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  • Writer's pictureImogen Tingay

Cortisol; friend or foe?

You may have heard of cortisol, its a hormone that occurs naturally in the body, but it's also the synthetic ingredient in many topical steroid creams. As someone who's used hydrocortisone creams and subsequently has experienced topical steroid withdrawal, the word cortisol brings up some weird feelings. I associate it with going through that awful condition and its something I talk a lot about in my TSW masterclass. But Cortisol is a substance that occurs naturally in the body and has some important jobs! Let's learn more...

Cortisol is a hormone produced by the adrenal glands, playing a crucial role in various physiological functions within the human body. This blog post will delve into what cortisol is, how its synthesized, its diverse functions and the potential repercussions when its levels are not properly regulated.


A stress Woman
Cortisol is known as the stress hormone

What is Cortisol

Cortisol is a steroid hormone, often referred to as the "stress hormone", as its secretions increase in response to stress. It belongs to a class of hormones called glucocorticoids and is essential for maintaining homeostasis, regulating metabolism, and responding to various environmental and internal stimuli.

How is Cortisol Produced

The adrenal glands, located on top of each kidney, are responsible for cortisol production. This process is intricately regulated by the hypothalamus-pituitary-adrenal axis (HPA). When the body perceives stress. the hypothalamus releases corticotropic hormones (ACTH). ACTH then stimulates the adrenal glands to produce and release cortisol into the bloodstream

Function of Cortisol

  • Metabolism Regulation: Cortisol plays a pivotal role in glucose metabolism, increase blood sugar levels by promoting gluconeogenesis (the synthesis of glucose from non-carbohydrate sources) and reducing glucose utilization in peripheral tissues.

  • Immune System Modulation: Cortisol has immunosuppressive properties, regulating the immune response to prevent overactivity and inflammation. This is crucial for preventing autoimmune reactions.

  • Anti-inflammatory Effects: Cortisol acts as a potent anti-inflammatory agent, suppressing the immune system's inflammatory response to various stimuli.

  • Stress Response: In times of stress, cortisol mobilizes energy reserves, redirects resources and heightens alertness to cope with the perceived threat


Dysregulation of Cortisol Levels

While cortisol is vital for normal physiological functioning. problems arise when its levels are not adequately regulated. Conditions such as Cushing's Syndrome, characterized by excessive cortisol production, can lead to symptoms like weight gain, high blood pressure and muscle weakness.

Conversely, insufficient cortisol production, as seen in topical steroid withdrawal, can result in fatigue, weight loss and electrolyte imbalances. Chronic stress, a common modern-day challenge, can also lead to dysregulated cortisol levels, contributing to conditions like anxiety, depression and sleep disturbances.


Cortisol is a multi-faceted player in the maintaining homeostasis and responding to challenges. Its production and regulation are tightly controlled by the HPA axis. While cortisol is essential for various physiological functions, imbalances can lead to a range of health issues. Understanding the intricate role of cortisol in the body can pave the way for better management of stress and overall well-being.

If you'd like to know more about the effect topical steroids can have on your cortisol levels, and what to do about it, read my blog post here

I'll also be posting more exerts from my Topical Steroid Withdrawal Masterclass, so keep an eye out for those on my social media!

Happy Wednesday Everyone!


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