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Cortisol: Definition, Functions, Release, and Role in Addiction

Cortisol is a steroid hormone produced by the adrenal glands, which are located on top of the kidneys. It belongs to a class of hormones called glucocorticoids, which regulate various metabolic functions in the body.

Cortisol regulates the body’s response to stress, maintains blood pressure and cardiovascular function, regulates metabolism and immune response, and increases energy production. It also plays a role in the sleep-wake cycle and aids in memory formation.

Cortisol is released in response to stress through a complex hormonal pathway involving the hypothalamus, pituitary gland, and adrenal glands. The hypothalamus releases corticotropin-releasing hormone (CRH), which stimulates the pituitary gland to release adrenocorticotropic hormone (ACTH). ACTH then signals the adrenal glands to produce cortisol.

In drug addiction, cortisol levels are affected in ways like chronic stress. Chronic drug use leads to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, resulting in elevated levels of cortisol. This can contribute to the development and maintenance of addiction by impacting mood, motivation, and decision-making.

What is Cortisol?

Cortisol is a hormone the adrenal glands produce on top of the kidneys. According to the Health Direct Journal titled “The Role of Cortisol in the Body.”

It plays a vital role in managing stress and regulating many body functions. When stressed, your brain signals your adrenal glands to release cortisol. This prepares your body to handle the stressful situation by increasing your heart rate and energy levels.

Cortisol is essential, but having too much or too little of it can cause various health problems. Understanding how it works can help you manage your stress and support your addiction recovery.

What are The Functions of Cortisol?

Cortisol regulates the body’s response to stress, maintains blood sugar levels, and controls inflammation, tolerance, and withdrawal. According to the WebMD Journal  article  ” What is Cortisol?” by   Traci C. Johnson ( Dec 2022), 

  1. Regulating Stress Response: Cortisol works with other hormones and systems in the body to control the fight or flight response, which helps us deal with potential threats or dangers. When we experience stress, cortisol levels rise, increasing our heart rate and blood pressure and providing energy to help us cope.
  2. Maintaining Blood Sugar Levels: Cortisol stimulates the production of glucose from proteins and fats stored in the body, ensuring enough energy is available for the body to use during times of stress. This process is important in preventing low blood sugar levels, which can lead to dizziness, weakness, and fatigue.
  3. Controlling Inflammation: Cortisol has anti-inflammatory properties that help reduce inflammation. When we experience an injury or infection, cortisol is released to help control the inflammation and promote healing.
  4. Tolerance and withdrawal: Cortisol plays a role in our body’s response to addictive substances, such as alcohol and drugs. It helps regulate the brain’s reward system and can impact how we experience cravings and withdrawal symptoms.

It is essential to find ways to manage stress and maintain a healthy cortisol balance in the body. This can include practicing relaxation techniques such as meditation or deep breathing, regular exercise, and a balanced and nutritious diet.

How Does My Body Control Cortisol Levels?

The control of cortisol levels is tightly regulated by the HPA axis, involving the hypothalamus, pituitary gland, and adrenal glands. According to a study titled “Physiology, Cortisol,” authored by Lauren Thau (August 2023).

This system ensures that cortisol is released in response to stress and is essential for the body’s ability to adapt and respond to environmental changes.

  1. Hypothalamus Perception of Stress: The process typically begins in the hypothalamus, a region in the brain that detects stressors. These stressors can be physical (like injury or illness) or psychological (like emotional stress). When the hypothalamus perceives stress, it releases corticotropin-releasing hormone (CRH) into the bloodstream.
  2. Stimulating the Pituitary Gland: CRH travels to the pituitary gland, a small gland located at the base of the brain. In response to CRH, the pituitary gland releases adrenocorticotropic hormone (ACTH) into the bloodstream. ACTH acts as a messenger, signaling the adrenal glands to produce cortisol.
  3. Adrenal Gland Response: The adrenal glands, located on top of the kidneys, receive the signal from ACTH. They respond by producing cortisol and releasing it into the bloodstream. The release of cortisol helps the body respond to stress by increasing glucose availability (for energy), suppressing non-essential functions (like digestion and immune response in the short term), and modifying inflammatory responses.
  4. Negative Feedback Loop: As cortisol levels rise in the bloodstream, they eventually reach a point where they signal back to the hypothalamus and pituitary gland to decrease the release of CRH and ACTH. This mechanism is a negative feedback loop and helps maintain stable cortisol levels in the body.
  5. Circadian Rhythm: Cortisol levels also follow a daily circadian rhythm pattern. Typically, cortisol levels are highest in the morning (helping us wake up and be alert) and lowest around midnight. The hypothalamus and pituitary gland adjust their release of CRH and ACTH accordingly to maintain this rhythm.
  6. Other Influences: Cortisol levels are influenced by other factors besides stress, such as illness, medication, and physical activity. For example, intense exercise can temporarily increase cortisol levels as part of the body’s response to physical stress.

How is Cortisol Produced?

Cortisol is produced in the adrenal cortex, the outer layer of your adrenal glands, according to a study titled “Physiology, Cortisol” by Lauren Thau (August 2023). The production process starts when your hypothalamus releases CRH. This hormone triggers your pituitary gland to release ACTH, which stimulates your adrenal glands to produce and release cortisol.

Cortisol depends on various factors, including stress levels, time of day, and overall health. Its production follows a daily rhythm, with levels peaking in the morning and gradually decreasing throughout the day.

How is Cortisol Released?

Cortisol is produced in the adrenal cortex, the outer layer of your adrenal glands. According to a study by the Science Direct Journal on “Cortisol” by Ursula Turpeinen (2013). The process starts with the release of corticotropin-releasing hormone (CRH) from the hypothalamus in response to stress or low cortisol levels. CRH then stimulates the pituitary gland, a small gland located at the base of your brain, to release adrenocorticotropic hormone (ACTH).

ACTH travels through the bloodstream to reach the adrenal cortex and signals it to produce cortisol. Cortisol production is regulated by a negative feedback loop, meaning that when cortisol levels are high, they suppress the release of CRH and ACTH to decrease production.

Cortisol is made from cholesterol, a type of fat found in all cells of the body. It is converted into cortisol through a series of chemical reactions in the adrenal cortex, which involves enzymes and other molecules specific to cortisol.

Once produced, cortisol enters the bloodstream and travels throughout the body, binding to various organ and tissue receptors. This allows it to carry out functions such as regulating metabolism, reducing inflammation, and assisting with stress response.

What Tests Can Check Cortisol Levels?

The main tests that can be used to check cortisol levels in the body are blood, saliva, and urine tests. According to The UNICEF Health Journal titled, “ Cortisol Blood Test,” on (Dec 2023).

  1. Blood tests: These tests measure the cortisol level in the blood at a specific time. They are typically done by drawing a small amount of blood from a vein in the arm and then analyzing it for cortisol levels. Blood tests are considered to be more accurate than saliva or urine tests, as they directly measure the hormone in the body.
  2. Saliva tests: Saliva tests also measure the cortisol level, but instead of using blood, they analyze saliva samples. The advantage of saliva tests is that they can be easily done at home and do not require a visit to a healthcare facility. However, they may not always be as accurate as blood tests.
  3. Urine tests measure cortisol levels but are not as widely used as blood or saliva tests. These tests look for metabolites of cortisol in the urine, which can indicate the hormone’s level in the body over a longer period.

These tests help diagnose conditions related to abnormal cortisol levels, such as Cushing’s syndrome (high cortisol) and Addison’s disease (low cortisol).

What Are Normal Cortisol Levels?

Normal cortisol levels have values between 5 and 25 mcg/dL or 140 and 690 nmol/L, as suggested by the UNICEF Journal.  Remember that these ranges can differ based on the lab and testing methods used. Your healthcare provider can help interpret your results and determine if your cortisol levels are within the normal range.

What Causes High Levels of Cortisol?

High levels of cortisol are caused by chronic stress, medical conditions like Cushing’s syndrome, poor sleep, unhealthy diet, and lack of exercise, as suggested by the Cleveland Clinic Journal on “Cortisol” (October 2021). 

  1. Chronic Stress: Stress is a natural response to challenging or threatening situations, and cortisol is one of the hormones released by the body during stress. While short-term cortisol levels are beneficial, chronic stress keeps cortisol levels elevated for extended periods, leading to health problems such as high blood pressure, weight gain, and mood disorders.
  2. Medical Conditions: Certain conditions like Cushing’s syndrome cause high cortisol levels. This condition occurs when the body produces excessive amounts of cortisol or when corticosteroid medications are taken in large doses over a long period. Other medical conditions that can affect cortisol levels include pituitary gland tumors, adrenal gland disorders, and chronic kidney or liver disease.
  3. Poor Sleep: Lack of quality sleep also contributes to high cortisol levels. Insufficient or poor-quality sleep disrupts the body’s natural cortisol release, increasing hormone levels. This disruption in cortisol levels further affects sleep patterns, creating a cycle detrimental to overall health.
  4. Unhealthy Diet: Consuming foods high in sugar, refined carbohydrates, and unhealthy fats also increases cortisol levels. These foods trigger an insulin response in the body, which leads to an increase in cortisol production. Additionally, a diet low in essential nutrients and high in processed foods can contribute to chronic inflammation, leading to elevated cortisol levels.
  5. Lack of Exercise: Regular exercise is crucial for maintaining healthy cortisol levels. Physical activity helps reduce stress and promotes the release of endorphins, which counteracts the effects of cortisol on the body. Not getting enough exercise or a sedentary lifestyle leads to chronically elevated cortisol levels, increasing the risk of various health problems.
  6. By managing stress, addressing any underlying medical conditions, prioritizing quality sleep, following a healthy diet, and incorporating regular exercise into your routine, you can help keep cortisol levels in check.

What Are the Symptoms of High Cortisol Levels?

The symptoms of high cortisol levels are weight gain, high blood pressure, muscle weakness, fatigue, insomnia, anxiety and depression, irritability, and memory and concentration problems, according to the WebMD Journal article titled “What is Cortisol?”: (Dec 2022),  the common symptoms include:

  1. Weight gain: High cortisol levels increase appetite and cravings for high-calorie and fatty foods, which can result in weight gain. Cortisol triggers the release of glucose into the bloodstream, stimulating insulin production and promoting fat storage.
  2. High blood pressure: Cortisol causes the blood vessels to constrict, leading to an increase in blood pressure. Over time, this damages the arteries and increases the risk of heart disease.
  3. Muscle weakness: Elevated cortisol levels cause muscle breakdown and weakness, especially in the legs and arms.
  4. Fatigue: Chronic stress that leads to high cortisol levels exhausts your body’s energy reserves, leading to fatigue and constant tiredness.
  5. Insomnia: Cortisol disrupts the body’s natural sleep-wake cycle, making it difficult to fall or stay asleep. This can further contribute to fatigue and other related symptoms.
  6. Anxiety and depression: High cortisol levels have been linked to an increased risk of anxiety and depression. This is because cortisol interferes with the production of serotonin, a neurotransmitter responsible for regulating mood.
  7. Irritability: Elevated cortisol levels affect our emotional state, making us more agitated, irritable, and easily frustrated.
  8. Memory and concentration problems: Stress and high cortisol levels impair cognitive function, making it difficult to focus, remember, and concentrate.

If you are experiencing any of these symptoms or notice changes in your body’s functioning, it is best to consult your healthcare provider for proper evaluation and treatment.

What Causes Low Levels of Cortisol?

Low levels of cortisol are caused by Addison’s disease, pituitary gland disorders, chronic stress, certain medications, infections, and autoimmune conditions.  According to Everly Well’s article “Understanding low cortisol levels: causes and effects.”

Addison’s disease: Addison’s disease is a rare disorder in which the adrenal glands do not produce enough cortisol and other hormones. This can be caused by an autoimmune reaction where the body attacks and damages the adrenal glands, or it can be due to damage from infections, cancer, or genetic factors.

  1. Pituitary gland disorders: The pituitary gland produces adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to produce cortisol. If the pituitary gland is damaged, such as by a tumor or radiation therapy, it won’t make enough ACTH, leading to low cortisol levels.
  2. Chronic stress: Chronic stress leads to low levels of cortisol. When a person is under constant stress, their body produces less cortisol to conserve energy and resources. This eventually leads to adrenal fatigue, where the adrenal glands become exhausted and unable to produce enough cortisol.
  3. Certain medications: Some medications, such as steroids and opioids, suppress the production of cortisol by the adrenal glands. Long-term use of these medications can lead to low levels of cortisol in the body.
  4. Infections: Infections, especially those that affect the adrenal or pituitary glands, can also cause low levels of cortisol. The body’s immune response to the infection can damage these glands and disrupt their ability to produce cortisol.
  5. Autoimmune conditions: Along with Addison’s disease, other autoimmune conditions can affect the production of cortisol. These include thyroiditis, where the body attacks and damages the thyroid gland, and hypopituitarism, where the immune system attacks and damages the pituitary gland.

How Can I Reduce My Cortisol Levels?

You can reduce your cortisol levels by practicing relaxation techniques, exercising regularly, and getting enough sleep. According to the Healthline article “ 11 Natural Ways to Lower Your Cortisol Levels” by Katey Davidson (January 2024), here are some effective ways to lower cortisol levels. 

Practice Relaxation Techniques

Relaxation techniques like deep breathing, meditation, and yoga can help reduce stress and lower cortisol levels. These practices promote relaxation and mindfulness, helping you stay calm and centered.

Exercise Regularly

Regular physical activity can help lower cortisol levels and improve overall well-being. On most days of the week, aim for at least 30 minutes of moderate exercise, such as walking, jogging, or swimming.

Get Enough Sleep

Quality sleep is essential for maintaining healthy cortisol levels. Aim for 7-9 hours of sleep each night and establish a regular sleep routine. To improve your sleep quality, avoid caffeine and electronic devices before bedtime.

What Role Does Cortisol Play in Addiction?

In addiction, cortisol levels are intricately linked to the intensity of cravings for drugs. When an individual experiences stress or anxiety, cortisol levels rise. This increase in cortisol heightens cravings for addictive substances such as drugs or alcohol as a means of coping with or alleviating stress, according to a study titled, “Cortisol secretion patterns in addiction and addiction risk,” authored by William R. Lovallo (Feb 2008).

The physiological response triggered by cortisol reinforces the association between stress and substance use, making it harder for individuals to resist cravings during challenging emotional states.

During withdrawal and detoxification from addictive substances, cortisol levels also fluctuate dramatically. The removal of the substance disrupts the body’s equilibrium, leading to heightened stress responses and, consequently, elevated cortisol levels. 

These high cortisol levels can exacerbate withdrawal symptoms, including anxiety, irritability, and restlessness, which are commonly experienced during detoxification. The interplay between cortisol and withdrawal symptoms underscores the complex nature of addiction recovery, where managing stress and cortisol levels becomes crucial.

Managing stress effectively and supporting cortisol regulation, treatment strategies potentially mitigate cravings and facilitate smoother withdrawal processes, thereby improving outcomes in addiction recovery programs.

How Can You Lower Your Cortisol Naturally?

You can lower cortisol levels naturally by eating a balanced diet, staying hydrated, and connecting with others, according to a Healthline post titled “11 Natural Ways to Lower Your Cortisol Levels” by Katey Davidson ( January 2024).

  • Eat a Balanced Diet: A healthy diet rich in fruits, vegetables, whole grains, and lean proteins can help regulate cortisol levels. Avoid excessive caffeine and sugar, as they can increase cortisol production.
  • Stay Hydrated: Drinking enough water is essential for maintaining healthy cortisol levels. Dehydration can increase cortisol production, so aim for at least 8 glasses of water daily.
  • Connect with Others: Social support and positive relationships can help reduce stress and lower cortisol levels. Spend time with friends and family, join support groups, or participate in community activities to build connections.


Why is Cortisol Called the Stress Hormone?

Cortisol is the stress hormone because it’s released in response to stress. When you encounter a stressful situation, your brain signals your adrenal glands to release cortisol, preparing your body to handle the stress.

What Are the Differences Between Cortisol and Oxytocin?

Cortisol is the stress hormone, while oxytocin is the “love hormone.” Oxytocin promotes bonding and social connections, while cortisol helps manage stress.

What Are the Differences Between Cortisol and Serotonin?

Cortisol is the stress hormone, while serotonin is a neurotransmitter that helps regulate mood, sleep, and appetite. High cortisol levels can lead to anxiety and depression, while balanced serotonin levels promote feelings of well-being.

What Are the Symptoms of Low Cortisol Levels?

The symptoms of low cortisol levels are Weight loss, low blood pressure, dizziness, nausea and vomiting, muscle and joint pain, depression and anxiety, and darkening of the skin, according to the National Institute of Diabetes on “Symptoms & Causes of Adrenal Insufficiency & Addison’s Disease” (2028). 

If you experience any of these symptoms, it is essential to seek medical attention. Your healthcare provider can help diagnose the cause of low cortisol levels and recommend appropriate treatments.

Is It Possible to Become Addicted to Cortisol?

Yes. While you can’t become physically addicted to cortisol, chronic stress leads to behaviors that create a cycle of stress and cortisol release. For example, individuals may engage in unhealthy coping mechanisms, such as substance abuse, to manage stress.

Understanding the role of cortisol in stress and addiction can help you develop healthier coping strategies and support your recovery.

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The Rubicon Editorial Team is a collective of seasoned professionals from The Rubicon, a renowned drug and alcohol treatment center. Comprising addiction counselors, medical experts, therapists, and recovery specialists, our team brings a wealth of diverse experience and compassionate insight to our blog. We are dedicated to providing valuable, research-backed information and practical advice to support individuals on their journey to recovery. Our articles aim to educate, inspire, and empower those affected by addiction, offering a beacon of hope and guidance through the complexities of rehabilitation and wellness.

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