High cortisol can cause weight gain, high blood pressure, and mood changes. It can come from stress, medicines, or Cushing’s syndrome, so see a doctor.
What it is
Cortisol is the stress hormone from the adrenal glands.
Causes of high cortisol
- Chronic stress.
- Steroid medicines.
- Cushing’s syndrome (pituitary or adrenal tumors).
Symptoms
Weight gain around the face and belly, purple stretch marks, high blood pressure, high blood sugar, muscle weakness, mood changes and thin skin.
Tests
Late night salivary cortisol, 24 hour urine cortisol and dexamethasone test.

See a doctor
For testing.
What cortisol is
Cortisol is a hormone made by the adrenal glands that helps regulate stress response, blood sugar, blood pressure and inflammation. Levels peak in the morning and fall at night. Chronically high cortisol can result from Cushing syndrome, which occurs in about 40 to 70 people per million per year.
- The most common cause of Cushing syndrome is long-term use of corticosteroid medicines such as prednisone.
- Other causes include a pituitary tumor (Cushing disease), an adrenal tumor or ectopic ACTH production by tumors.
- Chronic stress, depression, alcohol use disorder and obesity can mildly raise cortisol.
Symptoms and tests
Signs include weight gain in the face (moon face), upper back and abdomen, purple stretch marks, thin skin, easy bruising, muscle weakness, high blood pressure, high blood sugar and mood changes. Tests include a 24-hour urinary free cortisol, late-night salivary cortisol and the dexamethasone suppression test. Treatment depends on the cause, such as surgery or medication adjustment. See an endocrinologist for suspected Cushing syndrome.
What cortisol is
Cortisol is a steroid hormone from the adrenal glands that regulates stress, blood sugar and blood pressure. It peaks in the morning. Chronic high cortisol can occur with Cushing’s syndrome, often from steroid medicines.
Symptoms and tests
Symptoms include weight gain in the trunk, round face, purple stretch marks, high blood pressure and bruising. Tests include late night salivary cortisol, 24 hour urine and dexamethasone suppression.
What cortisol does
Cortisol is a steroid hormone from the adrenal glands that helps regulate stress response, blood sugar, blood pressure and inflammation. Morning blood levels are typically around 6 to 23 micrograms per deciliter, and levels fall at night. Short rises under stress are normal.
High levels and Cushing syndrome
Chronically high cortisol can cause weight gain in the face and trunk, purple stretch marks, high blood pressure, high blood sugar, thin skin, muscle weakness and mood changes. The causes include long term steroid medicine use, a pituitary tumor (Cushing disease) or an adrenal tumor. Diagnosis uses late night salivary cortisol, 24 hour urine cortisol and dexamethasone suppression tests. Treatment depends on the cause and includes medication or surgery. Stress alone rarely causes true Cushing syndrome.
Based on data from the Endocrine Society and the National Institute of Diabetes and Digestive and Kidney Diseases






