Why is everyone talking about cortisol?

Can't sleep? Do you have a bloated stomach? Is your skin losing its tone? Have you gained weight? Are you feeling tired? Is your menstrual cycle irregular? The culprit is cortisol. At least according to a myriad of TikTokers who—with hashtags like #cortisollevels and #howtoreducecortisol garnering over 140 million views—consider the stress hormone responsible for every conceivable ache or ailment. As a result, videos proliferate in which so-called experts spout information, offer solutions, or sponsor expensive powders that promise to balance cortisol levels. Some suggest changing the time you drink your morning coffee, others praise low-impact exercises, and some list supplements to take. But is TikTok really the right place to find a cure? Obviously not.

On TikTok, not only is the line between medical information and anecdotal experience dangerously blurred, but there is also an increased risk of believing incorrect notions and trying solutions that have no basis, with serious health implications. Every topic related to physical and mental health is much more complex than TikTok makes it seem. Let’s try to clarify cortisol, but keep one thing in mind: if something is wrong, if we feel unwell, there is only one thing to do: consult a doctor.

What is Cortisol?

Cortisol is one of the many hormones produced by our adrenal glands, located on top of each kidney. At the right levels, it is a fundamental part of our overall health: it is one of the hormones responsible for bodily functions such as blood pressure, metabolism, inflammation, immune function, sleep-wake cycle, and blood sugar regulation. It is called the stress hormone because when we perceive danger or need to face a challenge—whether psychological or physical, real or imagined (a bear attack or a hostile email from our boss)—the pituitary gland releases the adrenocorticotropic hormone (ACTH), which in turn prompts the adrenal glands to produce cortisol. This hormone prepares the body for fight or flight, increasing blood pressure and releasing glucose into our bloodstream to give us the energy needed to act.

What Happens When Cortisol Levels Are High?

Cortisol levels naturally fluctuate throughout the day, rising in the morning and falling in the late afternoon, due to a myriad of external factors. We all have elevated cortisol levels from time to time, perhaps during an intense workout or a stressful work call. When the brain perceives stress and cannot manage it, the body releases this hormone more frequently. However, if our cortisol levels remain high for a long time, it could signal a health problem. In these cases, we should consult a doctor who will test cortisol levels and proceed accordingly.

Symptoms and Causes of High Cortisol

A high cortisol level is associated with a wide range of symptoms, from feeling drained and tired to muscle weakness, from acne to irritability. According to the Society for Endocrinology, some of these symptoms are: bruising and purple stretch marks on the skin, anxiety, depression or irritability, increased thirst, irregular or absent menstrual cycle, weak bones and muscles, weight gain—especially in the face, chest, and upper back—slower healing times, difficulty concentrating, high blood pressure, and headaches. These could be signs of issues related to the stress hormone or linked to other conditions. A qualified expert will be able to determine the causes of this hormonal imbalance, to understand if they are due to lifestyle or medical conditions.

Does Lowering Cortisol Help with Weight Loss?

TikTok creators seem convinced and post a slew of videos showing how balancing cortisol helped them lose weight. But is this really the case? The answer is complex, nuanced, and varies depending on individual cases. Yes, a rounder face or weight gain in the central part of the body could be a symptom of high cortisol levels. However, remember that body size varies for many different reasons, many of which are entirely normal and not related to cortisol. Society’s obsession with certain aesthetic standards linked to thinness often pushes us towards diets that are harmful or useless as an easy path to physical and mental well-being, but we should be wary and not believe everything we see, avoiding DIY diets.

How to Balance Cortisol Levels

Persistently high cortisol can lead to negative long-term health consequences, so balancing levels can be important. Experts recommend leading a healthy lifestyle and managing chronic stress in the best way possible, rather than just trying to reduce cortisol levels. Dr. Aileen Alexander, a former family doctor and women's health and sleep expert, suggests that since stress increases cortisol (not the other way around), we should address the root cause rather than resort to TikTok hacks. According to Alexander: "Stress management strategies depend on the source of stress and need to be personalized. Suggestions include a healthy and balanced diet, regular exercise, prioritizing sleep, guided meditation, breathing exercises, taking breaks at work, connecting with friends and family in the evening or on weekends, journaling, or engaging in hobbies."