What Is Low Cortisol Level Indicative Of?

Posted on Wed, 30 May 2018

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 30 May 2018 Answered on

Tue, 21 Dec 2021 Last reviewed on

Question : What does a cortisol level of 6.2 at 8am and 1.2 at 4pm mean? Normal reference range for this lab is shown as 6.7-22.6.

Answered by Dr. Mirjeta Guni (1 hour later)

Brief Answer:
About adrenal failure;

Detailed Answer:

Hello,

A low cortisol level is suggestive of adrenal failure.
To confirm it a Synacten stimulation test is needed.

Adrenal glands are 2 small endocrine glands, located over each kidney and responsible for producing some hormones (including cortisol).

Failure to produce enough cortisol is called adrenal insufficiency and is manifested with;
-Fatigue, weight loss, diarrhea, nausea and vomiting, muscle weakness etc.
In most of the cases, it has autoimmune etiology.

Treatment with hydrocortisone improves the symptoms if the diagnosis is confirmed.

So, your physician will recommend a Synacten stimulation test after the results of the low cortisol you reported and if cortisol persists low after the test the diagnosis of adrenal failure is confirmed and treatment with hydrocortisone will be suggested to get normal cortisol level in blood. It'll improve the symptoms.

Hope the information will help. Feel free to ask further.
Best wishes,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Mirjeta Guni (8 days later)

I didn't mention that my thyroid medication just had to be increased, could this be related? Can low cortisol effect cognitive function or vision?

Answered by Dr. Mirjeta Guni (1 hour later)

Brief Answer:
About levothyroxine treatment and adrenal insufficiency;

Detailed Answer:

Hi,

Low cortisol is not caused by the increase of the dose of levothyroxine, but if adrenal insufficiency is present, the increase of levothyroxine may deteriorate it.
So, when adrenal insufficiency is suspected, it is not suggested to increase the dose without correcting cortisol level.

Wish you good health.
Best wishes,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Mirjeta Guni (24 hours later)

Could the low cortisol levels affect vision or cognitive function?

Answered by Dr. Mirjeta Guni (9 hours later)

Brief Answer:
About low cortisol

Detailed Answer:
Hello,
It can not affect vision but it may affect cognitive function.
Regards,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Mirjeta Guni (11 hours later)

Thank you for above answer. I for whatever reason am having problems with thinking and coordination. Had eye exam and my eyes are fine. Think I'm just having issues with spatial stuff.

Can you explain this part of your above answer to me: "but if adrenal insuficiency is present, the increase of levothyroxine may deteriorate it"?

Found out my thyroid was low before knew cortisol was low so they upped levothyroxine already. Is this a problem?

Answered by Dr. Mirjeta Guni (27 hours later)

Brief Answer:
About adrenal failure and levothyroxine dose:

Detailed Answer:

Hello,

The thyroid hormone (levothyroxine) increase the metabolism rate and energy expenditure, having low cortisol levels, the body can not afford it and the symptoms deteriorate.
That is why it is recommended to correct cortisol level before the increase of levothyroxine dose.
So, the diagnosis of adrenal failure should be confirmed and treatment started than the levothyroxine dose can be increased.

Best wishes,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Prasad