It's not always stress—these unexpected conditions can also elevate cortisol
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“A dysregulated HPA axis results in the body producing more cortisol than usual, contributing to the physical fatigue and emotional numbness that often come with depression.” — Raj Dasgupta, MD, internal medicine physician
Although the internet may have people convinced that stress is a common cause of elevated cortisol levels, excess cortisol—a condition known as hypercortisolemia—is actually low in the general population. []
It’s normal for cortisol levels to ebb and flow throughout the day. For example, cortisol levels naturally peak when you wake up, and they might skyrocket if you experience a stressful event.
That said, there are certain health conditions that can cause cortisol levels to rise and remain high. Here’s what these conditions are—and why they might cause cortisol levels to skyrocket.
April is Stress Awareness Month
Stress isn’t just a feeling—it’s a physiological response that spikes cortisol levels, impacting both mental and physical health. Read all our latest coverage on the topic:
Cushing syndrome
The first condition that comes to mind when doctors think of elevated cortisol levels is Cushing syndrome. According to Martina Ambardjieva, MD, PhD, a urologist at Dr Telx, Cushing syndrome can result from a tumor, like a pituitary adenoma or adrenal growth, or prolonged use of corticosteroid medication.
Related: Can you spot this before the labs come in? 4 signs of high cortisolDepression
While a short bout of stress won’t lead to perpetually high cortisol levels, major depressive disorder (MDD) can.[] According to Dr. Ambardjieva, people with MDD often exhibit a hyperactive hypothalamic-pituitary-adrenal (HPA) axis.
The body’s stress response can remain activated with MDD, even if a person isn’t actively experiencing physical stressors, Dr. Ambardjieva adds.
“A dysregulated HPA axis results in the body producing more cortisol than usual, contributing to the physical fatigue and emotional numbness that often come with depression,” says Raj Dasgupta, MD, an internal medicine physician at Huntington Health.
Ongoing, consistent, and unusually high stress
While not always the culprit, stress obviously can also send cortisol levels skyrocketing. But hypercortisolemia doesn’t just occur from a one-off event, but is the result of ongoing mental or physical stressors that keep the body in “fight-or-flight” mode, Dr. Dasgupta explains.
When this occurs, “the brain's hypothalamus signals the adrenal glands to keep pumping out cortisol to handle the perceived threat, even if the threat isn't physical,” he tells MDLinx.
If a person’s fight-or-flight system remains activated for months, or, in severe cases, years, they may be exposed to chronically high cortisol levels.
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