Doctor insights on:
What Does It Mean When Your Cortisol Levels Are Low
Collection time?: Well it depends on the time of when your cortisol level was checked. Maximal level of cortisol is usually between 5:00a-8:00am with the lowest (nadir) levels being after 5pm (almost zero level by bedtime). If your having symptoms such as malaise, increased napping, headaches, stomach ache or low bs, you may have adrenal insufficiency and will need referral to an endocrinologist for further testing.See 1 more doctor answer
Addison's disease: A very low cortisol could be addison’s disease, but this is relatively rare, and “low cortisol” is way over-diagnosed; the term “adrenal fatigue” is sometimes used, which is a fake diagnosis. If someone says you have this, see an endocrinologist for confirmation.
Cortisol tests: In normal people cortisol goes up and down throughout the day, although it is higher in am than in pm. Therefore, it is hard to define what is "low". An afternoon cortisol of 5 may be perfectly normal. Adrenal failure is called addison's disease and is dangerous, but a random cortisol usually cannot be used to diagnose addision's. An acth stim test may be needed if this diagnosis is considered.
Low Cortisol: Cortisol is produced by the adrenal glands. It is called the stress hormone, and is produced in response to either a physical stress or a mental stress, or both. Cortisol has a diurnal pattern, which means it starts highest in the morning and drops gently, and then is very low at night. Low cortisol is using referring to the flattening of the usual curve so that it is lower than it should be.
Complex: Hi. "Low cortisol" could be normal or sign of disease. I must assume your doctor checked cortisol because of some symptoms you've been having & maybe some findings on physical exam. Cortisol fluctuates throughout the day, so WHEN it's drawn does matter. Is your ACTH high? If your doc thinks you're underproducing cortisol, provocative testing may be needed if primary problem pituitary not adrenal
How high?: It depends on how high it is above normal? If mildly elevated and if you don't have symptoms of cushing's syndrome: fat at mid section, stretch marks in the abdomen, moon-face, buffalo humps...Then this might be just the way you are. If it's very high and you have symptoms of the above, see your doctor to make sure you don't have a pituitary or adrenal tumor overproducing cortisol.
How low are cortisol levels at the very end of the day (bedtime)? I had mine checked and it was at 1.0 after being awake for 16 hours.
It is probably: Normal. If it was deficient, you would have no need for high blood pressure medication. Discuss w/your doctor.
Is <0.8mcg/dl cortisol really low after taking dexamethasine the night before? What does that mean if it's low, is it extremely low or just low
Can it b lower?: The < sign implies that is lower than the lab can measure. That would be suppressed! And imply depression.
Stress: There are many different causes of high cortisol. I will mention one- stress. Usually cortisol is high in am and low in pm. Recent studies are showing woman in the workforce having higher pm cortisol levels associated with job stress. Other causes of high pm cortisol should be addressed by your doctor.
Adrenal insufficienc: People with adrenal insufficiency will have low cortisol levels. However, this is a very rare disorder. Just getting a random blood cortisol level is usually not of any value (saliva cortisol levels are worthless for this diagnosis). If you have symptoms of weight loss, loss of appetite, low blood pressure when standing, darkening of the skin, it is worth seeing an endocrinologist about it.See 1 more doctor answer
By itself nothing: Cortisol levels are drawn to rule Cushing's / Addison's in or out. Random salivary / urinary / 24 hour urinary / blood levels must be interpreted in light of your clinical picture. Addison's is typically diagnosed when cortisol won't rise appropriately in response to ACTH stimulation; Cushing's etc. When it won't suppress with dexamethasone. I hope this helps.
Depends: When it was done. Cortisol levels are higher in the am (15.3 would be normal) then in the pm (this level would be too high for the pm) ask your doctor why he/she drew it in the first place.
I found out that I have low fasting cortisol 111 nmol/l, does that mean all my adrenal hormones are low?
WHile your: Result is low, one abnormal test doesn't make a diagnosis. It needs to be repeated with an 8am blood cortisol at a quality lab and correlated with historical and physical exam data (plus potentially other lab tests) by your physician. Besides, the other adrenal hormones are controlled by different mechanisms than cortisol.
Recent tests showed my 9am plasma cortisol level was high (644 nmo/L ref range 170 - 550nml/L) and 11pm salivary cortisol normal. What can this mean?
Stress: Chronic stress can cause elevated cortisol--although it could also be due to your diabetes. I suggest DHEA (dehydroepiandrosterone), 25 mg in the morning. DHEA should help to normalize your cortisol, and help you handle stress. I also suggest 1, 000 mg mastic gum (available on line or from a health food store) for your abdominal distress--may be able to discontinue Rabeprazole.
Stress: Cortisol is produced by our adrenal glands and we release more cortisol in response to stress. This could be either emotional stress or physiological stress such as low blood sugar, allergic reactions, toxic exposures etc. Rarely it could be a sign of cushing's disease (hyperadrenalism) or an adrenal tumor but this is unlikely, a holistic doctor may help you determine the source of stress.
Severe symptoms: Patients with true addison's disease have severe symptoms that include: orthostatic hypotension (blood pressure drops when standing leading to lightheadedness), loss of appetite (that can be as extreme as nausea/vomiting), weight loss; weakness, fatigue, darkening of the skin. It may present as a chronic illness, suggesting an underlying cancer, as a result, the diagnosis is missed frequently.
Probably not...: ... But the more important question is why was the cortisol level drawn in the first place? Reference ranges for cortisol are almost meaningless as cortisol levels are affected by so many things... Including time of day, one's stress level, etc. Having said that, in some contexts, an 8am cortisol value of 6.7 mcg/dl might be considered a bit low. Best to get the advice of the doctor who drew it.
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