Should You Check Your Cortisol Levels? Everything You Need to Know
Checking Your Cortisol Levels and Should You Get It Tested?
Cortisol is a word that seems to pop up everywhere at the moment, typically in a negative light. As we have discussed in our page, What is Cortisol?, it is an essential component in the ecosystem that is your body. It certainly has its benefits but when out of balance it can have negative side effects too, Like many things in the body, cortisol works best when it's in balance.
Should You Check Your Cortisol Levels?
In short, most people do not need to check their cortisol levels. Cortisol is a normal and natural hormone, it is supposed to be in your body, and your reading at any given moment is not the end all and be all of your physical health or mental wellbeing.
If I was to measure your heart rate right now, and lets say it was 120 beats per minute, is that good or bad?
Well, at a glance it may seem a little high, but there are a few things that we should consider before judging.
- Were you asleep?
- Had you just run upstairs?
- Had someone just frightened you?
- Had you drunk three coffees?
Without context, the number doesn't tell us very much. Cortisol is very similar.
Cortisol naturally changes throughout the day
In healthy people, cortisol follows a daily rhythm called the diurnal cortisol rhythm.
Typically:
- It rises sharply shortly after waking (the cortisol awakening response).
- It's highest in the morning.
- It gradually falls throughout the day.
- It's usually at its lowest late in the evening.
So if I tested your cortisol at: 8:00am, 2:00pm or 10:00pm
I'd expect three completely different numbers. None of them would necessarily be abnormal. This reflects how your body naturally uses cortisol throughout the day. It increase when you wake up, to give you some alertness and awareness and allowing you to start your day. It gradually falls throughout the day and is at its lowest in the evening, typically again inline with when you would expect to start winding down for sleep.
For this reason a signal test result does not always mean much, and doctors usually request testing when there's a medical reason.
High cortisol isn't the same as "I'm stressed"
We have discussed that there is a link between cortisol and stress, but its equally important to explain that being stressed does not automatically mean you have abnormally high cortisol. The reverse is also true, someone with high cortisol does not necessarily "feel stressed". This is again a reason why if you tell your Doctor you feel stressed they will probably not push you towards a Cortisol test right away.
Instead they are likely to ask other questions along the lines of:
- What's causing the stress?
- How are you sleeping?
- How long has it been going on?
- Are there signs of anxiety or depression?
- Could another medical condition explain the symptoms?
A cortisol test often wouldn't change what happens next unless there are signs of a specific hormone disorder.
When Might Cortisol Testing Be Recommended?
As above, cortisol is typically tested when a doctor suspects a medical reason. There are two well-known medical conditions that a doctor would want to investigate as well as some additional adrenal disorders. There are a few symptoms that may lead a doctor to recommend this.
Rapid weight gain in the face or belly. A fatty hump between the shoulders and high blood pressure may be signs of high cortisol that would lead to testing.
Extreme tiredness, muscle weakness, weight loss, dark patches of skin and low blood pressure may be signs of low cortisol that would lead to testing.
Types of testing
There are three main types of tests that you should be aware of when it comes to cortisol. As we have discussed Cortisol levels change naturally throughout the day, this means different tests may be used based on the time of day or for a different purpose.
Cortisol Blood Test
Typically done in the morning when levels are at their highest, sometimes its down twice in one day, the second done later in the afternoon. It is similar to any other blood test, a nurse will use a need to take a sample. A blood test measures the amount of cortisol circulating in your bloodstream. Much of this cortisol is attached to proteins, while a smaller amount remains free and active.
Cortisol Saliva Test
This test can be done easily at home, it is painless and non-invasive and a key factor is that it avoids the stress of appointments and blood tests. Cortisol Saliva tests measures the active, free levels of cortisol in your body. Free cortisol is the stuff that is able to have an effect on you right at this moment, rather than the stored cortisol in a blood test.
Tests are typically done late at night (around 11 p.m.) when cortisol levels should naturally be at their lowest, or taken multiple times throughout the day to map your natural rhythm.
Cortisol Urine Test
A urine cortisol test is again going to measure the free cortisol levels, this time over a 24-hour period. It requires collecting all of the urine produced over a whole day. At the start of the first day you empty your bladder completely, this is not to be collected. Then over the following 24-hour period all of the urine produced is collected and stored, typically refrigerator (can be stored in a cooler with ice).
When should you speak to your GP?
If you've been experiencing ongoing symptoms such as persistent fatigue, unexplained weight changes, muscle weakness, dizziness, or other health concerns that don't improve, it's a good idea to speak to your GP. They can assess your symptoms and decide whether further investigations, including cortisol testing, are appropriate.
Can You Lower Cortisol Naturally?
It is possible, I however feel its important that I do not give you any promises here, I am not a doctor, and every person is a little different. So I am not going to say you can 100% lower it or by how much. Rather I will say if you wished to support healthy cortisol regulation. you would:
Improve healthy sleep: set a routine of going to bed and weaking up at the same time, let your body understand the rhythm of sleep and make it a habit.. Habits are easier to follow. Also, we advise putting down your device 1-hour before sleep time to reduce doom scrolling and promote rest. Read more on our Understanding Sleep page.
Exercise: We have discussed how the body and mind and chemicals in your body are related and interest. Low intensity activities like walking, yoga or gentle strength training can help to promote a health cortisol balance.
Diet Adjustments: Again, that mind body link can be supported with good food choices. Anti-inflammatory whole goods, Omega-3 fatty acids and foods rich in magnesium can be a great help. Avoid added sugars, excess caffeine and alcohol.
Stress Management: Stress is a normal part of life, as is cortisol, but as we have discussed balance is key. Prolonged stress can cause increases in Cortisol. Try to make use of our page Understanding stress to learn about ways you can lessens stress.
The Bottom Line
Cortisol has gained quite a reputation over the last few years, but the truth is a little less dramatic than social media sometimes suggests. It's an essential hormone that helps your body wake up, respond to challenges and keep many important systems running smoothly.
For most people, checking cortisol levels isn't necessary, and a single test result rarely tells the whole story. Cortisol naturally rises and falls throughout the day, and many factors can influence its levels. That's why testing is usually recommended when a doctor suspects an underlying medical condition rather than simply because life has been stressful.
If you're concerned about ongoing symptoms or your wellbeing, speaking with your GP is always the best place to start. They can help decide whether cortisol testing is appropriate and, more importantly, look at the bigger picture of your health.
Understanding your body is often far more valuable than fearing a single number. The more we learn about how hormones, sleep, stress and lifestyle work together, the better equipped we are to support our overall wellbeing.
