How Cortisol Affects Your Whole Health
What Is Cushing’s Syndrome?
Cushing’s Syndrome develops when the body is exposed to too much cortisol. This may result from long-term use of steroid medications such as prednisone, or from the body producing excess cortisol on its own (endogenous Cushing’s).
Even when cortisol levels are only slightly elevated, the effects can ripple through multiple body systems. That’s where MACS, a more subtle form of cortisol imbalance, becomes important to understand.
What Is MACS?
Mild Autonomous Cortisol Secretion (MACS) occurs when the adrenal gland produces a steady excess of cortisol, even when it isn’t needed. People with MACS may not notice obvious symptoms, but prolonged hormone imbalance can quietly damage overall health. Often, MACS is found incidentally when imaging reveals an adrenal nodule.
Why the ODST (Overnight Dexamethasone Suppression Test) Matters
The ODST is a key tool in evaluating how the body regulates cortisol. After taking a small dose of dexamethasone at night, the brain should respond by suppressing cortisol production the following morning. If cortisol levels remain high, it suggests the body isn’t regulating properly, signaling a disruption in the HPA axis (hypothalamus-pituitary-adrenal system).
Unlike a standard blood draw, this test captures how the body processes and responds to cortisol, making it especially valuable in identifying conditions such as MACS.
Health Consequences of Cortisol Dysregulation
Even mild cortisol elevation can put long-term strain on the body, gradually increasing the risk for a wide range of health problems.
In Everyone (Men and Women):
- High blood pressure
- Type 2 diabetes or insulin resistance
- Central weight gain (especially around the abdomen)
- Fatty liver disease (NAFLD)
- Depression, anxiety, irritability
- Sleep disturbances and fatigue
- Osteopenia or osteoporosis
- Weakened immune function
- Higher risk of heart disease and stroke
The effects can also differ by gender. For women, excess cortisol may disrupt menstrual cycles, trigger unwanted facial or body hair growth, and lead to thinning of scalp hair. Men may experience low libido, erectile dysfunction, and a loss of muscle strength. These gender-specific signs highlight how cortisol imbalance can interfere with reproductive and physical health in different ways.
What Can You Do?
Recognizing and addressing MACS starts with thorough testing. If you or your provider suspect a cortisol imbalance, completing an ODST and other hormone panels is a crucial first step. From there, regular monitoring of blood pressure, blood sugar, and weight can help track how your body is coping.
Treatment strategies vary depending on severity. Some cases may be monitored over time, while others may require surgery to remove an adrenal mass that is disrupting hormone levels. Medications are also available—some reduce cortisol production (such as Isturisa or Recorlev), while others block its effects (such as Korlym).
Alongside medical treatment, lifestyle plays an important role. Managing stress, exercising regularly, and maintaining a balanced diet can all support healthier cortisol regulation and better long-term outcomes.
Taking the Next Step with Endocrinology Associates
Living with a cortisol imbalance might feel overwhelming, but you don’t have to manage it alone. The team at Endocrinology Associates provides expert evaluation, testing, and treatment tailored to your needs. Whether you’re concerned about subtle hormone changes or seeking guidance after a diagnosis, our team is here to help you find answers and restore balance.
Schedule an appointment with Endocrinology Associates today to take control of your health and move forward with confidence.