Cortisol is a steroid hormone made in the adrenal glands and then released into the blood. Most cells have receptors for this hormone, which works in your body in several ways. This hormone helps control your body's blood sugar levels and metabolism and influences water and salt balance, blood pressure, memory, and the ability to fight infection. Like many other hormones, cortisol affects the circadian rhythm (sleep and wake cycle), with the highest levels in the morning and lowest around midnight.
Cortisol also is released in stressful situations, which is often called 'the stress hormone.' As the adrenal glands release cortisol into your bloodstream, your body automatically produces a surge of glucose into your larger muscles enabling you to jump into action. Also, while narrowing your arteries, your body produces another hormone called epinephrine (adrenaline), which increases your heart rate.
This reaction enables you to face any threat with a sense of heightened alertness and energy. Everybody will be familiar with that surging feeling when you narrowly avoid a thrown punch, your child breaks a bone, or you receive a large utility bill; this is Cortisol at work. Also known as "fight or flight," this sensation of increased stimulation and perception is what has kept us one step ahead of predators for millennia and essentially helped us survive. It allows you to jump into action at the drop of a hat.
What does Cortisol do?
Cortisol plays an essential role in many bodily functions, such as.
- Helps your memory
- Helps regulate your sleep cycle
- Helps reduce inflammation
- Regulates blood pressure
- Manages your body's use of fats, carbohydrates, and protein
- Helps boost alertness in stressful situations and calm you down afterward
- Regulates glucose levels
What if your body Produces too Much Cortisol?
In these modern times, everybody is under more pressure than your body is designed to cope with. Stress from work, busy lifestyles, and constant high-stress levels can wreak havoc on your levels. In turn, this can cause unpleasant symptoms, which can be very damaging in the long term. These symptoms include:
- Short temper and irritability
- Constipation, diarrhea, and bloating
- Poor sleep
- Weight gain, especially around the midsection and face
- High blood pressure
- Erectile dysfunction and low libido
- Menstrual problems
- Ovulation issues
- Slow recovery time after exercise
- Easily bruised
- Increased risk of bone fractures and osteoporosis
- Lack of concentration
- Flushing and acne
What Causes high Cortisol Levels?
Several different conditions can cause high Cortisol. While stress is the most obvious, other conditions can cause an imbalance.
Life in the fast lane: work hard, play hard, plenty of time to sleep when you are dead, all phrases that many find relatable. Modern life is relentless, and unless we learn to relax, Cortisol pumps through your system continuously. Long term high levels can increase the risk of heart disease, obesity, anxiety, and depression. So unless you are a yoga teacher living in a Yurt by a gentle river, you may be at risk.
Situations that cause stress are called 'stressors' causes the release of stress hormones. There are two categories of stressors: Physiological (physical) stressors and Psychological Stressors.
Physiological (or physical) stressors
Extreme temperature, injury, chronic illness, and pain can all be physical causes of stress. Your body is up against it and releases the stress hormone cortisol as a result.
Situations that make you feel under threat or even feeling insecure cause the release of cortisol. For example, an upcoming exam, high-pressure family situations, a near miss, or worrying for a sick child.
Cushing's Syndrome is a hormonal disorder where your adrenal glands produce too much Cortisol into your body for too long. Cushing's Syndrome may be caused by a pituitary tumor, causing the pituitary gland to overproduce this hormone. An adrenal gland tumor, a tumor elsewhere in the body, or a result of long-term use of certain drugs. These include cortisone medications and Prednisone, a medicine used to suppress the immune system and ease inflammation in asthma, COPD, and rheumatologic diseases.
Cushing's syndrome symptoms are similar to symptoms of high Cortisol, but some are unique.
- Obesity in the upper body
- Skinny arms and legs
- Muscle weakness
- Camel like fatty bulge between the shoulder at the base of the neck
- Purple stretch marks on the sides of the abdomen, hips, and underarms
- Round reddish face
- Erectile dysfunction and or lack of libido
- Irregular periods or they stop altogether
- Excessive body hair on women
Cortisol, Testosterone and Erectile Dysfunction
The relationship between cortisol, testosterone, and erectile dysfunction is not widely studied. However, there are plenty of studies linking the stress hormone and erectile dysfunction. However, living in a constant state of stress can also play havoc on your testosterone production. Cortisol pushes down testosterone levels. When you are is in a stressful or dangerous situation, the last thing your body needs is testosterone.
In one study (1), 109 trainee soldiers had hormone levels monitored undertaking intense military training to see the human response to acute, realistic military stress, and the findings were pretty conclusive.
"Cortisol significantly increased during the captivity experience and was greatest after subjects' exposure to interrogations. Cortisol remained significantly elevated at recovery. Testosterone was significantly reduced within 12 hours of captivity. Reductions of both total and free T4 and total and free T3 were observed, as were increases in thyrotropin" (Wang S, Mason J, Southwick SM, Fox P, Hazlett G, Charney DS, Greenfield G).
One other study (2) looked at 105 men between the ages of 35 and 72 and compared cortisol, testosterone levels, and incidence of erectile dysfunction. Testosterone levels start to decline as a male reaches around 35 years old, but cortisol does not. In the study, they determined that men with high cortisol levels were more likely to suffer from E.D.
"One reason why E.D. occurred in patients with high levels of cortisol is because cortisol is increased by stress. It is known that the blood cortisol level increases at the same time as the blood norepinephrine level when sympathetic nervous activity is dominant. Sympathetic nervous activity has a restraining effect on erection, and sexual function is thought to be reduced under stress. Our results indicate that increases in plasma and salivary cortisol may play causative roles in E.D. induced by social stress." (Kobori Y, Koh E, Sugimoto K, et al. 2009)
So, one can conclude that high cortisol levels can reduce testosterone levels and, both low T and high cortisol negatively impact erectile function.
What if your body Produces too Little Cortisol?
If your body doesn't produce enough cortisol without medical intervention, you will eventually die. Addison's disease is an uncommon condition where the adrenal glands don't make enough cortisol and aldosterone.
Addison's disease usually happens when your immune system starts to attack the adrenal glands. This type of autoimmune disease tricks your body into attacking an organ, thinking it is a harmful invader, such as a virus or bacterial infection.
Other Causes of Addison's Disease
- Infections: Caused by AIDS or fungal infection
- Hemorrhage: Bleeding in the adrenal gland caused by Meningitis or other types of severe sepsis
- Cancer: Cells can spread from different areas of the body
- Amyloidosis – a disease where protein produced in bone marrow builds up, damaging the adrenal glands
- Adrenal gland removal: Due to severe infection or cancer
- Medicines used to treat Cushing's Syndrome such a Prednisone
- Damage caused by accidents: Trauma from car accidents, for example
- Severe shock
- Severe dehydration
Low cortisol levels can cause extreme fatigue, weakness, and low blood pressure, and if levels fall too low, you will have an Addisonian crisis, a life-threatening event with a long list of symptoms.
- Extreme weakness
- Stomach pains
- Sickness and vomiting
- High fever
- Pain in the legs and lower back
- Low blood pressure
- Dark skin rash
- increased heart rate
- Loss of consciousness
During an Addisonian crisis, you desperately need a hydrocortisone injection. Once given, you will recover fairly quickly. Many people who suffer from this disease are unaware until they have a crisis and will require hormone therapy for the rest of their lives.
Fortunately, medication can control this condition. Because the adrenal glands are no longer producing cortisol and aldosterone, corticosteroid medication tablets can rectify this, usually taken 2-3 times a day.
Most people who have Addison's disease go on to lead a healthy life. However, they may suffer periods of severe fatigue, which can be challenging to manage. Many people who have to rely on daily medication suffer from feeling restricted and feel frustrated, affecting mental health.
After a super stressful situation such as a car crash, healthy people feel a surge of Cortisol. This hormone rush helps you cope with the stress and any injuries you may have incurred. People living with Addison's cannot produce Cortisol and will need a hydrocortisone injection to replace the Cortisol to avoid being overwhelmed by adrenalin and prevent an adrenalin crisis. Sufferers should wear medical bracelets indicating their condition, so anybody at the scene can identify any issues quickly.
How Can You Maintain Healthy Cortisol Levels?
- Maintain a good circadian rhythm: Go to bed and get up and at the same time every day; this helps maintain a healthy hormone balance. Lack of sleep can drop testosterone and raise stress hormones.
- Avoid caffeine before bed: Caffeine is a stimulant and will keep you awake.
- Exercise: But, don't go overboard; overtraining can increase Cortisol and decrease testosterone. Your muscles need glucose during recovery, and this can add chronic stress to your body. Try yoga, pilates, swimming, and walking, which can help you get fit and relax.
- Try meditating: Meditation slows down your mind and allows your body to relax, reducing cortisol levels. This method is proven to reduce the harmful risks of extreme stress, such as high blood pressure, psychiatric disorder, and even migraines.
- Medication: There are many medications used to slow cortisol production in the adrenal glands, such as ketoconazole, mitotane (Lysodren), and metyrapone (Metopirone); these meds are mainly for those with Cushing's Syndrome.
Maintaining healthy hormone levels can be tricky as a man's testosterone levels inevitably drop the associated negative symptoms can start to creep in. Weight around the middle, loss of libido, brain fog, inability to gain muscle, and general lethargy can all start to creep in. These adverse symptoms can lead to a guy losing confidence, losing their lust for life, and causing excessive physical and psychological stress. Factors we now know cause the stress hormone to kick in, hammering testosterone even more.
Bioidentical hormone replacement therapy (BHRT) therapy is now an excellent option for guys who want to tackle the overall picture. BHRT has so many benefits that can, in the long run, help reduce stress from your life and get things back in your control. By optimizing your testosterone level and getting fit and healthy, you can rewind the clock and grab your youthfulness with both hands.
Unsurprisingly, testosterone replacement therapy can significantly reduce stress levels. This list of benefits is closely related.
- A better night's sleep means you will wake up more rested and less stressed.
- More muscle, less fat, and a healthier body all will improve self-image and reduce stress.
- Improved drive, motivation, and reduced symptoms of depression. All will give you an energy boost and the ability to deal with stressful situations more capably.
- Improved red blood cell count, some studies show testosterone treatment can increase red blood cell production, so oxygen is delivered more efficiently from your lungs to your organs.
- Better cardiovascular health, a healthy heart and lungs are central to you being fit and healthy. If your engine runs without stress, so will you!
(1) Morgan CA 3rd, Wang S, Mason J, Southwick SM, Fox P, Hazlett G, Charney DS, Greenfield G. Hormone profiles in humans experiencing military survival training. Biol Psychiatry. 2000 May 15;47(10):891-901. doi: 10.1016/s0006-3223(99)00307-8. PMID: 10807962.
(2) Kobori Y, Koh E, Sugimoto K, et al. The relationship of serum and salivary cortisol levels to male sexual dysfunction as measured by the International Index of Erectile Function. Int J Impot Res. 2009;21(4):207-212. doi:10.1038/ijir.2009.14