Cortisol Evaluation & Disorders

Cortisol is an essential glucocorticoid hormone produced by the adrenal glands under regulation of the hypothalamic-pituitary-adrenal axis. Both cortisol deficiency and cortisol excess can represent important medical disorders and should be evaluated using established diagnostic approaches.

Low Cortisol and Adrenal Insufficiency

Possible adrenal insufficiency requires careful assessment. Depending on the clinical situation, evaluation may include an early-morning cortisol, ACTH and confirmatory stimulation testing. Severe symptoms or suspected adrenal crisis require urgent medical care.

High Cortisol

Persistent cortisol excess can occur in Cushing syndrome and can also result from glucocorticoid medications. Appropriate testing depends on the clinical presentation and medication history.

Cortisol Is Not an “Adrenal Fatigue” Test

Fatigue, stress and poor sleep can affect how a person feels, but nonspecific symptoms alone do not establish adrenal insufficiency. The goal is to distinguish recognized endocrine disorders from other medical causes of similar symptoms.

Written and medically reviewed by David Nazarian, M.D.