What Are Symptoms of Low Cortisol?

Cortisol is a vital hormone that helps your body respond to stress.

But when levels drop too low, it can wreak havoc on your energy, mood, and overall health. If you suspect your cortisol is the cause of your concerns, keep reading, because I'm going to reveal the top symptoms of low cortisol and share practical steps to restore balance and get your vitality back naturally!

Not only is cortisol dysfunction controversial, but it’s also confusing!

You’ve probably heard that cortisol problems are the root cause of everything from facial swelling to chronic fatigue to weight gain. It’s true - your stress-response system, also known as the HPA Axis, plays an outsized role in the way your body functions every day - and when it’s not working properly, it can trigger some serious symptoms.

We’ll get into the specific symptoms of low cortisol later on, but first you need to understand what cortisol is, what it does in the body, and how it’s regulated - otherwise we won’t be able to treat low levels at the root!

Cortisol is a hormone that is produced by the adrenal gland in response to stress.

That stress could be mental or emotional in nature - for example, childhood trauma, a demanding workload, relationship difficulties, or the everyday stressors of parenthood.

But stressors can also be physical -

for example, not getting enough sleep, eating lots of sweets, catching a nasty virus, or having a chronic condition like IBS, hypothyroid, or endometriosis.

Stress isn’t just in your head, it’s a very real, very biochemical process that involves a super complex cascade of neurologic signals and chemical messengers, including cortisol.

Our ancestors had different stressors than we do - like being chased by a saber-toothed tiger or running out of food in the winter - but their stress-response systems served the same function as ours do today: to help us survive.

When we face a stressor, the brain signals to the adrenal glands to release cortisol via the HPA-Axis. And cortisol interacts with the cells of different body systems to prepare us to fight or flee from danger.

Your HPA-Axis is trying to keep you safe - and so is cortisol. It gives you quick energy to burn, improves your focus, and even sharpens your eyesight. This helped our ancestors run from that saber-toothed tiger, and it can help you slam on the brakes when another car swerves in front of you. 

The HPA-Axis really shines in situations of short-term or acute stress.

But too much of a good thing can become a problem.

If stress becomes chronic, or we’re faced with stressor after stressor on a daily basis, cortisol can stay high for too long.

This turns the helpful, survival function of cortisol against us, resulting in weight gain, type 2 diabetes, chronic fatigue, gastrointestinal issues, elevated blood pressure, and problems with the immune system.

It also lowers your threshold for stress - meaning that it takes less stress to trigger your fight or flight response.

It can feel like every little thing overwhelms you, or things that never used to bother you throw you for a loop, irritate you, or make you anxious.

Yes, high cortisol is a problem, but if left uncorrected, elevated cortisol turns into depleted cortisol.

This is how it happens.  When your HPA-Axis is cranking out lots and lots of cortisol for a long time, your cells adapt to those high levels by decreasing their sensitivity to cortisol.

Here’s an analogy I find helpful: my sister has 4 energetic children, and they make a lot of noise. Someone is always shouting or crying or laughing or singing at the top of her lungs.

And when I visit my sister’s house, I am very sensitive and responsive to all of those sounds - I’m easily distracted by a yell or I might startle at a crash from the next room.

My sister, on the other hand, has adapted to all of this noise, and has much less reactivity to it - it’s not that she doesn’t hear her children, and she’s not ignoring them - she’s just responding more appropriately to the constant noise because it’s her typical, learned environment.

It wouldn’t be helpful for her to react with alarm or loss of focus every time someone in her house bursts into song - she’d never get anything done.

Same goes for your cells when they’re over-exposed to cortisol.

They turn down their responsivity, little by little over time, until the brain turns down it’s signal to release more cortisol and levels drop off and flatten out.

When cortisol levels are low, or they don’t follow a healthy daily rhythm, sometimes wellness experts refer to it as adrenal fatigue, adrenal exhaustion, or burnout.

But it’s not as if your adrenal glands can’t make cortisol - the brain, as part of the HPA Axis, is instructing it to make less cortisol because it’s not effectively lowering the stress input.

It makes sense if you think about it from the brain’s perspective - what’s the point of making all this cortisol if it’s not going to actually relieve the stressor?

But it’s not the same as having Addison’s disease, a rare condition where the adrenal glands are injured or incapable of producing enough cortisol - that requires a different approach than we’re talking about, though it certainly can be equally confusing to figure out.

So, what are some of the symptoms of low cortisol?

Let’s cover the top 5 that I’ve seen in over a decade of functional medicine practice.

The first is fatigue - both mental and physical.

Brain fog would also fit in this category.

The tricky thing about fatigue is that it can be caused by lots of things, including hypothyroidism, low iron reserves, and even high cortisol.

That’s right - you’ll find that many of the symptoms of low cortisol can also be caused by high levels - which is why it’s important to test. 

Second is changes in body composition.

While folks with extreme low cortisol can experience weight loss, I’ve found it’s more common that low cortisol correlates with weight loss resistance.

This happens for a few reasons.  One, because cortisol is needed to mobilize fat to burn as energy.

Two, because low cortisol can result in blood sugar crashes, which can trigger cravings for sugars and simple carbohydrates.

And three, because low cortisol equals low energy, which leads to less tolerance of exercise and lowered ability build muscle, which drives metabolism.

Again, weight gain or weight loss resistance is also a common symptom of high cortisol - that’s why we test instead of guess.

Third is low mood, low motivation, and depression.

This symptom often piles on top of the previous two symptoms, making both of them worse.  

It can be a really frustrating, vicious cycle.

One thing to remember is that low moods can also be a sign of low estrogen as well - recent research suggests that estradiol supplementation is often more effective than SSRI’s for treating depression in menopause.

I see low cortisol and low estrogen overlapping a lot, and often resulting in fatigue, low mood, and low motivation.

Number four is low blood pressure or sometimes orthostatic hypotension, when your blood pressure drops as a result of standing up from a seated or lying down position.

This often presents as occasional lightheadedness or dizziness, and is one of the most common sneaky signs of low cortisol and burnout that I see in practice.

Number five is low libido or low sex drive.

This makes sense, right? You’re chronically stressed, fatigued, unmotivated, and maybe depressed, so intimacy is often the last thing on your mind.

One of the physiologic reasons that low cortisol can result in low libido has to do with another adrenal hormone called DHEA, which is a precursor to testosterone.

If cortisol is low, often DHEA is also low, which means lower testosterone - and in many folks this results in a lower sex drive.

Other symptoms I’ve seen associated with low cortisol include constipation, nausea, hyperpigmentation of the skin, and even sleep apnea.

So, how do you figure out if you have high or low cortisol, given that the symptoms have so much overlap?

Well, there’s a test for that - an at-home urine test, to be specific. It’s important to go beyond simple blood testing when you’re checking cortisol levels for a few reasons.

First of all, because cortisol levels fluctuate greatly throughout the day, and a single blood test doesn’t always take that into account. Also, because there’s a difference between free cortisol levels and metabolized cortisol…and don’t get me started on free cortisone!

All that to say, a more comprehensive cortisol test is the best way to figure out if your levels are low. This is actually a common mistake I see people make - they’re taking all sorts of remedies intended to lower their cortisol levels when it turns out they’re already too low!

Thankfully, we help people all over the world get access to accurate, actionable, at-home testing for cortisol - and I’ll even help you interpret your results!

Click HERE for to sign up for your Cortisol Confidence Fast Track and get your comprehensive adrenal test kit - it also measures DHEA as a bonus!

Alright, so now that you know how to determine if your cortisol is high or low, how do you fix it?

It’s important to remember that cortisol is made from cholesterol. So, if you’re taking a medication that drives your cholesterol way down, or you eat a very low-fat diet, you could interfere with your body’s ability to make cortisol - and other crucial hormones, for that matter.

Contrary to the popular opinions of the 80’s and 90’s, eating fat doesn’t make you fat - as long as the fats you’re consuming are anti-inflammatory! Some good sources of healthy fats are avocados, salmon, olive oil, eggs, and nuts.

Seeking out and addressing sources of unresolved chronic stress in the body and the mind is also a critical component of reviving a burned-out HPA-axis.

Given that mental and emotional stress is often a normal part of life, and difficult to reduce or eliminate, I like to focus on physical chronic stress triggers.

This could mean improving your insulin sensitivity by cutting out sweeteners and low-quality carbohydrates from your diet, restoring the balance of your microbiome, or replenishing micronutrient insufficiencies.

Meaningful, results-oriented stress management isn’t as easy as drawing yourself a bubble bath and pouring a big glass of wine - it requires both intentionality and consistency.

But it pays off - cultivating a balanced, resilience stress-response system is literally the best thing you can do for your health and longevity.

That said, working on the root cause of your stress takes energy - and it’s tough to do when you’re already tired, foggy, and unmotivated.

That’s why I often suggest utilizing some pro-cortisol nutraceuticals to help boost energy while you’re getting to the underlying issues.

First on the list is my personal favorite - a blend of adaptogenic herbs that improves cortisol sensitivity, stimulation, and prevents adrenal atrophy from chronic stress.

The first ingredient is the most famous of all adaptogens, Panax Ginseng.

It’s one of the oldest herbs used in medicine - originally in China and other parts of Asia. Ginseng works on the stress-response system from the top down, as well as bottom-up!

Next on the list is Cordyceps sinensis, an adaptogenic fungus, also originally from China. It’s claim to fame is strengthening the body after long-term stress, exhaustion, or illness.

The last adaptogen in my favorite blend for low cortisol is Rhodiola rosea, a plant found in the high altitudes of the Arctic and Europe. More than 180 published studies support it’s efficacy in improving cognitive function and increasing physical capacity.

This herb is great for improving brain stamina, efficiency, and reducing mental fatigue. Like many adaptogens, Ginseng, Cordyceps, and Rhodiola tend to work best as a team.

You can purchase them HERE - simply click the link, sign up for a free account to my Fullscript dispensary, and they should pull right up.

You’ll also notice that I offer a really nice discount when you order supplements through my link - so nice that I’m actually not allowed to tell you, but when you click the link you’ll see right away.

Second on the list are adrenal glandular extracts, which help rebuild and refuel the adrenal cells that are needed to product cortisol.

These extracts contain the micronutrients needed for cortisol production in the exact form and proportion that the adrenals use - because they come directly from adrenal tissue.

And even though the signal to make cortisol comes from the brain, if your adrenal glands don’t have what they need to produce cortisol, you can still end up low.

Because these glandular extracts come from the tissues of animals, clean, non-toxic sourcing is really, really important, as is the way these extracts are processed, because high temperatures can denature the critical components of the extract.

You’ll find my quality-vetted product suggestions for glandulars and the other cortisol-boosters HERE.

Third is licorice root extract, specifically glycyrrhizic acid. 

It helps your body re-activate inactive cortisone into free cortisol, supporting higher circulating, activated cortisol levels and boosting energy.

Be careful not to get this confused with deglycyrrhizinated licorice, or DGL, which is used to support and soothe the lining of the stomach and GI tract.

Also, because licorice extract stimulates cortisol, it can raise your blood pressure - my clients with POTS actually find it really helpful for this reason - so it’s important to monitor blood pressure while taking licorice root extract.

And if you already have high blood pressure, or are taking medication to treat high blood pressure, licorice root is not for you.

There are many, many other Functional Medicine strategies you can use to recover from burnout and help your body make appropriate levels of cortisol whether your levels are too high or too low.

If you’d like a more in-depth resource I’d encourage you to check out my Stress Smarter Mini-Workshop.  You can find it in my Exclusive Member’s Library within my YouTube Membership! To sign up, head on over to the video page and tap the “Join” button.