What is cortisol—and should you actually be worried about it?
Myths about cortisol—also known as the “stress hormone”—abound on social media. Here’s what experts say about this substance that helps make your body tick.
How are your cortisol levels today? A few minutes on the internet might leave you convinced that your body is depleted of—or flooded with—the hormone.
Known colloquially as “the stress hormone,” cortisol plays a starring role in most of the physiological processes that make your body tick. But in recent years, it has become a victim of its own fame, with people blaming suspected imbalances of the hormone for ailments such as “adrenal fatigue,” weight gain, exhaustion, anxiety, headaches, and more.
Cortisol does play a vital role in your health. But are imbalanced cortisol levels really that common? Here’s what to know about the critical hormone—and why it may not merit as much worry as some social media health gurus would have you think.
A physical powerhouse
Secreted by the adrenal glands atop the kidneys, cortisol, known as a steroid hormone, can be found in nearly every tissue of the body.
“Honestly, we cannot do without it,” says Anat Ben-Shlomo, an endocrinologist and associate professor of medicine at Cedars-Sinai.
Cortisol allows the body to regulate everything from metabolism to sleep to immune function and inflammation, but it’s arguably best known for helping the body respond to perceived threats, a role that’s earned it the nickname of the “stress hormone.”
(Do you have chronic stress? Look for these signs.)
When the body perceives an internal or external threat, its sympathetic nervous system activates, triggering a complex sequence of hormonal responses. One such response is to prompt the adrenal glands to release cortisol, which helps give the body the energy it needs to cope with the stress and get back to homeostasis.
Too much—or little—of a good thing?
There is such thing as too much or too little cortisol.
Tumors in the pituitary gland can trigger too-high cortisol levels, leading to a condition called Cushing’s syndrome, characterized by weight gain, weakness, blood sugar problems, and bruising.
Meanwhile those whose immune systems attack their adrenal glands don’t produce enough cortisol and can develop chronic adrenal insufficiency, also known as Addison’s disease, which can cause crushing fatigue, dizziness, skin darkening, loss of appetite, and other symptoms.
“The diseases that are associated with cortisol deficiency or excess are very complicated, multiorganic, multisystemic diseases,” says Ben-Shlomo. They can be tricky to treat—and because cortisol issues share symptoms with other diseases, misdiagnosis is common.
But even though experts suspect these conditions are underdiagnosed, both are considered rare disorders.
The myth of ‘adrenal fatigue’
Despite the rarity of cortisol disorders, internet health gurus and alternative health practitioners claim that with sustained stress, the adrenal glands can burn out and become unable to produce cortisol, leading to a cascade of symptoms commonly called “adrenal fatigue.”
But the term is a myth, Ben-Shlomo says, and a 2016 literature review of studies suggests the condition doesn’t really exist.
“It really takes a pretty big insult for your adrenal glands not to work,” Anne Cappola, professor of endocrinology, diabetes, and metabolism at the University of Pennsylvania School of Medicine, told National Geographic in July 2023. “These glands have a lot of built-in redundancy. You have two adrenal glands. You need less than one to function.”
(Are your hormones balanced—and what does that even mean?)
Though serious endocrine disorders do exist, researchers warn against attempting to “balance” hormones at home or self-prescribing supplements—most of which are unproven and unregulated—to stave off cortisol deficiency or excess.
If your symptoms are affecting your quality of life, head to a doctor for more information. Endocrinologists can rule out adrenal problems and often identify other conditions, such as perimenopause and polycystic ovary syndrome (PCOS), that share symptoms with adrenal issues.
“The beauty of the adrenal glands is that they have a huge capacity to give you what you need to survive and withstand stress,” says Ben-Shlomo.
Fighting back against chronic stress
Stress may not burn out your adrenals or deplete your body’s cortisol reserves. But its effects are real, and supported by a vast body of literature that underlines the association between high stress levels and compromised health.
For example, those with multiple adverse childhood experiences are prone to a variety of health conditions, from mood disorders to obesity and stroke. Stress can trigger or worsen a slew of other conditions, compromising a variety of bodily systems and leading one group of researchers to write in 2017 that “the medical community needs to have a greater appreciation for the significant role that stress may play in various diseases.”
You may not be able to fend off a growing tumor or an autoimmune disorder. But you can modify your experience of stress through a variety of lifestyle modifications. Ben-Shlomo and colleagues stress regular exercise, a healthful diet, meditation or mindfulness, and enough sleep—factors that can treat or even prevent a variety of the conditions some people can mistake for an issue with cortisol production. After all, acute stress may have its evolutionary benefits but most of us would prefer not to experience it.
“Stress is a bad thing,” the physician says. “That’s been proven beyond any doubt.”
