What is cortisol?

Cortisol is known as the stress hormone because of its role in the body’s stress response. But cortisol is about more than just stress.

This steroid hormone is made in the adrenal glands. Most of the cells in our bodies have cortisol receptors that use cortisol for a variety of functions, including

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

Cortisol is important for your health, but too much of it can wreak havoc on your body and cause a number of unwanted symptoms.

High cortisol can cause a number of 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

A high cortisol level can mean several things.

High cortisol may be referred to as Cushing syndrome. This condition results from your body making too much cortisol. (Similar symptoms can arise after taking high doses of corticosteroids, so it’s recommended that this be ruled out before testing for Cushing syndrome).

Some common symptoms of Cushing syndrome include:

  • fatty deposits in the midsection, face, or between the shoulders
  • purple stretch marks
  • weight gain
  • slow-healing injuries
  • thinning skin

Several things can contribute to the development of high cortisol.


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

The result is an increase in 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. This whole process can be a lifesaver.

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

Long-term exposure to cortisol and other stress hormones can wreak havoc on almost all of your body’s processes, increasing your risk of many health issues, from heart disease and obesity to anxiety and depression

Pituitary gland issues

The pituitary gland is a tiny organ at the base of your brain that controls the secretion of various hormones. Issues with the pituitary gland can cause it to under- or over-produce hormones, including adrenocorticotropic hormone. This is the hormone that triggers the adrenal glands to release cortisol.

Pituitary conditions that can cause high cortisol levels include:

Adrenal gland tumors

Your adrenal glands are located 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. This can lead to Cushing syndrome.

In addition, if the tumor is large enough to put pressure on 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 more rare.

Medication side effects

Certain medications can cause an increase in cortisol levels. For example, oral contraceptives are linked to increased cortisol in the blood.

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:

  • prednisone (Deltasone, Prednicot, Rayos)
  • cortisone (Cortone Acetate)
  • methylprednisolone (Medrol, MethylPREDNISolone Dose Pack)
  • dexamethasone (Dexamethasone Intensol, DexPak, Baycadron)

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

Steroid medications should never be stopped without gradual tapering. Abruptly stopping can cause low levels of cortisol. This can cause low blood pressure and blood sugar, even coma and death.

Always speak to your doctor before making any changes to your dosing schedule when taking corticosteroids.


Circulating estrogen can increase cortisol levels in your blood. This can be caused by estrogen therapy and pregnancy. A high circulating concentration of estrogen is the most common cause of high cortisol levels in women.

If you think you might have high cortisol, it’s important to see a doctor for a blood test. High cortisol causes common signs and symptoms that can be caused by many other diseases, so it’s important to confirm what’s causing your symptoms.

If you’re experiencing symptoms that may be caused by high cortisol levels, your 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. A test called the 24-hours urinary free cortisol excretion test is used to check your urine. This 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 is used to check 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 scans or an MRI may be used to obtain images of your pituitary gland and adrenal glands to check for tumors or other abnormalities.

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

Everyone has high cortisol from time to time. It’s part of your body’s natural response to threats of harm or danger. But having high cortisol over a longer period of time can have lasting effects on your health.

If you have symptoms of high cortisol, it’s best to start with a blood test to see how high your cortisol level is. Based on your results, a doctor can help to narrow down the underlying cause and help you get your cortisol level back to a safe level.