In the ever-expanding world of online wellness, cortisol has become a buzzword that sparks anxiety and fuels a lucrative industry of supplements and advice. However, leading medical professionals are now pushing back against this trend, asserting that for the vast majority of people, actively trying to control this hormone is unnecessary and potentially misguided.
The Internet's Latest Villain: A Hormone We Actually Need
Cortisol, frequently labelled the "stress hormone," is currently dominating wellness conversations across social media platforms. Influencers routinely catalogue a litany of symptoms they attribute to chronically high cortisol levels, from disrupted 3 a.m. wake-ups and facial puffiness—dubbed "cortisol face"—to stubborn abdominal weight gain. In response, a market has flourished, promoting specific diets, exercise regimes, and supplements purported to regulate this biological compound.
But do healthy individuals genuinely require these products and influencer guidance to manage their cortisol? According to endocrinologists, the answer is a resounding no. They urge the public not to hastily demonise a hormone that is, in fact, critical for survival.
Cortisol's Crucial Role and the Rarity of True Disorders
Cortisol is a vital hormone produced by the adrenal glands, situated above the kidneys. It plays a key role in the body's stress response, influencing critical functions such as inflammation control, immune system activity, metabolism, and blood pressure regulation. Far from being a static presence, cortisol is exquisitely sensitive to both internal bodily states and external environments.
"Our cortisol level is regulated by the minute," explained Dr. Roberto Salvatori, an endocrinologist at Johns Hopkins University. "It is very sensitive." It follows a natural diurnal rhythm, peaking in the morning to help us wake and declining at night to facilitate sleep. Levels also temporarily rise during illness or acute stress, which is a normal, adaptive response.
Genuine medical disorders where cortisol itself is the primary problem are relatively uncommon. On one end of the spectrum, chronically low cortisol can indicate adrenal insufficiency, such as Addison's disease. On the other, excessively high cortisol defines Cushing's syndrome, often caused by benign tumours in the adrenal or pituitary glands. Both conditions require formal medical diagnosis and treatment, which may include medication or surgery.
Why Self-Testing and Unverified Supplements Are Risky
The symptoms associated with abnormal cortisol levels—fatigue, weight changes, blood pressure issues, sleep disturbances—are broad and nonspecific, easily overlapping with many other health problems. This makes accurate diagnosis complex, requiring multiple tests and a comprehensive evaluation by a healthcare professional.
Endocrinologists express significant concern over the trend of direct-to-consumer cortisol testing. "There’s a lot of nuance to interpreting cortisol," said Dr. Katie Guttenberg of UTHealth Houston. "That’s what makes me a little bit nervous about patients getting cortisol testing for themselves without having some kind of physician oversight." A single blood test can be misleading; for instance, women on birth control may show falsely elevated levels due to the medication's interaction.
Similarly, the market is flooded with supplements like ashwagandha and magnesium that claim to "lower cortisol." Endocrinologists state there are no proven over-the-counter treatments for regulating cortisol levels. Dr. James Findling of the Medical College of Wisconsin warned that these unregulated products are "not innocuous," and their contents are often unclear. Even prescribed medications for conditions like Cushing's syndrome require precise dosing to avoid swinging levels dangerously low.
Focus on Holistic Health, Not a Single Hormone
The doctors acknowledge that chronic stress is a legitimate health concern and that patients with true hormonal disorders can suffer while being undiagnosed. However, for the general healthy population, their advice is straightforward: consult a doctor if you have persistent concerns, but otherwise, shift the focus away from targeting one elusive hormone.
Instead, they advocate returning to established fundamentals of wellbeing. "Nothing new about any of that," Dr. Findling remarked, endorsing proven stress management techniques: maintaining a balanced diet, ensuring adequate sleep, engaging in regular physical activity, and seeking therapy if needed. Managing overall stress is beneficial for health, regardless of its direct, minute-by-minute impact on cortisol levels.
In an era of quick fixes and viral health trends, the medical consensus is clear: cortisol is a complex, essential hormone that rarely requires intervention from internet influencers or their recommended products. Prioritising evidence-based medicine and holistic lifestyle habits remains the soundest path to long-term health.
