Is stress affecting your blood sugar? Here’s how cortisol plays a key role
Cortisol is your friend - until it overstays its welcome
Feeling overwhelmed by stress? Maybe you're tossing and turning at night, or perhaps you're sleeping too much. Your irritability is through the roof - every little thing sets you off. You’re bloated, frozen in stressful situations, and staring at your screen feels like trying to see through fog. Your shoulders are tense, and nothing seems to ease the discomfort.
Sounds familiar? If you've turned to online searches to explain these symptoms, you might likely have stumbled across cortisol - the infamous stress hormone. But here's a twist: Cortisol isn’t the villain it’s often portrayed to be. In fact, it’s one of your body's most vital allies, connecting your mind and body in ways that keep you balanced. With receptors in nearly every organ, cortisol helps regulate blood pressure, control inflammation, and keep you functioning smoothly. The real issue arises when cortisol stays elevated for too long.
So what exactly is cortisol, and why does it have such a profound impact on your body and mind? To understand why this hormone is both a friend and a foe, it’s important to uncover how it works and how it shapes everything from your mood to your physical health.
What is cortisol?
Cortisol is your friend - until it overstays its welcome.
As Dubai-based physicians Susan Thomas and Manjiri Singh explain, produced by the adrenal glands above your kidneys, this steroid hormone belongs to the glucocorticoid family, which plays a crucial role in regulating metabolism and immune responses. While cortisol is best known for its role in managing the body’s stress response, its impact stretches far beyond that. It helps regulate metabolism, control inflammation, and oversees numerous vital functions, making it an essential hormone in keeping your body balanced.
However, like any good ally, it’s only truly helpful when it knows when to step back.
How is it produced?
Cortisol is released through the complex hypothalamic-pituitary-adrenal (HPA) axis, a feedback system connecting your brain to your adrenal glands. When your brain senses stress - whether physical, emotional, or environmental - it triggers the hypothalamus to start the process, explains Singh. “This sends signals to the pituitary gland, which then prompts the adrenal glands to release cortisol into the bloodstream. Once released, cortisol moves throughout your body, helping organs respond to stress and meet immediate needs. Cortisol follows a natural rhythm, peaking in the morning and declining in the evening, supporting your Circadian [day-night] rhythm.”
‘A true multi-tasker’
Cortisol is a true multi-tasker, as Thomas puts it. It helps convert food into energy and manages how the body uses it, playing a crucial role when extra energy is needed, especially during stress or fasting. "Additionally, it signals fat cells to release fatty acids into the bloodstream for energy, which is vital during exercise or physical stress when the body requires immediate fuel," she explains. But it doesn’t stop there - cortisol also breaks down muscle proteins into amino acids, which are then used for energy or tissue repair.
Furthermore, cortisol regulates the immune system by suppressing the release of pro-inflammatory molecules like cytokines, ensuring that inflammation stays in check and preventing excessive immune responses. This balancing act is why synthetic cortisol, such as corticosteroids, is often used to treat autoimmune and inflammatory conditions. Moreover, cortisol enhances focus during stressful situations, preparing both the body and brain for the ‘fight-or-flight’ response. It also supports memory and learning, especially in short-term situations.
As specialists explain, while cortisol's role in stress and metabolism is well-known, its impact on blood sugar regulation is just as critical. By raising blood sugar levels during stress, cortisol ensures that the body has enough fuel to meet its immediate needs. However, this vital function can turn problematic when cortisol stays elevated over prolonged periods.
Cortisol and blood sugar
While we often think of cortisol in the context of stress and metabolism, its influence on blood sugar regulation is just as critical. Here’s how: When the body experiences stress - whether physical, emotional, or environmental - cortisol's primary job is to increase blood sugar levels.
As Nupur Shastri, a Dubai-based physician, explains, cortisol does this by triggering gluconeogenesis: A process where the liver releases stored glucose (glycogen) into the bloodstream. This gives your muscles and brain an immediate source of energy, ensuring your body performs at its peak under pressure.
In a delicate balancing act, cortisol works alongside insulin, another key hormone that regulates blood sugar. While cortisol raises blood sugar to fuel your body, insulin ensures it doesn’t go too high by helping cells absorb glucose for energy or storage. The harmony between these two hormones is essential for maintaining stable blood sugar levels.
When cortisol levels remain high
The consequences compound when cortisol levels stay high. Prolonged high cortisol can disrupt blood sugar regulation, causing a cascade of health issues. Chronic stress, illness, or sleep deprivation can keep cortisol levels soaring, leading to insulin resistance. "When cortisol levels stay high for extended periods, the body’s cells can become less responsive to insulin, which may result in insulin resistance - a precursor to type 2 diabetes," explains Thomas.
But that's not all. Persistent cortisol elevation also triggers fat storage, especially around the abdomen. "Abdominal fat is closely linked to a higher risk of metabolic disorders and cardiovascular diseases," says Shastri. Additionally, this hormonal imbalance causes blood sugar fluctuations, leading to energy surges followed by crashes - resulting in fatigue, irritability, and a cycle that’s hard to break.
The ripple effects don’t stop there:
Arvind Gaddameedi, Specialist Endocrinology, Aster Clinic, Al Muteena, Deira explains:
• Increased risk of metabolic disorders: As cortisol disrupts the balance between blood sugar regulation and insulin function, it increases the risk of developing conditions like type 2 diabetes and metabolic syndrome.
• Cardiovascular risks: Chronic high cortisol levels are linked to increased abdominal fat, which contributes to a higher risk of heart disease, high blood pressure, and stroke.
• Cognitive impairment: Prolonged exposure to elevated cortisol can also impact brain function, particularly memory and learning. Over time, it may affect the hippocampus, the brain region responsible for long-term memory, leading to difficulties with focus and recall.
• Elevated cortisol breaks down protein, leading to muscle weakness and reduced bone density, increasing the risk of osteoporosis over time.
• Chronic stress affects gut health by altering the balance of gut bacteria and slowing digestion, leading to issues like bloating, indigestion, and irritable bowel syndrome (IBS).
• High cortisol levels can keep the body in a constant state of ‘fight or flight,’ causing persistently elevated blood pressure. Over time, this can damage blood vessels, leading to cardiovascular complications.
• Cortisol prompts the kidneys to retain sodium, which raises blood volume and, consequently, blood pressure. Chronically elevated blood pressure, or hypertension, is a leading risk factor for stroke and heart attack.
Research speaks volumes too: A 2018 review published in the US-based academic journal Diabetes Metabolism Research and Reviews highlighted the role of cortisol and enzymes in modulating insulin resistance. It noted that chronic stress and elevated cortisol are linked to visceral fat accumulation and impaired insulin sensitivity, particularly in those with metabolic risk factors.
Furthermore, as Singh cites, studies from the scientific journal Endocrinology and Metabolism have shown how elevated cortisol can influence glucose metabolism directly by increasing gluconeogenesis, which is the production of glucose from non-carbohydrate sources, in the liver. This could explain why people under chronic stress or those with high cortisol levels tend to experience blood sugar fluctuations, leading to a higher risk of developing type 2 diabetes.
Cortisol and mood
Imagine you’re at work, up against a tight deadline. Your heart rate speeds up, your muscles tense, and a burst of energy floods your system. That’s cortisol helping you rise to the challenge. You push through, complete the task, and for a moment, everything seems fine - until the next wave of stress hits. Suddenly, the energy boost doesn't seem to work. Instead, you feel jittery, overwhelmed, and short-tempered.
The more this cycle repeats, the more cortisol floods your system, leaving you emotionally drained and mentally exhausted.
Cortisol has a significant impact on mood and emotional regulation. In short bursts, it helps individuals respond to stress effectively. However, chronic elevation of cortisol, often due to prolonged stress, can negatively impact mood. It has been associated with anxiety, depression, and irritability. High cortisol levels can disrupt the balance of neurotransmitters like serotonin and dopamine, which are critical for maintaining emotional well-being.
Here’s the science behind it. Shastri explains, “When the cortisol levels are constantly at a peak, it disrupts the delicate balance of other hormones that regulate mood, like serotonin and dopamine. These ‘feel-good’ neurotransmitters play a vital role in stabilising your emotions, and when cortisol overrides them, you may find yourself feeling more anxious, stressed, or low than usual.”
While cortisol isn’t inherently harmful, balance is key. "A surge in cortisol during stress is natural, but prolonged high levels can trigger a ‘downward spiral’ of emotional instability," adds Thomas. "You might feel more irritable, short-tempered, or emotionally drained."
This imbalance fractures your sleep, leading to mood swings and more stress. “It’s a vicious cycle - cortisol spikes, causing anxiety and emotional exhaustion, which disrupts sleep, triggering more cortisol production.” Over time, sustained high cortisol levels may increase the risk of more serious mental health conditions like depression and anxiety. "Persistent cortisol elevation impacts the hippocampus, which regulates mood, memory, and emotional responses," Singh explains. When cortisol levels stay high, the hippocampus becomes less responsive, leading to difficulty processing emotions or coping with stress.
How to keep your cortisol levels under control
Keeping your cortisol levels in check is key to feeling your best. When stress takes over and cortisol runs high, it can lead to a range of health issues. But don't worry - by implementing a few simple strategies, you can regain control and keep this powerful hormone in balance for better physical and mental well-being.
For starters, as Thomas says, manage your stress. Practices like deep breathing and meditation activate the parasympathetic nervous system, lowering cortisol. Get your sleep patterns fixed: Aim for 7 to 9 hours of quality sleep. Avoid caffeine and screens before sleeping too. “Activities like walking and swimming can help reduce cortisol,” she adds.
The specialists also advise, maintaining a healthy diet:
Balanced meals: Include whole foods like lean proteins, healthy fats, and vegetables to maintain steady energy, which will avoid the spike in cortisol.
Stay hydrated: Dehydration can raise cortisol levels, so drink plenty of water.
Diet tips for managing cortisol:
Whole foods: Focus on complex carbs (oats, quinoa), healthy fats (Omega-3s from fish, flaxseeds), and lean proteins to stabilise blood sugar.
Limit sugar: Avoid processed foods and refined sugars that cause blood sugar fluctuations.
Magnesium and vitamin C: Foods like leafy greens, nuts, citrus, and berries help reduce stress and lower cortisol.
By integrating these practices into your lifestyle, you can maintain balanced cortisol levels, improve your health, and manage stress more effectively.