What is cortisol? When an organism undergoes a stressful event, it often releases a hormone called “cortisol.” Cortisol plays an amazing role in equipping our bodies for times of survival. However, chronically elevated cortisol may be a mismatch for what our body can handle, and may cause a cascade of issues in the body. A very healthy person might be able to handle life’s ups and downs with no issues at all. But for some, high cortisol in the body is an adaptive response. Anxiety from sleep deprivation, hunger, and social stress are often part of the high cortisol environment. Unburdening the body, by meeting nutritional requirements, removing inflammatory foods, and solving chronic mental stress are three key factors to lowering cortisol. Let’s dig into why chronically elevated cortisol may be a major health issue.
Studies show high cortisol promotes the development of NAFLD. One study noted, “It has been obvious for some time that there is an association between the body’s own cortisol or therapeutically administered cortisone and the development of fatty liver.” Cortisol’s role in metabolic diseases is still being researched, but some evidence does indicate that fatty liver might not just be related to diet, but rather your cortisol. The strong relationship between cortisol and fatty liver may be because cortisol regulates blood sugar and blood sugar is implicated as a cause of NAFLD. In addition, high cortisol increases gluconeogenesis and decreases glycogen synthesis. Cushing syndrome is a great example of this mechanism in action. One study concluded, “We have documented the presence of hepatic steatosis in 20% of patients with active Cushing’s syndrome using CT. We have also demonstrated a strong correlation between the presence of increased visceral fat and hepatic steatosis as measured by CT, which has not previously been documented.” Cushing syndrome is known to be driven by elevated cortisol, and many patients also have high blood sugar levels and fatty liver.
In addition, the administration of cortisone shots is commonly known to cause elevated triglyceride levels in the liver. One study showed, “The current case indicates that corticosteroid dose increase is a potential risk factor for NAFLD and contralateral ONFH.”2. Elevated cortisol may cause hair loss. Patients with hair loss often have excess levels of cortisol. In one study researchers noted, “Stress essentially just elevates this preexisting ‘adrenal gland–hair follicle axis,’ making it even more difficult for hair follicle stem cells to enter the growth phase to regenerate new hair follicles.” Interestingly enough, a symptom of Addison’s Disease (known to be driven by severe cortisol deficiency) is thick facial hair. Cortisol is a catabolic hormone meaning that it can break down the existing structures of the hair follicle. Whereas progesterone, testosterone, and DHEA are anabolic hormones that promote growth and tissue rebuilding including hair growth.3. Elevated cortisol may break down your bones.
Did you know U.S. military veterans diagnosed with PTSD have a higher risk of developing osteoporosis? Furthermore, among 73 female Holocaust survivors, there was a 3.47-fold increase in the prevalence of osteoporosis compared to controls. Why might this happen? How could stress be related to our bones? A recent study noted, “Stress, emotional or otherwise, can tip the balance over to the catabolic side. The main types of osteoporosis are disuse, with a lower blood flow through bone, steroid-induced and thrombus-induced osteoporosis. When the anticatabolic/catabolic ratio tips to the catabolic side, cell membranes become more rigid.”4. Elevated cortisol may make you look old.
Studies show higher levels of serum morning cortisol levels are associated with higher perceived age. The study noted, “Chronically high levels of cortisol, as is the case in Cushing syndrome, have severe adverse effects on almost all tissues throughout the body, but particularly skin tissue, which results in skin atrophy and impaired wound healing (Boscaro et al., 2001). In vivo studies have shown that exposing skin to cortisol (and other glucocorticoids) results in reduced pro-collagen production (Autio et al., 1994, Oikarinen et al., 1998).”5. Elevated cortisol is linked to breast cancer.
The relationship between stress and cancer is commonly debated, and studies confirm that the relationship may be significant. One study concluded, “Results showed that breast cancer patients had significant elevations in basal cortisol levels compared to controls. Metastatic breast cancer patients had higher cortisol levels than early-stage breast cancer patients.” What mechanisms might be at play? Another study notes, “Our findings indicate, for the first time that increased cortisol levels facilitate breast-to-brain metastasis through the BCSFB-a vulnerable point of entry which has been typically overlooked in brain metastasis. Our study suggests cortisol plays a pro-metastatic role in breast-to-brain metastasis and thus caution is needed when using glucocorticoids to treat breast cancer patients.” The implications of these findings are amazing! More research should be done on administering cortisol blockers to avoid breast-to-brain metastasis.Being human means facing the inevitable ups and downs of life — even when it comes to hormones. The key here is that stress happens, but when it’s chronic, that’s when issues may arise. Furthermore, measuring cortisol levels is simple. I prefer to measure my cortisol levels through blood because the blood is the highway to hormones. Knowing my cortisol levels (and all my hormone levels)gives me peace of mind that I’m being proactive about not exacerbating disease in the one home I was given, my body!
About the author
Alannah Slingsby is the CEO and founder of Moment, a health femtech startup focused on testing and treating hormone imbalances with a whole-person approach — from the comfort of your own home.