Cortisol and cortisone, you hear the two terms again and again in different contexts. Be it as an ointment, as a stress hormone or as a medication. What are the differences between the molecules and what does the hormone actually do?
Cortisol – from the cortex into the (body) world
Cortisol is a hormone from the group of glucocorticosteroids, which is produced in the outer layer (cortex) of our adrenal glands. The adrenal gland sits as an independent organ on the kidney, is important for our water and salt balance and its cortex is an important production site for many hormones. But let's stick with cortisol: After it is formed in the adrenal cortex (NNR), it enters our bloodstream and from there can act in practically all parts of our body. It binds to a receptor that can be found in almost all tissue structures and thereby triggers many different reactions. In stressful situations, for example, it influences metabolism, blood pressure, heart rate and the immune system.
The adrenal glands sit on the kidneys like small triangular caps. The outer part of the adrenal gland, also called the cortex, is where cortisol is produced.
Cortisol in stressful situations
Do you know the function of the sympathetic and parasympathetic nervous systems? These are part of the autonomic nervous system. The parasympathetic nervous system is active during periods of rest (“rest and digest”). The sympathetic nervous system operates in phases of activity (“fight or flight”). These two antagonists regulate the body's functions so that the body can digest, store energy and regenerate at rest. In stressful situations, the activity-increasing sympathetic nervous system becomes active. The body then draws on its energy reserves, the heartbeat becomes faster, alertness increases and more oxygen is transported to the brain.
Cortisol is a classic effector hormone of the sympathetic nervous system and therefore controls some of its reactions. It has a similar effect to the well-known catecholamines adrenaline and norepinephrine. These are known to be released in stressful situations. They also increase the heart rate and catabolic metabolism in our body. Catabolic metabolism means that energy-rich stores in our body are broken down to make energy available to the body, which is then used by the muscles, for example. However, the reaction of adrenaline and norepinephrine sets in much more quickly than that of cortisol. The cortisol system is comparatively sluggish because it is only activated through several steps and transcription factors. These induce the synthesis of cortisol via the DNA blueprint. Adrenaline, on the other hand, can be assembled more quickly from existing building blocks.
As you can imagine, stressful situations are not healthy for the body. When cortisol is constantly elevated, the body is signaled by ongoing stress. This suppresses repair mechanisms in the body and increases the risk of permanent cell damage . Cortisol also increases blood pressure and activates the storage of fat, which in the long term increases the risk of cardiovascular disease.
If your body is currently in a stressful situation, it is not the right time to react allergically or heal wounds. Cortisol causes the cells with the highest current demand to be supplied with sugar as an energy source - meaning that muscles have enough energy to fight or run away. At the same time, the body's immune reactions are suppressed because the energy is needed elsewhere at that moment.
Cortisone is the inactive precursor of cortisol and is very similar to cortisol. Our body can convert cortisone into cortisol. Cortisone occurs naturally in our bodies, but many know it as a medicine for use in inflammation or autoimmune diseases. It can be used both in tablet form and as an ointment. The body then converts it into the active glucocorticosteroid hormone cortisol. By administering cortisone, you take advantage of the fact that cortisol suppresses immune reactions such as inflammation .
A lot of stress in everyday life and at work reduces the immune system's ability to respond to threats.
Cortisol over the course of the day
The most cortisol in our bodies is between 6 and 9 a.m. Throughout the day, cortisol levels fluctuate depending on activity and the lowest value can be measured around midnight. Those who have a moderate level of stress throughout the day also have a more consistent cortisol level. Long-term stress causes constantly high cortisol levels and strong fluctuations in stress naturally also cause major changes in cortisol levels. It is healthiest for the body when cortisol levels remain consistently low. However, since this is often difficult in everyday life, you should make sure to build in enough rest and relaxation time.
In addition, sufficient sleep promotes balanced cortisol levels. So if you get enough sleep and have a regular, calm daily routine, you tend to have a more balanced cortisol level. Constantly low cortisol results in the body being able to devote more energy to the health and regeneration of its own cells and tissues, which in turn improves well-being and longevity.
Is it useful to measure my cortisol level?
If you want to check your cortisol level, you should keep a few things in mind: Firstly, a one-time measurement is not enough. In order to get a good overview, cortisol must be examined throughout the day. Cortisol can be measured from blood, urine or saliva . Only 10% of cortisol is unbound and free; the rest is bound to plasma proteins in the blood serum. Only free cortisol is biologically active, which is why it makes most sense to primarily measure free cortisol during examinations. Urine and saliva tests both measure free cortisol and are therefore comparable. However, there is no validated reference range for saliva measurement - so the comparison and standard values are missing. In order to get a good picture of your cortisol level, you should carry out the examinations regularly and, above all, look at the level throughout the day. There are different standard values for different times of the day.
Cortisol can be measured in blood serum (shown here), urine and saliva. Normal values vary depending on the time of day.
Tips for cortisol levels
In order to offer the cells the opportunity for regeneration , it is important to continually reduce the cortisol level in the blood - i.e. to reduce stress. Regular rest and recovery breaks are suitable for this, which are not only very healthy for your cortisol, but also for your psyche.
Since cortisol production in the body follows a circadian rhythm - always the same every 24 hours - regular and sufficient sleep also helps to keep cortisol levels low. The relationship between cortisol and sleep also works the other way around. If your cortisol gets out of sync throughout the day for various reasons, sleep disorders can occur. Too much cortisol keeps your body awake, even when you actually want to sleep, and in turn promotes an unhealthy sleep rhythm.
As you may know, caffeine stimulates cortisol production and thereby increases your physiological stress level. So try to avoid foods containing caffeine if you want to watch your cortisol. As always, the dose makes the poison here. In addition, alcohol and unhealthy foods require more energy to digest and process. When the body needs more energy, the risk of stress is increased, so to speak. The situation is similar with many other aspects of an unbalanced everyday life: long periods of hunger, little drinking, excessive sunbathing.
Indirectly, you can reduce your stress level and therefore your cortisol level through various relaxation activities. These include yoga, meditation, power naps, massages, walks, time with loved ones (if it's really relaxing 😉), listening to music, painting, reading and much more.
However, the most important thing for a healthy cortisol level is to avoid or the reduction of chronic stress. In addition to the risk of a permanently elevated cortisol level, the risk of psychological suffering also increases, which in turn clouds the prospect of a long and healthy life.
