Lexicon
Cortisol
Definition
How it works
Cortisol exhibits a 24-hour circadian rhythm, with the lowest levels around the onset of sleep and a rise toward the end of sleep reaching its highest level around waking. [1] Psychological stressors reliably increase cortisol, with the largest responses elicited by tasks that are uncontrollable or involve social-evaluative threat. [4] The changes in cortisol levels from morning to evening, known as the diurnal cortisol slope, become flatter with chronic stress and flatter slopes are associated with poorer mental and physical health. [5] Stress management interventions can positively influence cortisol levels, with mindfulness, meditation, and relaxation techniques being most effective at lowering this stress hormone [6]. Meditation practice, particularly focused-attention forms, reduces cortisol alongside other physiological markers of stress [7].
Connected concepts
How it's measured
Initial screening for Cushing syndrome uses one test with high diagnostic accuracy, such as urinary free cortisol, late-night salivary cortisol, or a 1 mg overnight dexamethasone suppression test. [8] Salivary cortisol measurements have the advantage that only free hormone is detected and samples can be collected during normal daily routines, with less stress-induced cortisol release than venepuncture. [9] Adrenal insufficiency is diagnosed by early-morning measurement of serum cortisol and corticotropin, and the short corticotropin (cosyntropin, 250 µg) stimulation test is the reference diagnostic tool. [10]
What levels mean
Cushing syndrome is a prolonged increase in plasma cortisol not due to a physiological cause, and the estimated incidence of endogenous overproduction ranges from 2 to 8 per million people annually. [11] Serum cortisol above 50 nmol/L (1.8 µg/dL) after a 1 mg overnight dexamethasone suppression test defines mild autonomous cortisol secretion, a condition carrying increased risk of morbidity and mortality. [12]
| Cortisol finding |
|---|
Community knowledge
## Testing & Measurement Challenges
The longevitydocs community's collective insight and shared knowledge on this concept — across text, video, audio and images from members and faculty, reserved for members.
Learn about our Membership planReferences
- 1.Mohd Azmi NAS, Juliana N, Azmani S, Mohd Effendy N, Abu IF, Mohd Fahmi Teng NI, Das S. Cortisol on Circadian Rhythm and Its Effect on Cardiovascular System. Int J Environ Res Public Health · 2021
- 2.O'Connor DB, Gartland N, O'Connor RC. Stress, cortisol and suicide risk. Int Rev Neurobiol · 2020
- 3.De Nys L, Anderson K, Ofosu EF, Ryde GC, Connelly J, Whittaker AC. The effects of physical activity on cortisol and sleep: A systematic review and meta-analysis. Psychoneuroendocrinology · 2022
- 4.Dickerson SS, Kemeny ME. Acute stressors and cortisol responses: a theoretical integration and synthesis of laboratory research. Psychol Bull · 2004
- 5.Adam EK, Quinn ME, Tavernier R, McQuillan MT, Dahlke KA, Gilbert KE. Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis. Psychoneuroendocrinology · 2017
- 6.
Community discussion
Clinical pearls and discussion posted by community members on this concept — signed contributions, reserved for members.
Learn about our Membership plan