Cortisol is a steroid hormone produced in the cortex of the adrenal glands. In times of stressful situations, the adrenal glands secrete the “stress hormone” cortisol as part of your coping mechanism. This hormone is also released when your blood sugar levels fall below normal in order to maintain homeostasis (balance). In the morning, cortisol levels are at its highest and gradually decline throughout the day.

Functions of Cortisol

The primary functions of cortisol are the following:

  • Energy regulation and mobilization by promoting glycogenolysis (conversion of the primary carbohydrate glycogen into blood sugar).
  • Helps the body responds to stress or danger by providing a quick burst of energy (“fight or flight response”).
  • Controls blood pressure.
  • Reduces inflammation.

Cortisol Imbalance

In order to cope up with stressful situations, your body produces the right amount of cortisol. However, if you have a medical condition known as Cushing’s syndrome, your cortisol levels will remain elevated for prolonged periods of time. In this case, you may experience the following symptoms:

  • Acne
  • Facial hair in women
  • High blood pressure
  • Increased thirst
  • Irregular menstrual periods.
  • Mood changes
  • Muscle weakness
  • Osteoporosis
  • Rapid weight gain, particularly in the face, chest and abdomen contrasted with slender arms and legs.
  • Skin bruises
  • Thinning of skin resulting in delayed wound healing.
  • Urinary frequency

On the other hand, some people can also experience cortisol deficiency. Medical conditions such as adrenal insufficiency and Addison’s disease can cause low cortisol levels. If you have these conditions, you may experience the following symptoms:

  • Abdominal pain
  • Darkening of regions of the skin
  • Extreme fatigue
  • Muscle weakness
  • Nausea and vomiting
  • Weight loss

If you experience any of these symptoms, consult with your doctor immediately to determine the best course of action. Typically, your doctor will conduct blood test, saliva test, and urine test to determine your cortisol levels. Your doctor may also order an MRI or CT scan if he or she suspects that a tumor is causing your cortisol imbalance.

Proven Benefits of Cortisol Replacement Therapy

If your body is not producing sufficient amounts of cortisol, your doctor may prescribe cortisol replacement therapy. When used as a medication, cortisol is known as hydrocortisone or corticosteroids. There is compelling evidence that restoring cortisol to healthy levels yields diverse health benefits:

Improves blood sugar levels

One of the vital functions of cortisol is to restore body homeostasis by regulating blood sugar levels. Because of this ability, cortisol may help bring down elevated blood sugar levels, making it beneficial in patients with diabetes and those with uncontrolled blood sugar levels. There are several studies supporting the anti-diabetic effects of cortisol:

  1. Cortisol reduces blood sugar levels by increasing glucose uptake and usage in the brain, heart, and muscles.[1]
  2. In older men and women, higher cortisol levels are associated with decreased insulin levels, suggesting that cortisol improves blood sugar level by allowing insulin to enter into the cells.[2]


[1] Macfarlane DP, Forbes S, Walker BR. Glucocorticoids and fatty acid metabolism in humans: fuelling fat redistribution in the metabolic syndrome. J Endocrinol. 2008;197(2):189-204.

[2] Kamba A, Daimon M, Murakami H, et al. Association between Higher Serum Cortisol Levels and Decreased Insulin Secretion in a General Population. Nishimura W, ed. PLoS ONE. 2016;11(11):e0166077. doi:10.1371/journal.pone.0166077.

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