From the Guidelines
Cortisol is harmful to human health.
Evidence of Harm
- Elevated cortisol levels have been linked to metabolic syndrome, visceral obesity, and cardiovascular mortality 1.
- Long-term use of corticosteroids has been shown to cause osteoporosis, compression fractures, avascular necrosis, excessive weight gain, hypertension, stretch marks, growth delay in children, cataracts, diabetes, dyslipidemia, and corticosteroid-induced myopathy 1.
- The use of corticosteroids for more than 6 weeks can lead to hypertension, hyperglycemia, sleep and mood disturbances, gastric irritation or ulcer formation, glaucoma, myopathy, and osteoporosis 1.
- Systemic corticosteroids may increase the risk of 28-day mortality 1.
- Elevated levels of cortisol can cause hypertension, hyperglycemia, hypokalemia, and muscle atrophy 1.
Clinical Implications
- The evidence suggests that cortisol can have harmful effects on human health, particularly when elevated or used long-term.
- Clinicians should be cautious when prescribing corticosteroids and monitor patients closely for potential adverse effects.
- Alternative treatments should be considered when possible to minimize the risks associated with cortisol and corticosteroids.
From the Research
Cortisol's Impact on Human Health
- Cortisol is a steroid hormone that plays a crucial role in maintaining homeostasis in the body, particularly during times of stress 2.
- While acute elevations in cortisol levels can be beneficial for survival, chronic exposure to stress can lead to maladaptive effects, resulting in a range of health problems, including:
- Metabolic syndrome
- Obesity
- Cancer
- Mental health disorders
- Cardiovascular disease
- Increased susceptibility to infections 2
- Elevated cortisol levels have been linked to poorer cognitive functioning, including:
- Episodic memory
- Executive functioning
- Language
- Spatial memory
- Processing speed
- Social cognition 3
- High cortisol levels may also contribute to neurodegeneration, particularly in Alzheimer's disease, by exerting neurotoxic effects on the hippocampus and promoting oxidative stress and amyloid β peptide toxicity 3.
Cortisol as a Biomarker for Mental Health
- Fluctuations in cortisol secretion often accompany psychiatric disorders, and normalization of cortisol levels correlates with improvement in patient health 4.
- Cortisol may be a useful biomarker for determining the likelihood of mental illness, its impending onset, and symptom severity 4.
- Changes in cortisol levels have been observed in individuals with depression, bipolar disorder, and psychosis, with cortisol levels often increasing in response to stressful situations 4.
Prevalence of Cortisol Dysregulation
- Disruption in cortisol production can have a significant impact on health, contributing to various chronic conditions, including noncommunicable diseases (NCDs) 5.
- Timely detection, screening, and treatment for NCDs are vital to address the growing problem of NCDs worldwide, which would have health and socioeconomic benefits 5.
- Hair cortisol analysis has been used to assess long-term systematic levels of cortisol, providing insight into the relationship between chronic stress and mental health 6.