Cortisol is a hormone you’ve probably heard of. But when it comes to what cortisol does day to day, few of us know more than the fact that it has something to do with stress.
WellTuned spoke with Dr. John Calvin Channell, a medical director for BlueCross BlueShield of Tennessee, to learn more.
What is cortisol?
Dr. Channell: Cortisol is a hormone that’s primary role is to manage how your body uses carbohydrates, fats and protein. Along with your brain, it helps control your mood, fear and motivation. Cortisol is made by your adrenal glands. These are triangle-shaped organs above each kidney.
In general, cortisol:
- Helps us manage the metabolism of carbs, fats and proteins
- Boosts energy for stress management
- Reduces inflammation
- Manages blood sugar
- Controls the sleep-wake cycle
- Maintains balance in energy use and energy supply
Cortisol is sort of the “keep-everything-stable” hormone. Cortisol levels are highest in the early morning and lowest in the evening. This is why it’s also sometimes called the “get-out-of-bed” hormone.
How is cortisol related to stress?
Dr. Channell: In people who are stressed — whether it’s from an injury, surgery or other physical stress — cortisol helps us manage and recover from that stress. When your body is on high alert, cortisol can even shut down functions that get in the way, such as digestion, reproduction or the immune system.
Is cortisol related to the “fight-or-flight” response?
Dr. Channell: Not really. Those hormones (epinephrine, norepinephrine, adrenaline) come from the adrenal glands, and so does cortisol. But cortisol’s role in fight-or-flight is actually to help you calm down after the adrenaline is no longer needed.
How is cortisol connected to inflammation?
Dr. Channell: One function of cortisol is decreasing white blood cell response. This action helps reduce inflammation. Cortisone medications mimic the action of cortisol but tend to be more powerful. Common synthetic equivalents of cortisone include:
- Hydrocortisone, which is used to treat redness, swelling, itching and other skin conditions
- Glucocorticoids, which are used to treat rheumatoid arthritis, inflammatory bowel disease (IBD), asthma and allergies
Is there anything you can do to ensure healthy cortisol levels?
Dr. Channell: Problems with cortisol are complex to diagnose. Cortisol is controlled by a complex feedback system. Your hypothalamus, pituitary and adrenal glands all work together to regulate it. So it takes more than a standard blood draw to know if something’s off.
The good news is that you don’t have to do anything if your cortisol is functioning as it should. But if you notice any of the symptoms above, contact your healthcare provider.
What health conditions can cortisol levels cause?
Dr. Channell: Cortisol is difficult to pin down. We can look at what happens when you don’t have it, or when you have too much. But cortisol levels speak more about when things are going wrong than when everything is okay.
Addison’s disease occurs when you don’t have enough cortisol. It causes:
- Extremely low blood pressure
- Loss of appetite
- Nausea, vomiting and diarrhea
- Muscle weakness
Dr. Channell: If you don’t have enough cortisol, you don’t even want to get out of bed. You may have a general rundown feeling. This can look like depression, as well as other personality changes.
Another side effect of Addison’s disease is darkening of the skin. Remember how people used to talk about President John F. Kennedy having such a great tan? Well, it wasn’t from the sun; it was Addison’s disease.
Dr. Channell: Cushing’s disease, on the other hand, is what happens when your body has too much cortisol.
Symptoms of Cushing’s disease are:
- Rapid weight gain
- Easy bruising
- Muscle weakness
Both Cushing’s and Addison’s cause muscle weakness though. This is why each requires specialized testing to diagnose.
More from Dr. Channell: Anemia 101: Causes, symptoms and why it often goes untreated
Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.