12 Signs Your Cortisol Is Out of Control
Cortisol, often called the “stress hormone,” is a vital steroid hormone produced by your adrenal glands. While it plays a crucial role in your body’s stress response, its functions extend far beyond that, influencing everything from your metabolism and immune system to your sleep-wake cycle and blood pressure. When cortisol levels are in balance, your body functions optimally. However, when these levels become too high or too low for extended periods, it can lead to a state of dysregulation, causing a cascade of health problems. Recognizing the signs of cortisol imbalance is the first step toward addressing the root cause and restoring your health. This article will explore 12 key signs that your cortisol may be out of control, backed by scientific research and medical expertise.
1. Unexplained Weight Changes
One of the most common and noticeable signs of cortisol dysregulation is a significant change in your weight that isn’t attributable to changes in your diet or exercise habits. This can manifest as either weight gain or weight loss, depending on whether your cortisol levels are too high or too low.
High Cortisol: Chronically elevated cortisol levels can lead to weight gain, particularly in the abdominal area. This is often referred to as “cortisol belly.” You might also notice a rounder face, often called “moon face,” and an accumulation of fat on the upper back, sometimes described as a “buffalo hump.” This occurs because high cortisol can increase your appetite and cravings for high-calorie foods, and it also promotes the storage of visceral fat, which is the fat that surrounds your organs.
Low Cortisol: On the other hand, low cortisol levels, as seen in adrenal insufficiency, can cause unintentional weight loss and a loss of appetite. This is because cortisol is necessary for maintaining normal metabolic function and appetite.
Why it matters: Beyond the cosmetic concerns, the type of weight gain associated with high cortisol is particularly dangerous. Visceral fat is metabolically active and is linked to an increased risk of serious health problems, including heart disease, type 2 diabetes, and certain types of cancer. Unexplained weight loss from low cortisol can lead to malnutrition and weakness.
2. Chronic Fatigue and Energy Issues
Feeling constantly tired, despite getting enough sleep, is a hallmark symptom of cortisol imbalance. This can be a debilitating symptom that significantly impacts your quality of life.
High Cortisol: While you might expect high cortisol to give you more energy, the opposite is often true. Chronically high cortisol can disrupt your natural sleep-wake cycle, leading to insomnia or poor-quality sleep. This can leave you feeling exhausted during the day, even if you’ve been in bed for a full night. This state is often described as feeling “wired but tired.”
Low Cortisol: Low cortisol levels can cause a profound and persistent fatigue that isn’t relieved by rest. You might struggle to get out of bed in the morning and feel like you’re moving through a fog all day. This is because cortisol is essential for energy production and for helping your body respond to the demands of the day.
Why it matters: Chronic fatigue can have a major impact on your physical and mental health. It can make it difficult to work, socialize, and engage in activities you enjoy. It can also be a sign of an underlying medical condition that needs to be addressed.
3. Muscle Weakness and Physical Changes
Cortisol plays a critical role in maintaining muscle mass and strength. When cortisol levels are out of balance, it can lead to noticeable changes in your muscles.
High Cortisol: High cortisol levels can cause muscle weakness, particularly in the large muscles of the arms and thighs. This can make it difficult to climb stairs, get up from a chair, or lift heavy objects. In severe cases, it can lead to muscle wasting, where your muscles begin to break down.
Low Cortisol: Low cortisol can also cause general muscle weakness and a feeling of physical frailty. This is because cortisol is necessary for proper muscle function and for helping your muscles recover from exertion.
Why it matters: Muscle weakness can increase your risk of falls and injuries. It can also make it difficult to perform daily activities and maintain your independence. It’s a sign that your body isn’t able to properly maintain and repair its tissues.
4. Blood Pressure Abnormalities
Cortisol is a key regulator of blood pressure. When cortisol levels are dysregulated, it can lead to either high or low blood pressure, both of which can have serious health consequences.
High Cortisol: High cortisol levels can cause hypertension, or high blood pressure. This is because cortisol can increase the constriction of your blood vessels and cause your body to retain sodium and water. Over time, high blood pressure can damage your heart and blood vessels, increasing your risk of heart attack, stroke, and kidney disease.
Low Cortisol: Low cortisol levels can lead to hypotension, or low blood pressure. You might experience dizziness or lightheadedness, especially when you stand up from a sitting or lying position. This is known as orthostatic hypotension. In severe cases, low blood pressure can cause fainting.
Why it matters: Both high and low blood pressure can be dangerous. High blood pressure is a major risk factor for cardiovascular disease, while low blood pressure can lead to falls, fainting, and inadequate blood flow to your organs.
5. Blood Sugar Dysregulation
Cortisol has a profound impact on your blood sugar levels. When cortisol is out of balance, it can lead to significant problems with blood sugar control.
High Cortisol: Chronically high cortisol can cause hyperglycemia, or high blood sugar. It does this by promoting the production of glucose by the liver and by making your cells more resistant to the effects of insulin. This can lead to an increased risk of developing type 2 diabetes. You might also experience symptoms of high blood sugar, such as increased thirst, frequent urination, and increased hunger.
Low Cortisol: Low cortisol levels can cause hypoglycemia, or low blood sugar. This can cause symptoms like shakiness, sweating, anxiety, and confusion. You might also experience intense cravings for sugary foods as your body tries to raise its blood sugar levels.
Why it matters: Uncontrolled blood sugar can have serious long-term consequences, including damage to your nerves, blood vessels, and organs. It’s a sign that your body’s metabolic processes are not functioning correctly.
6. Skin and Hair Changes
The health of your skin and hair is often a reflection of your internal health, and cortisol dysregulation can manifest in a variety of skin and hair problems.
High Cortisol: High cortisol can cause a number of skin changes, including acne, thinning skin, and easy bruising. You might also notice the appearance of purple or red stretch marks on your abdomen, thighs, and breasts. This is because high cortisol can break down collagen, the protein that gives your skin its structure and elasticity. In women, high cortisol can also cause hirsutism, which is the growth of excess hair on the face, neck, and body.
Low Cortisol: The most distinctive skin change associated with low cortisol is hyperpigmentation, or a darkening of the skin. This is most noticeable in areas of sun exposure, as well as in scars, skin folds, and on the gums.
Why it matters: Skin and hair changes can be distressing and can be a visible sign of an underlying health problem. They can also indicate that your body is not able to properly repair and regenerate its tissues.
7. Mood and Mental Health Issues
Cortisol has a powerful influence on your brain and your mood. When cortisol levels are out of balance, it can have a significant impact on your mental and emotional well-being.
High Cortisol: Chronically high cortisol is strongly linked to anxiety, depression, and irritability. You might find yourself feeling constantly on edge, or you might experience mood swings and have difficulty controlling your emotions. This is because cortisol can affect the levels of neurotransmitters in your brain, such as serotonin and dopamine, which are important for mood regulation.
Low Cortisol: Low cortisol can also cause depression and irritability. You might feel apathetic and have a lack of interest in activities you once enjoyed.
Why it matters: Your mental health is just as important as your physical health. Mood and mental health issues can have a profound impact on your quality of life and can be a sign that your body’s stress response system is not functioning properly.
8. Cognitive Problems
Cortisol can also affect your cognitive function, including your memory, focus, and ability to concentrate.
High Cortisol: High cortisol levels can lead to problems with memory and concentration. You might find it difficult to learn new things or to recall information. This is because cortisol can damage the hippocampus, a part of the brain that is important for memory and learning. You might also experience “brain fog,” a feeling of mental cloudiness and confusion.
Low Cortisol: Low cortisol can also cause difficulty concentrating and mental fatigue. You might find it hard to focus on tasks and feel mentally exhausted, even after a good night’s sleep.
Why it matters: Cognitive problems can make it difficult to perform at work or school and can impact your ability to carry out daily tasks. They are a sign that your brain is not functioning at its best.
9. Immune System Dysfunction
Cortisol plays a complex role in regulating your immune system. In the short term, it can help to reduce inflammation. However, when cortisol levels are chronically high or low, it can lead to immune system dysfunction.
High Cortisol: Chronically high cortisol can suppress your immune system, making you more susceptible to infections. You might find that you get sick more often, and it might take you longer to recover from illnesses. This is because high cortisol can interfere with the production and function of your immune cells.
Low Cortisol: Low cortisol can also lead to immune system problems. In some cases, it can lead to an overactive immune system and an increased risk of developing autoimmune diseases.
Why it matters: A healthy immune system is essential for protecting you from illness. Immune system dysfunction can leave you vulnerable to infections and can be a sign of an underlying health problem.
10. Reproductive and Sexual Health Issues
Cortisol can have a significant impact on your reproductive and sexual health. When cortisol levels are out of balance, it can interfere with the normal functioning of your reproductive system.
High Cortisol: In women, high cortisol can lead to irregular menstrual cycles, or it can cause your periods to stop altogether. This can make it difficult to get pregnant. In men, high cortisol can cause erectile dysfunction and a low libido. It can also affect fertility.
Low Cortisol: Low cortisol can also cause irregular or absent periods in women and a loss of interest in sex in both men and women.
Why it matters: Reproductive and sexual health issues can have a major impact on your quality of life and your relationships. They can also be a sign of an underlying hormonal imbalance that needs to be addressed.
11. Bone and Joint Problems
Cortisol plays a role in maintaining bone density and joint health. When cortisol levels are dysregulated, it can lead to problems with your bones and joints.
High Cortisol: High cortisol can lead to bone loss, or osteoporosis. This can increase your risk of fractures, particularly in your spine and hips. You might also experience back pain, a loss of height, or a stooped posture.
Low Cortisol: Low cortisol can cause joint pain and muscle aches.
Why it matters: Strong bones and healthy joints are essential for mobility and independence. Bone and joint problems can be painful and debilitating and can be a sign of an underlying health problem.
12. Digestive and Appetite Issues
Cortisol can affect your digestive system and your appetite in a number of ways.
High Cortisol: High cortisol can increase your appetite and cravings for high-calorie, sugary, and fatty foods. This can contribute to weight gain and other metabolic problems.
Low Cortisol: Low cortisol can cause a loss of appetite, nausea, vomiting, and diarrhea. You might also experience abdominal pain and cravings for salty foods.
Why it matters: Digestive and appetite issues can be uncomfortable and can be a sign that your body is not able to properly digest and absorb nutrients. They can also be a sign of an underlying health problem that needs to be addressed.
Conclusion
Cortisol is a powerful hormone that affects nearly every aspect of your health. While short-term fluctuations in cortisol are a normal part of life, chronic dysregulation can have serious consequences. If you are experiencing any of the signs and symptoms described in this article, it is important to speak with a healthcare professional. They can help you to determine the underlying cause of your symptoms and develop a treatment plan that is right for you. By taking a proactive approach to your health, you can help to ensure that your cortisol levels are in balance and that you are living your life to the fullest.
Disclaimer
This article is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
References
- Cleveland Clinic. (n.d.). Cortisol: What It Is, Function, Symptoms & Levels. Retrieved from https://my.clevelandclinic.org/health/articles/22187-cortisol
- Healthline. (2025, March 20). High Cortisol Levels: Symptoms, Causes, and More. Retrieved from https://www.healthline.com/health/high-cortisol-symptoms
- Verywell Health. (2025, September 3). 10 Warning Signs Your Cortisol Levels Might Be Too High. Retrieved from https://www.verywellhealth.com/high-cortisol-symptoms-11796696
- National Institute of Diabetes and Digestive and Kidney Diseases. (2018, September). Symptoms & Causes of Adrenal Insufficiency & Addison’s Disease. Retrieved from https://www.niddk.nih.gov/health-information/endocrine-diseases/adrenal-insufficiency-addisons-disease/symptoms-causes
