Stress and certain underlying conditions can increase your cortisol levels. High cortisol levels can cause a range of symptoms, including weight gain, acne, and fatigue.

Everyone has high cortisol from time to time, and levels vary throughout the day. It’s part of your body’s natural response to threats of harm or danger.

But, if your body consistently makes too much cortisol, it usually indicates an underlying health problem. Doctors may refer to high cortisol as Cushing syndrome or hypercortisolism.

Read on to learn how to recognize the symptoms and potential causes.

The adrenal glands make this steroid hormone, but the hypothalamus-pituitary-adrenal axis controls how much your body releases.

Most of the cells in your body have cortisol receptors. They use it for a variety of functions, such as:

  • blood sugar regulation
  • inflammation reduction
  • metabolism regulation
  • memory formulation

Cortisol is important for your health, but too much of it can harm your body and cause several unwanted symptoms.

High cortisol can cause several symptoms throughout your body. Symptoms can vary depending on what’s causing the increase in your cortisol levels.

General signs and symptoms of too much cortisol include:

  • weight gain, mostly around the midsection and upper back
  • weight gain and rounding of the face
  • acne
  • thinning skin
  • easy bruising
  • flushed face
  • slowed healing
  • muscle weakness
  • severe fatigue
  • irritability
  • difficulty concentrating
  • high blood pressure
  • headache

The brain’s hypothalamus interacts with various glands in our body to regulate the levels of hormones. When it comes to cortisol, this is known as the hypothalamic-pituitary-adrenal axis.

When cortisol levels are low, the hypothalamus releases the corticotrophin-releasing hormone (CRH), which triggers the anterior pituitary gland to release the adrenocorticotropic hormone (ACTH). ACTH then causes the adrenal gland to create and release more cortisol.

There are different reasons why the adrenal gland may release too much cortisol.


Stress triggers a combination of signals within the body from both hormones and nerves. These signals cause your adrenal glands to release hormones, including adrenaline and cortisol.

The result is an increased heart rate and energy as part of the fight-or-flight response. It’s your body’s way of preparing itself for potentially dangerous or harmful situations.

Cortisol also helps to limit any functions that aren’t essential in a fight-or-flight situation. Once the threat passes, your hormones return to their usual levels, and bodily functions return to typical levels.

But when you’re under constant stress, this response doesn’t always turn off.

Long-term exposure to cortisol and other stress hormones can negatively affect almost all of your body’s processes. This can increase your risk of health issues such as heart disease, lung issues, obesity, anxiety, depression, and more.

Pituitary gland issues

The pituitary gland is located at the base of your brain. People sometimes refer to it as the “master gland” because it monitors and helps control many of the body’s functions by releasing hormones.

Issues with the pituitary gland can cause it to under or over-produce hormones, including ACTH, which then triggers the adrenal glands to release more cortisol.

Pituitary conditions that can cause high cortisol levels include:

Adrenal gland tumors

Your adrenal glands sit above each kidney. Adrenal gland tumors can be benign (noncancerous) or malignant (cancerous) and range in size. Both types can secrete high levels of hormones, including cortisol.

In addition, if the tumor is large enough to pressure nearby organs, you might notice pain or a feeling of fullness in your abdomen.

Adrenal tumors are usually benign and found in approximately 1 in 10 people having an imaging test of the adrenal gland. Adrenal cancers are much rarer.

Medication side effects

Certain medications can cause an increase in cortisol levels. For example, some studies note a link between oral contraceptives and blood cortisol levels.

Corticosteroid medications used to treat asthma, arthritis, certain cancers, and other conditions can also cause high cortisol levels when taken in high doses or for a long period of time.

Commonly prescribed corticosteroids include:

Finding the right dose and taking corticosteroids as prescribed may help reduce the risk of developing high cortisol levels.

You should never stop steroid medications without gradual tapering or talking with a doctor first. Abruptly stopping can cause low levels of cortisol. This can cause low blood pressure or blood sugar, coma, and death.

If you think you might have high cortisol, you should see a doctor for a blood test. High cortisol levels cause several nonspecific symptoms, which means several medical conditions and diseases may be responsible for them.

If you’re experiencing symptoms, a doctor may recommend the following tests:

  • Cortisol urine and blood tests. These tests measure the levels of cortisol in your blood and urine. The blood test uses a sample of blood drawn from your vein. The cortisol urine test is a 24-hours urinary-free cortisol excretion test that entails collecting urine over a 24-hour period. Blood and urine samples are then analyzed in a laboratory for cortisol levels.
  • Cortisol saliva test. This test checks for Cushing syndrome. A sample of saliva collected at night is analyzed to see if your cortisol levels are high. Cortisol levels rise and fall throughout the day and drop significantly at night in people without Cushing syndrome. High cortisol levels at night would indicate you may have Cushing syndrome.
  • Imaging tests. CT or MRI scans may be used to obtain images of your pituitary gland and adrenal glands to check for tumors or other abnormalities.

Poorly managed high cortisol levels can have serious consequences on your health. Left untreated, high cortisol can increase your risk of serious health conditions, including:

The following sections answer some frequently asked questions about high cortisol levels.

What causes cortisol to rise?

If your cortisol levels rise, the direct cause is high levels of ACTH in the adrenal glands. This may result from an underlying health condition, medication, or other causes.

How do I know if I have high cortisol?

High cortisol levels can cause several symptoms, such as weight gain, headaches, irritability, and others. In most cases, the symptoms are not specific to increased cortisol levels. You will need to see a doctor for a formal diagnosis, which often requires a blood, saliva, or urine test.

Does vitamin D reduce cortisol levels?

Some evidence suggests that vitamin D supplements may help reduce cortisol levels in the blood and urine. This can help reduce the risk of cardiovascular disease.

Having high cortisol over a longer period of time can have lasting, negative effects on your health. This is known as Cushing syndrome.

If you have symptoms of high cortisol, you should consider seeing a doctor. A doctor can help determine the underlying cause of your symptoms and help you treat or manage the condition.