What is high cortisol? The stress hormone social media says is to blame for belly fat

Posts linking the imbalance to weight gain and other ailments have millions of views

High levels of the stress hormone cortisol have been linked to weight gain, poor sleep and acne. Unsplash / Yunmai

The latest health obsession on TikTok concerns cortisol.

“High cortisol” is the specific term users of the social media platform have blamed for an array of ailments including weight gain, specifically in the face and stomach, food cravings, low energy, acne, poor sleep, brain fog, headaches and dozens more.

Hundreds of thousands of posts boasting millions of views have popped up over the last few months as influencers, experts and users share videos purportedly about the causes and effects of high cortisol. Some document their experiences of the imbalance while others offer tips on how to regulate hormone levels.

But what is cortisol? “Cortisol is a steroid hormone produced by the adrenal glands, which are located on top of each kidney and is controlled by another hormone named ACTH which is released from the pituitary,” says Dr Kingini Bhadran, specialist endocrinology at Aster Hospital & Aster Clinic, Al Qusais. “It’s often referred to as the ‘stress hormone’ because its levels increase in response to stress.”

What role does cortisol play in the body?

Cortisol plays several essential roles in the body. It aids metabolism by helping to regulate blood sugar levels, helps metabolise carbohydrates, fats and proteins and influences how the body responds to insulin. It also increases blood glucose levels to create “fight or flight” energy.

“As many hormones in the body, cortisol coordinates different functions such as suppressing inflammations, controlling the body’s use of carbohydrates, proteins and lipids, and it is essential for metabolism,” says Ruba ElHourani, senior clinical dietitian and head of nutrition department at RAK Hospital, Ras Al Khaimah.

“It regulates blood pressure and blood sugar, coordinates sleep cycle and regulates the body’s stress response.”

Cortisol tests are usually conducted to rule out other underlying conditions and diseases. The test, called free cortisol, urinary cortisol or salivary cortisol, allows doctors to diagnose the likes of Cushing’s syndrome, when the body produces too much of the hormone; Addison’s disease, when the body has too little; or the presence of a tumour, also characterised by high levels of the hormone.

What is high cortisol?

High cortisol caused by stress is different to high cortisol caused by an existing health issue.

Even small daily stresses, such as being stuck in traffic, missing a deadline or a minor disagreement can cause a temporary spike in cortisol, but levels will quickly return to normal. Prolonged stresses, such as those caused by financial or employment issues or grief can cause higher levels to be maintained over a longer period.

“Cortisol levels vary among people during different times of the day,” says ElHourani. “Levels usually peak between 6am and 8am and again in the evening around 4pm. But if the body consistently makes too much cortisol this actually indicates underlying health problems that doctors may refer to as hypercortisolism.”

Bhadran adds: “Excessive cortisol levels caused by overproduction of cortisol from adrenal glands or ACTH from the pituitary gland can lead to Cushing’s syndrome. Symptoms may include weight gain, especially in the face, neck and abdomen, along with fatigue, muscle weakness, high blood pressure and other issues.”

Which parts of the body does cortisol affect?

Cortisol levels can play a part in an array of different health issues, particularly relating to weight, sleep and energy levels.

“Cortisol can influence weight by affecting appetite and promoting the storage of fat, particularly in the abdominal area,” says Bhadran. “Chronic stress and elevated cortisol levels may contribute to weight gain. At the same time low-cortisol-producing capacity of adrenal [glands] can lead to weight loss.”

Quality of sleep can also be affected by cortisol levels. However, this is usually due to stress elevating the hormone which in turn affects sleep, leading to insomnia or night-time disruption.

Social media users are also keen to point out that unsatiated cravings for very sweet or very salty foods are also indicative of high cortisol. However, an individual's relationship with different types of food is related to anxiety or worry, resulting in what is commonly called “stress-eating”.

“Cortisol can influence cravings for high-calorie and high-carbohydrate foods, particularly during stressful periods,” says Bhadran.

Another symptom, low energy, is tied to blood sugar levels, with chronically elevated cortisol or cortisol deficiency leading to fatigue and exhaustion.

When it comes to skin, increased cortisol levels due to stress can contribute to various skin issues, such as acne, eczema or accelerated ageing.

“High cortisol levels can also affect the skin as it prompts the skin's sebaceous glands to produce more sebum, leading to clogged pores, inflammation and more bacterial productions,” says ElHourani.

How to maintain cortisol levels

Experts advise steering clear of products claiming to be able to lower the hormone: “There are no specific supplements that directly regulate cortisol levels,” says Bhadran.

If high-cortisol levels are not being caused by underlying health issues, changes in lifestyle are the only way to regulate the hormone, including more effectively managing stress.

“Some herbs like ashwagandha or phosphatidylserine are thought to help manage stress and indirectly impact cortisol levels, but needs more evidence,” says Bhadran. “Lifestyle changes, stress-management techniques like mindfulness, meditation or yoga, adequate sleep, regular exercise and a balanced diet can help maintain healthy cortisol levels.”