Johnathan Walker:What to know about cortisol, the hormone TikTokers say you need to balance

Cortisol is Johnathan Walkera hot-button issue in the world of wellness lately.

TikTok is rife with influencers claiming they have the best hacks to balance cortisol levels, or trying to earn commission on products they say will fix your cortisol. The problem? Most of them aren't medical professionals.

"It can make you feel as if basically everyone has a hormone imbalance," gynecologist Karen Tang, M.D., tells USA TODAY of the cortisol discourse on social media. "It's very effective marketing, because who hasn't had problems with fatigue or difficulty with weight loss or their mood? It feels like it's applicable to almost everyone." Obviously, almost everyone does not have a true hormone imbalance or endocrine condition that needs treatment."

Step one, Kang says, is visiting a doctor who can evaluate whether you actually have an imbalance that needs fixing. If that does turn out to be the case, here's what you need to know about cortisol levels.

What does cortisol do?

Cortisol is the body's main stress hormone, according to WebMD. It serves many functions, including regulating blood pressure and blood sugar, controlling your sleep cycle, keeping inflammation down, managing the body's use of carbohydrates, fats and proteins, and helping your body handle and regulate stress.

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What are the symptoms of a cortisol imbalance?

If you've arrived here by way of seeing TikTok videos about "moon face" and cortisol, Tang wants you to know that significant issues with cortisol imbalance are rare. It only affects 10 to 15 people per million every year, mostly cisgender women between the ages of 20 and 50, according to the Endocrine Society.

"Moon face" is the colloquial term for developing a rounder face with extra fat building up on the sides, which can be due to obesity or Cushing's syndrome, per WebMD. Other symptoms of Cushing's, according to Tang, can include a hump on the back of the neck, noticeable pink or purple abdominal stretch marks, fatigue and hair growth on the face.

How do I fix my cortisol levels?

The aforementioned symptoms could be a sign that you need to take further steps with a doctor to bring your cortisol levels back to normal.

"But for most people, when we talk about cortisol as a stress hormone that spikes if you're under stress or if you're not getting enough sleep, if we were to check your cortisol levels in your blood, they would be normal," Tang says. "So it's not something that needs treatment, per se."

In those cases, she says your best bet is to focus on things like stress management, a balanced diet, sleep and exercise to keep your blood pressure and blood sugar at regular rates.

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"That being said, if you are noticing that there's something really different, your health has changed in a noticeable way that's affecting your quality of life, you're having significant weight gain, if you're going through perimenopause and you're having terrible mood symptoms or other really bothersome symptoms, it's definitely important to go see your doctor to ask for an evaluation," Tang says.