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. See our Hormone Testing & Evaluation page for broader laboratory context and our hormone deficiency symptoms guide for overlapping symptoms.
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 disorders are distinct from general hormone-replacement treatment; see our main HRT evaluation page for the broader care framework.
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.
