Survive stress and stay healthy

What is cortisol?

Cortisol, also called hydrocortisone, is a steroid hormone produced in the adrenal cortex. After synthesis it is released into the bloodstream to exert its effects throughout the body. The hormone is subsequently broken down in the liver and excreted via the kidneys. Cortisol therefore follows a constant cycle of production, action and elimination.

It is made from cholesterol, which the body converts into this hormone through several intermediate steps. The adrenocorticotropic hormone (ACTH), which plays a regulatory role, is crucial in this process. Through a feedback loop, ACTH controls cortisol production so that hormone levels remain balanced and adapt to the body's needs.

What does cortisol do to the body?

Cortisol is an essential hormone that is released in larger amounts especially during mental or physical stress, to prepare the body for challenges. It causes a rise in blood pressure, heart rate and breathing activity, improving circulation and oxygen supply to tissues.

At the same time, cortisol promotes the mobilisation of energy reserves by supporting the breakdown of fats and proteins and increasing the conversion of stored carbohydrates into glucose. This provides a rapid and sufficient energy supply, which is particularly necessary in stressful situations.

Moreover, cortisol has important effects on the immune system: it dampens inflammatory processes and modulates the immune response to prevent an excessive reaction by the body. It also helps regulate blood pressure by acting on blood vessels and supporting their function.

Its level varies over the day according to a circadian rhythm: it peaks in the morning to prepare the body for daytime activity and falls in the evening to support the onset of sleep. In this way, cortisol influences many bodily processes and plays a key role in maintaining internal balance.

How do you know if you have too much cortisol?

An elevated cortisol level can present with various symptoms that differ in intensity and combination. They may also point to other health issues. Typical signs include weight gain, especially around the abdomen and upper back, and a rounder facial appearance, colloquially referred to as a “moon face”.

Skin changes such as acne and thinning of the skin, which leads to easier bruising, can also be indicators. Affected people may also experience muscle weakness, general fatigue, difficulty concentrating and mood swings. High blood pressure and headaches often occur alongside these symptoms.

If cortisol remains elevated for a long time, additional health problems may arise. In women, for example, menstrual irregularities can occur. Other possible consequences include sleep disturbances, digestive complaints, reduced libido and a higher susceptibility to infections.

In extreme cases, such as the rare Cushing's syndrome, particularly pronounced symptoms appear. These include extra fat deposits around the shoulder blades, reddish to purple stretch marks on the abdomen and hips, pronounced muscle weakness and poor wound healing. A high blood sugar level, which can lead to diabetes, and increased body hair in women are also characteristic. If such symptoms are suspected, medical evaluation is essential.

What does a cortisol belly look like?

A cortisol belly results from fat deposits in the abdominal cavity caused by chronically high cortisol levels. The fat is stored not only under the skin but mainly as visceral fat around the internal organs. This accumulation produces a soft-looking, often protruding abdomen that can be visible even in an otherwise slim person or with normal eating habits. Affected individuals often notice their waistline increasing while arms and legs remain thin, making this particular fat distribution especially noticeable.

Typical features of a cortisol belly, besides central weight gain, include difficulty losing that fat. Cravings, particularly for sweets and fatty foods, sleep disturbances and increased susceptibility to infections may also occur. This condition is associated with a hormonal imbalance and is a warning sign, as visceral fat raises the risk of various chronic diseases.

What symptoms occur with cortisol deficiency?

A lack of cortisol, also called hypocortisolism, can cause a range of symptoms often accompanied by reduced capacity. Affected people report persistent tiredness and a general feeling of weakness. They often experience nausea and sometimes vomiting, accompanied by low blood pressure that can cause dizziness, especially when standing up.

Typical signs also include unexplained weight loss, loss of appetite and an increased craving for salty foods. In Addison's disease, a form of adrenal insufficiency, the skin may darken due to increased pigmentation.

In severe cases, particularly when cortisol levels are extremely low, an adrenal crisis can occur. This acute, life-threatening condition requires immediate medical treatment. People whose bodies no longer produce sufficient cortisol often need long-term hormone replacement therapy.

In stressful situations, such as infections or operations, cortisol doses must be increased to meet the special demands. Persistent exhaustion and the inability to cope with daily life can be warning signs of such a deficiency and should be medically assessed.

What opposes cortisol?

The counterpart to cortisol is the hormone DHEA, which has actions opposite to the stress hormone. While cortisol is produced in the adrenal cortex as a glucocorticoid and supplies energy in stressful situations, DHEA concentrations decline with age. This imbalance between the two hormones significantly affects ageing processes and the hormonal balance in the body. DHEA acts similarly in men and women, being partly converted into estradiol in men and into testosterone in women.

Moreover, cortisol stands in functional opposition to melatonin, the hormone that governs the sleep rhythm. While melatonin promotes calm in the evening and supports falling asleep, cortisol is activating and keeps the body awake. Too much cortisol in the evening can inhibit melatonin release, leading to difficulties falling and staying asleep.

How to lower your cortisol level: effective tips

• Structure your diet to avoid industrial sugar and refined wheat products, favouring fibre-rich whole grains and fresh fruit and vegetables. These provide valuable nutrients and help keep cortisol at a healthy level.
• Avoid alcoholic beverages and caffeine-containing products, as they can raise cortisol levels. Instead, ensure adequate water intake and drink at least 1 to 1.5 litres daily to support your body.
• Ensure regular, sufficient sleep by going to bed at roughly the same time each night and well before midnight. A consistent sleep routine promotes natural cortisol reduction and supports recovery.
• Reduce smartphone, computer and other screen use in the evening and switch off artificial blue light as early as possible. This prevents disruption of melatonin production and helps your body prepare for rest.
• Incorporate gentle forms of exercise such as walking, yoga or tai chi into your daily routine. These activities not only support physical health but also relax the nervous system and help to lower excess cortisol.
• Avoid intense physical exertion in the evening, since strenuous exercise shortly before bedtime raises cortisol secretion and can make falling asleep more difficult. Opt for moderate sessions at times that suit you.
• Use relaxation techniques regularly—breathing exercises, meditation or tapping—to reduce stress in a simple way. Such methods support the autonomic nervous system and help keep the stress hormone balanced.
• Maintain social contacts and spend time with family and friends. Positive interpersonal relationships strengthen emotional wellbeing and reduce stress levels in the long term.
• Include magnesium-rich foods like nuts and seeds in your diet. Magnesium is an important mineral that supports stress management and thus positively influences cortisol balance.
• Ensure a balanced intake of omega-3 fatty acids, as found in fatty fish. These have anti-inflammatory effects and may help lower cortisol naturally.
• Drink green tea, whose component L-theanine has a relaxing effect and can ease stress management.
• Develop a personal stress-management strategy based on your individual preferences. Whether reading, playing music, dancing or laughing—what matters is regularly making time for activities that make you feel good and relaxed.
• If needed, complement your diet with plant-based supplements such as ashwagandha, rhodiola rosea or ginseng. These substances can strengthen physical and mental resilience to stress.
• Plan deliberate breaks and recovery phases into your daily routine to avoid overload. Whether walking in nature or intentionally pausing: such moments are essential to keep cortisol stable and to promote your health.

Cortisol is an important stress hormone that accompanies us daily and influences our health in many ways. Learning to regulate this hormone consciously lays the foundation for greater inner calm, healthier skin and a stronger immune system.