Chronic Stress and Cortisol
Chronic Stress, Cortisol, and Why Patient Advocacy Matters
Chronic stress is often discussed in relation to mental health, but its effects on the body extend far beyond mood alone. Prolonged stress has measurable physiologic consequences, particularly through its impact on cortisol and the hypothalamic-pituitary-adrenal (HPA) axis. Understanding how stress affects the body is essential for recognizing symptoms early and addressing health concerns before they become chronic or debilitating.
Cortisol is a glucocorticoid hormone released by the adrenal glands in response to real or perceived stress. It plays a critical role in regulating metabolism, blood pressure, immune function, and the body’s acute stress response. When functioning normally, cortisol follows a predictable daily rhythm and helps the body adapt to short-term stressors. In appropriate amounts, cortisol is not harmful—it is necessary for normal physiologic function. However, when stress becomes chronic, persistent activation of the HPA axis can lead to dysregulation of cortisol production and an impaired stress response.
Research has linked chronic stress and HPA axis dysfunction to a wide range of health conditions. These include fatigue, sleep disturbances, mood changes, impaired concentration, increased susceptibility to infections, autoimmune conditions, and neurodegenerative diseases such as Alzheimer’s and Parkinson’s disease. Many individuals experiencing chronic stress report feeling “burned out” or unable to tolerate stressors that previously felt manageable.
In clinical practice, patients with chronic stress may have labs drawn to assess for underlying conditions or hormonal abnormalities when appropriate. However, treatment is most often focused on lifestyle-based interventions rather than medication alone. Adequate and consistent sleep, balanced nutrition emphasizing whole foods, regular moderate physical activity, and stress-reduction strategies are foundational to restoring physiologic balance. Evidence-based therapies, such as cognitive behavioral therapy, can also be highly effective in helping individuals manage ongoing stressors.
From a patient advocacy perspective, symptoms related to chronic stress should never be dismissed or minimized. Patients deserve to be heard, taken seriously, and supported with care that considers the whole person—not just isolated symptoms or lab values. Advocacy plays a critical role in helping patients understand their health, ask informed questions, and receive care that addresses both the physical and emotional contributors to chronic stress.
