Though rare, high levels of cortisol can cause acne, puffy face, headache and more.
Contrary to claims making the rounds on social media, excess cortisol is likely not the cause of most people’s puffy eyes, puffy face or acne.
Best known as “the stress hormone,” cortisol is less likely to be the cause of facial puffiness than, say, high-salt intake and diet, eczema, allergies or how you sleep, says UCI Health endocrinologist Dr. Mehboob Hussain.
While very high levels of the hormone can make one’s face puffy, Hussain is skeptical of connecting this result with life’s stressors. Usually, he says, too much cortisol in the body occurs mainly “when people are taking it for medical reasons at high doses for prolonged periods.”
What is cortisol?
Produced mainly in the adrenal glands that sit atop each kidney, cortisol is released naturally when we awaken or when a threat is perceived, providing energy and alertness.
But it does so much more.
Cortisol is critical to many bodily functions, including controlling metabolism and the use of fat, protein and carbohydrates.
“Without cortisol, many functions of the body would not occur properly,” says Hussein, who leads UCI Health Endocrinology Services. “Essentially, no cortisol means you would die if there’s no treatment or remediation.”
How cortisol helps
In the right amount, doses, cortisol is extremely beneficial.
“There are times when your body makes extra cortisol, such as when you break a bone, or are undergoing surgery, or have a fever.” Hussain says.
It also helps to reduce inflammation.
The hormone levels normally fluctuate during the day. They are highest in the early morning and prepares us to start the day.
Too much cortisol
Having elevated cortisol for extended periods of time can be harmful.
When the adrenal glands consistently produce high levels of cortisol, it can lead to Cushing syndrome.
“But most of the time, it’s not going to be Cushing syndrome,” Hussain says, noting the rarity of the condition that causes the body to overproduce cortisol.
“It’s most likely going to be a more common condition, such as acne, polycystic ovary syndrome, diabetes, obesity or metabolic syndrome. Those are associated with these changes.”
Polycystic ovary syndrome (PCOS), which can disrupt hormones that regulate menstruation and ovulation, can lead to weight gain, irregular periods and even excess hair growth.
High levels of cortisol can also increase appetite, especially for sweet and high-calorie foods, as well as fat storage, especially around the abdomen. This can lead to insulin resistance, a pre-diabetic condition, as well as metabolic syndrome.
Other symptoms of too much cortisol include:
Risks of persistent high cortisol
Untreated, prolonged high levels of cortisol can increase a person’s risk for diabetes, cardiovascular disease, osteoporosis and even psychiatric disorders.
“These rare situations can be very detrimental to our health,” says Hussain.
If you are concerned about your cortisol levels, he recommends talking with your primary care doctor, who can order initial testing and refer you to an appropriate specialist, if needed.
These may include urine, blood and saliva tests, along with imaging scans of the adrenal and pituitary glands to look for tumors or abnormalities.
Despite the rarity of conditions related to high cortisol, it’s still a good idea to keep a healthy and balanced lifestyle. As a bonus, this will also avoid unnecessary spikes in cortisol.
Things you can to achieve a healthy and balanced lifestyle:
Our blood cortisol levels normally fluctuate according to the body’s sleep-wake cycle. They also adjust to the body’s needs, Hussain points out.
“High blood cortisol levels when the body needs them to be high are not detrimental to our health.”
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