Is your cortisol optimal?

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Is your cortisol optimal?

Dr. Doni Wilson

Our adrenal glands are two small organs that sit on top of our kidneys.  When our bodies perceive a stress, the adrenal glands are cued to set off a stress response, a complicated chemical cascade in which many stress hormones are triggered.  The first step in the process, though, is always cortisol, which is part of what makes it so important.

Cortisol should turn off the stress response, however when the stress doesn’t end, cortisol can’t turn it off.

Besides controlling the stress response, cortisol also has another job: to help us follow our circadian rhythms.  Optimal cortisol levels are highest in the morning when you wake up.  In fact, the rising cortisol levels wake you up, which is why ideally,  you should be able to wake up without an alarm clock, feeling energized and alert as soon as you open your eyes.  (If this sounds impossibly far from your own life, don’t worry!  I can help you with optimizing sleep.)

Throughout the day, optimal cortisol levels gradually fall, following a nice, smooth downward curve, until finally, by evening, they are low enough to allow you to fall asleep.  They are lowest while you are asleep, and in fact, your body uses that sleep time to make more cortisol.  For most people, this cortisol-making process happens primarily during the seventh and eighth hours of sleep, which is why getting a full night’s sleep is so crucial to overall good health.

That’s what happens when cortisol levels are optimal.  Whenever we have any symptoms of ill-health or any ongoing distress, however, our cortisol levels are suboptimal, in one of the following three ways:

  1. Too much cortisol causes us to feel anxious and agitated, unable to settle down and often unable to sleep.
  2. Too little cortisol causes us to feel exhausted and unmotivated.
  3. Cortisol at the wrong times of day—anything other than that nice, smooth downward curve—disrupts our energy levels, our mood, and our sleep patterns.

If your adrenal glands aren’t working properly, they can produce one, two, or all three of those suboptimal conditions.  You might have cortisol levels that are too high all day long, too high in the morning when you wake up, or too high at night, when you should be settling down to sleep.

Alternately, you might have cortisol levels that are too low all day long, too low in the morning when you are supposed to be energized, or too low at the wrong times.  You can also have cortisol levels that are too high at some points of the day and too low at others.  Finally, you might have a cortisol pattern that does not fit that nice, smooth downward curve—that rises at night, for example, so that you are unable to sleep, or that droops in the morning, so that you feel groggy and listless when you wake up.

As I’ve said, just about anyone who’s not feeling “100 percent” is likely to be experiencing suboptimal cortisol levels.  These suboptimal results don’t show up on standard medical tests, which are geared towards detecting extreme adrenal dysfunction, such as Addison’s disease (too little cortisol) or Cushing’s syndrome (too much).  However, a scientific test for less extreme conditions does exist.  This other test—which measures cortisol levels in the saliva at four key times during the day—allows us to see when adrenal glands are functioning suboptimally.

Because cortisol is so central to our health and well-being, I have virtually all my patients test their cortisol levels—and all but a handful of patients suffer from suboptimal levels, usually without realizing it.  If you suffer from any regular symptom—headaches, frequent colds and infections, acne or skin conditions, low sexual energy, menstrual or menopause issues, digestive problems, sleep problems, or autoimmune conditions, including allergies and asthma—then you, too, are almost certainly suffering from the effects of suboptimal cortisol production.

Patients often ask me whether cortisol caused all their symptoms.  No, in some cases, suboptimal cortisol levels may have caused your symptoms, while in other cases, symptoms triggered by other causes themselves stress your adrenals and thereby affect your cortisol levels.  However, whether the problem was caused by suboptimal cortisol levels or has produced suboptimal levels (or both), any symptom big enough to notice almost certainly tells us that your cortisol levels are off.

By the same token, improving your cortisol levels is likely to have a huge, positive effect on any symptom, regardless of what initially caused that symptom.

Another sign of adrenal distress is anxiety and/or depression.  Too much cortisol—for all or part of the day—is associated with both anxiety and depression.  Interestingly too little cortisol—again, for any part of the day—is also linked to depression.

Cortisol affects our mental functioning as well as our physical and emotional reserves. So if you’re struggling with fatigue, mood, irritability, poor concentration, or lack of mental focus, your cortisol levels are almost certainly off.

Optimal cortisol levels are key to optimal health.  When your cortisol levels are where they should be, you can almost always count on a strong immune system, a happy set of neurotransmitters (the brain chemicals that control mood and focus), a high-functioning digestive system, and a stable set of hormones (indicating healthy functioning in the thyroid, pancreas, ovaries, testes, and adrenals).

To learn more about the impact of stress and cortisol on your body, or if you’d like to find out your cortisol levels, schedule a time for us to meet.

Warm regards,

Dr. Doni


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  1. My name is Lina and I have been suffering form low cortisol levels for a long time. My last test for the count of cortisol was in June of 2015 ath 10:00 morning and the count was 17 so, I feel tired and not well most of the time.
    Can you tell me if you cold help me? Thank you

    LIna Wood

    • Hello Lina,
      I help many patients with low cortisol. Do you have a diagnosis from an endocrinologist? Have you ever had a salivary cortisol panel throughout the whole day?

      Either way, I’m sure I can help. Please go to to arrange a time for us to meet.

      Dr. Doni

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