Common causes of elevated cortisol include chronic stress (work, personal life), which keeps the adrenal glands constantly active. Poor or irregular sleep disrupts the natural cortisol decline. Overtraining in athletes – as noted in the MyBody-X article on cortisol symptoms – can also lead to chronically high levels because intense exercise without adequate recovery overstimulates the stress axis. Other triggers: high caffeine intake, chronic inflammation (e.g., from gut dysbiosis), psychological strain, and certain medications. Genetic variants (e.g., in the CRY1 gene) may slightly shift cortisol rhythm but have a minor effect. Importantly, cortisol rises naturally with acute stress; only persistent elevation is harmful. Evidence is based on clinical practice and observational studies; no RCTs comprehensively confirm all causes.
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