Anyone who’s stumbled onto the “wellness” side of TikTok recently will no doubt have seen some sort of video about cortisol, with a whole bunch of people claiming that an imbalance of the oft-dubbed “stress hormone” is responsible for all sorts of health problems. Should we really be worried about it, or is this yet another case of popular pseudoscience?

What is cortisol?

Cortisol is a hormone produced by the adrenal glands, the two triangular blobs sitting on top of the kidneys. It’s quite the all-rounder in terms of the functions it has in the body, which range from reducing inflammation to increasing the breakdown of glucose.

It’s perhaps best known, however, as the “stress hormone”. That’s because it’s released as part of the body’s stress response, helping it to stay on high alert by ramping up the functions we do need and slowing down the things we don’t.

The rest of the time, when we’re not stressed, the levels of cortisol in the body change throughout the day, usually peaking in the morning and declining to a low at night.

Medical misinformation

We weren’t overselling it when we said just how popular a topic cortisol is on the wellness side of the internet at the moment; over the last three months, there have been 30,000 TikToks posted with the tag “#cortisol”, gaining a whopping 529 million views. Google searches for “cortisol levels” have also ramped up since the beginning of this year.

Clearly, there’s an appetite for it – but unfortunately for something racking up so many views, a lot of what’s being broadcast about the hormone (and how to combat its apparent effects) is plain ol’ misinformation.

According to some of the most popular of these videos, high cortisol levels can be responsible for bloating and facial puffiness (often dubbed “cortisol belly” and “cortisol face”), being tired in the afternoons, bruising easily, not being able to think clearly, and the list goes on and on.

If those symptoms sound like they could be the result of a plethora of other things – anemia, not getting enough sleep/food/water, menstruation – then you’re not mistaken. While many have pointed the finger at out-of-whack cortisol, for the vast majority of people, the hormone is unlikely to be the responsible party for experiencing these symptoms on a noticeable, consistent basis.

For most people, an increase in cortisol “wouldn’t be something so dramatic where they would have to go seek an endocrinologist to go get treated,” Dr Charlotte Hodges, chair of the surgery department at White Rock Medical Center in Dallas, told CNN Health.

Somewhat more bluntly, Professor Stafford Lightman, a professor of medicine at the University of Bristol said to Dazed: “[T]here is no such thing as ‘raised cortisol’ outside of clinical conditions.”

One such clinical condition is Cushing’s syndrome, which is caused by having too much cortisol in the body over a long period of time. A tumor in the pituitary or adrenal glands or long-term steroid medication use can cause this. One of its symptoms can be a puffy face, which is likely where the “cortisol face” idea stems from – but there are plenty of others, such as a fatty hump between the shoulders, muscle weakness, thin skin, irregular periods, and mood changes.

While some of these are name-dropped on TikTok, it’s unlikely that everyone who identifies with them has Cushing’s syndrome – it’s rare, estimated to affect only around 40 to 70 people out of every million each year.

It’s also important to note that plenty of the ways in which wellness videos recommend tackling high cortisol won’t actually make a difference if you have a condition like Cushing’s syndrome. 

Going out on a walk, getting more sleep, and swapping some of your coffees for water might help you feel less stressed, but if you actually have clinically high levels of cortisol, more targeted treatments (which one depends on the cause) like surgery or changing medications are required.

For people without such conditions, no fancy supplements are required – it’s normal for cortisol to fluctuate throughout the day, and the body is capable of keeping that in check, even if the day is a bit of a stressful one.

As well as medical conditions like Cushing’s, prescription corticosteroid medications can be behind some of the symptoms associated with increased cortisol in the body. These drugs – which act as anti-inflammatories and can be used for a range of different conditions – contain synthetic versions of cortisol, so if you have to take them for a long period of time you can start to see some of the physical effects of high cortisol levels, like a rounder face and bruising of the skin. 

In these cases, the potential risks of the treatment will have been weighed against the risks of not taking it, so before stopping or changing any prescribed medication you should always speak to your doctor.

What about low cortisol?

Another way in which some of the videos about high cortisol provide misinformation is that some of the symptoms they list can actually be signs of lower-than-normal cortisol, such as fatigue, low mood, and muscle weakness – if their tips for reducing cortisol did work, this just goes to show that taking advice from TikTok isn’t a safe thing to do.

Clinically low levels of cortisol are often a sign of a condition called Addison’s disease, or adrenal insufficiency, where something has gone wrong with the adrenal glands and as a result, they don’t produce enough cortisol or another hormone called aldosterone.

Again, it’s unlikely to be something that will apply to the vast majority of people who come across popular videos about cortisol; Addison’s disease is estimated to affect around 100 to 140 of every million people.

The bottom line

If you’re unsure about whether or not cortisol could be behind any health problems that you’re experiencing, it’s best not to try and tackle it yourself with the help of TikTok – it’s just not reliable. The only way to know for sure is to speak to a doctor, who can carry out tests to confirm your cortisol levels.

All “explainer” articles are confirmed by fact checkers to be correct at time of publishing. Text, images, and links may be edited, removed, or added to at a later date to keep information current.

The content of this article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.