Wellness vs. PubMed, Vol. 3: Will intense exercise spike my cortisol?

Hop on the Magic School Bus into our bodies and PubMed as we look around at the nuance of TikTok's demonized "stress hormone" and exercise

Hello, and welcome back to another deep dive into the process of exploring the literature behind trends in the wellness world. I take joy in doing this for my own human experience, and I’ve loved bringing you all along so far. Something I am learning as I write these is how to pick a salient, specific question to address a broader trend. I have four drafts trying to pick apart the cortisol trend gathering dust, and part of that is because it was too general. One of my big misgivings with the Wellness Industrial Complex is that it often relies on the opacity of either a degree of the person talking OR on “the research says” without actually talking about WHAT research they are citing OR who their expert is. So, for today’s post, dear reader, we are going to HAVE A FOCUS (so feasibly you can disagree with points of research or data I lay out here).

us locking in on a specific question

As always, this is meant to serve as an exploration of the claims of the non-regulated wellness industry, and not as direct or personalized medical advice. We are hoping to increase health literacy so that when you have access to healthcare, you can ask more specific questions in the limited time you have. Please listen to your personal physicians, clinicians, and professionals in guiding your own healthcare decisions (not a random person on the internet, even if you trust me).

Point 1: What do we mean when we say cortisol?

I will let the American Association of Clinical Endocrinology start us off on our basic terms.

“Cortisol is your body's main stress hormone. It helps control your metabolism by regulating how fats, proteins, and carbohydrates are made, stored, and broken down. It also suppresses inflammation, regulates the immune system, helps to maintain blood pressure, increases blood sugars, and controls the sleep/wake cycle. Cortisol is produced and released from your adrenal glands, which sit on top of your kidneys.”¹

Cortisol is not a solo act—hardly anything in our bodies are. Cortisol most notably is regulated and helps regulate what is known as the HPA Axis, aka the Hypothalamic-Pituitary-Adrenal Axis. The Cleveland Clinic notes this as, “The hypothalamic-pituitary-adrenal (HPA) axis is a communication system between three organs. It’s crucial for your body’s stress management. These endocrine system organs create a feedback loop of hormones to enact and regulate your body’s stress reaction.”²

This is our 101, and you could (and I know people who do) dedicate the better part of 20 years trying to understand this hormone, its cascade of effects, and how it plays with other signaling pathways in the body. It’s not to say, “Let’s throw our hands up and give up, NOTHING is knowable.” Rather, my point with saying this is that anytime someone gives you a simple explanation for a complex, seemingly unsolved in the wider community phenomenon, you should pause, big time. From a scientific lens and as a clinician myself, one of the big beauties and thorny annoyances of working in healthcare is the labyrinthine nature of understanding and treating the body.

Point 2: Why do people online care if their cortisol is high or spiked by certain things?

In theory, dysregulation of cortisol and/or the HPA axis really can and does have negative impact, especially on those with endocrine disorders. In particular, too-much cortisol is known as Cushing’s Syndrome (or Disease, if caused by a pituitary tumor). Too low of cortisol is also a possibility, like if someone is coming off of chronic corticosteroid use or is gravely ill in the hospital, but we will stick with high given the question of “spiking” cortisol.