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The connection between cortisol and chronic stress: Learning about cortisol’s role in the body and why everyone’s talking about it
If you’re anything like me, your social media feeds have been inundated with videos about fitness, stress, and what to do to promote your physical and mental health. And if you’re anything like me, your mind has been filled with important-sounding concepts and a laundry list of tasks to complete if you want to live a healthier, more peaceful life.
I first heard about the significance of cortisol as I was scrolling online and was quickly made aware of the consequences of one’s cortisol being too high or too low. But figuring out how cortisol works—and how to regulate these levels—was a different story, as I never was told what exactly I should know or do about it. Let’s explore what cortisol is, how it functions inside the body, and how to interpret cortisol levels to boost wellness.*
Understanding what cortisol is
According to the Cleveland Clinic, cortisol is a glucocorticoid hormone, a type of steroid hormone that suppresses bodily tissue inflammation; controls muscle, fat, liver, and bone metabolism; and affects sleep-wake cycles. As a hormone—one of the “chemicals that coordinate different functions in your body”—that impacts almost every bodily organ and tissue, cortisol also is responsible for regulating stress responses in the body and regulating both blood pressure and blood sugar.
While cortisol has a multitude of roles, it is popularly associated with the body’s stress response because, whether acute, chronic, or traumatic stress is endured, cortisol is released in the body. As described by Jennifer Durgin for Dartmouth Medicine in spring 2012, we typically understand how adrenaline factors into a stress response, but we rarely know what cortisol accomplishes.
How cortisol levels change and regulate
As the Mayo Clinic points out, adrenaline increases the heart rate, blood sugar, and energy levels in the body when it is released in response to a stressor. Meanwhile, cortisol heightens glucose levels in the bloodstream, giving the brain enhanced access to these sugars while also providing more reparative substances to the body. In order to focus on fight-or-flight necessities, cortisol also “changes immune system responses and suppresses the digestive system, the reproductive system and growth processes.”

Photo by iStock user PeopleImages.
So, cortisol takes care of a lot in light of stressful events. But why? Durgin referenced “Cortisol exerts bi-phasic regulation of inflammation in humans,” a Dose-Response paper by Mark Yeager, M.D., Patricia Pioli, PhD, and Paul Guyre, PhD, to explain that “the temporary spike in cortisol primes the body to react to a secondary threat,” like an infection, by triggering inflammation when the body endures a stressful situation.
Durgin goes on to clarify the study’s intricate findings, revealing that cortisol impacts inflammation differently depending on the level of the hormone in the body. That being said, cortisol’s effects go far beyond its familiar, anti-inflammatory role in hydrocortisone cream, or a cortisone shot.
To regulate cortisol levels, a small section of the brain called the hypothalamus and the pituitary gland work together to control the production of cortisol in the adrenal gland. “When the levels of cortisol in your blood fall, your hypothalamus releases corticotropin-releasing hormone (CRH), which directs your pituitary gland to produce adrenocorticotropic hormone (ACTH),” the Cleveland Clinic explains. “ACTH then stimulates your adrenal glands to produce and release cortisol.”
The effects of abnormal cortisol levels
Also, according to the Cleveland Clinic, cortisol levels being too high or too low can yield distinct effects on the body. When cortisol is too high, symptoms can include weight gain (in the face and abdomen particularly), fatty deposits (between the shoulder blades), stretch marks (on the abdomen), muscle weakness (in the upper arms and thighs), high blood sugar and pressure, excessive hair growth (for those assigned female at birth), and weak bones. Low cortisol, on the other hand, can be indicated by fatigue, unintentional weight loss, poor appetite, and low blood pressure.
Cortisol can accumulate to a dangerous level in the body as a result of a rare condition called Cushing’s syndrome, but also as a result of taking corticosteroid medications in abundance and particular tumors, including neuroendocrine and adrenal gland tumors. It can become too low as a result of primary or secondary adrenal insufficiencies, as well as the cessation of corticosteroid treatments.
One of the most common associations with cortisol is chronic stress. Indeed, cortisol is often referred to as the stress hormone. As Harvard Health Publishing outlines, the amygdala communicates that there is a stressor to the brain’s hypothalamus, which activates the sympathetic nervous system, triggering fight-or-flight. From here, adrenaline is released, and you feel the typical symptoms—increased pulse and blood pressure, fast heartbeat, quicker breathing, sharper senses—and eventually, cortisol is released in a hormonal chain reaction prompting continuous alert.
In many cases, feeling constant stress means that the hypothalamus is constantly setting off the alarm bells to the rest of the body, alerting the adrenal glands to release a constant outpouring of adrenaline and cortisol. If the cycle of threat perception and high stress is constant, then cortisol levels remain high. As the Mayo Clinic warns, this can lead to a high risk for numerous conditions, including anxiety, depression, digestive problems, headaches, tension and pain in the muscles, heart problems, stroke, sleep issues, weight gain, and trouble with memory and focus.
Harvard Health Publishing reiterates this. Existing research indicates that “chronic stress contributes to high blood pressure, promotes the formation of artery-clogging deposits, and causes brain changes that may contribute to anxiety, depression, and addiction.”
Both sources illustrate that when the parasympathetic nervous system fails to halt stress and encourage the body to relax, the brain and body continue to behave as though there is something to be on high alert about. This sustains the flow of cortisol and, as a result, chronic stress.

Photo by iStock user eternalcreative.
Chronic stress & how to manage it
Behavioral sciences manager and University of Utah Health Comprehensive Assessment Treatment Program admissions coordinator Tina Halliday, LCSW, explains that chronic stress, at its core, is an overuse of a response that is not necessary every time something stressful occurs.
Rather than believing the stress our mind creates and immediately having a strong reaction to it, Halliday considers, “‘Can some of those events be managed in a way that brings them down to size and does not produce unnecessary wear on an individual?’”
How, then, can you manage chronic stress and decrease all of the negatives that come with it? Many sources suggest the typical recommendations: healthy eating, a regular sleep schedule, movement, meditation, connecting with friends and family, community involvement, and more. Harvard Health Publishing emphasizes the relaxation response, which can be invoked by “deep abdominal breathing, focus on a soothing word (such as peace or calm), visualization of tranquil scenes, repetitive prayer, yoga, and tai chi.”
Furthermore, as the Mayo Clinic clarifies, professional counseling can be beneficial when it comes to learning coping mechanisms and talking through various stressors. The overall idea, then, is to better equip your body to manage the physical aspects of stress, while soothing your mind through relaxation and joy. If you need some inspiration for the latter, check out my article about mindfulness here!
Cover photo by iStock user Jacob Wackerhausen.
*Disclaimer: All medical claims made in this article are information provided by the subject. The information is general in nature and not specifically meant for any particular individual. You should always seek out medical assistance from a medical professional based on your individual needs and circumstances.