Cortisone reaction: Cortisone Injection Risks and Side Effects

18.06.202121.07.2023 by alexxlab

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Cortisone Injection Risks and Side Effects

Arthritis and other joint problems may be treated with cortisone injections. Like any treatment, these injections carry certain risks and side effects. Most are mild or temporary, but some can be serious or long-lasting.

Patients are advised to discuss concerns about risks and side effects with their health care providers before receiving cortisone injections. Potential risks and side effects include:

Pain and Swelling (Cortisone Flare)

The injected cortisone medication can crystallize inside the body. The crystals can cause pain and inflammation that is worse than the pain and inflammation caused by the condition being treated. This side effect is called a cortisone flare. A flare typically lasts one or two days and can be treated with rest and intermittent cold packs.

See When and Why to Apply Cold to an Arthritic Joint

Skin Discoloration

Patients may notice the skin around the injection site changes color a few weeks or months after the injection.

¹
Gupta A, Garg M, Johnson N, Vignesh P. Hypopigmentation after intra-articular corticosteroid injection. BMJ Case Rep. 2019 Mar 31;12(3). doi: 10.1136/bcr-2018-228921. PubMed PMID: 30936358.
^,
²
Park SK, Choi YS, Kim HJ. Hypopigmentation and subcutaneous fat, muscle atrophy after local corticosteroid injection. Korean J Anesthesiol. 2013;65(6 Suppl):S59–S61. doi:10.4097/kjae.2013.65.6S.S59
This side effect is most common in darker-skinned patients, who notice the skin becomes lighter.

¹
Gupta A, Garg M, Johnson N, Vignesh P. Hypopigmentation after intra-articular corticosteroid injection. BMJ Case Rep. 2019 Mar 31;12(3). doi: 10.1136/bcr-2018-228921. PubMed PMID: 30936358.

Skin discoloration may last a few weeks or months or be permanent.

²
Park SK, Choi YS, Kim HJ. Hypopigmentation and subcutaneous fat, muscle atrophy after local corticosteroid injection. Korean J Anesthesiol. 2013;65(6 Suppl):S59–S61. doi:10.4097/kjae.2013.65.6S.S59
Skin discoloration is not harmful to patients’ health. This side effect occurs in 1.3% to 4% of patients

³
Newman RJ. Local skin depigmentation due to corticosteroid injection. Br Med J (Clin Res Ed) 1984;288:1725–1726. As cited in Park SK, Choi YS, Kim HJ. Hypopigmentation and subcutaneous fat, muscle atrophy after local corticosteroid injection. Korean J Anesthesiol. 2013;65(6 Suppl):S59–S61. doi:10.4097/kjae.2013.65.6S.S59
and seems to be related to the type and concentration of corticosteroid medication used.

Fat Atrophy

A cortisone injection may cause fat cells at the injection site to atrophy. A divot or depression in the skin may appear because the underlying fat cells have deteriorated. The skin’s appearance usually goes back to normal in 6 months but may take 2 or 3 years.

²
Park SK, Choi YS, Kim HJ. Hypopigmentation and subcutaneous fat, muscle atrophy after local corticosteroid injection. Korean J Anesthesiol. 2013;65(6 Suppl):S59–S61. doi:10.4097/kjae.2013.65.6S.S59
Authors of one study estimate this side effect occurs in 0.6% (6 out of every 1000) injections.

⁴
Newman RJ. Local skin depigmentation due to corticosteroid injection. Br Med J (Clin Res Ed) 1984;288:1725–1726. As cited in Park SK, Choi YS, Kim HJ. Hypopigmentation and subcutaneous fat, muscle atrophy after local corticosteroid injection. Korean J Anesthesiol. 2013;65(6 Suppl):S59–S61. doi:10.4097/kjae.2013.65.6S.S59

Elevated Blood Sugar

In addition to decreasing inflammation, corticosteroids can raise blood sugar levels. A patient with diabetes should inform their doctor prior to receiving an injection and then closely monitor blood sugar levels for a day or two following a cortisone injection.

The injection does not deliver cortisone directly to the bloodstream, but it can still influence blood sugar levels in some patients.

Tendon Injury

Cortisone injections can weaken nearby tendons and make them more prone to tearing.

⁵
Kleinman M, Gross AE. Achilles tendon rupture following steroid injection: report of three cases. J Bone Joint Surg Am. 1983; 65(9):1345-1347. As cited in Brook EM, Hu CH, Kingston KA, Matzkin EG. Corticosteroid Injections: A Review of Sex-Related Side Effects. Orthopedics. 2017 Mar 1;40(2):e211-e215. doi: 10.3928/01477447-20161116-07
Because of this risk, physicians take precautions to avoid placing a cortisone injection in or directly next to a tendon.

Patients can reduce their risk of tendon injuries by resting the affected joint for a few days after the injection and then gradually increasing activity with recommended stretching and exercises.

Cartilage Loss

Research suggests cortisone injections may have a negative effect on cartilage. For example, one study

⁶
McAlindon TE, LaValley MP, Harvey WF, et al. Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial. JAMA. 2017;317(19):1967–1975. doi:10.1001/jama.2017.5283
found an association between repeated cortisone injections and 0.11 cm loss of cartilage in the knee. The same study did not find an association with increased knee pain.

Infection

Though rare,

⁷
McGarry JG, Daruwalla ZJ. The efficacy, accuracy and complications of corticosteroid injections of the knee joint. Knee Surg Sports Traumatol Arthrosc. 2011 Oct;19(10):1649-54. doi: 10.1007/s00167-010-1380-1. Epub 2011 Jan 11. Review. PubMed PMID: 21222099.
^,
⁸
Pal B, Morris J. Perceived risks of joint infection following intra-articular corticosteroid injections: a survey of rheumatologists. Clin Rheumatol. 1999;18(3):264-5. doi: 10.1007/s100670050098. PubMed PMID: 11206357.
infection is a serious potential side effect. People who are more prone to infection, such as those who have autoimmune diseases and who take immune-suppressing medications, should inform their health care provider. After receiving a cortisone injection, any patient who suspects an infection or runs a fever is advised to contact their doctor.

Allergic Reaction

Patients should tell their doctor if they have ever had an allergic reaction following an injection. While uncommon, some patients have allergic reactions to the local anesthetic added to the injection. Allergic reactions to the cortisone itself are rare because cortisone is a synthetic version of cortisol, a steroid naturally found in the body.

While not common, women may experience

⁹
Brook EM, Hu CH, Kingston KA, Matzkin EG. Corticosteroid Injections: A Review of Sex-Related Side Effects. Orthopedics. 2017 Mar 1;40(2):e211-e215. doi: 10.3928/01477447-20161116-07
:

Irregular menstruation
Disturbances in lactation, if the woman is breast-feeding
Skin flushing
Excess hair growth

Unlike women, men do not seem to experience any unique side-effects.

⁹
Brook EM, Hu CH, Kingston KA, Matzkin EG. Corticosteroid Injections: A Review of Sex-Related Side Effects. Orthopedics. 2017 Mar 1;40(2):e211-e215. doi: 10.3928/01477447-20161116-07

Doctors do not recommend cortisone injections for patients who have an existing infection, including skin infections and septic arthritis. In addition, cortisone injections may not be appropriate for patients who are taking blood thinners or who have broken bones.

Some patients may be concerned about weight gain and water retention from corticosteroid use. However, these side effects are common only for patients who take corticosteroid medications orally for an extended period of time. These side effects rarely occur when the cortisone medication is injected into a joint.

See What Is Cortisone?

Read more articles about other types of injections in the Injections Health Center

Dr. Emmanuel Konstantakos is an orthopedic surgeon specializing in sports medicine, arthroscopic surgery, and general orthopedics. Dr. Konstantakos has authored numerous research articles published in academic journals.

1
Gupta A, Garg M, Johnson N, Vignesh P. Hypopigmentation after intra-articular corticosteroid injection. BMJ Case Rep. 2019 Mar 31;12(3). doi: 10.1136/bcr-2018-228921. PubMed PMID: 30936358.
2
Park SK, Choi YS, Kim HJ. Hypopigmentation and subcutaneous fat, muscle atrophy after local corticosteroid injection. Korean J Anesthesiol. 2013;65(6 Suppl):S59–S61. doi:10.4097/kjae.2013.65.6S.S59
3
Newman RJ. Local skin depigmentation due to corticosteroid injection. Br Med J (Clin Res Ed) 1984;288:1725–1726. As cited in Park SK, Choi YS, Kim HJ. Hypopigmentation and subcutaneous fat, muscle atrophy after local corticosteroid injection. Korean J Anesthesiol. 2013;65(6 Suppl):S59–S61. doi:10.4097/kjae.2013.65.6S.S59
4
Newman RJ. Local skin depigmentation due to corticosteroid injection. Br Med J (Clin Res Ed) 1984;288:1725–1726. As cited in Park SK, Choi YS, Kim HJ. Hypopigmentation and subcutaneous fat, muscle atrophy after local corticosteroid injection. Korean J Anesthesiol. 2013;65(6 Suppl):S59–S61. doi:10.4097/kjae.2013.65.6S.S59
5
Kleinman M, Gross AE. Achilles tendon rupture following steroid injection: report of three cases. J Bone Joint Surg Am. 1983; 65(9):1345-1347. As cited in Brook EM, Hu CH, Kingston KA, Matzkin EG. Corticosteroid Injections: A Review of Sex-Related Side Effects. Orthopedics. 2017 Mar 1;40(2):e211-e215. doi: 10.3928/01477447-20161116-07
6
McAlindon TE, LaValley MP, Harvey WF, et al. Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial. JAMA. 2017;317(19):1967–1975. doi:10.1001/jama. 2017.5283
7
McGarry JG, Daruwalla ZJ. The efficacy, accuracy and complications of corticosteroid injections of the knee joint. Knee Surg Sports Traumatol Arthrosc. 2011 Oct;19(10):1649-54. doi: 10.1007/s00167-010-1380-1. Epub 2011 Jan 11. Review. PubMed PMID: 21222099.
8
Pal B, Morris J. Perceived risks of joint infection following intra-articular corticosteroid injections: a survey of rheumatologists. Clin Rheumatol. 1999;18(3):264-5. doi: 10.1007/s100670050098. PubMed PMID: 11206357.
9
Brook EM, Hu CH, Kingston KA, Matzkin EG. Corticosteroid Injections: A Review of Sex-Related Side Effects. Orthopedics. 2017 Mar 1;40(2):e211-e215. doi: 10.3928/01477447-20161116-07

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Cortisone Flare: What to Expect

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9 Ways to Reduce Cortisol and Prevent Stress

Stress is the body’s response to a potential threat that can be linked to physical and psychological factors. Learn about the role of cortisol in stress and how to lower cortisol.

Cortisol is one of the hormones produced by the adrenal cortex. It is involved in many metabolic processes, for example, it helps regulate blood pressure and blood sugar levels.

In addition, cortisol plays a role in the process of awakening from sleep. When you wake up, the level of the hormone rises, reaching peak after 30 minutes and then gradually decline throughout the day.

Cortisol is also called the “stress hormone”.

When your body feels threatened, either physically or psychologically, the brain sends a signal to the adrenal glands, and in response they release cortisol.

Thanks to this hormone, concentration improves , blood circulation and glucose synthesis increase – this helps the body release additional energy in order to more effectively overcome stress.

Frequent or prolonged increases in cortisol levels can harm the body.

Despite the benefits of cortisol, frequent or prolonged increases in its levels can harm the body.

For example, chronic stress causes cortisol dysfunction, which leads to inflammation, depression, and accelerated cell aging . It is also associated with the development of osteoporosis, muscular dystrophy and a decrease in antitumor immunity.

Chronic stress results from repeated exposure to situations that lead to the release of stress hormones, including cortisol.

We’ve rounded up nine science-based ways to naturally lower cortisol levels and manage stress. So your body will be less likely to experience a state of mobilization to eliminate a potential threat.

The Whole Genome Test helps you avoid the stress associated with health concerns. Learn about personal risks and learn how to manage them.

1. Identify factors that trigger stress

Threats to life or change of scenery – irritants that provoke anxiety and can become a trigger or stressor.

Photo by Christian Erfurt / Unsplash

These irritants include physical pain, relationship or work problems, financial difficulties. It is, of course, impossible to predict when you will hit your foot on a chair. But some kinds of triggers can be learned to recognize.

One of the first steps for anti-stress is understand what causes stress . I do not want to remember and think about unpleasant situations once again. But a stress diary can help you recognize stimuli so you can learn to respond less to them.

It is not necessary to remember all the details of an unpleasant event – it is enough to write down the fact and try to analyze why what happened caused you a negative reaction.

Photo by Alexandra Fuller / Unsplash

A stress diary can help you find practical ways to deal with such situations. For example, avoid quarrels, learn to build personal boundaries in relationships and at work, and say “no” at the right time. Moreover, you will be able to identify the hidden causes of stress as hanging out on social networks.

2. Learn to recognize stressful thoughts

Thinking about negative and traumatic events is a trigger for cortisol synthesis.

British scientists conducted a study in which participants recorded their most negative memories for 20 minutes over three days. The results showed that it caused the participants to have high levels of cortisol. Scientists attribute this to long-term effects on the entire body.

Photo by Aarón Blanco Tejedor / Unsplash

Also, the scientific community highlights the role of anxiety and fixation on negative thoughts in stress levels. It has been proven that negative thinking not only increases cortisol levels, but also has a bad effect on the production of oxytocin, a hormone that calms the human nervous system.

Mental practice or mindfulness is one way to combat negative thinking and help lower cortisol levels.

3. Pay attention to the quality of your sleep

A person who has had a good night’s sleep finds it easier to deal with stress and unpleasant situations.

The quality and duration of sleep is largely dependent on your circadian rhythms and habits. What time you go to bed and wake up also plays a role. Studies show that people who work night shifts and sleep during the day are more likely to have elevated cortisol levels.

Shift work before age 40 is associated with higher body mass index (BMI) and higher cortisol levels.

Photo by Ben Blennerhassett / Unsplash

Cortisol can be elevated due to lack of sleep or insomnia , especially in the evening after sleep deprivation.

Sleep hygiene is one of the decisive factors in its quality. Try to create conditions in which the amount of noise and light will be minimal. Blackout curtains, an eye mask, and earplugs will help with this.

Sleep Tips to Reduce Cortisol:

Try to go to bed and wake up at the same time.
Wash bed linen and sleepwear regularly – the fresh smell helps the body to relax.
Avoid using blue light devices (TV, phone, tablet) 2-3 hours before bedtime.
Avoid caffeinated drinks in the afternoon.
Avoid excessive cardio and strength training two hours before bedtime.

4. Exercise regularly

Exercise can either increase or decrease cortisol levels, depending on the length and intensity of exercise.

Despite the benefits of playing sports, it is still a load and stress for the body. Therefore, as a result of intense exercise, cortisol usually rises briefly, but then drops at night.

Photo by Abigail Keenan / Unsplash
At the same time, moderate-intensity exercise does not lead to an increase in the level of the stress hormone. Like intense exercise, moderate exercise has been linked to lower nighttime cortisol levels.

Regular exercise can control cortisol levels. And in addition to reducing the stress hormone, sports have a good effect on the microbiota.

But it’s better to avoid strenuous evening workouts that will keep you awake. Physical activity isn’t just good for the body—many doctors recommend it to improve mental health as well.

The Atlas Genetic Test can assess the body’s ability to synthesize important amino acids and hormones, as well as the genetic susceptibility to sports injuries.

5. Find something to do

Learning to relax is really good, especially if you want to manage stress. A new hobby is one way that also helps you learn a new skill. It doesn’t matter what you do, the main thing is that you enjoy the activity.

Photo by Steve Johnson / Unsplash

American scientists conducted a study of 50 former combatants who had depression, post-traumatic stress disorder or substance abuse. For a month they were engaged in gardening and occupational therapy. The results showed a reduction in stress and a decrease in cortisol.

Think about what you would like to do, perhaps painting, music, or gardening.

6. Laugh more often

Laughter is good not only for the soul, but also for the body. This is a natural way to overcome stress and lower cortisol levels.

Photo by Lesly Juarez / Unsplash

A study published in 2008 showed that even the anticipation of laughter leads to a decrease in blood levels of cortisol, as well as two other stress hormones – adrenaline and norepinephrine.

Laughter reduces not only the level of stress hormones, but also blood pressure.

If you are having a fun and interesting time, it is unlikely that you will experience a lot of stress at the same time. That is why it is so important to plan your pastime and visit interesting places and events.

7. Connect with animals

It has been scientifically proven that contact with animals is associated with lower cortisol levels.

Scientists have studied how interaction with animals affects stress, and found that prolonged contact with dogs, even strangers, as well as owning a pet, has a positive effect on cortisol levels.

In addition, interactions between humans and dogs increase oxytocin levels in both.

Photo by Vitalie Sitnic / Unsplash. Contact with animals is associated with reduced cortisol levels.

Pets are associated not only with reduced stress levels, but also with other health benefits.

Owners of cats, dogs, parrots and other pets find it easier to focus.

Animals also have a positive effect on blood pressure and help avoid feelings of loneliness.

8. Add foods that reduce cortisol levels to your diet

Nutrition affects not only the metabolic processes in the body, but also the level of cortisol.

Photo by Ala / Unsplash

Certain foods, such as sugar, can increase the amount of the stress hormone.

Neurotransmitter chemicals are responsible for signaling the nervous system and controlling mood. And hormones and food are responsible for their production.

Good food management will help Atlas microbiota test . Personalized nutritional advice will help you improve your diet and make proper nutrition a part of your life.

How to reduce cortisol through nutrition

Foods rich in polyphenols help reduce stress hormone levels. For example, the long-term health benefits of drinking green tea are scientifically proven – drinking just half a glass a day reduces the risk of depression and dementia.

Eating the foods and drinks below will help control cortisol levels:

Food	Drinks
Bananas	Black tea
Dark chocolate	Green tea
Vegetable fibers	Probiotics (yogurt)
Probiotics (sauerkraut)	Water

Please note that Stress eating provides only temporary relief and can lead to eating disorders, weight gain and blood sugar problems.

Photo by Isaac Quesada / Unsplash

In times of stress, try to choose foods containing vegetable fibers – fiber provides a feeling of satiety for a long time and regulates blood sugar levels.

Regular sugar intake is associated with long-term high cortisol levels and is associated with a higher risk of heart disease in overweight men.

Probiotics

The gut microbiota contains trillions of bacteria that are good for your health. They strengthen the intestinal mucosa, fight inflammation, regulate the immune system and even mental health. That’s why it’s important to take care of the composition of your gut bacteria.

Photo by Daniel Cabriles / Unsplash

Among the inhabitants of the gut microbiota are probiotic bacteria that reduce cortisol levels and, consequently, stress. Among them are bacteria Lacticaseibacillus rhamnosus and L. farciminis.

Probiotic foods help support beneficial gut bacteria.

Fermented milk drinks such as kefir and yogurt, as well as fermented foods such as kimchi, contain certain strains of probiotic bacteria.

Studies show that one strain of Lactobacillus, L. Plantarum 299v , reduces exam stress in patients with irritable bowel syndrome (IBS).

With the Atlas Microbiota Test, you can learn about the bacterial diversity of your gut, as well as assess the level of probiotic bacteria.

9. Spend time in nature

City noise, rush and traffic jams are a part of many people’s lives, but not everyone realizes the extent of the negative impact of such an atmosphere on physical and mental health. Even a park or reserve within the city is a great opportunity to recover and relax.

Photo by Amos G / Unsplash

Forest therapy is a part of life for most Japanese people. They call it “shinrin-yoku”, which translates to “forest bath” . This is the practice of walking in the park or in the forest for 2-4 hours, which includes the contemplation of nature and deep breathing.

Scientists have proven that such a pastime reduces the level of cortisol, normalizes the heartbeat and blood pressure.

Deep breathing reduces heart rate, improves mood and reduces stress.

There is no one-size-fits-all method of coping with stress, because every body and brain is unique. Good sleep, proper nutrition and regular exercise are the basis for good health.

Now you know the scientifically proven ways to prevent and reduce stress.

Kara E. Hannibal, Mark D. Bishop, Chronic Stress, Cortisol Dysfunction, and Pain: A Psychoneuroendocrine Rationale for Stress Management in Pain Rehabilitation, 2014
Harri Lindholm et al., Morning Cortisol Levels and Perceived Stress in Irregular Shift Workers Compared with Regular Daytime Workers, 2012
Center for studies of human health, Acute vs. chronic stress
Veronika Engert et al., Mind your thoughts: associations between self-generated thoughts and stress-induced and baseline levels of cortisol and alpha-amylase, 2014
Karen Weintraub, “Stress Hormone” Cortisol Linked to Early Toll on Thinking Ability, 2018
Susan Jennifer Thomas, Theresa Larkin, Cognitive Distortions in Relation to Plasma Cortisol and Oxytocin Levels in Major Depressive Disorder, 2020
Adam Koncz, Meditation interventions efficiently reduce cortisol levels of at-risk samples: a meta-analysis, 2019
Harvard Health School, Blue light has a dark side, 2012
Sean M. Smith, The role of hypothalamic-pituitary-adrenal axis in neuroendocrine responses to stress, 2006
Mark B Detweiler et al., Horticultural therapy: a pilot study on modulating cortisol levels and indices of substance craving, posttraumatic stress disorder, depression, and quality of life in veterans, 2015
Sophie Bostock, Andrew Steptoe, Influences of early shift work on the diurnal cortisol rhythm, mood and sleep: Within-subject variation in male airline pilots, 2013
American Physiological Society, Anticipating A Laugh Reduces Our Stress Hormones, Study Shows, 2008
John P Polheber, Robert L Matchock, The presence of a dog attenuates cortisol and heart rate in the Trier Social Stress Test compared to human friends, 2014
NIH, The Power of Pets, Health Benefits of Human-Animal Interactions, 2018
Ali Iranmanesh et al., Glucose ingestion selectively amplifies ACTH and cortisol secretory-burst mass and enhances their joint synchrony in healthy men, 2011
Saki Kakutani et al. , Green Tea Intake and Risks for Dementia, Alzheimer’s Disease, Mild Cognitive Impairment, and Cognitive Impairment: A Systematic Review, 2019
Yvonne H. C. Yau, Marc N. Potenza, Stress and Eating Behaviors, 2013
Bum Jin Park et al., The physiological effects of Shinrin-yoku, 2010
Valentina Perciavalle et al., The role of deep breathing on stress, 2017
International Scientific Association for Probiotics and Prebiotics, New names for important probiotic Lactobacillus species, 2020

Stress hormone: how to identify elevated cortisol and what to do about it

. And what to do to bring it back to normal? Back in the early twentieth century, Russian physiologists, led by academician Ivan Pavlov, proved that this is a physiological process. Its essence is to launch a whole cascade of biochemical reactions, which are primarily controlled by cortisol. It’s called the stress hormone. We understand why it is so important to track its level, and what to do if it gets out of control.

Cortisol is one of the hormones produced by the adrenal cortex, a pair of secretory organs located in the upper part of the kidneys.

Evolutionarily, its mechanism of activity was associated with a long period of the body’s struggle with a lack of food. As a result, the key function of cortisol has become to protect the body from external stresses by regulating blood pressure.

Cortisol is involved in many vital mechanisms. Here are just a few of what this hormone does:

takes part in the metabolism of proteins, carbohydrates and lipids;
performs a number of regulatory functions, such as stimulating the production of glucose from liver amino acids and the breakdown of fats for energy;
responds to inflammatory processes in the body;
is involved in many metabolic processes, such as helping to regulate blood sugar levels;
plays a role in the process of waking up from sleep: when you wake up, the hormone levels rise, reaching a peak after 30 minutes, and then gradually decrease throughout the day.

Exactly how stress and cortisol are related

When the body feels threatened, whether physical or psychological, the brain sends a signal to the adrenal glands, and in response they release cortisol. Thanks to this hormone, concentration improves, blood circulation and glucose synthesis increase – all this together helps the body release additional energy in order to successfully overcome stress.

Essentially, cortisol keeps the body functioning in a stressful situation and helps to quickly make the “fight or flight” decision – this is how the oldest evolutionary mechanism is formulated. However, there is one feature: nature did not assume that a person would be in a stressful situation for a long time. And because cortisol reserves are by no means endless.

Stress in modern conditions is not a specific threat to life, as in ancient times. This is the daily pressure of society, including today’s media storm.

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Despite all the benefits of cortisol, the current electrified information and emotional background leads to too frequent and long-term increase in its level, which causes significant damage to both the body and appearance. For example, chronic stress causes cortisol dysfunction, which leads to inflammation, depression, and accelerated cellular aging. Also, cortisol in an off-scale amount can spur the development of osteoporosis, muscular dystrophy and reduce antitumor immunity.

Sofya MelkomyanObstetrician-gynecologist, reproductologist, chief physician of the Family Health and Reproduction Clinic GM Clinic

“Cortisol is on a par with all the other stress hormones — adrenaline and norepinephrine. That is, with any stress, the level of this hormone rises. Its release during the day is uneven – different in the morning, afternoon and evening. There are also seasonal fluctuations in cortisol levels.

If the stress is one-time, then there are no harmful consequences due to the increase in this hormone. In fact, it is adaptive – the body increases it in order to overcome a stressful or increased load, to increase efficiency. But if the overvoltage is chronic, then complications begin, and very different ones. Since cortisol is built into the hormonal correction system, it turns out that its chronic excess, which, paradoxically, can eventually lead to its own deficiency, can begin to manifest itself negatively and unbalance all body systems.

The symptom complex can be very different, ranging from insomnia to edema. Everyone shows it in their own way. However, absolutely everyone begins to rapidly decline in the quality of life and develop comorbidities. As a result, it negatively affects health, appearance and overall well-being.”

If you imagine the hormonal system in the form of a pyramid, then at the base there will be cortisol, and at the very top – valuable sex hormones, which are not only responsible for procreation, but also ensure the health of blood vessels and connective tissue, muscle strength, youth and beauty of the skin. All these hormones are produced from the same substrate. When it becomes insufficient, the body refuses to produce sex hormones and puts all resources into the production of cortisol necessary for survival.

If you notice that you are getting tired faster and it is more difficult to think, if in the middle of the day you start to sleep for no reason and there is a constant decline in strength, if your hair falls out, and your libido gradually fades away – these are sure signals that you are faced with the steal syndrome, as endocrinologists call it.

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It works like this: all steroid hormones, including cortisol and sex hormones (testosterone, estrogen and progesterone), are synthesized from the same precursors. When the body’s need for cortisol increases during stress, and the stocks of this hormone are depleted during stress, the body compensates for the lack of cortisol by reducing the synthesis of sex hormones. The reason is that the survival of the organism is much more important than its reproduction.

What is the risk? You can look in the mirror and feel as if you have grown old. In fact, this, alas, is not an illusion – everything is so. Nothing passes without consequences for our body. Even under the condition that hormones return to normal, stress can be “unpacked” with negative manifestations in full in 4-6 months, and for someone even faster: skin and hair problems can worsen, chronic diseases worsen – and not only.

Natalia TanyginaEndocrinologist, Center for Molecular Diagnostics CMD Perovo Central Research Institute of Epidemiology, Rospotrebnadzor

“Excess cortisol is very clearly reflected in the appearance, as this hormone affects the distribution of subcutaneous fat. Being in excess, it thins the skin, which is why when you gain weight, wide burgundy stretch marks form on it. Such people fall under the supervision of an endocrinologist, undergo complex examinations and receive treatment. In the case when there are no such clinical manifestations, it is very difficult to suspect an increase in cortisol levels, and it is even more difficult to confirm hormonally.

The fact is that this hormone is very labile, its fluctuations during the day are so great that there are two norms for it: morning and evening. In addition, cortisol has a “controller” in the pituitary gland, its level must also be measured and changed. In addition, a 24-hour urine test for cortisol is often done. And only if all these parameters show violations, the doctor has the right to diagnose hypercortisolism or hypercortisolemia – that is, a noticeable increase in the level of cortisol in the body.

High cortisol: what to do?

Everything is simple to the point of banality: get back to your daily routine, sports, proper nutrition. What exactly are the steps to start with?

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Normalize your sleep. If you do not sleep according to the schedule, then the next day, on average, a person eats 30% more calories. Sleeping the right number of hours (everyone has their own) is not enough, suitable conditions are important – maximum darkness and coolness in the bedroom, 30-60 minutes before bedtime we put gadgets away and turn off the TV and laptop.
Add anti-stress nutrition. Oily fish (herring, sardines, mackerel, salmon, cod, wild trout), pistachios, green leafy vegetables, fermented vegetables, bananas, nuts and seeds, avocados, eggs, blueberries, broccoli and Brussels sprouts, dark chocolate, seaweed. Eliminate coffee, strong tea, alcohol. If you can’t live without tea and coffee, limit yourself to two cups a day.
Fill in the gaps. Vitamins, fatty acids, and trace elements are also important. These are C, D and vitamins of group B (with high cortisol, according to the results of the analysis, vitamin B5 is contraindicated), chelated forms of magnesium, omega-3, chromium, zinc, type 1 and 3 collagen, adaptogens: ginseng, eleutherococcus, rhodiola (adaptogens are contraindicated in autoimmune diseases, with exhaustion and hyperthyroidism).
Try to relax. Sign up for a massage course, spa treatments. At home, you can take baths with magnesium.

Sofya Melkomyan: “What kind of prevention can be here? The first is to minimize the negative information impact and move away from chronic stress. The second is to normalize sleep in quantity and quality. Thirdly, try to eat rationally and balanced. It is also extremely important to add physical activity – walks in the fresh air are very good. All this is guaranteed to positively affect the stabilization of cortisol.

If you run this question, the consequences can be very different, and, alas, they will all be with a minus sign. These can be both psychological disorders (depression) and organ dysfunction (chronic diseases, eating disorders). Against the background of hypercortisolemia, the cardiovascular system is also at risk.”

Maria ShirshakovaCosmetologist, dermatovenereologist, Candidate of Medical Sciences. Chief physician of the clinic of Maria Shirshakova

“Chronic stress leads to a change in the antioxidant potential of the body – in other words, to earlier aging. If the root cause (high cortisol) is not addressed, any aesthetic result from beauty treatments will be short-lived.

The sequence of actions should be as follows. First, we do everything to reduce the stress hormone. Based on the recommendations of the attending physician, you need to undergo an examination, select replacement therapy and dietary supplements to eliminate existing deficiencies. This is a top priority. Then we remove muscle spasticity – we neutralize excessive tension in the jaw area. Facial massage with an emphasis on the masticatory muscles will help with this. Next, you need to work with the oval of the face and “set” the contour of the lower jaw, and then fix the result in the lateral limits. In this matter, one cannot do without an ultrasonic facelift – this can be done by signing up for a session on Ulthera or Ultraformer devices. The next step is to remove creases near the corners of the mouth: they are also called “puppet wrinkles” – this is done with the help of filler injections. Only after that it makes sense to move on to work with the quality and hypersensitivity of the skin. This will help photorejuvenation, biorevitalization, mesotherapy and all kinds of facial treatments.

What other procedures, preparations and means will help to win peace of mind and a youthful “exterior” from elevated cortisol

From procedures

Droppers with iron and glutathione, Laennec placental therapy, biorevitalization , mesotherapy, microcurrents, course of procedures on devices Artistic & Co. (in the cabin and in the version for home use).

From cosmetics

Home care is selected according to the type and condition of the skin – this rule is unchanged. But since the face loses its tone and radiance during stress, it is necessary to rely on antioxidant serums. My picks are CE ferulic from Skinceuticals and Power Serum from HydroPeptide. Good masks Black Rose Cream Mask from Sisley (instantly returns a fresh look to dull skin) and Masque Gel from Arise (activates cellular metabolism, relieves puffiness, promotes detoxification).

From preparations

Hemorrhagic drops “Lymphomyosot” course of 8-14 days.

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Cortisone Injection Risks and Side Effects

Pain and Swelling (Cortisone Flare)

Skin Discoloration

Fat Atrophy

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Infection

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Stress is the body’s response to a potential threat that can be linked to physical and psychological factors. Learn about the role of cortisol in stress and how to lower cortisol.

1. Identify factors that trigger stress

2. Learn to recognize stressful thoughts

3. Pay attention to the quality of your sleep

4. Exercise regularly

5. Find something to do

6. Laugh more often

7. Connect with animals

8. Add foods that reduce cortisol levels to your diet

9. Spend time in nature

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