Amy Schumer’s Cushing syndrome diagnosis raises questions about cortisol. What is it, and how do you know if your levels are high?
Amy Schumer announced on Friday that she was diagnosed with Cushing syndrome — a condition caused by the body's production of excess cortisol, known as the "stress hormone," for a prolonged period of time. But she's far from the only person who has their cortisol levels top of mind.
Searches around cortisol, including high cortisol and cortisol imbalances, have been trending on Google throughout the year, while the conversation has also taken off on social media. Wellness influencers have shared their own experiences with inflammation, weight gain and bad sleep, which they blamed on too much cortisol.
Upon Schumer's diagnosis, however, health experts are emphasizing that cortisol and any medical issues related to it are much complicated than online influencers might make it seem. Here's what to know.
What is cortisol?
Cortisol is a steroid hormone produced by the adrenal glands. It's more commonly known as the "stress hormone" as it plays a crucial role in the body's response to stress. Cleveland Clinic endocrinologist Dr. Divya Yogi-Morren calls it a "multitasker hormone" because it helps to keep a number of the body's processes in balance, as well.
"It helps to control your body's use of fats, proteins, carbohydrates and your metabolism. It can also suppress inflammation," she tells Yahoo Life, noting that steroids used to treat inflammation are often different forms of the hormone or related to it. "Cortisol is also important in the body for regulating blood pressure and for regulating blood sugar."
While cortisol has a hand in all of these different processes, it's important to remember its main function: responding to stress.
"When you're stressed, the levels will go up right away and help you get through the stress," she says. It will allow glucose to get to your brain and your muscles in order to power through those moments. However, "it was not meant to be high in your body for a prolonged period of time, like we see in Cushing's disease [also known as Cushing syndrome]."
What happens if your cortisol levels are off?
Dr. Travis McKenzie, professor of surgery in the Mayo Clinic's division of endocrine surgery, tells Yahoo Life that cortisol is "necessary for life." But either too much or too little of it can cause problems.
"The absences or diminution of cortisol can cause adrenal insufficiency, which can be life-threatening in extreme circumstances," he says. "In excess, cortisol can have a negative impact on a number of health parameters."
"Cortisol imbalances can range from mild disruptions to severe conditions like Cushing syndrome, with symptoms varying in intensity and severity," Michelle Routhenstein, a registered dietitian with a focus on preventive cardiology and diabetes, tells Yahoo Life. "Other official diagnoses related to cortisol imbalances include adrenal insufficiency, called Addison's disease, and congenital adrenal hyperplasia, each presenting distinct symptoms and treatment approaches."
How can you tell if there's an imbalance?
What Schumer referred to as her "puffier" appearance was a sign of her own heightened cortisol levels, she revealed in Jessica Yellin's "News Not Noise" newsletter last week. The Life & Beth actress had also already been aware of some imbalances due to having endometriosis.
As Routhenstein notes, there are other physical signs of a cortisol imbalance. "Symptoms of low cortisol may include fatigue, weight loss, nausea and low blood pressure, while high cortisol levels may manifest as weight gain, thinning skin, muscle weakness and mood changes," she says.
When cortisol levels are extremely high, which can cause Cushing syndrome, there are drastic signs like "distinctive changes in body fat distribution, such as the development of a rounded face (often referred to as 'moon face') and accumulation of fat in the abdominal area," Routhenstein adds.
Yogi-Morren explains that the weakness of the skin can lead to bruising, while another sign of a condition like Cushing are irregular stretch marks. "They're usually wide, about more than one centimeter wide. And these stretch marks stay purple or bright red and they don't heal," she says. A fatty lump may also appear between the shoulders.
Despite these signs, self-diagnosing a cortisol imbalance is "frequently inaccurate," says McKenzie. "Many of the symptoms of excess cortisol overlap with other medical problems," including diabetes, he notes. "Diagnosis of cortisol excess can only be accurately diagnosed by a medical provider such as a medical endocrinologist. This may include urine, saliva and/or blood tests."
What can you do about it?
Cortisol imbalances are associated with various underlying causes, which would require different methods of treatment. It is important to seek out a proper diagnosis from a trained medical professional to determine if an imbalance truly exists and then discuss the why and how to treat it.
Causes and treatments, as listed by the Cleveland Clinic, can include:
? Taking large amounts of corticosteroid medications (man-made drugs that closely resemble cortisol) for the treatment of other conditions, like endometriosis. A doctor might lessen the dose of the needed medication or switch to an alternative.
? Tumors, most often on the pituitary or adrenal glands, which can cause excess production of cortisol. Although these are most likely benign, meaning they aren't cancerous, Yogi-Morren says they need to be addressed and removed.
? General lifestyle stress associated with sleep, diet, physical activity and caffeine intake can also lead to high cortisol levels. These are the easiest to control, according to Yogi-Morren. "Things like mindfulness, meditation, mind-body exercises like yoga, tai chi [and] deep breathing exercises are natural stress relievers that can help reduce cortisol levels in the body," she says.
Nevertheless, it's important to discuss any and all treatment options with a doctor.
"A lot of this is very, very medically complex and very multifaceted," says Yogi-Morren. "Make sure that you actually go talk to your doctor about what you're experiencing. Let them practice with an open mind and check."