spinner Costamed

Cortisol: What This Hormone Reveals About Your Health

13/01/2026 Laboratories

There are days when fatigue cannot be explained by lack of sleep alone. You wake up exhausted, have trouble concentrating, your body feels sluggish, and rest does not feel restorative. At other times, the opposite happens—you feel wired, unable to relax or fall asleep, even when you are physically tired.

In many of these cases, one hormone plays a central role: cortisol.

Cortisol is not a “bad hormone.” It is essential for life. It regulates how we use energy, how we respond to stress, how we sleep, and how the body adapts to daily demands. Problems arise when cortisol levels remain altered for prolonged periods.

In this article, we explain what cortisol is, why measuring it is important, which factors can affect it, and what information it can provide about your health.

 

What Is Cortisol and Why Is It So Important?

Cortisol is a hormone produced by the adrenal glands. Its release follows a natural rhythm: levels are typically higher in the morning to help you wake up and become alert, and gradually decrease throughout the day to allow for nighttime rest.

Its main functions include:

  • Regulating energy levels
  • Participating in the metabolism of fats, proteins, and sugars
  • Modulating the inflammatory response
  • Helping the body respond to physical and emotional stress
  • Influencing the sleep–wake cycle

When this balance is disrupted, the effects can be felt throughout the entire body.

 

Cortisol and Stress: A Necessary but Delicate Relationship

Cortisol is released in response to stress. This is normal and beneficial—it allows us to react, focus, and adapt. The issue is not short-term stress, but chronic stress.

When the body remains in “alert mode” for weeks or months, cortisol levels may stay elevated or, paradoxically, become depleted and remain too low. Both scenarios can lead to symptoms.

 

Signs That May Indicate Altered Cortisol Levels

Changes in cortisol are not always obvious, but they often present with symptoms such as:

  • Persistent fatigue
  • Difficulty waking up in the morning
  • Trouble falling or staying asleep
  • Unexplained weight changes
  • Anxiety or feeling constantly “on edge”
  • Difficulty concentrating
  • Irritability
  • Low tolerance to stress
  • A weakened immune system

These symptoms are not exclusive to cortisol imbalance, but they can be an important clue.

 

Why Measure Cortisol in the Laboratory?

Measuring cortisol helps objectify what the body is expressing. It is a tool that allows physicians and specialists to better understand how the body is responding to stress, rest, and daily demands.

Cortisol testing may provide valuable information when:

  • Symptoms are persistent
  • Fatigue does not improve with rest
  • Sleep disturbances are present
  • Hormonal disorders are suspected
  • Chronic stress or prolonged overload is being evaluated

 

How Cortisol Can Be Measured

In the laboratory, cortisol can be measured using different tests, each with specific clinical indications.

  • Blood testing is the most commonly used method in daily medical practice. It is accessible, reliable, and provides clear information about cortisol levels at a specific time of day, particularly for initial evaluations.
  • 24-hour urine testing offers a broader view of total cortisol production over an entire day. However, it requires careful urine collection over 24 hours, which may be less practical for some patients.
  • Saliva testing can be useful for more specific assessments of cortisol’s circadian rhythm, but it requires special collection devices and more complex processing.

In practice, many laboratories—like ours—prioritize blood testing as the first diagnostic tool due to its simplicity, availability, and clinical value, reserving other methods for selected cases where more detailed information is required. This approach allows us to provide meaningful insights into a patient’s condition without unnecessarily complicating the process or delaying medical decisions.

 

Factors That Can Alter Cortisol Levels

Cortisol is influenced by multiple factors, including:

 

Prolonged emotional stress

Ongoing worries, work pressure, personal conflicts, or sustained emotional strain.

 

Lack of sleep or irregular rest

Sleeping too little or poorly disrupts cortisol’s natural rhythm.

 

Excessive exercise without recovery

Physical activity is healthy, but insufficient recovery can raise cortisol levels.

 

Illness or inflammatory processes

The body releases cortisol as part of its defense response.

 

Medications
Certain drugs can affect cortisol levels.

 

Disordered daily routines

Irregular schedules, inconsistent meals, and lack of breaks.

 

 

What a Cortisol Test Can Reveal About Your Health

A laboratory result should never be interpreted in isolation, but it can help to:

  • Identify hormonal imbalances
  • Understand causes of chronic fatigue
  • Evaluate the body’s stress response
  • Support clinical diagnoses
  • Guide medical decisions and lifestyle adjustments

Its true value lies in integrating the result with symptoms and medical history.

 

When Is Cortisol Testing Recommended?

Cortisol testing is usually considered when:

  • There is persistent fatigue without a clear cause
  • Sleep disturbances are prolonged
  • Symptoms of anxiety or chronic stress are present
  • Endocrine disorders are suspected
  • A physician seeks a better understanding of the body’s response to stress

It is not a routine test for everyone, but it is a valuable tool when there are clear indications.

 

Listening to Your Body Is Part of Preventive Care

Cortisol is a key hormone for understanding how your body responds to stress, rest, and daily demands. When its levels are altered, the body often sends signals that are worth addressing before discomfort becomes persistent.

If you experience symptoms such as constant fatigue, sleep disturbances, or a prolonged sense of overload, discussing them with your physician and considering cortisol testing may be a first step toward understanding what is happening and taking timely action.

Caring for your well-being begins with listening to your body and relying on trusted tools that support clarity and responsible medical care.

Like it? Share it!