Is Stress (Cortisol) Making you Fat? 

Dr. Debbie Smrz, ND

The short answer, maybe. 

Cortisol can cause cravings and promote overeating.  We often think of fat that is accumulated around the stomach and underarms as specifically attributed to it. 

But, before we talk about all the negative things that it does, let's take a moment to sing its praise. Cortisol supports the inflammation pathway – attempting to bring down inflammation, helps metabolism and allows us to deal with stress. Short term, it helps us get out of bad situations.

Unfortunately, chronic stress, means chronic and excess cortisol exposure, and that's when the problems come in. So, let's take a deeper dive on it. Typical symptoms of include weight gain, acne, thinning skin, easy bruising, muscle weakness and facial flushing. Cortisol is produced in the adrenal glands, and typically is highest in the morning, and lowest in the evening. The reduction of the anti-inflammatory effect of cortisol at night is why pain and colds and flus are worse at night (see – it's not all bad). 

In a perfect world, we have an optimal cortisol production to help us with daily function, it easily gets metabolized to its inactive form, cortisone, and removed from the body. But, like all hormones, it's never that simple. 

A woman smiling and holding a bowl of fruit salad, eating a healthy meal to ease stress, manage fat intake, and support cortisol levels (NatLiving)

Woman enjoying a healthy fruit salad to ease stress, manage fat intake, and support cortisol levels #NatLiving

Stress and inflammation causes the brain to produce extra hormones, like estrogen, DHEA and cortisol. These hormones must then be broken down into metabolites, which are either active, or inactive in the body, and finally excreted. 

Thyroid and cortisol are closely related, and one of the reasons for excess cortisol, can be sluggish or hypo functioning thyroid glands. If your thyroid is under-functioning, cortisol clearance is may be less, resulting in excess cortisol. Likewise, if your liver is metabolizing slowly, symptoms of high cortisol may also be seen. 

Common causes of 'high' cortisol due to poor clearance or production: 

  • Hypothyroid 
  • Inflammation 
  • Increased adipose tissue 
  • Insulin sensitivity 
  • Stress 

I love analyzing hormone tests, such as the DUTCH (dried urine) saliva or blood test, and connecting the dots so we understand the what and why of your symptoms. But, that's because I'm a chemistry nerd. Do you really need to get testing? The longer I've been in practice, the more I realize that a great case history and clinical experience usually tells the story quite nicely.  BUT, testing is validation. Just like the patient who refuses to give up gluten despite the bloating and nausea until they see the diagnosis, testing can be helpful. 

Before you get tested, I strongly suggest you spend a few weeks eating clean and ensuring you are not doing anything specific to ease inflammation in your life. You don't want to spend $400+ only to be told that you should stop eating ice cream every night when you already knew that…but…if you didn't already know that, maybe it would be useful. 

If you are experiencing symptoms of cortisol excess, speak to a Naturopathic doctor who is well trained in hormone therapy.