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The chemical structure of cortisol
January 2, 2025
Birgitta Dunckel
Cortisol is important for our health. Among other things, it protects against inflammation and regulates sleep. However, too much stress causes an excess of cortisol, which can make you sick.
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Cortisol has an image problem. Known as the "stress hormone," many overlook its vital functions. But when does the helpful assistant become a health risk? And how can a high cortisol level be naturally regulated?
Cortisol is far more than just a stress hormone – it is a vital glucocorticoid produced in the adrenal cortex and plays a central role in numerous body functions. From regulating the sleep-wake cycle to fat metabolism to enhancing physical performance, cortisol is a multitasker.
The problem: The dose makes the poison. While acute cortisol releases make us fit, focused, and efficient, a permanently elevated level can cause serious health problems.
Cortisol belongs to the group of glucocorticoids – steroid hormones produced in the adrenal cortex. Production is controlled via the so-called hypothalamic-pituitary-adrenal (HPA) axis, a complex regulatory system that responds to internal and external stimuli.
The release follows a circadian rhythm:
This natural fluctuation is crucial for a healthy sleep-wake cycle and daily condition.
Cortisol is involved in a variety of physiological processes. Its main tasks at a glance:
In stressful situations, cortisol works closely with adrenaline and noradrenaline. It quickly mobilizes available energy by:
This mechanism originates from evolutionary times and prepared our ancestors for "fight or flight" – even today, it helps us to perform at our best in the short term.
Cortisol supports cardiovascular function by:
These effects are useful in the short term, but problematic in the long term.
Cortisol has strong anti-inflammatory and immunomodulatory effects. It:
At the right dose, cortisol enhances:
Athletes benefit from acute cortisol releases that enable peak performance—provided the body can recover afterward.
The problem starts when cortisol levels remain elevated permanently. Chronic stress—whether from work, relationship problems, financial worries, or illnesses—prevents the HPA axis from calming down. The result: useful "eustress" becomes harmful "distress."
A chronically elevated cortisol level manifests through various symptoms:
An extremely high cortisol level can indicate Cushing's syndrome, a rare but serious condition. Typical signs are:
If suspected, a doctor should definitely be consulted.
If you suspect your cortisol levels are imbalanced, there are various testing options:
Important: Interpretation should always be done by a doctor, as values can vary greatly between individuals.
The good news: An elevated cortisol level can often be regulated without medication. The following measures have proven effective:
Moderate physical activity is one of the most effective methods to reduce stress hormones while releasing endorphins (happiness hormones).
Optimal are:
Walks in nature (even 20-30 minutes have been proven to lower cortisol), yoga and Tai Chi (combine movement with relaxation), swimming, Pilates, cycling, and gentle jogging
Caution: High-intensity training (HIIT, marathons) can temporarily increase cortisol. With chronic stress, it is advisable to start with gentler forms of exercise.
Contact with nature enhances the effect: Studies show that exercise in natural environments lowers cortisol levels more effectively than indoor or urban sports.
Lack of sleep is one of the strongest cortisol drivers. Conversely, good sleep normalizes hormone balance.
Tips for restful sleep:
Both substances negatively affect cortisol levels: Coffee and caffeinated drinks acutely increase cortisol release, raise blood pressure and heart rate, and can exacerbate nervous restlessness. Recommendation: Maximum of 2 cups of coffee in the morning, caffeine-free after 2 PM. Alternatives: Herbal tea, green tea (less caffeine), water.
Alcohol can massively disrupt the sleep-wake cycle, prevent deep sleep phases, and increase cortisol at night. Recommendation: Completely abstain from alcohol on at least 3-4 days per week.
A balanced diet stabilizes blood sugar levels and reduces inflammation – both lower cortisol.
Fatty sea fish: salmon, herring, mackerel, sardines (2-3 times a week)
Active relaxation measurably and sustainably lowers cortisol:
Meditation and mindfulness: Just 10-15 minutes daily shows effects. Apps like Headspace, Calm, or 7Mind make it easier to start. Particularly effective: MBSR (Mindfulness-Based Stress Reduction)
Breathing techniques: 4-7-8 breathing (inhale for 4 seconds, hold for 7 seconds, exhale for 8 seconds) or coherent breathing (5-6 breaths per minute).
Progressive Muscle Relaxation (PMR): Systematic tensing and relaxing of muscle groups. It is also suitable for beginners.
Yoga: Combines movement, breath, and meditation, especially Hatha and Yin yoga have a calming effect. Yoga reduces cortisol with regular practice (3x weekly).
Loneliness and social isolation increase cortisol. Conversely, conversations with friends, hugs (release oxytocin, lower cortisol), laughter (significantly reduces stress hormones) - and also pets (especially dogs and cats) can demonstrably contribute to sustainably lowering cortisol levels.
In the case of proven deficiency or increased need, supplements can be useful:
In the following cases, medical advice is essential:
The doctor can measure cortisol levels and rule out other causes (e.g., thyroid diseases).
Cortisone – the synthetic form of cortisol – also has a bad reputation. Unjustly so: In medicine, it is an indispensable drug for:
Important: Cortisone preparations should never be discontinued on one's own. The dosage must be monitored by a doctor and gradually reduced.
Cortisol is not an enemy but a vital hormone that keeps us alert, capable, and healthy – as long as the balance is right. Acute stress and temporarily elevated cortisol levels are natural and even beneficial. It only becomes dangerous when chronic stress permanently disrupts the regulation of the hormone.
The good news: With the right lifestyle changes, elevated cortisol levels can often be normalized. The combination of regular exercise, good sleep, healthy nutrition, and active relaxation has been proven to be effective.
