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Beware High Levels of Cortisol, the Stress Hormone

We’ve all felt that surge of energy as we confront something threatening or startling. A barely avoided car accident. A call that your child has been hurt. The pressure to meet a deadline.

As your body perceives stress, your adrenal glands make and release the hormone cortisol into your bloodstream. Often called the “stress hormone,” cortisol causes an increase in your heart rate and blood pressure. It’s your natural “flight or fight” response that has kept humans alive for thousands of years.

Normal levels of cortisol also are released when you wake up in the morning or exercise. These levels can help regulate your blood pressure and blood sugar levels and even strengthen your heart muscle. In small doses, the hormone can heighten memory, increase your immune system and lower sensitivity to pain.

“Stress is a lifestyle factor and a fact of life that we all face; however, reacting to stress in unhealthy ways can increase the risk of high blood pressure, heart attack and stroke,” says interventional cardiologist Dr. Sagger Mawri. The amount of stress we experience has increased since the COVID-19 pandemic, he adds. “Many people reacted to the stress of the pandemic with unhealthy weight changes, a decline in physical activity, and increased alcohol consumption. In fact, the average weight gain was 26 pounds among those who gained more weight than they wanted.” Widespread grief and other hardships caused by the pandemic have increased stress for many, Dr. Mawri adds.

If your body experiences chronic stress, you may begin to feel unpleasant and even dangerous effects, such as:

• Fatigue
• Irritability
• Headaches
• Intestinal problems, such as constipation, bloating or diarrhea
• Anxiety or depression
• Weight gain
• Increased blood pressure
• Low libido, erectile dysfunction or problems with regular ovulation or menstrual periods
• Difficulty recovering from exercise
• Poor sleep
• Muscle pain or tension in the head, neck, jaw, or back

How Cortisol Works

When the adrenal glands release cortisol into your bloodstream, the hormone triggers a flood of glucose that supplies an immediate energy source to your large muscles. It also inhibits insulin production so the glucose won’t be stored but will be available for immediate use.

Cortisol narrows the arteries, while another hormone, epinephrine, increases your heart rate. Working together, they force your blood to pump harder and faster as you confront and resolve the immediate threat.

If your entire life is high-stress and always in high gear, your body may constantly pump out cortisol.

Hormone levels return to normal as you swerve to miss an oncoming car, find out that your child has only a few scrapes or meet the deadline for your presentation.

Why Too Much of a Good Thing is Bad for You

If your entire life is high-stress and always in high gear, your body may constantly pump out cortisol. "This has several negative effects," says Dr. Mawri.

1. Increased blood sugar levels. Insulin typically helps the cells convert glucose to energy. As your pancreas struggles to keep up with the high demand for insulin, glucose levels in your blood remain high and your cells don’t get the sugar they need to perform at their best.
2. Weight gain. As your cells are crying out for energy, your body may send signals to the brain that you are hungry and need to eat. Studies have demonstrated a direct association between cortisol levels and calorie intake in populations of women. False hunger signals can lead you to crave high-calorie foods, overeat and thus gain weight. Unused glucose in the blood is eventually stored as body fat.
3. Suppressed immune system. Cortisol’s positive action to reduce inflammation in the body can turn against you if your levels are too high for too long. The elevated levels may actually suppress your immune system. You could be more susceptible to colds and contagious illnesses. Your risk of cancer and autoimmune diseases increases and you may develop food allergies.
4. Digestive problems. When your body reacts to a threat, it shuts down other less critical functions, such as digestion. If the high-stress level is constant, your digestive tract can’t digest or absorb food well. It’s no coincidence that ulcers occur during stressful times and people with colitis or irritable bowel syndrome report better symptom control when they get their stress under control.
5. Heart disease. Constricted arteries and high blood pressure can lead to blood vessel damage and plaque buildup in your arteries. They could be setting the stage for a heart attack or stroke.

How to Take Action

“Given the dramatic increase in stress in recent years, it is crucial that we all find healthy ways to cope with and manage the stress in our lives,” says Dr. Mawri. “Fortunately there are ways to do so and develop healthy behaviors that improve heart health.” He shares these tips from the American Heart Association:

• If you are often stressed, learn the cause and constructive ways to deal with it.
• Slow down and plan ahead to avoid feeling rushed.
• Get 7 to 9 hours of sleep a night.
• Let go of worry and take breaks.
• Laugh more.
• Make time to connect with friends and family and maintain a social support system.
• Become more organized to stay on top of important tasks.
• Practice giving back by volunteering and helping others.
• Get exercise every day to relieve mental and physical tension.
• Give up bad habits like excess alcohol, tobacco, and too much caffeine.
• Lean into things that you can change, like a new skill or working towards a particular goal.
• Learn to say no to things that are not a high priority.
• Ask for help when you need it.

“If you have more stress than you can handle on your own, it’s a good idea to seek stress management counseling or speak to a mental health professional,” Dr. Mawri recommends. 

Be aware of your own stress levels and takes steps to manage your stress. Simple practices such as getting enough sleep, exercising, meditating, deep breathing techniques and scheduling leisure activities are a good start.

Source: Today’s Dietitian; American Osteopathic Association; VeryWell; Sagger Mawri, MD, Premier Cardiovascular Institute; American Heart Association

Sagger Mawri, MD

Premier Cardiovascular Institute

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