To know if cortisol levels are high, one can look for a range of symptoms that often indicate elevated cortisol. Common signs include weight gain, especially around the face and abdomen, acne, thinning skin, easy bruising, flushed face, muscle weakness, severe fatigue, irritability, difficulty concentrating, high blood pressure, and headaches. More specific signs linked to prolonged high cortisol include a rounded "moon" face, fatty hump between the shoulders, pink or purple stretch marks on the skin, slow wound healing, and mood swings like anxiety or depression. Testing cortisol levels through blood, urine, or saliva tests is the definitive way to confirm high cortisol, with most tests done in the morning when cortisol peaks naturally.