Endocrinology

Free Cortisol, Serum

Optimal Result: 0.2 - 1.8 ug/dL.

This cortisol test measures the level of cortisol in your blood to see if your levels are normal.

Cortisol is made by your adrenal glands, two small glands that sit above the kidneys. A gland in your brain, called the pituitary gland, makes a hormone that tells your adrenal glands how much cortisol to make. If your cortisol levels are too high or too low, it may mean you have a disorder of your adrenal glands, a problem with your pituitary gland, or a tumor that makes cortisol.

Cortisol is a hormone that affects almost every organ and tissue in your body.

It helps your body:

- Respond to stress (cortisol is sometimes called the "stress hormone")
- Reduce inflammation
- Regulate blood sugar and metabolism (how your body uses food for energy)
- Control blood pressure

Without treatment, cortisol levels that are too high or too low can be very serious.

What does it mean if your Free Cortisol, Serum result is too low?

Low levels of cortisol may mean you have Addison disease or secondary adrenal insufficiency:

  • Common causes of Addison's disease include damage to the adrenal glands from conditions, such as:
    • Autoimmune disease
    • Certain infections, such as tuberculosis (TB) and HIV/AIDS
  • Common causes of secondary adrenal insufficiency include:
    • Autoimmune diseases
    • Problems with the pituitary gland
    • Traumatic brain injury

You may have these symptoms:

- Weight loss

- Muscle and joint pain

- Fatigue, or extreme long-lasting tiredness

- Low blood pressure

- Belly pain

- Irritability and depression

- Nausea, vomiting

 - Diarrhea

- Dark patches of skin

- For women, decreased armpit and pubic hair and decreased sexual desire

The most common cause of low cortisol levels is suddenly stopping steroid medicines after using them for a long time.

If your cortisol results aren't normal, it doesn't always mean you have a medical condition that needs treatment. Cortisol levels can be affected by:

- Stress

- Pregnancy

- Exercise

- Serious illness

- Hot and cold temperatures

- Certain thyroid diseases

- Obesity

- Certain medicines, such as birth control pills

What does it mean if your Free Cortisol, Serum result is too high?

High levels of cortisol may be a sign that you have Cushing's syndrome.

It may be caused by:

- Taking high doses of certain steroid medicines for a long time to treat conditions, such as asthma, rheumatoid arthritis, and lupus
- Tumors in your pituitary gland or other parts of your body that make too much of the hormone that tells your adrenal glands to make cortisol
- Tumors in your adrenal glands that make extra cortisol

If your cortisol results aren't normal, it doesn't always mean you have a medical condition that needs treatment. Cortisol levels can be affected by:

- Stress

- Pregnancy

- Exercise

- Serious illness

- Hot and cold temperatures

- Certain thyroid diseases

- Obesity

- Certain medicines, such as birth control pills

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Cortisol levels may be high in people with psychiatric disorders, alcoholism, or morbid obesity. This may be called "pseudo-Cushing state."

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