High cortisol levels are caused primarily by chronic stress, excessive use of steroid medications, and medical conditions such as Cushing syndrome. The main triggers include tumors on the pituitary gland, adrenal glands, or ectopic tumors in other parts of the body that cause excessive cortisol production. Other factors that raise cortisol levels are intense exercise, sleep deprivation, inflammatory conditions, certain medications (like corticosteroids), and lifestyle factors such as high alcohol and caffeine consumption. Conditions like depression, anxiety, and chronic illnesses can also contribute to elevated cortisol levels.

Specifically, Cushing syndrome, a disease characterized by prolonged high cortisol, can be caused by:

• Pituitary tumors producing excess ACTH (Cushing disease)
• Adrenal tumors producing excess cortisol
• Ectopic tumors producing ACTH in other organs
• Long-term corticosteroid medication use

Stress-induced hypercortisolism occurs when the body is exposed to prolonged emotional or physical stress, leading to constant high cortisol secretion.

In summary, the main causes of high cortisol levels are:

Cause| Description
---|---
Chronic stress| Emotional or physical stress triggering continuous cortisol release
Pituitary tumors| Tumors secreting ACTH, causing adrenal glands to produce excess cortisol (Cushing disease)
Adrenal tumors| Tumors in adrenal glands producing excess cortisol
Ectopic tumors| Tumors outside normal glands producing ACTH
Prolonged corticosteroid use| Long-term use of steroid medications raising cortisol levels
Sleep deprivation| Poor sleep quality increasing cortisol
Inflammatory conditions| Chronic infections or autoimmune diseases
Lifestyle factors| Excess alcohol, caffeine consumption
Mental health conditions| Depression, anxiety affecting cortisol regulation

This explains the various mechanisms and triggers underpinning high cortisol levels.