Cortisol

Erstellt am: May 20, 2025 | Letzte Aktualisierung: May 20, 2025 | Laura Mertel
Cortisol

basic

Here you will learn the basics – explained simply and understandably.

Alternative names for cortisol

In addition to the spelling with a C, the spelling with a K is also common in German, i.e. cortisol. Colloquially, it is often referred to as the stress hormone.

The synthetic form used as a pharmaceutical is officially called " hydrocortisone " – and here, too, there is an alternative spelling with a K: hydrocortisone. From this, the shortened term "cortisone" has also become common in the medical field; for example, one often speaks of "cortisone therapy." Unfortunately, this is somewhat misleading, because "cortisone" actually refers to a biologically inactive precursor of the active ingredient. 1

The chemical formula of cortisol is C 21 H 30 O 5 . Given the structural formula, one can also use the admittedly very cumbersome but highly precise chemical name 11β,17α,21-trihydroxypregn-4-ene-3,20-dione. 2

What is cortisol?

Cortisol is a vital hormone and the most important member of the endogenous (i.e., self-produced) glucocorticoids. Glucocorticoids, in turn, are steroid hormones. 3

The body's own cortisol production in the adrenal glands is 8–25 mg per day. 4 Some textbooks also cite higher values ​​of 20–25 mg per day. 5

Cortisol is essential for maintaining physiological body functions. However, it is best known for its function as a " stress hormone ," which enables us to respond quickly to external stimuli but can lead to problems in chronic stress.

What function does cortisol have in the body?

The hormone is involved in controlling various body functions around the clock:

  • It regulates our carbohydrate, protein and fat metabolism and also influences the water and electrolyte balance, among other things it inhibits calcium absorption in the intestine.
  • It influences the process of blood formation (especially the proportion of leukocytes, lymphocytes and granulocytes) and blood pressure.
  • It affects connective tissue, bone metabolism and the pigmentation of skin and mucous membranes.
  • It affects the central nervous system and can therefore also cause psychological changes. 6

Perhaps most well-known is its function as a " stress hormone ": When our body is challenged by environmental stimuli (stressors), it can activate a series of neuronal and endocrine processes to cope with the stressful situation. This includes the release of cortisol, which is involved in the mobilization of the body's energy resources, particularly in gluconeogenesis. The liver converts various amino acids into glucose, which enters the bloodstream and serves as a quick energy source for the cells. 7 The hormone also acts on the receptors in various brain regions, thus influencing our perception, our emotions, and our behavior in stressful situations. 8

When cortisol is administered as a medication , its anti-inflammatory, anti-allergic, and immunosuppressive effects are primarily utilized. Consideration must be given to both the effect on the body's own hormone synthesis and adverse effects on the bodily functions described above. 9

How is cortisol regulated in the body?

The synthesis of this hormone is controlled by the so-called hypothalamic-pituitary-adrenal axis (HPA axis), which consists of the hypothalamus, pituitary, and adrenal glands. Regulation occurs via three mechanisms:

  1. Basic rhythm: Cortisol release occurs approximately every 90 minutes.
  2. Circadian rhythms: The frequency and amount of rhythmic release varies throughout the day - see also: When is my cortisol level highest and when is it lowest?
  3. Stress adaptation mechanism : Both physical and mental/emotional stress can affect the circadian rhythm and cause it to skyrocket. 10

The activation of the HPA axis occurs in several steps: In the brain, specifically in the hypothalamus, CRH (corticotropin-releasing hormone) is released, which stimulates the pituitary gland to release ACTH (adrenocorticotropic hormone) . This, in turn, stimulates cortisol synthesis in the adrenal cortex. A sufficiently high level then leads, via several negative feedback loops on the HPA axis, to a downregulation of CRH and ACTH release and thus also further synthesis. 11

In addition, there are also local regulatory mechanisms: In blood plasma, a greater or lesser portion of the total cortisol can be bound to other proteins such as transcortin or albumin and thus temporarily "deactivated." Target organs, such as the kidneys, can convert the hormone into cortisone. Even within individual cells, various regulatory mechanisms are found. 12

How does cortisol affect my mood and behavior?

The hormone released in acute stress situations influences the excitability of several brain regions. The amygdala is activated, anxiety and alertness are increased, and all attention is focused on the stressor to enable a quick response . However, we often act rashly and according to fixed, established patterns. This is because the cortisol surge simultaneously inhibits cognitive activity in the dorsolateral cortex—there's no time for thinking! A few hours later, this brain area is reactivated, neural resources are directed toward flexible and goal-oriented action, and the original stressful situation often appears in a completely new light. 13

The retrieval of information from memory is also impaired under the influence of the stress hormone – the consolidation of new memory content, however, is positively influenced. 14

Acutely elevated cortisol levels can also have a euphoric effect and stimulate sensation seeking —the need for new experiences and the willingness to take risks to achieve them. This is especially true for people who exhibit a comparatively strong hormonal stress response, and more so for men than women. 15

The stress hormone is also involved in appetite control : In acute stress, appetite is suppressed by glucocorticoids – first, the stressor must be dealt with! Afterward, however, energy reserves must be replenished: Cortisol now intensifies food-seeking behavior, with "comfort eating" in particular becoming highly popular. Furthermore, its effect on the enzyme lipase increases fat storage. 16

What happens if I have too much cortisol?

Elevated cortisol levels in the evening can make it difficult to fall asleep and reduce both sleep duration and sleep efficiency. 17

Persistently elevated levels , for example as a result of chronic stress, can contribute to dysregulation of the HPA axis (see: How is cortisol regulated in the body? ) and even damage hippocampal neurons. This is considered one of the mechanisms for the development of depression , which is often associated with elevated cortisol levels and altered circadian rhythms (see: When are my cortisol levels highest and lowest? ). 18 The association between increased irritability, emotional instability, and depression is particularly typical. 19

Elevated cortisol levels are also a risk factor for the cardiovascular system; they can contribute to high blood pressure, elevated blood lipid levels (hyperlipidemia), and atherosclerosis. Furthermore, chronic stress inhibits the immune response, which presumably results from the downregulation of cellular hormone receptors, which reduces the cells' ability to respond as effectively to pro-inflammatory cytokines. 20

A pathologically elevated cortisol level, known as hypercortisolism , can also be caused by medications (hydrocortisone therapy) or organic diseases (Cushing's syndrome). In addition to physical symptoms (obesity, muscle weakness, facial redness, stretch marks on the skin, and acne, and in women, hirsutism and menstrual disorders), psychological symptoms can also occur. In these cases, medical attention is always required. 21

What happens if I have a cortisol deficiency?

Low cortisol levels in the morning can negatively impact well-being: energy is lacking, everything feels like it requires great effort, sexual interest suffers, and headaches can also occur. 22

Persistently low levels can have psychological effects, typically resulting in a combination of increased irritability, apathy, and depression. 23 Here, too, dysregulation of the HPA axis, for example, due to childhood trauma 24 , and possibly also PTSD 25 , is discussed as a contributing factor.

A pathologically low hormone level ( hypocortiosolism ) results from chronic underfunction of the adrenal cortex. The cause lies either in the organ itself (primary adrenal insufficiency, especially Addison's disease) or in its lack of stimulation by the pituitary gland or hypothalamus (secondary adrenal insufficiency). Diagnostic symptoms include dizziness, fatigue, weight loss, vomiting, and hypoglycemia (low blood sugar). Medical attention is essential in these cases to avoid life-threatening crises. 26

In alternative medicine, there is also the diagnosis of adrenal fatigue resulting from chronic stress, which is said to be associated with symptoms such as fatigue, sleep disturbances, and caffeine dependence. From the perspective of conventional medicine, however, this is a "pseudo-endocrine disorder." Diagnosis using a scoring system and saliva tests is inadequate and not evidence-based, and treatment recommendations (if they go beyond general recommendations for a healthy lifestyle) are sometimes hazardous to health. 27

Advanced

This section will deepen your knowledge and give you more detailed insights.

When is my cortisol level highest and when is it lowest?

Cortisol levels are subject to characteristic fluctuations throughout the day: 80% of daily production is accounted for by the so-called resting secretion between 4 and 8 a.m. 28 Approximately 10 minutes after waking up and the light stimulus upon opening the eyes, the so-called cortisol awakening response (CAR) occurs, with a steep increase of 58–156%. 29

Accordingly, hormone levels are highest early in the morning, then drop steeply throughout the day and are close to zero late in the evening. 30

A change in this circadian curve can result from changes in the natural day-night rhythm, such as traveling to different time zones, as well as from shifted sleep-wake patterns, such as shift work. 31 Chronic stress can also alter the normal curve: the morning rise is smaller, but as the day progresses, the curve declines less steeply, so the evening value remains elevated. 32

How can I influence my hormone levels?

The question of whether and how one can influence one's own cortisol levels is usually asked in the context of stress and the associated health risks.

Studies show that stress management training can help reduce the hormonal response to stressors. Such training includes, first, teaching cognitive strategies for stress management (e.g., positive self-instruction), second, strengthening social skills (e.g., improved anger regulation), and third, practicing relaxation techniques . 33 These include progressive muscle relaxation 34 and meditation 35 , but laughter yoga 36 can also effectively lower cortisol levels during acute stress.

Physical activity can work in both directions: Moderate exercise lowers cortisol levels, while moderate to strenuous exercise causes physical stress and increases cortisol levels. However, regular training allows the body to adapt accordingly, meaning that in trained athletes, the exercise-related increase is lower than in untrained individuals. 37

A simple example of moderate exercise: walking. Some studies suggest that walking in green surroundings can achieve a 53% reduction in cortisol, while purely urban walks only reduce levels by 37%, but this effect has not been consistently confirmed. 38

Touch also works: Studies show that the stress response is significantly reduced after a short shoulder massage from a partner. 39 Hugs also have this effect—it even helps if you hug yourself or place your hand on your heart! 40

Regular sauna sessions , preferably in a dry sauna, can also measurably reduce cortisol levels. 41

Regarding intermittent fasting , studies are inconsistent regarding cortisol levels. However, an influence on the circadian rhythm seems quite certain. 42

Which foods can affect my cortisol levels?

Coffee drinkers beware: Caffeine increases cortisol synthesis, both during rest and under stress. With daily caffeine consumption, this reaction is attenuated but still present. 43 Furthermore, regular caffeine consumption shows an increased hormonal response under stress. 44

Alcohol also acutely induces a stress-like cortisol response; long-term consumption can contribute to the dysregulation of the HPA axis. 45

Larger amounts of licorice can also increase cortisol levels: The glycyrrhizic acid contained in the black candy inhibits the conversion of the hormone to cortisone, thereby shifting the ratio of the two substances. 46

A balanced diet rich in vitamins and minerals , on the other hand, can help reduce stress-related elevated cortisol levels. Vitamin C 47 , vitamin D 48 , and magnesium 49 are particularly important.

How does cortisol change with age?

Older textbooks still state that age has no significant influence on cortisol. 50

However, recent studies point to increased activity of the HPA axis during aging: The mean serum cortisol level is higher overall, and the pattern is also altered: the morning cortisol wake-up response is weaker, the decline in the curve over the course of the day is flatter, and the evening cortisol level is increased. Furthermore, the number and sensitivity of cortisol receptors are reduced. 51

How does sleep affect my cortisol levels?

Cortisol secretion follows a characteristic pattern throughout the day (see: When is my cortisol level highest and lowest? ). This pattern can be influenced by individually shifted sleep-wake patterns, for example, through shift work, particularly irregular shifts. 52 Nighttime sleep duration and sleep disturbances can also influence the pattern: For example, the decline in the curve is flatter over the course of the day, and the evening cortisol level is correspondingly higher. 53

Elevated cortisol levels in the evening are, in turn, closely linked to shortened sleep duration and reduced sleep efficiency. 54 Thus, there is an interrelationship that can also lead to a vicious cycle of sleep disturbances and dysregulation of the HPA axis. 55

What false myths are there about cortisol?

Cortisol is also one of the biochemical substances about which various half-truths or even completely false claims circulate. You shouldn't fall for these myths:

  • "How to get rid of your cortisol face (or rather, your cortisol belly)!" – A current influencer trend that's particularly convincing because it taps into some of what we know about cortisol. Indeed, the hormone also affects metabolism. Indeed, abnormally elevated hormone levels (hypercortisolism) can also alter the face and figure, but such conditions (such as Cushing's syndrome or adrenal tumors) are very rare. The often self-diagnosed "cortisol face," like the "cortisol belly," is likely an exaggeration in most cases. 56
  • " Cortisol detox " – A common recommendation after self-diagnosis of a "cortisol face" and "cortisol belly." Any recommended "detox preparations" should always be viewed with caution. The behaviors advertised as "cortisol detox" (especially regular and sufficient sleep, exercise, and relaxation techniques, see: How can I influence my hormone levels? ) actually reduce stress and thus regulate cortisol levels. However, contrary to what the term "detox" suggests, no "detoxification" takes place here, because cortisol is not a toxic substance, but a vital hormone. True hypercortisolism cannot be cured with mere stress reduction; it requires cause-specific therapy.

Expert

This is about advanced concepts for a deeper understanding.

Which substances are involved in the formation of cortisol?

The starting material for the biosynthesis of cortisol is cholesterol , which is stored in lipid droplets in the cytoplasm. Catalyzed by the enzyme cholesterol desmolase, this first produces pregnenolone —a common precursor of various steroid hormones—and then, in a further conversion step, converts it into the steroid hormone progesterone . With the assistance of the enzyme 17-steroid hydroxylase, progesterone is then converted into 17α-hydroxyprogesterone, which then undergoes two successive hydroxylation steps via the intermediate 11-deoxycortisol to form cortisol. 57

What substances are produced from cortisol?

Cortisol is broken down in the liver. The first step is hydrogenation, the chemical attachment of hydrogen atoms. This first produces dihydrocortisol, then tetrahydrocortisol, which is subsequently converted into glucuronide or sulfate esters.

Part of the cortisol is also converted into cortisone in the liver, which in turn is rapidly reduced to tetrahydrocortisone glucuronide. The water-soluble breakdown products are then excreted in the urine.

A small portion of cortisol is converted in the liver into 17-keto steroid derivatives, which are largely bound to sulfate and also excreted in the urine. 58

Scientific sources

  1. Hanns Kaiser, Hans K. Kley: Cortisone Therapy. Corticoids in Clinical Practice. Thieme 2002, p. 10. ↩
  2. Hanns Kaiser, Hans K. Kley: Cortisone Therapy. Corticoids in Clinical Practice. Thieme 2002, p. 10. ↩
  3. Heinz Lüllmann, Klaus Mohr, Lutz Hein: Pharmacology and Toxicology. Thieme 2010, p. 416. ↩
  4. Hanns Kaiser, Hans K. Kley: Cortisone Therapy. Corticoids in Clinical Practice. Thieme 2002, p. 12. ↩
  5. Heinz Lüllmann, Klaus Mohr, Lutz Hein: Pharmacology and Toxicology. Thieme 2010, p. 416. ↩
  6. Walter Siegenthaler, Hubert E. Blum: Clinical Pathophysiology. Thieme 2006, pp. 336-337. ↩
  7. Gustavo E. Tafet: Neuroscience of Stress. Springer 2024, pp. 8-9, 80. ↩
  8. Julia Wiederhofer: Psychoneuroendocrinology in Psychosocial and Psychotherapeutic Practice. Springer 2024, 106-107. ↩
  9. Heinz Lüllmann, Klaus Mohr, Lutz Hein: Pharmacology and Toxicology. Thieme 2010, pp. 416–17. ↩
  10. Hanns Kaiser, Hans K. Kley: Cortisone Therapy. Corticoids in Clinical Practice. Thieme 2002, pp. 15-17, 22. ↩
  11. Gustavo E. Tafet: Neuroscience of Stress. Springer 2024, pp. 9, 84. ↩
  12. Hanns Kaiser, Hans K. Kley: Cortisone Therapy. Corticoids in Clinical Practice. Thieme 2002, pp. 17, 22. ↩
  13. Julia Wiederhofer: Psychoneuroendocrinology in Psychosocial and Psychotherapeutic Practice. Springer 2024, 106-107. ↩
  14. Livia Thomas: Neuroendocrine stress reactivity in the context of stress coping skills and detection performance. Logos 2015, pp. 21–23. ↩
  15. Ruud van den Bos et al.: Stress and decision-making in humans: Performance is related to cortisol reactivity, although differently in men and women. In: Psychoneuroendocrinology 2009, Vol. 34(10), pp. 1449-1458, https://doi.org/10.1016/j.psyneuen.2009.04.016. ↩
  16. Joan E. Standora, Alex Bogomolnik, Malgorzata Slugocki: Steroids. History, Science, and Issues. Bloomsbury Pub. 2017, Chapter 5. ↩
  17. Anette Harris et al.: Diurnal cortisol rhythm: Associated with anxiety and depression, or just an indication of lack of energy? In: Psychiatry Research 2015, Vol. 228(2), pp. 209-215, https://doi.org/10.1016/j.psychres.2015.04.006. AS WELL AS Yang Yap et al.: Daily associations between salivary cortisol and electroencephalographic-assessed sleep: a 15-day intensive longitudinal study, In: Sleep 2024, Vol. 47 (9), https://doi.org/10.1093/sleep/zsae087. ↩
  18. Gustavo E. Tafet: Neuroscience of Stress. Springer 2024, pp. 80, 84-85. ↩
  19. Ewelina Dziurkowska, Marek Wesolowski: Cortisol as a Biomarker of Mental Disorder Severity. In: Journal of Clinical Medicine 2021 Nov 8;10(21), https://doi.org/10.3390/jcm10215204. ↩
  20. Hermann Faller, Hermann Lang: Medical Psychology and Sociology. Springer 2010, pp. 25-27. ↩
  21. Walter Siegenthaler, Hubert E. Blum: Clinical Pathophysiology. Thieme 2006, pp. 337–33. ↩
  22. Anette Harris et al.: Diurnal cortisol rhythm: Associated with anxiety and depression, or just an indication of lack of energy? In: Psychiatry Research 2015, Vol. 228(2), pp. 209-215, https://doi.org/10.1016/j.psychres.2015.04.006. ↩
  23. Ewelina Dziurkowska, Marek Wesolowski: Cortisol as a Biomarker of Mental Disorder Severity. In: Journal of Clinical Medicine 2021 Nov 8;10(21), https://doi.org/10.3390/jcm10215204. ↩
  24. Janine D. Flory et al.: Childhood trauma and basal cortisol in people with personality disorders. In: Comprehensive Psychiatry 2009, Vol. 50 (1), pp. 34-37, https://doi.org/10.1016/j.comppsych.2008.05.007. ↩
  25. Marie-Louise Meewisse et al.: Cortisol and post-traumatic stress disorder in adults: Systematic review and meta-analysis. In: British Journal of Psychiatry 2007;191(5), pp. 387-392. https://doi.org/10.1192/bjp.bp.106.024877. ↩
  26. Walter Siegenthaler, Hubert E. Blum: Clinical Pathophysiology. Thieme 2006, pp. 339–40. ↩
  27. Michael T McDermott: Pseudo-endocrine Disorders: Recognition, Management, and Action, In: Journal of the Endocrine Society 2025, Vol. 9 (1), https://doi.org/10.1210/jendso/bvae226. ↩
  28. Heinz Lüllmann, Klaus Mohr, Lutz Hein: Pharmacology and Toxicology. Thieme 2010, p. 416. ↩
  29. Alfred Wolf, Pasquale Calabrese: Stress Medicine and Stress Psychology, Schattauer 2020, 80. ↩
  30. Hanns Kaiser, Hans K. Kley: Cortisone Therapy. Corticoids in Clinical Practice. Thieme 2002, pp. 13-14. ↩
  31. Joan E. Standora, Alex Bogomolnik, Malgorzata Slugocki: Steroids. History, Science, and Issues. Bloomsbury Pub. 2017, Chapter 5. ↩
  32. Gustavo E. Tafet: Neuroscience of Stress. Springer 2024, pp. 80, 84-85. ↩
  33. Livia Thomas: Neuroendocrine stress reactivity in the context of stress coping skills and detection performance. Logos 2015, pp. 21–23. ↩
  34. Karin Chellew et al.: The effect of progressive muscle relaxation on daily cortisol secretion. In: Stress 2005, 18(5), pp. 538–544. https://doi.org/10.3109/10253890.2015.1053454 ↩
  35. Adam Koncz et al.: Meditation interventions efficiently reduce cortisol levels of at-risk samples: a meta-analysis. In: Health Psychology Review 2020, 15(1), pp. 56–84. https://doi.org/10.1080/17437199.2020.1760727 ↩
  36. Maria Meier et al.: Laughter yoga reduces the cortisol response to acute stress in healthy individuals. In: Stress 2020, 24(1), pp. 44–52. https://doi.org/10.1080/10253890.2020.1766018 ↩
  37. James M. Greenblatt, Kelly Brogan: Integrative Therapies for Depression. CRC Press 2015, p. 313. ↩
  38. Shravan G. Aras et al.: Is Greener Better? Quantifying the Impact of a Nature Walk on Stress Reduction Using HRV and Saliva Cortisol Biomarkers. In; International Journal of Environmental Research and Public Health 2024, 21(11), https://doi.org/10.3390/ijerph21111491. ALSO Wenfei Yao et al.: The effect of exposure to the natural environment on stress reduction: A meta-analysis. In: Urban Forestry & Urban Greening 2021, Vol. 57, https://doi.org/10.1016/j.ufug.2020.126932. In contrast: Jenny Veitch et al.: Examination of the acute heart rate and salivary cortisol response to a single bout of walking in urban and green environments: A pilot study, In: Urban Forestry & Urban Greening 2022, Vol. 74, https://doi.org/10.1016/j.ufug.2022.127660. ↩
  39. Beate Ditzen et al.: Effects of different kinds of couple interaction on cortisol and heart rate responses to stress in women. In: Psychoneuroendocrinology 2007, Vol. 32 (5), pp. 565-574, https://doi.org/10.1016/j.psyneuen.2007.03.011. ↩
  40. Aljoscha Dreisoerner et al.: Self-soothing touch and being hugged reduce cortisol responses to stress: A randomized controlled trial on stress, physical touch, and social identity. In: Comprehensive Psychoneuroendocrinology 2021, Vol. 8, https://doi.org/10.1016/j.cpnec.2021.100091. ↩
  41. Jalal Fatahi et al: The Effect of 12 Weeks of Dry and Steam Sauna on Fasting Glucose, Sleep Quality, and Cortisol Hormone in Middle-Aged Men. In: Journal of Nutrition, Fasting and Health 2023; 11(3), pp. 225-236, https://doi.org/10.22038/jnfh.2023.75385.1470 ↩
  42. Shreya Chawla et al.: The Window Matters: A Systematic Review of Time Restricted Eating Strategies in Relation to Cortisol and Melatonin Secretion. In: Nutrients 2021, 13(8), https://doi.org/10.3390/nu13082525 AS WELL AS Esra Şentürk et al.: Investigation of the effect of Ramadan fasting on serum levels of melatonin, cortisol, and serotonin: the case of Turkey. In: Irish Journal of Medical Science 2024, Vol. 193, pp. 1073–1077. https://doi.org/10.1007/s11845-023-03532-1 AS WELL AS Amin Riat et al.: Ramadan Fasting in Germany (17–18 h/Day): Effect on Cortisol and Brain-Derived Neurotrophic Factor in Association With Mood and Body Composition Parameters. In: Frontiers in Nutrition 2021, Vol. 8, https://doi.org/10.3389/fnut.2021.697920 ↩
  43. William Lovallo et al.: Caffeine Stimulation of Cortisol Secretion Across the Waking Hours in Relation to Caffeine Intake Levels. In: Psychosomatic Medicine 2005, Vol. 67(5), pp. 734-739, https://doi.org/10.1097/01.psy.0000181270.20036.06. ↩
  44. William R. Lovallo et al.: Cortisol responses to mental stress, exercise, and meals following caffeine intake in men and women. In: Pharmacology Biochemistry & Behavior 2006, 83(3), pp. 441-7. https://doi.org/10.1016/j.pbb.2006.03.005 ALSO Elli L. Cole et al.: Habitual Caffeine Use Is Associated With Heightened Cortisol Reactivity to Lab-Based Stress in Two Samples. In: Psychosom Medicine 2024 Oct 1; 86(8), pp. 730-737. https://doi.org/10.1097/psy.0000000000001334 ↩
  45. William R. Lovallo: Cortisol secretion patterns in addiction and addiction risk. In: International Journal of Psychophysiology 2006, Vol. 59(3), pp. 195-202, https://doi.org/10.1016/j.ijpsycho.2005.10.007. ↩
  46. Walter Siegenthaler, Hubert E. Blum: Clinical pathophysiology. Thieme 2006, p. 179 AS WELL AS Marcus Imamovic et al.: Confounding effects of liquor ice, hydrocortisone, and blood contamination on salivary cortisol but not cortisone in: Endocrine Connections 2022, 12 (1), https://doi.org/10.1530/EC-22-0324. ↩
  47. Narine Beglaryan et al.: Vitamin C supplementation alleviates hypercortisolemia caused by chronic stress. In: Stress and Health 2024 Jun; 40(3), https://doi.org/10.1002/smi.3347. ↩
  48. Emad AS Al-Dujaili et al.: Effect of vitamin D supplementation on cardiovascular disease risk factors and exercise performance in healthy participants: a randomized placebo-controlled preliminary study. In: Therapeutic Advances in Endocrinology and Metabolism 2016 Aug;7(4), pp. 153-65, https://doi.org/10.1177/2042018816653357. ↩
  49. Joëlle C. Schutten et al.: Long-term magnesium supplementation improves glucocorticoid metabolism: A post-hoc analysis of an intervention trial. In: Clinical Endocrinology (Oxford) 2021 Feb; 94(2), pp. 150-157. https://doi.org/10.1111/cen.14350. ↩
  50. Hanns Kaiser, Hans K. Kley: Cortisone Therapy. Corticoids in Clinical Practice. Thieme 2002, pp. 13-14. ↩
  51. Nikolina Erceg: The Role of Cortisol and Dehydroepiandrosterone in Obesity, Pain, and Aging. In: Diseases 2025; 13(2):42. https://doi.org/10.3390/diseases13020042. ↩
  52. Linda Grosser et al.: Cortisol and shiftwork: A scoping review. In: Sleep Medicine Reviews 2022, Vol. 64, https://doi.org/10.1016/j.smrv.2021.101581. ↩
  53. Meena Kumari et al.: Self-Reported Sleep Duration and Sleep Disturbance Are Independently Associated with Cortisol Secretion in the Whitehall II Study, In: The Journal of Clinical Endocrinology & Metabolism 2009, Vol. 94 (12), pp. 4801-4809, https://doi.org/10.1210/jc.2009-0555. ↩
  54. Yang Yap et al.: Daily associations between salivary cortisol and electroencephalographic-assessed sleep: a 15-day intensive longitudinal study, In: Sleep 2024, Vol. 47 (9), https://doi.org/10.1093/sleep/zsae087. ↩
  55. Raphael J. Dressle et al.: HPA axis activity in patients with chronic insomnia: A systematic review and meta-analysis of case–control studies. In: Sleep Medicine Reviews 2022,, Vol. 62, https://doi.org/10.1016/j.smrv.2022.101588. ↩
  56. Walter Siegenthaler, Hubert E. Blum: Clinical Pathophysiology. Thieme 2006, pp. 337-339 (hypercortisolism) and https://www.apotheken-umschau.de/gesund-bleiben/cortisol-detox-warum-social-media-hype-medizinisch-fragwuerdig-ist-1221571.html ↩
  57. Georg Löffler, Petro E. Petrides: Biochemistry and Pathobiochemistry. Springer 2003, pp. 882-883. ↩
  58. Georg Löffler, Petro E. Petrides: Biochemistry and Pathobiochemistry. Springer 2003, pp. 882-883 AND William Francis Ganong: Medical Physiology. Springer 1971, pp. 348-50. ↩

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