Cortisol is one of the stress hormones produced by the adrenal glands that sit on top of the kidneys. Our health depends on cortisol since it helps build stronger immunity, lower inflammation, and improve metabolism and stress control. The very distinct 24-hour cycle, in which levels peak soon after waking up is a hallmark of cortisol.
Certain lifestyles as well as foods and drinks can affect cortisol levels. However, sleeping pattern is one of the most common reasons your cortisol rhythm might be off. For example, changes in sleeping time due to jetlag or working night shifts can affect daily cortisol rhythm.
Also, coffee, alcohol, and carbonated or caffeinated drinks with lots of sugar can increase cortisol levels. They may shift your peak levels after waking up.
Some studies suggest there is small decline in the morning cortisol peak from spring to fall seasons.
As we grow old, levels increase at about 2% every 10 years in adults. It seems this rise starts in men about 10 years earlier than women.
Pregnancy also affects peak cortisol levels. After the second trimester, average levels almost double before returning back to baseline few days after delivery.
The good news is that married people seem to have relatively lower cortisol stress hormone levels.
All of us have different response to medicine, depending on our age, genes, and many other factors. But certain drugs used for mental health are known to interfere with cortisol, e.g., those prescribed for psychiatric disorders, ADHD, and depression. Synthetic hormones and steroids can also affect the HPA cycle which involves the brain and adrenal glands for making cortisol. In general, there are three types of such drugs:
These are prescribed for depression, anxiety, and chronic pain, e.g., Prozac, Zoloft, and Lexapro. They help normalize neurotransmitter levels in the brain to improve mood and behavior. But this process interferes with brain’s ability to control cortisol production. Generally, they tend to lowers cortisol levels.
Used for schizophrenia, bipolar disorder, and severe depression, antipsychotics also help in balancing neurotransmitter levels in the brain. Abilify, Haldol, and Risperdal are a few examples of such medicines. Antipsychotics also tend to lower cortisol levels.
These are drugs are used to improve attention, alertness, and energy for ADHD and sleep disorders. Adderall, Ritalin, and Concerta are some of the few stimulant drugs that improve mental acuity. This makes stimulants very desirable, with a tendency to abuse them unless carefully controlled. These psycho-stimulants might increase your cortisol levels.
Medicines for depression and psychotic behavior generally reduce cortisol. They are often prescribed to people with excess cortisol or abnormal neurotransmitter levels. Not all the examples below may affect everyone in the same way, but they are generally known to lower production of cortisol:
Fluoxetine, Escitalopram, Paroxetine, Citalopram, Desvenlafaxine (and other such SSRI drugs)
Duloxetine, Desvenlafaxine, Venlafaxine (and similar SNRI medicines)
Mirtazapine, Amitriptyline, Trimipramine, Tianeptine (and similar tricyclic or tetracyclic antidepressants)
Risperidone, Olanzapine, Quetiapine, Aripiprazole (and similar Atypical antipsychotics)
Mifepristone – and other drugs that block the effect of corticosteroids
Ketoconazole – an anti-fungal medication
Venlafaxine – and similar neurotransmitter inhibitors
Propranolol – and other beta-blockers used to treat high-blood pressure
Anesthesia drugs such as Propofol, and an insomnia medication called benzodiazepines (which were allegedly given to Michael Jackson before he died)
Certain antihistamines used for allergies, itching, sneezing, runny nose, congestion, hives, hay fever, flu, bee stings or insect bites
Luminal, Seconal, Pentobarbital, Etomidate and other barbiturates used as sedatives
Certain chemotherapy drugs used for adrenal insufficiency such as Mitotane or Lysodren
Many drugs used in allergies, asthma, inflammation, and autoimmune diseases include a class of steroids called corticosteroids that might have the side effect of increasing cortisol levels. Here are few such drugs that might increase cortisol levels:
Prednisone, prednisolone, methylprednisone
Modafinil (used for drowsiness and sleep apnea)
Adderall or Mydayis (which are salts of amphetamine)
Methylphenidate (and other CNS stimulants)
PTZ or phenothiazine (which tends to affect neurotransmitter levels)
ADHD drugs based on amphetamine, e.g., Vyvanse, Dexedrine, methamphetamine (also called 'meth')
Fluticasone and Budesonide (used in inhalers)
Pseudoephedrine (used for congestion)
Clobetasol (used for skin rashes, psoriasis, and dry skin)
Epinephrine, norepinephrine – synthetic forms that mimic neurotransmitters in the brain
Cortrosyn or Cosyntropin – synthetic form of ACTH hormone
Opioids such as morphine and codeine
MDMA – also called ecstasy, molly, mandy
Imipramine, desipramine, and similar tricyclic antidepressants
Somatropin (e.g., Genotropin, Humatrope, Norditropin, Saizen)
Insulin-like growth factor 1 (IGF-1) such as Mecasermin or Increlex
Egrifta or Tesamorelin for HIV treatment
Certain chemotherapy drugs that reduce inflammation, nausea and allergic reactions
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Order a 24-hour cortisol test kit.
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All About Cortisol - key facts about the stress hormone.