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?
What is cortisol?
Cortisol is a hormone from the group of glucocorticosteroids, which is produced in the outer layer (cortex) of our adrenal glands. The adrenal gland is an independent organ located 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 stay with cortisol: After it is produced in the adrenal cortex (ADC), it enters our bloodstream and from there can act on 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 like small triangular caps on the kidneys. The outer part of the adrenal gland, also called the cortex, is where cortisol is produced.
How does cortisol work in the body?
Cortisol is a versatile hormone that is involved in many processes in the body. It plays a central role, especially in stressful situations, by providing energy and regulating important bodily functions. But how exactly does cortisol work?
Cortisol as a stress hormone
Our body is controlled by two opponents in the nervous system: sympathetic and parasympathetic nervous systems. While the parasympathetic nervous system is active during rest periods ("rest and digest"), the sympathetic nervous system takes over in stressful or challenging moments ("fight or flight").
If a stressful situation occurs – be it due to time pressure, physical exertion or a dangerous situation – the sympathetic nervous system activates the so-called stress hormone systemIn addition to the well-known catecholamines adrenaline and noradrenaline Cortisol is also released.
Main task: generating energy
One of the main functions of cortisol is provision of energyso that the body can react quickly to stress. This happens through the following mechanisms:
- increase in blood sugar levels → So that the brain and muscles receive enough energy
- promoting fat and muscle loss → Energy reserves are mobilized
- Faster oxygen supply → Blood pressure and heart rate increase
These processes help you to be more efficient in the short term – whether in sports, in exam situations or in sudden stress.
regulation of the immune system
Cortisol is not only a stress hormone, but also an important regulator of the immune system. It influences how our body responds to infections, inflammations and healing processes.But why does stress weaken our immune system – and why is cortisol therefore used as a drug?
Cortisol suppresses immune reactions
In acute stress situations, cortisol ensures that the body energy reserved for survival – not for healing processes. This means:
- wounds heal more slowly → The body prioritizes fight or flight
- Allergic reactions are inhibited → The immune response is shut down
- Inflammations decrease → The body saves energy for other processes
In the short term, this reaction may be useful, but in the long term it weakens the immune system. chronic stress is often more susceptible to infections because the body can no longer fight pathogens efficiently.
Cortisone as a drug – why it works
cortisone, the inactive precursor of cortisol, is often used as a drug against inflammation and autoimmune diseases. Once it enters the body, it is converted into the active cortisol converted.
Areas of application of cortisone:
- treatment of allergies (e.g. hay fever, asthma)
- relief of inflammation (e.g. joint pain, skin problems)
- use in autoimmune diseases (e.g. rheumatism, multiple sclerosis)
However, long-term cortisone therapy can have side effects because it affects the body's natural cortisol balance. Therefore, it is usually only prescribed for limited periods of time or in low doses.
Cortisol levels too high? Why this is problematic
While a short-term increase in cortisol is completely normal, a permanently elevated cortisol level can have negative consequences. The body then remains in a kind of constant stress mode, which is stressful in the long term.
Particularly treacherous: Chronically elevated cortisol is often not directly noticeable. Many people get used to constant stress, but do not realize that their body is constantly running at full speed.
Reasons for increased cortisol levels
A permanently elevated cortisol level can be triggered by various factors – both external stress and internal physiological processes.
Physical or emotional stress
Whether it's intense workouts, lack of sleep or emotional stress - every type of stress activates cortisol production. Chronic stress prevents the body from breaking down cortisol sufficiently.
Professional or private pressure
Constant time pressure, high levels of responsibility or conflicts in your private life can keep cortisol levels constantly high. Without sufficient recovery phases, the body remains in stress mode.
Excessive alcohol consumption
Alcohol affects hormone regulation and can increase cortisol secretion. At the same time, it puts a strain on the liver, which further impairs the body's ability to cope with stress.
Too much caffeine
Caffeine stimulates the sympathetic nervous system and signals the body to release cortisol – especially when consumed regularly and in high amounts.
Depression & psychological stress
Studies show that people with depression often have elevated cortisol levels. Chronic emotional stress can permanently disrupt the hormone balance and lead to overproduction.
hypoglycemia
Low blood sugar levels signal a potential threat to the body. To provide energy, cortisol is released because it stimulates glucose production in the liver.
Hormonal changes
Pregnancy, menopause or diseases that affect hormone levels can also lead to an imbalance in cortisol production.
Long-term use of cortisone-containing medications
Medications containing cortisone (e.g. for treating inflammation or allergies) can affect the body's natural cortisol balance and inhibit or increase its own production.
overactivity of the adrenal cortex (Cushing's syndrome)
In rare cases, a pathological overproduction of cortisol can be caused by a malfunction of the adrenal cortex or the pituitary gland (hypophysis) This leads to permanently elevated cortisol levels with serious health consequences.
The consequences
- sleep problems
- Rising blood sugar levels
- high blood pressure
- overweight
- Coronary heart disease
- Cushing's syndrome
- loss of libido
- weakness
- stomach problems
- weight gain
In contrast, chronic cortisol deficiency other symptoms:
- low blood pressure
- weight loss
- mood swings
- attacks of weakness
cortisol throughout the day
Cortisol follows a natural rhythm that is based on the body’s internal clock. Its concentration in the blood fluctuates throughout the day and is strongly influenced by Sleep, stress and daily routines.
Morning: Highest cortisol levels for the perfect start
Between 6 and 9 a.m. Cortisol reaches its peak. This is because the body is preparing to wake up:
- Energy is mobilizedto start the day actively
- blood sugar risesto supply the brain with fuel
- Alertness and attention increase
Tip: Getting plenty of daylight in the morning can help to stabilize the natural cortisol rhythm. Click here for the ideal morning routine.
During the day: Fluctuations depending on activity
Over the course of the day, cortisol levels gradually drop. However, depending on how stressful everyday life is, short-term cortisol spikes occur – for example during meetings, intensive workouts or time pressure.
People who are under a lot of stress during the day continually produce cortisol – this can lead to an unbalanced hormone level in the long term.
A lot of stress in everyday life and at work reduces the ability of the immune system to respond to threats.
Evening: Cortisol drops to its lowest point
Against midnight Cortisol reaches its lowest level. Now the regeneration in the foreground:
- Cells are repaired
- The body prepares for sleep
- Relaxation and recovery begin
Tip: Blue light from screens and late caffeine can artificially increase cortisol levels – it is better to avoid digital devices two hours before going to bed. Click here for the ideal sleep routine.
Why a stable cortisol rhythm is important
A healthy cortisol profile is crucial for performance, well-being and sleep quality. People with chronic stress often experience unnatural fluctuations:
- Persistently high cortisol levels → Can lead to sleep disorders, weight gain and burnout
- Low cortisol levels → Can cause fatigue, lack of motivation and concentration problems
Measuring cortisol levels: How useful is it?
Anyone who suspects that their cortisol level is too high or too low can have it medically tested. But a one-time measurement is not enough, because cortisol fluctuates greatly throughout the day. To obtain a meaningful result, the daily course of cortisol recorded and a so-called daily cortisol profile is created.
How can cortisol be measured?
There are different methods for determining cortisol levels:
blood test:
- Measures total cortisol in the blood (bound & free)
- Meaningful for a moment, but not for the course of the day
Test with urine or saliva:
- Captures the free, biologically active cortisol
- Multiple measurements per day possible to analyze the rhythm
- Particularly helpful if you suspect imbalances throughout the day
Important: Saliva testing is practical, but there are no standardized norm values, which can make interpretation difficult.
When is cortisol measurement useful?
A test can be helpful if symptoms such as persistent fatigue, sleep disorders, unexplained weight gain or concentration problems Even if there is a suspicion of adrenal insufficiency or excessive stress Regular measurements can provide information.
If you want to test your cortisol level, you should in most cases measure it throughout the day to take the natural rhythm into account. Individual values are not very meaningful.
Lowering cortisol levels: Practical tips
A permanently elevated cortisol level can have a negative impact on your health - from sleep disorders to a weakened immune system. The good news: There are numerous simple methods that can have a positive effect on your cortisol level.
actively reduce stress
Long-term stress is one of the biggest cortisol drivers. To get your body out of the "fight or flight" mode To get to the top, targeted relaxation techniques help:
- breathing exercises & mindfulness training – can be proven to lower cortisol levels
- walks in nature – reduce stress hormones naturally
- power naps & rest breaks – help the body to regenerate
Tip: Regular mindful breaks in everyday life can effectively regulate cortisol.
Healthy sleep for a stable cortisol level
Since cortisol circadian rhythm follows is Sleep essential for its regulation. Those who sleep too little or irregularly risk persistently high cortisol levels.
- Maintaining fixed sleeping times – for a stable internal clock
- Avoid blue light – in the evening, stay away from mobile phones and computers for at least an hour before going to bed so as not to disturb the natural breakdown of cortisol
- sleep duration of 7–9 hours – promotes regeneration and lowers cortisol
Tip: A dark, cool bedroom can improve sleep quality and thus cortisol balance.
Control your diet and caffeine cleverly
Your diet also influences your cortisol levels.
This can lower cortisol:
- magnesium-rich foods (e.g. nuts, leafy vegetables, bananas)
- omega-3 fatty acids (e.g. salmon, chia seeds)
- Adaptogenic plants (e.g. Ashwagandha, Rhodiola)
This can increase cortisol:
- Too much caffeine – stimulates the stress hormone system
- Alcohol & highly processed foods – place additional strain on the body
- Long periods of hunger – can cause cortisol levels to rise
Tip: If you are sensitive to caffeine, try to avoid it in the afternoon or eveningso as not to keep your cortisol levels unnecessarily high.
Exercise – but in the right dose
Exercise can help lower cortisol – but only if it is done in dimensions is operated.
Moderate exercise (e.g. yoga, swimming, walking) → lowers cortisol sustainably
Intense training (e.g. excessive cardio, HIIT) without recovery → can increase cortisol significantly in the short term
Tip: After training for ensure sufficient regenerationto keep cortisol levels stable.
