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CNET
18-07-2025
- Health
- CNET
9 Foods That Will Naturally Increase Your Testosterone Levels, According to Experts
Everyone produces testosterone, regardless of sex. Not only is it a pivotal hormone in development (particularly for males) and for masculine characteristics, it's also essential for muscle growth, strength, bone density and sex drive. Like the best tools we rely on every day -- from solid routines to dependable phones -- testosterone plays a foundational role in how our bodies function, according to the director of Clinical Operations at ModifyHealth, Madison Reeder. Reeder explains that testosterone is far more involved than you would first think -- it plays are part in everything from muscle maintenance to energy levels to red blood cell production. "It plays a far more expansive role by supporting cellular signaling, protein synthesis, fat distribution and cognitive and emotional regulation," she says. Testosterone is vital for overall well-being, especially in men. Low testosterone, or hypogonadism, happens when the testicles don't produce enough of the hormone. It's more common than you might think, affecting about 35% of men over 45. To maintain healthy testosterone levels, it's helpful to moderate alcohol consumption and, if possible, quit smoking entirely. Your diet is equally important, so make sure to include these top foods (as picked out by our CNET experts) to boost your testosterone levels effectively. Why do testosterone levels vary? Testosterone naturally fluctuates. According to Dr. Justin Houman, an assistant professor of urology at Cedars-Sinai Medical Center, testosterone levels are generally at their highest point in the morning and decline throughout the day, in line with the body's circadian rhythm. Testosterone also changes throughout life. It increases sharply during puberty and then gradually decreases after age 30. "Beyond that, fluctuations can be influenced by a wide range of factors: sleep quality, stress levels (particularly cortisol), body fat percentage, alcohol consumption, certain medications and even acute or chronic illness," said Houman. The pituitary gland is central to regulating testosterone production in the body, and it's a sensitive system that can easily be thrown off. Things that can impact testosterone levels include but are not limited to: Medications like steroids or opioids Chronic health conditions like kidney disease, lung disease or diabetes Sleep apnea and poor sleep Stress Obesity According to the American Urological Association, low testosterone is a level below 300 ng/dL. A healthy range is considered between 450 and 600ng/dL. "However, there is no 'one-size-fits-all' testosterone level. The body's ideal level is influenced by age, sex, genetics, health history, and even how well you sleep or manage stress," Reeder said. If you're struggling with low testosterone, one of the first places you can look is your diet. Unhealthy diets or chronic under-fueling can impair hormone production while working toward a balanced diet full of nutrients can help stabilize your levels. 9 foods that may increase testosterone "There isn't a single 'testosterone superfood,' but certain foods support the body's natural testosterone production by providing key nutrients or reducing inflammation and oxidative stress," Houman said. The nutritional content of certain foods can give you a leg up when it comes to testosterone, especially if you're deficient in that particular nutrient. Reeder pointed to zinc, vitamin D, magnesium, omega-3 fatty acids and high-quality protein as pivotal nutrients for healthy testosterone production. Adding the foods on this list to your diet won't magically fix low testosterone levels. However, being intentional about making good food choices can help supplement level management as you speak to your doctor. Your needs will vary depending on your age, health conditions and hormonal status. Milan_Jovic/Getty Images Leafy greens Leafy greens like spinach, kale and collard greens contain a lot of magnesium, which can help regulate total and free testosterone. Research suggests that magnesium deficiency may also play a role in low testosterone levels. Magnesium reduces oxidative stress, or the body's imbalance of antioxidants and free radicals. Reducing oxidative stress benefits testosterone bioactivity because inflammation and oxidative stress can lower testosterone levels. Eating leafy greens may help boost testosterone levels. However, if you're not a big green eater, beans, nuts and dark chocolate are also excellent sources of magnesium. Fatty fish Fatty fish have a lot going for them in the testosterone department. They are great sources of "good fats" known as omega-3s, which are known to support heart and joint health. Research has revealed that low-fat diets can be associated with lower testosterone levels. While we need more research to fully understand why this is the case, incorporating healthy fats into your diet, such as fatty fish, can benefit your overall health. That's not the only benefit of fatty fish. They have a high nutritional content of essential vitamins like zinc and vitamin D, which are crucial for healthy testosterone levels. Those with less vitamin D tend to have lower testosterone levels than those with more vitamin D. You can take a fish oil supplement if you're not a fish eater. A 2020 study found that fish oil supplements with omega-3s boost testosterone in men. Cruciferous vegetables Houman explained that cruciferous vegetables like broccoli, cauliflower and Brussels sprouts can indirectly support healthier testosterone balance by lowering estrogen levels. They can do this because cruciferous vegetables have a compound called indole-3-carbinol. Some studies suggest that indole-3-carbinol may slow the growth of cancer cells, although the research is limited. DragonImages/Getty Images Eggs Eggs can help maintain healthy testosterone levels because they contain vitamin D and healthy fats. They also contain the antioxidant selenium. Animal studies have found that selenium can increase testosterone production. However, it's important to remember that we don't have human studies to draw any conclusions about the extent of the relationship between selenium and testosterone. Regardless, eggs are highly nutritious and contain other testosterone-friendly nutrients. One smaller study found that eating the whole egg will be better for testosterone levels than egg whites. Avocados Avocados are a triple threat when it comes to boosting testosterone levels. They are a great source of healthy fats and magnesium and contain boron, a trace element linked to testosterone production. One study found that within a week of taking boron supplements, testosterone levels in males increased up to 32%. Oysters and other shellfish According to Houman, zinc is an essential nutrient for testosterone synthesis in the testes. Oysters offer the most zinc per serving than any food. Other shellfish, like shrimp, clams, mussels, crab and lobster, have notable zinc levels. If seafood isn't your thing, red meat, pumpkin seeds and lentils are other zinc-rich foods. Beyond the benefits of zinc, oysters and other shellfish's antioxidant effect may boost testosterone by increasing the efficiency of the Leydig cells, the primary source of testosterone. Read more: 15 Best Food Sources of Zinc Select fruits Fruits with flavonoid antioxidants, like pomegranates, berries and cherries, can help support testosterone production. A study of active young men found that drinking two cups of pure pomegranate juice each day for three weeks helped with muscle recovery, reduced inflammation and saw an increase in testosterone. Olive oil Olive oil has several health benefits, like increasing good cholesterol and lowering bad cholesterol. There is also some evidence that it may increase testosterone. One small study published in the Journal of Strength and Conditioning Research of 60 young males discovered that a daily intake of around five teaspoons of extra virgin olive oil increased testosterone by 17%. Fermented foods Reeder explained that gut health is gaining more attention for its role in hormone regulation. Fermented foods, such as yogurt and kimchi, can indirectly support testosterone levels by ensuring your gut microbiota is healthy. A healthy gut plays a role in inflammation and hormone metabolism, so eating gut-friendly foods is always good. "While eating these foods won't artificially raise testosterone beyond your body's natural capacity, they can help create the right environment for hormonal stability," Reeder said. Jose LuisWhat is the best diet for boosting testosterone levels? Any balanced diet that includes testosterone-friendly foods is a good option. However, if you're looking for a specific diet to help you create meals, try the Mediterranean diet. It's rich in lean proteins, healthy fats and plenty of veggies. Houman explained that following a Mediterranean diet has been linked to higher testosterone levels and better reproductive health in men. You don't have to follow the Mediterranean diet to boost your testosterone levels; you can focus on healthy eating habits to see the benefits. However, it's essential to acknowledge what not to do. Houman explained that ultra-processed foods and high-sugar diets can suppress testosterone by promoting insulin resistance. You'll always want to stay away from trans fats and packaged snacks. Read more: The Best Food Subscriptions for a Mediterranean Diet That said, you don't want to cut out fats entirely. "Very low-fat diets can be problematic. Fats, especially those from whole food sources, provide cholesterol, a crucial building block for hormone production," Reeder said. Don't cut out all fats from your diet or you may see a hormone level drop. Instead, focus on high-quality fats and moderate how often you eat processed foods. If you don't know where to start with your diet or how to recognize your food patterns, working with a registered dietitian can help you find a diet that works best for your body. Other natural ways to boost testosterone Everything starts with the foods you eat, though your diet isn't the only thing that could impact your testosterone levels. Your lifestyle matters too. Other healthy habits to maintain testosterone levels:
CNET
17-07-2025
- Health
- CNET
I Got a Cortisol Blood Test. What I Learned About My Stress Was Important, but Not Fun
Historically, I haven't been great about managing my stress and anxiety, so whenever I come across a video or article about cortisol imbalances, my interest is piqued. Since cortisol is also called the "stress hormone," this content has made me wonder: Is my stress causing my cortisol levels to rise? Though I was nervous, I decided to take Quest's Cortisol Blood Stress Hormone Test, which was offered to me for free, to find out more. After my cortisol blood test, I had a lot of residual questions about cortisol. That's why I spoke with several doctors to find out everything we should all know about cortisol and how it affects our bodies. What is cortisol? "Cortisol is an essential hormone produced and released by adrenal glands," said Dr. Sanjay Dixit, medical director of cardiometabolic endocrine and wellness solutions at Quest Diagnostics and medical expert for in an email. "Many people associate cortisol as being the 'stress hormone,' but it actually has many additional important functions." In addition to managing the body's response to stress, cortisol regulates blood sugar and blood pressure, the sleep-wake cycle and metabolism while suppressing inflammation. "It is most commonly known as the 'stress hormone' because it's released in response to stress and works to prepare the body for 'fight-or-flight,'" added Dr. Sajad Zalzala, co-founder and chief medical officer of longevity platform AgelessRx, via email. "It increases glucose availability, which supplies energy and mobilizes stored fats and proteins to provide additional fuel." Should you get a cortisol test? Dixit explained that someone could get a cortisol test to see if they have a cortisol deficiency, also known as adrenal insufficiency. Symptoms of this can include: Fatigue or being overly tired Worsening muscle weakness Skin changes (particularly darkening in folds and scars) Loss of appetite Unintentional weight loss Low blood pressure Another reason a cortisol test may be ordered is to see if a patient has excess cortisol, generally known as Cushing's syndrome. Potential symptoms for this include: Bruising easily Unintentional weight gain Muscle weakness Fatigue Rounded and rosy face Increased fat in the upper back Impaired glucose tolerance "[Impaired glucose tolerance is] something that can be particularly noticeable in type 2 diabetic patients who have trouble managing their glucose levels even with adherence to prescribed medication," said Dixit. Westend61/Getty Images What is a cortisol blood test? Before my blood was drawn for this test, I had my yearly physical with my primary care provider. I notified her that I would be getting this test and asked to have my other preventative blood tests taken simultaneously. I want to mention this because it's important to run any health-related tests by a doctor who knows you and your health history. According to Quest, you must be at least age 18 to buy a test, which is unavailable in Alaska, Arizona or Hawaii. For select tests, you will be asked to answer relevant medical questions. Before a test order is submitted for processing, your purchase and answers will then be reviewed by a telemedicine doctor affiliated with the national clinician network PWNHealth to ensure this test is medically appropriate for you. You must also schedule the cortisol test between 7 a.m. and 9 a.m. "Cortisol levels naturally change throughout the day," Quest answered in an FAQ, stating that since cortisol levels usually peak in the morning, this particular level would be the best indicator of a cortisol problem. No fasting is required. But I had to fast for the other blood tests ordered by my doctor. According to Dixit, it is also important to note that "a blood test for cortisol can be inaccurate in some cases." Inaccurate results, for example, can happen if a person is taking oral contraceptives or steroids, such as prednisone. Once I bought the cortisol test on Quest's website -- it ordinarily costs $89 with a $6 physician service fee -- I was sent an email with my order number and a link to schedule an appointment at a nearby Quest location. I scheduled my appointment for 8:20 a.m. at the facility closest to me. On the day of my appointment, I was texted a link to check in when I arrived and was admitted within 5 minutes. (I highly recommend scheduling beforehand so you don't have to wait.) I get particularly anxious about blood tests, so I notified my technician and asked if I could lie on an exam table. She assured me that many people get nervous about blood tests and, after I signed off on my tests, did a great job talking to me as a distraction while my blood was drawn. Later that night, I received the results of my cortisol test. As for the results from the tests ordered by my doctor, I received them five days later. Quest reports that processing times vary, but it generally takes up to eight business days to receive results. My cortisol blood test results Unsurprisingly, my cortisol blood test results came back as "high" at 33.2 mcg/dL. Quest reports that a normal range between 7 a.m. and 9 a.m. is 4.0-22.0 mcg/dL. To be frank, this freaked me out. I had a feeling that my cortisol levels would be high because of my general anxiety and heightened nerves around blood tests, but actually seeing that "high" result and not fully understanding it ironically increased my stress levels even more. Quest allows you to discuss your results with an independent physician, so I took advantage of this offer. I called Quest's customer service line and was emailed to schedule my appointment with a physician at PWNHealth via Everly Health Solutions, a digital health company that acquired PWNHealth in 2021. When scheduling my appointment, I provided context about my cortisol blood test. I was then told that a physician would call me within 4 hours during business hours. Within 4 hours, a PWNHealth physician called. I asked the doctor if my cortisol level was in line with the fact that I have anxiety and was stressed about the blood test. She said that it could be why my cortisol was acutely high, but that chronically high cortisol levels could be concerning and caused by other conditions, certain medications or pregnancy. She added that it could be related to an adrenal gland condition. I also asked about how high cortisol levels can go and she stated that there is no "highest point," especially since it varies from person to person, depending on the condition. She added that people with adrenal gland conditions typically show higher cortisol levels, but there isn't a specific cutoff. Though the doctor stated that my high cortisol was likely due to anxiety, she recommended that I follow up with my primary care physician. Afterward, I was able to download my Quest results as a PDF and send them to my PCP. mapodile/Getty Images What are normal cortisol levels? "The 'normal' reference range varies slightly with the lab that's doing the testing," said Zalzala. "Quest reports a normal a.m. (7 to 9 a.m.) blood level of 4.0 to 22.0 mcg/dL, whereas Labcorp reports normal a.m. blood level of 6.2 to 19.4 mcg/dL." As for why cortisol varies throughout the day: "Cortisol is very important in helping a person transition from sleep to wakefulness," Zalzala explained. "This triggers a 'morning cortisol surge' -- a rapid rise in cortisol levels within 20 to 30 minutes of waking, which jumpstarts alertness and prepares the body for the day." Over the course of the day, our bodies will also experience mini peaks in cortisol levels to help us maintain energy and alertness. These peaks typically occur around noon and in the early evening. "Interestingly, these peaks often align with standard meal times, playing a key role in supporting our body's ability to metabolize food and regulate energy levels," said Zalzala. Dr. Betul Hatipoglu, MD, professor of medicine at Case Western Reserve University's School of Medicine and medical director of the Diabetes and Metabolic Center at the University Hospital Cleveland Medical Center, stated in an email that there is a "normal, what we call 'circadian rhythm' for cortisol." As the day goes on, cortisol levels will gradually decrease and become lowest closer to bedtime. How high can cortisol levels go? "Cortisol levels could go as high as or closer to 40 [mcg/dL] in individuals who are extremely ill, such as people in intensive care," Hatipoglu said. Zalzala added that a normal adult can generate cortisol levels up to 50 mcg/dL, which is about two to three times their morning surge level, during times of stress. Zalzala also mentioned Cushing's syndrome, a rare disorder in which "the adrenal gland starts making cortisol on its own (adrenal tumor) or in response to a pituitary gland tumor that makes too much ACTH [adrenocorticotropic hormone, which regulates cortisol] and ignores the feedback cycle." For those with this disorder, cortisol levels can go as high as 100 mcg/dL. In cases where someone is extremely ill, such as with septic shock, Zalzala stated that levels can be as high as 1,000 mcg/dL. Maskot/Getty Images Can anxiety affect cortisol? I shared my results with all the doctors I consulted to see if I could get a better understanding of how anxiety could affect my cortisol levels -- and any other factors that may be at play. "High cortisol in a normal individual can be a sign of stress in your case," said Hatipoglu. "However, sometimes other hormones can affect the cortisol levels. For example, if someone is taking oral contraceptives or estrogen therapy, this can increase total cholesterol, which is what you have been tested for." Due to fasting, anxiety and being stressed about my blood draw, Zalzala said that combination could have caused my morning cortisol level to be higher than normal. He added, "Studies have shown that stress or acute anxiety can drive cortisol levels significantly higher, often to values similar to what you experienced." What other cortisol tests are there? "I usually would check a random cortisol before 9 a.m. in the morning to make sure the level is not low," said Hatipoglu. "If we are concerned about high cortisol, it is usually recommended that we actually do different evaluations." To understand whether elevated cortisol levels are a normal reaction or an abnormal increase, Hatipoglu may then want to do testing such as a milligram dexamethasone suppression test (which measures whether cortisol secretion by the adrenal gland can be suppressed) or a 24-hour urine cortisol test (which measures the amount of cortisol in a person's urine over a day). However, if a patient is on birth control, stopping it for a few months and then repeating the cortisol test may help show their body's actual cortisol levels. Zalzala, on the other hand, stated that he rarely recommends a single morning cortisol test unless a patient is believed to have Addison's or Cushing's disease. Addison's is a rare endocrine disorder caused by damaged adrenal glands that can't produce enough hormones. "For those people who want to use cortisol levels as a tool to make lifestyle adjustments and to monitor other interventions (like therapy or sleep medications), then the saliva cortisol level is the one I would recommend," stated Zalzala. "Studies indicate that salivary cortisol levels show a reasonably strong correlation with serum cortisol." For my "high" result specifically, Zalzala stated, "While this result aligns with the stress factors you've described, cortisol levels above 20–25 µg/dL [which is the same as mcg/dL] in the morning can sometimes prompt further evaluation, particularly if symptoms suggest additional hormonal imbalance." If I were to take supplementary tests under less stressful conditions and my cortisol continues to be elevated, Zalzala said I should explore other factors with my healthcare provider. "They may consider repeating the test using alternative methods, like a 24-hour urinary free cortisol or late-night salivary cortisol test, which are less affected by immediate stress responses." While this particular cortisol blood stress hormone test can be a good first step, Dixit acknowledges that it may not necessarily be the last one. He suggested that a person concerned about their health should talk to their doctor -- even if the test results don't show anything wrong. AzmanJaka/Getty Images What happens if a cortisol blood test is abnormal? "I think the best way here would be to see a physician, a nurse practitioner or a healthcare provider to get an evaluation," Hatipoglu said. "[This is] done to understand if it is true [cortisol] elevation or is it stress-induced." Dixit specifically recommended that in addition to a primary healthcare provider, one could see an endocrinologist, a doctor specializing in diagnosing and treating health conditions that affect the endocrine system. "That's because testing for excess cortisol is not as straightforward as a single blood test," he said, adding that a healthcare provider could perform an evaluation, recommend additional tests and consider other potential causes. However, if additional tests remain abnormal, a trained clinician must be consulted for further diagnostic decisions. "Most conventionally trained physicians would initially evaluate for Cushing's or Addison's disease," Zalzala said. "If these are ruled out, a thorough clinician would then investigate other contributing factors affecting cortisol levels. Conversely, a less attentive approach might dismiss the patient without addressing the underlying issues." If a doctor does determine that there are problems with excess cortisol or adrenal insufficiency, Dixit stated that the methods used to address the issue depend on the root cause. For example, with Cushing's syndrome, medication or surgery may be required since the disorder can be caused by a tumor on the adrenal or pituitary glands. What can cause abnormal cortisol levels? "I think it's useful to talk about the ways the normal cortisol cycle can be disrupted, that could show up on salivary testing if done at the right times of day," said Zalzala, who listed the following as common causes for a disrupted cortisol cycle: For cortisol levels that remain low and flat throughout the day: Chronic stress, adrenal fatigue, burnout and some chronic inflammatory conditions. Chronic stress, adrenal fatigue, burnout and some chronic inflammatory conditions. For lower morning cortisol levels that then peak in the evening: Chronic stress, sleep disorders, shift work and certain mental health conditions (for example, PTSD). Chronic stress, sleep disorders, shift work and certain mental health conditions (for example, PTSD). For normal morning cortisol levels that increase in the evening: Anxiety, high-stress lifestyle, evening exposure to artificial light (such as from screens) and late-day caffeine or high-stress activities. Anxiety, high-stress lifestyle, evening exposure to artificial light (such as from screens) and late-day caffeine or high-stress activities. For a lower or absent rise in cortisol upon waking, or Cortisol Awakening Response): Chronic stress, depression, PTSD, burnout and shift work. Symptoms of high cortisol or cortisol deficiency can also be connected to non-cortisol-related conditions and health issues, according to Dixit. That is why consulting a doctor about your results and symptoms is can high cortisol affect health? While social media may oversimplify all things cortisol as a means of clickbait, Zalzala said it should not be dismissed. That's because dysregulated cortisol has the following long-term health impacts: Mental health issues such as anxiety, depression and mood instability. such as anxiety, depression and mood instability. Cognitive impairment such as memory problems and impaired executive function. such as memory problems and impaired executive function. Metabolic disorders that involve weight gain and obesity, insulin resistance, increased risk of metabolic syndrome and type 2 diabetes and blood sugar instability (such as hypoglycemia or hyperglycemia). that involve weight gain and obesity, insulin resistance, increased risk of metabolic syndrome and type 2 diabetes and blood sugar instability (such as hypoglycemia or hyperglycemia). Cardiovascular issues like hypertension, arterial stiffness, inflammation and heart disease, raising the risk of heart attacks and stroke. like hypertension, arterial stiffness, inflammation and heart disease, raising the risk of heart attacks and stroke. Immune system impairment that can include increased susceptibility to infections and autoimmune conditions such as rheumatoid arthritis or lupus. that can include increased susceptibility to infections and autoimmune conditions such as rheumatoid arthritis or lupus. Bone health issues and muscle wasting like osteoporosis and muscle loss. like osteoporosis and muscle loss. Sleep disruption and fatigue , including insomnia, chronic fatigue, low motivation and difficulty managing stress. , including insomnia, chronic fatigue, low motivation and difficulty managing stress. Digestive issues such as gastrointestinal inflammation contributing to conditions like irritable bowel syndrome and exacerbating symptoms of inflammatory bowel diseases like Crohn's disease, and gastric ulcers. Should people be concerned about their cortisol levels? The question that's on everyone's mind. After mentioning all of the social media videos circulating saying that people should be worried about their cortisol levels, I asked doctors if there is any legitimacy to these claims or if it's just fearmongering. "I don't think it is fair to say people should be concerned about their cortisol levels -- as you can see, cortisol constantly fluctuates," said Hatipoglu. "The fluctuation occurs so many times that it is sometimes even difficult to know what is very normal or very abnormal." However, if you are concerned about your cortisol, she recommends seeing a doctor to see if a test is needed first instead of having it tested randomly. While Zalzala acknowledges that there is some truth to the concept of "minding your cortisol levels," since there are medical conditions that can cause abnormal cortisol levels, he believes "social media often oversimplifies this, turning cortisol into a scapegoat for various health issues." He specifies that cortisol imbalances are typically caused by deeper issues such as poor sleep, unhealthy habits, unmanaged stress and substance abuse, in which case "cortisol is more of a symptom than the root cause." "Cortisol levels, as a tool, should be used in conjunction with other tools like a CGM sensor or a sleep monitor," concluded Zalzala. How can you naturally reduce cortisol? "I usually recommend important, basic lifestyle management, [including] nutritious meals and good nutrition; movement exercise like yoga, walking and swimming; a good night's sleep, meditation and mindfulness; good vitamin D; and stress management for day-to-day stresses of life," said Hatipoglu. "And last, as much as possible, eliminating smoking and excess alcohol." "Minimize caffeine and sugar intake, especially later in the day," Zalzala recommended. "Both can elevate cortisol and disrupt the normal rhythm, making it harder to wind down at night." Excess sugar and starch can cause a spike in blood sugar followed by a crash. This can occur in the middle of the night, disrupting your sleep. If you maintain a consistent sleep schedule and evening routine without screen time or intense exercise (which can elevate cortisol and disrupt sleep) but still struggle to fall asleep, Zalzala recommends mild sleep aids like melatonin or L-theanine before moving on to stronger options like passionflower or California poppy. "If these aren't effective, consult a doctor about medications like trazodone or doxepin and rule out conditions like sleep apnea," he said. "Always discuss sleep therapies, including OTC supplements, with a doctor." The bottom line While the results of my cortisol blood test did stress me out, I'm glad I tried it because it helped me learn more about cortisol. It also gives me even more of an incentive to increase my stress and anxiety management. While I've always prioritized my health and wellness, since getting the cortisol blood test, I've started exercising more than before, going to bed earlier, thinking up new ways to lower my stress levels and paying closer attention to having a well-balanced diet. As for ordering the test through Quest, I thought the process was smooth, and it's nice to have control over the health tests you can get done (if approved, of course). I also appreciated having the option to speak with an independent physician about my results. However, as both Quest and the doctors I consulted advised, it is best to do any health tests under the supervision of a healthcare provider, who can then help with diagnosis and potential treatment. I'm glad I told my doctor about the test and that it was easy to send her my results. And now, I'm way more informed about what the next steps could be if further testing is needed.
CNET
17-07-2025
- Health
- CNET
Cortisol Imbalance: High Cortisol Symptoms and How to Fix Stress Levels
Cortisol is a hot topic these days, especially as many struggle to manage their stress. You may also have heard of the term "cortisol face" or "moon face," which can be attributed to high cortisol levels. "Cortisol is a hormone produced by the adrenal glands that helps regulate your metabolism, blood sugar, inflammation, blood pressure and sleep-wake cycle," explains Dr. Mark Hyman, co-founder and CMO of Function Health, which offers a cortisol lab test. "It's most known for managing the body's response to stress." But what exactly does a cortisol imbalance look like, and how does it affect the body? To find out, we consulted doctors for symptoms, causes, when to see a doctor for cortisol testing and how to regulate cortisol. What is cortisol? "Cortisol is a hormone produced by your adrenal glands in response to stress," says Dr. Fady Hannah Shmouni, medical director at Eli Health, which sells an instant cortisol test. "When a stressful situation arises, cortisol can help your body prepare to respond by increasing energy, focus or alertness." Shmouni states that in the short term, your body's cortisol response is necessary and helpful. However, chronic stress can cause cortisol to remain elevated, which can negatively affect your organs, including your brain. For instance, elevated cortisol can disrupt sleep, increase inflammation or impair memory. Dr. Andy Franklyn-Miller, a dual board-certified sports and exercise medicine physician, adds that cortisol is like your body's built-in alarm system and is often called the "stress hormone." "Cortisol is part of the glucocorticoid family, and it's released as part of the hypothalamic-pituitary-adrenal (HPA) axis, your body's stress response headquarters," Franklyn-Miller says. In the morning, your cortisol spikes to help you get moving. At night, it dips to help you rest. Where the adrenal glands are located. SEBASTIAN KAULITZKI/SCIENCESymptoms of cortisol imbalance "Cortisol imbalances often go unnoticed until symptoms become disruptive," explains Hyman. "If you feel wired at night, crash mid-afternoon or struggle to get restful sleep, your cortisol could be out of sync." Franklyn-Miller adds that it can be difficult to spot a cortisol imbalance, since it can mimic other conditions. However, telltale signs include persistent fatigue, trouble sleeping or unexplained weight changes. "Home wearables tracking heart-rate variability, such as Whoop, Oura or Apple Watch, can also give indirect clues, as low HRV often correlates with cortisol dysregulation due to stress and a reduction in HRV," he says. Symptoms of high cortisol "Under normal conditions, your cortisol levels peak in the morning to help you wake up and then gradually decrease throughout the day," Shmouni explains. "But if you experience chronic stress, your body may make excess cortisol, and one of the most common ways this shows up is in disruptions to energy patterns." Some common symptoms of high cortisol, according to Shmouni, include nighttime sleep disturbances, energy dips caused by blood sugar spikes and crashes, and feeling constantly tired. Hyman adds that chronically high cortisol can also lead to: Anxiety and irritability Weight gain Sleep disruptions, fatigue High blood pressure Frequent illnesses due to a weakened immune system Over time, Hyman states that elevated cortisol can cause more serious problems, like cardiovascular disease, insulin resistance and cognitive decline. High cortisol is often connected to conditions like Cushing's syndrome or chronic stress, according to Franklyn-Miller, who adds that weight gain can be especially noticeable in the midsection and face (also known as "moon face"). You can experience osteoporosis and muscle loss, since cortisol can break down tissue over time, or skin changes, like thinning skin, bruising easily or stretch marks. Symptoms of low cortisol Hyman states that low cortisol symptoms often include: Fatigue that doesn't improve with rest Low blood pressure Cravings for salt or sugar Dizziness upon standing Mood swings or depression "Low blood pressure, fogginess, weight loss and muscle weakness can occur; any serious symptoms are a sign that you should consult your doctor, as they could mean a more serious adrenal issue (like adrenal insufficiency) is at play," advises Shmouni. According to Franklyn-Miller, low cortisol is often seen in Addison's disease. People with Addison's disease may notice a darkening of the causes a cortisol imbalance? "There's no single cause of cortisol imbalance -- it's a result of multiple stressors piling up," says Hyman. "This can include: chronic psychological stress (work, relationships, trauma), poor sleep habits, blood sugar imbalances, overtraining without recovery, inflammation, infections and nutrient deficiencies, especially B vitamins and magnesium." Franklyn-Miller explains that the HPA axis is designed for short-term stress, so constant, long-term activation or suppression can lead to an imbalance. Stress If you deal with long periods of stress -- caused by factors like a high-pressure job, financial struggles or family responsibilities -- Shmouni says that cortisol can stay elevated in the body instead of fluctuating normally throughout the day. "This can create a cycle whereby elevated cortisol is not appropriately managed, resulting in prolonged cortisol release," he states. "If we don't see that someone's cortisol levels decline throughout the day, with a normal awakening response in the morning, it can be a sign that cortisol is dysregulated." Certain medications or medical conditions If you deal with chronically elevated cortisol levels, Shmouni says that this may be a side effect of medications like steroid inhalers, as one example. On the other hand, Franklyn-Miller reports that long-term use of corticosteroid drugs (e.g., prednisone) can shut down natural cortisol production, causing low cortisol. As Franklyn-Miller mentioned earlier, certain medical conditions, like Cushing's syndrome, can also cause high cortisol. "Cushing's syndrome, caused by tumors or excessive steroid use, floods the body with cortisol," he reports. When it comes to low cortisol, it may be caused by adrenal insufficiency. "Conditions like Addison's disease damage the adrenal glands, slashing cortisol production," Franklyn-Miller explains. Autoimmune disorders can also cause low cortisol, as the body attacks its own adrenal glands and reduces cortisol output. Your lifestyle: Sleep, exercise and nutrition "Poor sleep, overexercising or a high-sugar diet can spike cortisol by stressing the body," says Franklyn-Miller. When planning your workout, consider your stress and sleep. If you had trouble sleeping last night and are dealing with high stress at work, it may not be the best time for an intense workout. If you find that a workout leaves you feeling fatigued or sick, you may be going too hard. In addition to a high-sugar diet, alcohol and caffeine can also affect cortisol levels. For most adults, the FDA recommends 400 milligrams of caffeine or two to three 12-fluid-ounce cups of coffee. However, certain medications or conditions can make someone more sensitive to caffeine, so make sure to consult your doctor if you're unsure. According to the American Heart Association, it's advised to limit alcohol to two drinks per day for men and one drink per day for women. The National Institute on Alcohol Abuse and Alcoholism explains that in the US, a standard drink contains 14 grams or about 0.6 fluid ounces of "pure" ethanol. For sugar, the AHA states that men shouldn't consume more than nine teaspoons of added sugar daily. For women, consumption should be no more than six teaspoons of sugar per day. Ensure you're eating a balanced diet filled with colorful fruits and vegetables, leafy greens, whole grains and protein. And of course, make sure you're drinking enough to regulate cortisol "Regulating cortisol is like tuning an instrument -- it takes mindful adjustments to your lifestyle," says Franklyn-Miller, who recommends the follow strategies: Prioritize sunlight exposure after waking up: "Only 20 minutes can stimulate your circadian release of cortisol, helping with body balance." "Only 20 minutes can stimulate your circadian release of cortisol, helping with body balance." Focus on sleep: "Stick to a consistent sleep schedule." In general, 7 to 9 hours of sleep is recommended, but it depends on your age. "Stick to a consistent sleep schedule." In general, 7 to 9 hours of sleep is recommended, but it depends on your age. Manage stress: "Practices like mindfulness meditation, yoga or diaphragmatic breathing can calm the HPA axis." "Practices like mindfulness meditation, yoga or diaphragmatic breathing can calm the HPA axis." Exercise smart: "Moderate exercise, like walking or yoga, balances cortisol, but overtraining can spike it. Aim for 30 minutes most days." "Moderate exercise, like walking or yoga, balances cortisol, but overtraining can spike it. Aim for 30 minutes most days." Eat balanced meals: "Avoid high-sugar diets, which can elevate cortisol. Focus on whole foods, like vegetables, lean proteins and healthy fats. Omega-3s, found in fish, may lower cortisol." Hyman also recommends prioritizing fiber. "Avoid high-sugar diets, which can elevate cortisol. Focus on whole foods, like vegetables, lean proteins and healthy fats. Omega-3s, found in fish, may lower cortisol." Hyman also recommends prioritizing fiber. Limit caffeine: "Too much coffee can mimic stress, raising cortisol. Try cutting back after noon." When should you see a doctor about cortisol levels? "If you experience significant symptoms that interrupt your ability to participate in daily activities, or if you experience extreme changes in appetite, energy, mood or sleep, bring this up with your medical provider so that they can work with you to manage symptoms and make lifestyle adaptations," advises Shmouni. Franklyn-Miller adds, "Also, if lifestyle changes (better sleep, stress management) don't improve symptoms after a few months, or if you're on long-term steroids, get checked." He explains that the gold standard for checking cortisol is through lab tests for blood, saliva or urine samples. For these, consult your doctor.
