Chances are you’ve heard of cortisol—it’s often called the "stress hormone." But did you know that cortisol does more than just handle stress? It impacts your energy, weight, blood sugar, sleep, and even cholesterol levels. When your body pumps out too much cortisol for too long, it can leave you feeling exhausted, struggling with weight, or even dealing with elevated cholesterol. Let's explore how common health conditions, lifestyle habits, and medications can lead to elevated cortisol and, ultimately, adrenal fatigue.

What is Cortisol?

Cortisol is produced by your adrenal glands, two tiny glands that sit above your kidneys. It helps regulate your body's response to stress, maintain blood sugar levels, reduce inflammation, and manage your metabolism. Sounds great, right? The problem arises when cortisol levels remain elevated for extended periods.

Common Health Conditions Linked to Elevated Cortisol

Elevated cortisol levels don't just happen in isolation—they’re often part of a larger web of health conditions that people experience daily. Here are some common examples:

1. Fatigue and Chronic Stress

Do you wake up tired, even after a full night’s sleep? If so, your cortisol levels might be to blame. Chronic stress leads to the overproduction of cortisol. Initially, this might feel like an energy boost, but over time, your adrenal glands can’t keep up. This is when you start to experience adrenal fatigue. You feel constantly worn out, your energy levels crash in the afternoon, and even after rest, you just don’t feel refreshed.

2. Elevated Cholesterol

Stress and adrenal health have a strong connection to your cholesterol levels. When cortisol levels are consistently high, they can lead to increased production of LDL (bad cholesterol) and triglycerides. This is why some people, despite eating a healthy diet, still struggle with elevated cholesterol—it might be a stress issue, not a diet issue!

3. Hypothyroidism

The thyroid and adrenal glands are closely related. Hypothyroidism, or an underactive thyroid, can develop alongside adrenal dysfunction. Chronic stress and elevated cortisol can slow down thyroid function, leading to common hypothyroid symptoms like weight gain, sluggishness, and feeling cold all the time. To make matters worse, when thyroid function slows, your body compensates by producing more cortisol, creating a vicious cycle of stress and hormonal imbalance.

Symptoms of Elevated Cortisol in Hypothyroidism

When hypothyroidism and adrenal issues co-occur, the symptoms can overlap or amplify each other. If you have erratic thyroid function or taking thyroid medication doesn't seem to be helping your symptoms here are some signs that cortisol might be a hidden factor for someone with hypothyroidism:

1. Persistent Fatigue
   While fatigue is common in hypothyroidism, when cortisol levels are also elevated, this fatigue can become more severe or last throughout the day. You might feel completely drained, especially in the afternoon, despite getting enough rest.
2. Difficulty Losing Weight
   Hypothyroidism can slow metabolism, making weight loss difficult. However, if cortisol is high, you may notice stubborn weight gain, especially around the belly. Elevated cortisol can trigger fat storage in the abdomen, a common sign of adrenal stress.
3. Sleep Disturbances
   If you’re struggling to fall asleep, wake up frequently during the night, or feel wired but tired, cortisol may be disrupting your sleep. High cortisol levels at night can interfere with your body’s ability to enter a deep, restorative sleep cycle, leaving you feeling groggy in the morning.

Why You Should Check Cortisol if You Have Hypothyroidism

Because the adrenal glands and thyroid are so closely related, supporting both is crucial to overall health. If you’re managing hypothyroidism but still struggling with these symptoms, getting your cortisol levels checked can help uncover adrenal dysfunction and guide a more complete treatment plan. Balancing cortisol and supporting your adrenals can often improve thyroid function, energy levels, and your ability to manage stress.

4. Insulin Resistance and Type 2 Diabetes

Cortisol plays a role in blood sugar regulation by helping the body increase blood glucose levels during stressful situations. However, when cortisol is chronically elevated, it can disrupt insulin sensitivity, leading to insulin resistance—a precursor to Type 2 diabetes. Insulin resistance makes it harder for cells to absorb glucose, causing the pancreas to produce more insulin to compensate. Over time, this process can elevate blood sugar levels, increase body fat (especially around the abdomen), and further stress the adrenals, exacerbating adrenal fatigue.

In fact, people with insulin resistance often struggle with weight gain, particularly in the midsection, which is a common sign of both elevated cortisol and adrenal issues. Managing stress and blood sugar levels is crucial for reversing insulin resistance and supporting healthy adrenal function.

5. Hypertension (High Blood Pressure)

Cortisol influences blood pressure by regulating sodium and water balance in the body. Chronically high cortisol levels can lead to an increase in sodium retention, causing the blood vessels to constrict and elevate blood pressure. High blood pressure is commonly seen in people dealing with chronic stress and adrenal dysfunction. This is particularly concerning because prolonged high blood pressure increases the risk of heart disease and stroke.

In some cases, medications like corticosteroids used to treat conditions such as asthma or arthritis can also raise blood pressure by increasing cortisol levels. For individuals managing hypertension, it’s important to address both stress and any underlying adrenal fatigue to prevent further cardiovascular strain.

6. Anxiety and Depression

While cortisol is vital for managing stress, too much of it can actually make emotional stress harder to manage. High cortisol levels can affect brain chemistry, particularly serotonin and dopamine levels, which are closely tied to mood regulation. Elevated cortisol has been linked to anxiety, depression, and even mood swings.

On the flip side, as adrenal fatigue sets in, cortisol production may drop too low, leading to emotional exhaustion, lack of motivation, and feelings of burnout. This can leave people feeling trapped in a cycle of stress, mood issues, and fatigue.

Additionally, certain antidepressants and anti-anxiety medications can interfere with the body's stress response and potentially increase cortisol levels. Managing stress through lifestyle changes, relaxation techniques, and proper nutrition can go a long way in reducing anxiety and supporting adrenal health.

7. Digestive Disorders (IBS, GERD)

The gut and the adrenals have a strong connection. Elevated cortisol can disrupt normal digestive function, contributing to conditions like Irritable Bowel Syndrome (IBS), Gastroesophageal Reflux Disease (GERD), and general digestive discomfort. Cortisol impacts gut motility, the production of digestive enzymes, and even the balance of gut bacteria. When stress and cortisol levels are high, digestion often slows down, leading to bloating, constipation, or diarrhea.

Over time, stress-induced digestive issues can become chronic, especially if cortisol remains elevated. Many people with adrenal fatigue experience gut problems, as their stressed-out systems struggle to process food efficiently, leading to nutrient malabsorption. In turn, nutrient deficiencies can further exacerbate adrenal fatigue, creating a vicious cycle.

8. Sleep Disorders

If you’re tossing and turning at night, cortisol might be the culprit. Cortisol should follow a natural rhythm—highest in the morning to help you wake up and lowest in the evening to prepare your body for sleep. However, chronic stress can disrupt this rhythm, leading to high nighttime cortisol levels that keep you awake and interfere with restful sleep.

Lack of sleep further strains your adrenal glands, as they work overtime to manage energy and stress throughout the day. Sleep deprivation is also linked to weight gain, insulin resistance, and mood disorders, creating a cascading effect on your overall health. To break this cycle, focusing on stress management and healthy sleep habits is key to supporting adrenal recovery and regulating cortisol levels.

Medications That Raise Cortisol Levels

Certain medications, while necessary for treating various conditions, can unfortunately lead to higher cortisol levels, increasing the risk of adrenal fatigue. If you’re on any of these, it might be time to assess whether cortisol and adrenal health could be impacting your well-being.

1. Steroid Medications (Corticosteroids)

Commonly prescribed for conditions like asthma, autoimmune disorders, and allergies, corticosteroids (such as prednisone or hydrocortisone) mimic cortisol and can cause your body to reduce its own cortisol production. Over time, this can lead to adrenal insufficiency or burnout. While these medications are effective for reducing inflammation, long-term use can have an unintended impact on adrenal function, causing symptoms like fatigue, weight gain, and muscle weakness.

2. Antidepressants

Certain antidepressants, especially those affecting serotonin and norepinephrine levels, can indirectly impact cortisol production. Chronic use may cause your adrenal glands to overproduce cortisol, contributing to increased stress levels and, eventually, adrenal fatigue.

3. Oral Contraceptives (Birth Control Pills)

Birth control pills alter hormone levels to prevent pregnancy, but they also affect cortisol production. Prolonged use of oral contraceptives can increase cortisol, which might explain why some women experience fatigue, weight gain, or difficulty managing stress while on the pill.

4. Stimulants (Caffeine, ADHD Medications)

It’s no surprise that caffeine, a stimulant many of us rely on to power through the day, can increase cortisol production. But it’s not just caffeine. Medications used to treat ADHD, like Adderall or Ritalin, can also elevate cortisol levels, especially when used long term, leading to burnout of the adrenal glands and persistent fatigue.

5. Proton Pump Inhibitors (PPIs)

PPIs, used to treat GERD and acid reflux, are designed to reduce stomach acid production. However, some research suggests that long-term use of PPIs can affect cortisol metabolism, potentially leading to increased levels of circulating cortisol. Some PPIs can increase cortisol adding to caloric intake and signs of adrenal fatigue, it might be time to discuss alternatives with your healthcare provider.

Signs of Adrenal Fatigue

So, how do you know if your body is struggling with adrenal fatigue? Here are a few signs to watch for:

• Constant fatigue, no matter how much sleep you get.
• Unexplained weight gain, especially around your midsection.
• High cholesterol, even with a healthy diet and exercise routine.
• Difficulty handling stress, with seemingly minor issues feeling overwhelming.
• Craving salty foods, as your body tries to balance sodium levels due to low aldosterone production.
• Brain fog, trouble concentrating, or memory issues.
• Any medication (specifically thyroid), that you question whether it is working, “you don’t feel any differently taking it”

What Can You Do to Support Your Adrenal Health?

If you suspect elevated cortisol or adrenal fatigue, there are steps you can take to restore balance and support your adrenal function:

1. Manage stress: Incorporate daily practices like meditation, deep breathing, or yoga. These help to lower cortisol levels and keep stress in check.
2. Eat a balanced diet: Focus on whole foods, particularly those rich in fiber, healthy fats, and lean proteins. Avoid excessive sugar, processed foods, and caffeine.
3. Get plenty of sleep: Aim for 7-9 hours of quality sleep each night. Try to establish a bedtime routine that promotes relaxation, and avoid screens before bed.
4. Exercise mindfully: While regular physical activity is important, high-intensity workouts can actually spike cortisol levels. Balance cardio with restorative practices like walking, stretching, or Pilates.
5. Get tested and Consider supplements: Adaptogens like ashwagandha and rhodiola can help balance cortisol levels naturally. However, some medications and treatments can increase pregnenolone and progesterone which can increase cortisol.

Final Thoughts

It’s clear that many common health conditions, ranging from fatigue and digestive issues to elevated cholesterol and high blood pressure, are linked to elevated cortisol levels and adrenal dysfunction. And while medications can be lifesaving, their impact on adrenal health can’t be ignored. By taking a holistic approach—managing stress, supporting adrenal function, and making mindful lifestyle choices—you can reduce cortisol’s damaging effects and restore balance to your body.

Remember, you don’t have to feel stuck in the stress and fatigue cycle. With the right strategies, you can nurture your adrenal glands, lower cortisol, and regain your energy and vitality. Take a step toward better health today by assessing your stress levels, understanding how medications impact your adrenal function, and adopting habits that support both your body and mind.