol can have a range of adverse effects on the body, including:

  • Weight Gain: Increased cortisol levels can lead to the accumulation of fat, particularly around the abdomen.
  • Muscle Weakness: Cortisol can break down muscle tissue, leading to muscle weakness and loss of muscle mass.
  • High Blood Pressure: Cortisol can increase blood pressure by promoting sodium retention and vasoconstriction.

Hyposecretion of Cortisol

Sometimes, the adrenal glands don't produce enough cortisol. This condition is called adrenal insufficiency.

There are two main types:

  • Addison's disease: This is the most common type, and it happens when the body's immune system mistakenly attacks the adrenal glands, causing them to malfunction.
  • Secondary adrenal insufficiency: This less common type occurs when another health problem, like a medication issue or a pituitary gland disorder, disrupts cortisol production.

In Addison's disease, not only cortisol production is low, but the adrenal glands also make less of another hormone called aldosterone. Aldosterone helps keep the right balance of sodium (Na+) and potassium (K+) in the body fluids.

Lifestyle and Treatment Approaches:

Managing cortisol levels is crucial for maintaining overall health and well-being. Here are some lifestyle changes and treatment approaches that can help:

Lifestyle Modifications:

  • Stress Management: Practicing stress-reduction techniques such as meditation, deep breathing exercises, and yoga can help lower cortisol levels.
  • Healthy Diet: Consuming a balanced diet rich in whole foods, fruits, and vegetables can support adrenal health and regulate cortisol production.
  • Regular Exercise: Engaging in regular physical activity can help reduce stress and promote overall health.

Medical Treatment:

  • Medication: In cases of Cushing's syndrome caused by adrenal tumors or pituitary gland abnormalities, surgery may be required to remove the tumors. Medications to block cortisol production may also be prescribed.
  • Hormone Replacement Therapy: For individuals with adrenal insufficiency, hormone replacement therapy may be necessary to restore cortisol levels to normal.

Cortisol and the stress

Secretion of cortisol is an important part of the body's stress response. When the body is under stress, cortisol helps to:

  • Providing energy
  • Increasing alertness
  • Reducing pain
  • Regulating the 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 the sleep-wake cycle.

However, chronic stress can lead to high levels of cortisol, which can have several negative effects on the body, including:

  • Weight gain
  • Headaches
  • Difficulty sleeping
  • Reduced immune function

How does the body control cortisol levels?

The body maintains cortisol levels through a fascinating interplay between different parts. The hypothalamus and pituitary gland, two pea-sized maestros in the brain, lead the cortisol production show in our adrenal glands. Optimal cortisol levels depend on the smooth performance of this trio: hypothalamus, pituitary gland, and adrenal glands.

The level of cortisol monitored in the blood, urine and saliva normally peaks in the early morning and declines throughout the day, reaching its lowest level around midnight. 

This pattern can change if you work a night shift and sleep at different times of the day!

Managing cortisol levels

Several things can be done to manage cortisol levels, including:

  • Exercise
  • Relaxation techniques
  • Getting enough sleep
  • Eating a healthy diet

Conclusion

Cortisol is an important hormone that plays several vital roles in the body. 

However, chronic stress can lead to high levels of cortisol, which can have many negative effects on health (high blood pressure, weight gain)

Several things can be done to manage cortisol levels, including exercise, relaxation techniques, getting enough sleep, and eating a healthy diet.

The information on this blog is intended for informational purposes only and is not a substitute for professional medical advice.  Always consult with a qualified healthcare professional before making any decisions about your health or treatment.

The information contained in this blog may not apply to your specific health situation.

If you have any questions or concerns about your health, please contact your doctor or other qualified healthcare professional.

Article Citations & Bibliography

  1. Raff H, Carroll T. Cushing's syndrome: from physiological principles to diagnosis and clinical care. J Physiol. 2015 Feb 01;593(3):493-506. 
  2. Wojcik M, Ruszala A, Janus D, Starzyk JB. Secondary Adrenal Insufficiency due to Intra-articular Glucocorticoid Injections. Indian Pediatr. 2019 Mar 15;56(3):242-243.
  3. Ramamoorthy S, Cidlowski JA. Corticosteroids: Mechanisms of Action in Health and Disease. Rheum Dis Clin North Am. 2016 Feb;42(1):15-31, vii. doi: 10.1016/j.rdc.2015.08.002. PMID: 26611548; PMCID: PMC4662771.
  4. Angelousi A, Margioris AN, Tsatsanis C. ACTH Action on the Adrenals. 2020 Jun 13. In: Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000–. PMID: 25905342.

Please note that the information provided on this blog is for educational and informational purposes only. It is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog.

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M.B.
Manuela Băbuș.
Medical Writer