Cortisol Regulation and Your Health: The Real Story

Cortisol is a hormone (chemical) produced by the adrenal glands which is essential for life. Without cortisol the blood pressure would drop and shock followed by death would occur. Cortisol is also thought to play a role in general maintenance of the body’s tissues and functions. Conditions of excessive adrenal cortisol production known as Cushing’s syndrome cause high blood pressure, thinning of the skin, storage of fat in the abdomen, defective immune function, and mood disorders such as depression. People who take steroids such as Prednisone, Dexamethasone, and Hydrocortisone in high doses over long periods of time can also develop the complications of Cushing’s Syndrome.

Several products now on the market claim to help regulate cortisol levels to assist in weight loss. The theory is that stress due to our environment or to dieting itself leads to excessive cortisol production which then leads to fat (and weight) accumulation in the body. These products then claim to reduce these harmful cortisol effects on the body.

As a practicing endocrinologist and author of a textbook chapter on the effects of cortisol on the body, I think I understand this problem fairly well. Over the last 25 years I have treated a number of individuals with excessive cortisol levels due to Cushing’s Syndrome. The treatments must be monitored very carefully to avoid dropping the cortisol levels too low, as well as to prevent serious side-effects of the medications themselves. Since cortisol is essential for life, too much lowering of this hormone can be as bad as too much cortisol.

I was fascinated when I first heard about supposed over-the-counter cortisol regulators. From a medical point of view it would be a great advance if these products could do what they claim. I was skeptical however, because if a product could decrease cortisol levels it could also kill you by dropping levels too low. If these products really worked as well as the advertisements stated wouldn’t there be people dying from overdoses?

Since then I have reviewed the claims of adrenal gland regulation by over-the-counter products. I have reviewed their lists of ingredients. These products seem more appropriate as hair gel then cortisol regulators. I found nothing to indicate they have any beneficial effects on cortisol levels what-so-ever. What is amazing to me is that with nothing to substantiate their claims, no regulatory agency has stepped in to stop their sales. I suggest you ask you own doctor their opinion of these supposed cortisol regulators before spending your hard earned money on them.

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  • Fatima Jones

    Dear Dr. Pepper,
    Hello. I have been doing research on high cortisol and adrenal disorders on the web. I have been experiencing these types of problems but I’m having difficulty finding a doctor who can help. Maybe you can give me some advice. I have high saliva cortisol levels in addition to high levels of metanephrines in urine. I also have a slightly enlarged left adrenal gland. I would like more information on how you treat your patients with high cortisol? Do you differentiate between Cushing’s disease and the first stage of adrenal fatigue, when cortisol is high? Are there certain drugs that are used to lower cortisol and bring it back to normal levels? I’m not sure if I have Cushiings or any kind of tumor, but my urine hormones keep getting higher, and I’m not sure how I should go about treatment. I’m having terrible symptoms because of it. I am also skeptical of natural treatment and the so called cortisol lowering drugs sold over the counter. I am having trouble finding a good doctor in my area, the Washington DC area. Thanks for your help.

    Fatima Jones

  • Dawn

    Hi Fatima

    If this good doctor cannot help you, maybe you could telephone Dr Rind who is in DC, he was very helpful to me, however I am low cortisol adrenal fatitgue.


  • barbara kraemer

    is there anything to the claim that DHEA (over the counter) can help regulate cortisone production?

  • barbara kraemer

    is there anything to the claim that DHEA (over-the-counter) can help regulate cortisol levels?

  • Ian

    Dear Dr. Pepper. I’m in my 40’s now, but had been given Prednisone pills/shots for many years to counter seasonal allergies (approx. from the time I was 12 through my mid 20’s). Is it possible, if I have some symptoms of Cushing’s Syndrome, that such Rx from when I was younger contributed? Do you have anyone in the Southern NJ area you might recommend for metabolism issues/weight gain/lethargy? Thanks.

  • Dr. G. Pepper

    Although I can’t provide medical advice on this forum I can make some general comments I hope will be helpful. I can’t see how someone treated 20 years ago with steroids could stil be having complications of steroid excess. On the other hand, people treated over long periods of time with Prednisone, dexamethasone, Cortef, hydrocortisone etc. can develop potentially dangerous degrees of adrenal insufficiency once they stop taking this medication. Adrenal insufficiency that develops from steriod use can last for almost a year in some cases.

    Taking steroids 20 years ago is not a guarantee that you haven’t developed Cushing’s as a coincidental problem, although that would be extremely rare.

    To locate an endocrinologist I would contact a nearby hospital and ask if they have board certified endocrinologists on staff. Most hospitals maintain a referral service just to respond to this type of question.

    Best of luck and let us know how things go.

  • ElvinDwain

    The results of his experiments, which were conducted in the laboratory of senior researcher David R. Smith, the William Bevan Professor of Electrical and Computer Engineering, appeared as an advanced online publication of the journal Nature Materials.

  • mohammed shaik

    hello my overall dhea and cortisol levels are ok but cortisol is a little high what can i take to stabilise the level of cortisol, i know reducing stress and exercise e.t.c but i mean in terms of products is there anything that can balance cortisol, because i am suffering from low t3 and i know without good adrenal fnx
    thyroid supplemts wont be as effective

    • Gary Pepper M.D.

      Hi Mohammed

      As you know the adrenal gland produces a hormone that is vital to survival known as cortisol, cortisone, or glucocorticoid. Excess of cortisol causes a disorder known as Cushing’s Syndrome and a deficiency is called Addison’s Disease or adrenal insufficiency. Both of these disorders can cause illnesses serious enough to result in death. Fortunately cortisol excess or insufficiency is very rare and when diagnosed in time can be controlled. Several years ago there was an unethical company marketing a product called Cortislim which they claimed reduced cortisol levels to induce healthy weight loss. This product was removed from the market. As far as I’m concerned there is no legitimate product that will safely reduce cortisol levels, nor should there be. The body regulates production of cortisol very carefully because it is such a potent hormone with potential to help and harm in major ways. I believe you would be safer letting your body decide what your cortisol level should be rather than trying to do it yourself. You can check out another of my blogs on the subject of adrenal function. My book includes a section where I review the controversy about adrenal fatigue as well.

  • Melissa

    At what 8am cortisol number do you begin prescribing HC?
    Why is it at 8am? What if your cortisol rhythm is different because you work a later shift and don’t get up until 10am?

    • Gary Pepper M.D.

      Hi Melissa

      The adrenal gland is controlled by the pituitary gland which resides at the base of the brain just behind the eyes. The pituitary gland makes a hormone called ACTH which tells the adrenal gland to make the hormone cortisol, which is vital for life. Early in life the pituitary gland develops a cycle of activity known as the circadian rhythm (circadian refers to a daily process). During this cycle the pituitary is most active just before dawn and is mostly quiet after 11 pm. This cycle is established based on social stimuli and the effect of light and darkness. In order to get the body ready for the stress of a new day the pituitary gland wakes up just before the rest of the brain and begins pumping out ACTH telling the adrenal gland to wake up. At that time the cortisol level reaches a peak. Other hormones are also wakening up before you do to prepare the body in a similar way. Growth hormone is one of these. Consider the pituitary like the donut man who wakes up before everyone else to get things ready for the new day.
      If the morning cortisol is low it can mean that the adrenal gland or the pituitary gland is defective. You ask how low is too low? Most endocrinologists consider a value of less than 5 ug/dl to be suspicious. This is not the end of the story but will make the doctor suspicious enough to want to do additional testing. It is a good idea to get and ACTH level at the same time as the cortisol level to help decide if it is an adrenal or pituitary problem.

      Hope that helps.

      Dr. G. Pepper

      • Melissa

        I am trying to understand when I should test my blood cortisol if I wake up around 10:30am. Do I drag myself out of bed after 5 hrs of sleep for the 8am test or will I get a more accurate result if I go as soon as I wake up and is the cortisol at its highest when you wake or is it at 8am no matter what your sleep schedule is? Thanks again Dr. Pepper.

  • Jeani

    I have been having major fatigue for a year from hypothyroid due to Hashimotos, i have been taking medication for this for about at least 6 months and just lately I tried acupuncture for this condition and dont you know two days after the acupuncture, I could feel my breasts grow and it was as if it stimulated my hormone production, since then my fatigue has vanished and my medication actually works very well. I go back every 3 months for a little more as maintenance. Do you know of any side effects of this kind of treatment. Maybe too much hormone production as my breasts have become very lumpy. Thanks for your time, its great to find your website!

    • Melissa


      It’s great to hear that just one treatment has help you so much. I am seeing an acupuncturist for adrenal fatigue and had two treatments so far and have heard that acupuncture has helped many with hormone issues. Maybe you’re acupuncturist is better. Is he in the Palm Beach area? If so, can I get his name?