Do you really need to control your cortisol? Doctors say it's unlikely. Here's why.
The internet is abuzz with cortisol, the stress hormone. Wellness influencers warn of its symptoms: waking up at 3 a.m., a swollen face, and belly fat. They offer diet and exercise advice, but is it necessary? Doctors say no. They urge caution against demonizing cortisol and advise seeking professional help if you suspect a problem.
Cortisol is essential for survival, produced by the adrenal glands above the kidneys. It regulates inflammation, the immune system, metabolism, and blood pressure. It's finely tuned to your body and environment, fluctuating throughout the day. Rising in the morning and falling at night, it also increases during illness or stress.
"Our cortisol levels are regulated by the minute," says Dr. Roberto Salvatori, an endocrinologist. "It's very sensitive."
Cortisol disorders are rare. Chronic low levels lead to adrenal insufficiency, including Addison's disease, where the immune system attacks the adrenal gland. High cortisol levels cause Cushing's syndrome, often due to tumors in the adrenal or pituitary glands, treated with medication, surgery, or both.
Symptoms of high or low cortisol overlap with other health issues. Adrenal insufficiency causes fatigue, weight loss, low blood pressure, and loss of appetite. Cushing's syndrome leads to weight gain, high blood pressure, brittle bones, facial and belly fat, abnormal hair growth in women, and sleep issues.
Diagnosis requires multiple tests and understanding a patient's health. Cortisol can be measured through saliva, blood, or urine. Dr. Katie Guttenberg warns against self-testing, as it can lead to unnecessary stress and medical follow-ups.
Endocrinologists say there are no proven over-the-counter treatments for cortisol issues. Despite claims, supplements like ashwagandha and magnesium are not proven to lower cortisol. Dr. James Findling warns against unregulated supplements, as they can be harmful.
Managing stress is key, regardless of cortisol. Doctors acknowledge the subjective nature of stress and the potential for Cushing's syndrome patients to go undiagnosed. They advise talking to a doctor if concerned.
For healthy individuals, the focus should be on stress management basics: eating well, sleeping enough, exercising, or therapy. "There's nothing new about that," says Dr. Findling. "Just do the basics."
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
