Cortisol, known as the stress hormone, has become a popular topic on the internet, with wellness influencers warning about symptoms of chronically high cortisol—waking at 3 a.m., swollen “cortisol face,” and belly fat accumulation—and offering diet and exercise routines they claim will help control it. However, doctors say it is very unlikely most people need supplements or influencer advice to manage their cortisol levels.
Cortisol is a hormone essential for survival, produced by the adrenal glands located above the kidneys. It influences inflammation, the immune system, metabolism, blood pressure, and many other bodily functions. Cortisol is highly attuned to the body and environment, fluctuating throughout the day, rising in the morning when you wake and falling at night before sleep. It also rises when you are sick or under stress. According to Dr. Roberto Salvatori, a Johns Hopkins University endocrinologist, “Our cortisol level is regulated by the minute. It is very sensitive.” It is rare that people have a disorder where cortisol alone is the cause. Adrenal insufficiency (including Addison’s disease) involves chronically low cortisol, while Cushing’s syndrome involves chronically high cortisol, typically caused by benign tumors in the adrenal or pituitary glands.
Testing and Treatment Caution
Symptoms of high or low cortisol are wide-ranging and overlap with signs of other health issues. Diagnoses require multiple tests and understanding of a patient’s overall health. A one-off cortisol blood test won’t provide useful information for most people and could lead to unnecessary stress and medical follow-ups. Women on birth control will have falsely high cortisol blood results because of how the medicine works in the body. Endocrinologists say there are no proven over-the-counter treatments for high or low cortisol despite claims that supplements like ashwagandha and magnesium are helpful. Unregulated supplements are “not innocuous,” and even in patients with Cushing’s syndrome, medications must be carefully dosed to avoid overcorrection.
The doctors recommended that healthy people manage stress through basics: eating well, getting enough sleep, moving the body, or going to therapy. Anyone concerned should talk to a doctor rather than pursuing internet-driven cortisol control trends.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.eptrail.com/2026/02/04/be-well-cortisol-explainer/