Doctors Challenge Cortisol Panic: Why the 'Stress Hormone' Isn't Your Enemy
In the ever-expanding world of online wellness, cortisol has become a buzzword synonymous with modern stress. Influencers frequently attribute a host of symptoms—from 3 am wake-ups to changes in facial appearance and abdominal weight gain—to chronically elevated levels of this so-called 'stress hormone'. Their proposed solutions often involve specific diets, exercise regimes, and a growing market of supplements. However, the medical community is pushing back against this narrative, urging the public to view cortisol not as a villain, but as a vital, finely-tuned component of human biology.
Cortisol: An Essential Hormone, Not an Inherent Foe
Cortisol is a steroid hormone produced by the adrenal glands, which sit atop the kidneys. It plays a critical role in numerous bodily functions, including regulating metabolism, reducing inflammation, controlling blood pressure, and managing the body's response to stress. Far from being an unwanted chemical, it is essential for survival.
"Our cortisol level is regulated by the minute," explained Dr. Roberto Salvatori, an endocrinologist at Johns Hopkins University. "It is very sensitive." Levels naturally fluctuate throughout the day, peaking in the morning to help you wake and declining at night to facilitate sleep. Temporary spikes also occur during illness or acute stress, which is a normal, adaptive response.
Disorders Are Rare; Self-Diagnosis Is Risky
True medical disorders related to cortisol dysfunction are relatively uncommon. On one end of the spectrum is adrenal insufficiency, where the body produces too little cortisol. This includes conditions like Addison's disease. On the other is Cushing's syndrome, characterised by excessively high cortisol levels, often due to benign tumours.
The symptoms for both can be broad and non-specific—fatigue, weight changes, blood pressure issues—and easily overlap with other health problems. Diagnosing these conditions requires time, multiple tests, and a comprehensive understanding of a patient's overall health by a qualified professional.
Endocrinologists express significant concern about the trend of self-ordering cortisol tests. "There’s a lot of nuance to interpreting cortisol," said Dr. Katie Guttenberg of UTHealth Houston. A single blood test is rarely useful for a healthy person and can lead to false readings—for instance, in women taking birth control—causing unnecessary anxiety and medical follow-ups.
The Unproven World of Cortisol-Lowering Supplements
Despite bold marketing claims, doctors state there are no proven over-the-counter treatments, such as ashwagandha or magnesium, specifically for regulating cortisol levels in otherwise healthy individuals.
"They're not innocuous," warned Dr. James Findling of the Medical College of Wisconsin, highlighting concerns about the unregulated nature of many supplements. Even for patients with diagnosed Cushing's syndrome, medication must be carefully dosed to avoid swinging cortisol levels dangerously low.
Back to Basics: Managing Stress, Not Chasing Hormones
For the vast majority of people, the doctors' advice is straightforward: if you have genuine concerns, consult a doctor. For healthy individuals, instead of fixating on one elusive hormone, the focus should return to fundamental, evidence-based stress management.
This includes maintaining a balanced diet, ensuring adequate sleep, engaging in regular physical activity, and seeking therapy if needed. "Nothing new about any of that," Dr. Findling remarked, emphasising that these timeless practices are far more beneficial than chasing unproven supplements or diagnoses based on online trends.
The key takeaway from endocrinologists is clear: cortisol is a crucial, dynamic hormone. While chronic stress is undoubtedly harmful, the hormone itself is rarely the root cause of general wellness complaints. Professional medical guidance, not influencer advice, remains the safest path to understanding and managing your health.
