Cortisol is a steroid hormone that is responsible for a wide range of processes within the body including immune responses, the regulation of metabolism, and acting as an anti-inflammatory. It also plays an important role in the way in which the body responds to stress. It is created in the cortex of the adrenal glands and is transported and released through the body by our blood.
The balance of cortisol levels that are present within the body at any one time is extremely important for our overall health. Having too much and too little cortisol in your system can cause a number of issues that range from minor to serious. The effects of having too much cortisol in the body can include rapid weight gain, high blood pressure, muscle weakness, and severe mood swings that manifest in anxiety and depression. On the other hand, individuals who possess an extremely low amount of cortisol are susceptible to experiencing problems such as dizziness, fatigue, weight loss and a peculiar darkening in certain skin areas.
Fortunately, the body possesses a clever system that enables us to regulate the levels of cortisol that are present in our systems. The optimal level, interestingly, varies quite drastically at different times throughout the day.
Cortisol levels are generally high in the morning as we wake from a prolonged period of sleep, with an increase of up to fifty percent in the twenty to thirty minutes after waking. This is known as the ‘cortisol awakening response’. Then, as the day progresses, our cortisol levels naturally begin to drop in a fairly constant and regular fashion that is termed a diurnal rhythm, ending up as low in the late evening. This allows the body to keep a regular sleeping pattern, with the cortisol level dropping for periods of sleep, then replenishing during the following morning.
The body can also detect and change the timing and cycle of cortisol production and release for certain individuals. A great example is those individuals who work on night shifts. In these cases, the pattern and timing of the release of cortisol is reversed to allow for higher levels throughout the late evening and early morning hours. For those of you who travel long distances, a similar rearrangement occurs when we experience jetlag.
Cortisol levels are not just dependent on the time of day. Stress also plays an important role. The exact response depends on the type of stress, whether its short-term acute stress or long-term chronic stress. For short-term stressors like an argument or a fall, we will see a brief spike in cortisol. For longer term stressors like work stress or illness, we see a consistently higher level of cortisol at all times of the day.
How does all this relate to Adrenal Fatigue? Well, those long-term stressors can eventually deplete the nutrients and precursors that we need to produce cortisol and other hormones. In other words, chronic stress will raise your cortisol levels for a while, but eventually your body is unable to continue producing cortisol in such high amounts. At this point we start to see declines in not only cortisol, but also key hormones and neurotransmitters like aldosterone, testosterone, epinephrine and more. Additionally the diurnal rhythm of cortisol production is often disrupted, resulting in late-evening spikes that cause insomnia.
This dysregulation of hormone production is the ‘burnout’ that follows long periods of stress. The body is no longer able to regulate cortisol levels effectively, which leads to symptoms like fatigue, a lack of enthusiasm, insomnia, and a general lack of vitality.
How can we reverse the effects of long-term stress and regain our energy levels? A combination of good nutrition, supplementation, and effective stress management techniques can quickly result in some significant changes. In the longer term, eliminating the causes of stress is crucial for a full recovery.
Hello, Ms. Hansen!
I have a question regarding adrenal fatigue and whether your book could be helpful to me. I had a burn-out 4 years ago and my actual level of cortisol is really high (over the limit, especially in the morning), as well as the ACTH. Is this still adrenal fatigue – if the cortisol and ACTH are high??? Or AF is only in the case of low levels of cortisol, etc. ?
Also, do you have tips on how to reduce the cortisol levels/balance them in the book?
I hope you can help me with an answer!
Thank you in advance!
Best wishes,
Roxana
Hi Roxana, adrenal exhaustion comes in several stages. In the first stages you will see elevated cortisol as the body reacts to the perceived stressors. You should consider some relaxation and stress management techniques, combined with an adrenal-supportive diet and some appropriate lifestyle changes. Finally, yes the ebook contains lots of information on all of this!
Thank you very much for the answer! 🙂
HI Fawne:please write the list of foods with high cortisol.
Regards
Hi Kaka. Foods don’t generally contain cortisol. However, certain foods can cause your cortisol levels to spike. These include coffee, sugary snacks, and anything that would usually be regarded as a stimulant. I hope that clears things up!
Hi there so my Doctor ordered a random cortisone test done. The tech wrote the time wrong on the collection time. She put 1150 It was actually just after 12pm. probably 1205-1210pm. I had already been up over 5 hours. My lab work says the range is AM: 137-537 and PM: Less then one half of the patients Am range…. So does that mean mine is actually high? Ive had stress for years more then i can count…. i have sleeping problems and chronic fatigue, and low/normal iron and lately been passing out when i get my cycle like a narcoleptic would. But i am not. My doctor took it i believe too see if that was the cause of my fatigue. Should he not of ordered at least 2 tests the same day a morning and afternoon one? im confused. also if it helps my paper work says its measured in nmol/L Im in canada so the ranges i think by math are shown differently so its hard for me to tell where i would be. Also should I be more On the Pm then since it was after noon and i had already been awake for 5 hours? Or morning even if you went by 1150 something am? Should I be asking too for more cortisone testing? I cant change my diet as i am a gastric bypass patient I barely eat. and have too consume protein, protein….. ugh… So thats not really a huge thing for me. also i dont smoke, not on medications, low blood pressure, and postural hypotension, and not over weight anymore well within normal BMI. dont drink coffee and dont drink alcohol.. so i cant see it being by that either or lifestyle.
You need to look into cushings disease. No diet or book is going to fix that
Roxana, when cortisol levels are high it’s called Cushings disease, when cortisol levels are low it’s Addison’s disease. In your case its Cushings disease. I have read so much about cortisol levels because I have Addison’s disease and my doctor didn’t even know. She kept telling me it was depression till the dentist I worked for looked up all my symptoms and he discovered it was Addison’s disease, not depression. Doctors nowadays don’t take the symptoms of their patients seriously. My doctor rolled her eyes a couple of times when I kept on going back with the same symptoms. Your doctors should test your ACTH levels and cortisol with a blood test, and should refer you to an endocrinologist – they specialize in hormones.
I agree with you on doctors not taking symptoms of their patients seriously. I wasn’t well for over 5 years and after multiple tests and doctors and one even telling me I just needed a hot lavender bath and a good therapist I finally had a naturopath figure out that I had Cushings! I wish they would listen to us as we know our bodies best so if your not getting better don’t give up just keep on the doctors to get to the bottom of it!
I’ve had random high morning cortisol level episodes for 45 years. My morning saliva cortisol was 16.7 when the normal range is 3-8. I don’t know what brought it on….no negative events in my life. Just some major malfunction in my body, which I’m still attempting to find answers to. Some doctors aren’t helpful.
Not even necessarily. I found out my cortisol and ACTH levels were high because I developed tachycardia and low potassium, both can be attributed to high cortisol and high ACTH levels. I had and still have none of the normal changes like weight gain or fatigue. I’ve never complained to my doctor about symptoms. The only time I’ve ever seen a doctor are when I have physical signs of not being healthy like a fever and enlarged lymph nodes. My friend suspects because it’s probably a condition I’ve had all of my life so there would be no changes because I’ve always had it.
I had no idea my cortisol was high and the only symptoms I had could also be attributed to other problems. My cortisol wasn’t checked when I developed tachycardia only my potassium. But because I wanted to find out why I had developed it because no one develops any health problems without there being a reason behind it.
Hi Fawne,
in March of last year, I collapsed after years of feeling fatigued and burned out, of being insomniac, of suffering from pain due to inflammation and of experimenting memory problems etc. My cortisol level in the a.m was the only one in the normal range. Throughout the rest of the day, it was very low at about.00001. My doctor told me it was the lowest she has ever seen. I was bedridden for practically 4 months and on hydrocortisone .20 mg. for 5 months. It’s been 11 months and although I am better and able to function now, it is a constant struggle. I have no energy, I am weak, loosing muscle mass and I have an ill feeling sensation all day long with very strange symptoms. I struggle to get out of bed every day and cannot do much without feeling fatigue. I spend most of my days at home. I have been taking vitamin C, B, magnesium, omega 3-6, digestive enzymes and probiotics since March. I am also on a strict diet of mainly animal proteins and veggies and exercise 5 days a week. Is it normal that it is taking so long for my body to recuperate, I am loosing hope? And what could I do more to help it get better? Thanks for your help…
Hi Myriam, I’m sorry to hear that you’ve been so sick. Have you seen an integrative doctor or one experienced in bioidentical hormones? Have you had your thyroid levels checked? Recovering from adrenal insufficiency does take time, but there are always other options to try. Keep persevering 🙂
I was in the same boat and saw a dr that put me on Douglas Labs adrenaplus 300. labs are great now in the daytime but still high at nite.
It could be a result of carnitine deficiency, and that can be checked with a blood test.
Lori
Myriam,
I am in a similar situation as you. May I ask if you eventually improved ?
Hi Myriam,
Your story very much resembles my own. I hope you’ve recovered more since you wrote this. If not, I also recommend getting your thyroid levels checked. Have you had a parasite test? Your symptoms sound like you could have a parasite causing the extra fatigue, weakness, ill feelings, “very strange symptoms”, etc. Unfortunately parasite tests often produce false negatives and most do not scan for all possible parasites. I would look into finding a Functional Medicine/Neuropath practitioner to help narrow it down for you.
Best,
A
you need to be assessed for Addison’s Disease.
I have the same problems I was diagnosed with Addison’s disease 3 years ago I take steroids. You need to see an endocrinologist.
Thyroid TSH test is rubbish .. Endos swear by it … but the parameters are wrong and many people are told they are in the normal range when they are tired all the time especially afternoons.
The tests you need are…
T3 and T4 everytime
Antiperidoxidase if underactive is suspected.
Grave’s disease if overactive suspected.
Tsh tends to need to be slightly high or just overdosed with Levothyroxine to be symptom free but it takes 3 months to get into your system and have a culmative effect so wait it out.
Hope this helps x x
I had the flu last December and then could not recover my energy. I then was diagnosed with a sinus infection in February and got rid of that too but still no energy. I had a blood panel down and Thyroid was a little off, afternoon cortisol was off and testosterone free & Bioavailable both below range with Binding Globulin above range. So, the doctor has ramped me up from 5mg cortisol to 20mg which I have been on now for 2 weeks. I noticed that if I try to work out, run on treadmill, energy collapes for several days. All levels will be tested he at the end of may, 4 weeks on 20mg. I am trying to understand why the reserve of energy is not there and what else I can do? Even if I do yard work I feel exhausted. Yes, I eat well and get 8hrs of sleep etc. Thoughts or suggestions?
Thank you,
Kevin
Have you been tested for carnitine deficiency?
Lori
Do not do cardio or intense workouts. Only walking and yoga.
Hi there,
My doctor checked my cortisol level at approx 11:15 a.m. and the result was 5.7. She said this was low, however, from what I have read it may not be, since it drops throughout the day. I’m sure numerous factors affect the level. I woke up at 5 a.m. and my appt with my Dr. not being until mid/late morning, I just wonder if this 5.7 may be actually normal? They have referred me to an endocrinologist, so I’m just doing some research.
Thanks for any info you can provide!
Jessica
Do you have the lab reference ranges? And did you get a 24 hour test, or was it just a single reading?
I have been under extreme stress for years and have all the symptoms of adrenal fatigue. My 24 hr test came back today and the first level was a 3 and the second was a 10. From what I have read these are both low. What is your take on these tests? I can’t get in to see the Dr for 2 weeks and was wanting to get some sort of opinion. I think it’s adrenal fatigue and I’m thinking I need to get your book today. Thanks so much!
Hi Jane, what were the reference ranges supplied by the lab? And was it an average 24-hour sample, or a sample taken at 4 points during the day?
Fawne thank you for responding! ! It says 3 mcg/L reference range undefined and 10 mcg/24hr reference range 0-50. It was an average 24 hours sample. Thanks so much for your help!
Hi Jane, I’m still not sure what the first reading is, but the 24 hour average is definitely towards the bottom of the range. Have you considered getting a 24 hour cortisol test with 4 separate readings? That gives you and your doctor a lot more information about your daily cortisol cycle, and what stage of dysfunction your HPA axis may or may not have reached.
I took my sample at night 11pm it came back .032 the range was <.010-.090…I'm assuming it is normal.
That’s nicely in the range, but you would get a much better picture by taking 4 tests over the course of the day. For example, you might find that your cortisol remains at a similar low level all day. Or you might find that it shows a perfect ‘ski-slope’ shape. Either way, its good to know.
I did a saliva cortisol test with the following results
8 a.m. – 3.7 – Reference range 8 – 10
12:30 p.m. – 6.7 – Reference range 3.1 – 7.3
5:30 p.m. – 6.7 – Reference range 2.1 – 3.9
10 p.m. – 6.7 – Reference range 1.5 – 2.5
I’ve been under prolonged stress for 18 mos. I can’t sleep although I’m taking 4 meds. for sleep. I am exhausted all the time and my hypothyroid is now fluctuating. Doc is working with meds to regulate thyroid.
Any suggestions?
Thank You,
Suzan
Hi Suzan, your 24hr cortisol results definitely suggest adrenal fatigue. As the ranges imply, there should be more of a ski-slope shape starting high in the morning and then dropping low in the evening. I’m sure that with a high evening cortisol reading like that, you’re having problems sleeping too.
The good news is that your overall cortisol levels are reasonably high. That implies that your HPA axis, although dysregulated, is still capable or producing stress hormones when needed.
The most important thing that you need to do is figure out what is causing this stress, and work out some way to cope with it. That might be through lifestyle changes, therapy, or simply removing the source of stress (where possible). We discuss options like deep breathing and progressive muscle relaxation in the book. Until you get your stress under control, your doctor will find it very difficult to correct any of those hormone imbalances.
Thank you so much. My stress is that I found out 18 mos. ago, by accident, that my husband had been having a 21 year Emotional Affair with his High School girlfriend. He has broken it off. She lives out of State from us. We are trying to work it out. I’ll get your book and read what you suggest to help with relaxation. Again, Thank You.
Suzan
Suzan,
I can’t even believe the similarities of how our issues were stemmed by the same situation. I have had low blood pressure since I was young, always felt faint if I stood up too quickly, thought it was normal. I had been dealing with back aches, headaches, and fatigue before my situation arose. I also found out that my fiancee, and father of our two children, had in fact been having an emotional affair with an ex co-worker. I instantly gagged and almost threw up after it sank in, the next week had been really odd with my body’s hormonal reaction to it. Today, is the first day that I actually feel somewhat normal again. I am waiting to get in with an endocrinologist, but it’s taking forever. She kept telling me that it sounds more like depression, but I dropped from 164 down to 125lbs from June until now. I just found out about this information before Thanksgiving. Last week I developed serious neck pain on both sides, my left side of my chest, my hips. I was so fatigued I could hardly open my eyes. I had a fever, and it felt like my brain was going to break open my skull. I have been getting these weird unexplainable bruises on my upper thighs on both legs. I can feel when they happen, it feels like a burning/itching sensation, and when I lift up my pant legs, it is already bruised to the size of a golf ball — not just circular though, odd patterns. Each time I went into the ED and my doctors office, they said I was having a panic attack. There was no panic, all of the heartache and BS had already been settled, but I felt like my body was responding to stress in a very different manner. I am hoping to get in with an Endo as soon as possible. I may be alright this time around, but what happens in the next high stress scenario?
Thank you,
Nicole
celiac….check out the symptoms
I was under prolonged stress about a year ago for several months. My body hasn’t recovered. I am showing all signs of low cortisol and adrenal problems but recently got the following results:
In August cortisol levels were at 0.8 at 8am. 3 months later i had an ACTH test done. At 8 am (before the cortrosyn) my cortisol level was at 12 and 1 hour after the cortrosyn shot it jumped to 22. Dr said this indicates my adrenals are working properly and had no idea why my 8am levels changed so drastically in 3 months. In the meantime, I still feel the same. Any thoughts?
Jon,
How is your cortisol now? Its been 9 months since you last posted.
I would love your input on the energy cycle I have been experiencing recently. I am home recuperating from a recent hospitalization. When I wake up in the morning, I feel normally rested. This energy lasts about an hour or so after I get up. Then it drops off suddenly and I am completely fatigued, to the point that I have to lie down and even sleep. My energy then comes back about mid afternoon and stays up until I go to sleep. In fact, I don’t even feel like going to bed no matter how late it gets. (But I go to bed at a reasonable time). – I am trying to understand why am I so depleted in the morning and don’t get tired at night? – My doctor says that there is nothing wrong with me…but I can’t go back to work the way things are.
Rahnen cortisol is only one of the many hormones that can influence energy levels. I suggest you have a look at your blood glucose levels in the morning as well. It could be that if you eat a carbohydrate rich breakfat in the morning, what you are experiencing is the slump that comes after. Hormones are inter-related and a disfunction in one will always influence the function of the others. also have your thyoid checked.
Good afternoon, my husband was diagnosed with a statin induced Myopathy a year and a half ago. His Rheumotologist put him on 40mg of prednisone for a couple of months and once his CPK numbers were back in normal range started dropping back the prednisone. She got him down to 15 and then dropped him to 7.5 and that caused him to crash. His stomach muscles felt so weak he could not hold himself up…the doctor raised the prednisone back up some and he got much better. Well the Rheumatologist started reducing the prednisone agian, at a much slower pace but the abdominal weakness never went away. The rheumatologist sent him to a neurologist to have a muscle and nerve test conducted and he passed that. Then he did some research and thought he needed to see an endocronologist because he thought the prednisone pushed him into adrenal fatigue. He was right he was diagnosed with secondary adrenal fatigue because of the steroids. She was able to transfer him to hydrocortisone and work him off of the steroids all together…but the abdominal muscle weakness is still present daily. Its not bad all the time, just different times of the day and really bad when he doesn’t get at least 8 hours of sleep. He has a hard time getting up in the morning and a hard time going to sleep and staying asleep at night. The endocronologist did check his AM cortisol level and once it was in the normal range she said he was better and there was nothing further she could do. He has since had a physical and all blood work was good and his thyroid was great. He is not better, we are just wondering if it could possibly still be from the adrenal fatigue and how can you reset it if so? How long could it take your body to recuperate from this? Any information is greatly appreciated. Thank you!
My MD said my a.m. cortisol levels (blood test) were in the normal range at 12.3. However, I have had symptoms of adrenal fatigue for years. Is that possible?
Fawne, I would welcome your opinion on my 25 year old son’s results below. He has classic CFS symptoms of brain fog and extreme fatigue. An injury caused a prolonged state of pain and severe stress that over time led to an overall fatigued state with intermittent “crashes” when he pushes outside of his available “energy envelope . Also, what are your thoughts on low-dose Cortef? Thank-you.
DHEA 423.69 pg/ml
Cortisol nmol/L:
morning – 8.27
noon – 2.21
evening – – .74
night less than .33
Hi my cortisol level test shown :
at 9 a.m was 10.1
at 9 p.m was 2.4
Is it normal or not as lately my blood presure became low at night it was 90/50 and I always have fatigue.
Thanks
Do you have the lab reference ranges?
Yes, lab reference range as following:
Cortisol level in the morning : 5 – 22
In the evening : 3 – 16
Your evening number is below range and your morning number is in the lower half of the range too. Combined with the fatigue, it seems like adrenal fatigue is definitely possible. Have you seen a naturopath or integrative doctor?
Hi Fawne,
I would love you opinion on my saliva cortisol test.
DHEA 1.5 Reference Range 0.3-1.8
CORTISOL
8.00am 23.7H Reference Range 3.9-13.5 nmol/L
12.00pm 1.8 Reference Range 1.2-4.8 ” ”
4.00pm 3.1 Reference Range 0.5-3.7 ” ”
8.00pm 1.3 Reference Range 0.3-2.0 ” ”
I’ve had a lot of stresses in the past 3 years, running 3 jobs, financial pressure, family conflict and a premature grandson with a lot of health issues. I don’t sleep very well as you can imagine and my mind very rarely shuts off. Thanks in advance
Karen
Hi fawn, I cannot sleep. Is this a sign of high cortisol? Would Holy Basil help!! Thanks, Kate
I have had high levels f stress for over a few years now. I have 12 specialists helping me deal with different conditions. I have no support system but fortunately I am quite self sufficient and self reliant. In order toncombat stress, I started listening to Zen music or meditation chanting like Aum in the mornings while I was getting ready for work. The days I do this I feel calm, and under low stress. I can feel my body relax. Before going to bed, atleast an hour before I turn off all the electronics and just read a book. Even though I am still struggling with insomnia, it has shown marked improvement. Also occassionally I listen to zen music in low volume when I go to bed. Sometimes that has helped me sleep. Just another suggestion for others to reduce your stress levels.
I need help please. I have had a range of symptoms that I just couldn’t figure out and had been through 2 PCP’s that would just say “it’s your depression” well I’m having severe muscle weakness and pain, I’m so tired I can sleep for hours and not feel well rested at all, hyperpigmented skin which I’ve never had, just a host of issues. Had a thyroid u/s after one of my antibodies and my parathyroid hormone came back out of whack and also had a AM/PM cortisol blood test with the AM one fasting. My AM one was normal but my PM one was 14.1. Range 2.3-11.9 Can you give me any insight on that cause I thought it was supposed to be if anything higher in am lower in pm? I’m just confused and out of work cause I felt if I didn’t take a leave I was just going to have a nervous breakdown honestly. I’m so tired I can’t do much and I feel like I’m dying. Please help!! Thank you!
If your weight is high then normal with sudden onset i.e within half a year r may b for more then a year. And if you have abdominal strias, blurring of vision. Increased blood pressure and face more healthy then before just like a moon like face with r without achne . Then you should consult your doctor to have your acth levels and plasma cortisol again. If evening levels r high then you should keep in mind about cushing’desease. R syndrome. Go for further test regarding this condition my sister. It is a serious problm if it really is. Good luck. May God Bless you With Good Health
HI Fawne, I was wondering if you could offer me your expertise and have any suggestions for me? Here are my results from the 24 hr Saliva test. I am going to a functional med doc and he started me on 30 mg Armour, Vit C,D,B, Test, Progesterone and DHE. I am not feeling anybetter, actually worse. The anxious feelings and vibrations are hard to deal with. I already know my body can’t handle Armour right now. I have been off Armour for 2 weeks and the heart palps, anxiety has continued. Do you have any suggestions for me?? Maybe i should take 15 mg of Armour daily?
Morning, 3.6 (3.7-9.5); Noon 2.1 (1.2-3.0); Evening 1.3 (.6-1.9); Night 1.7 (.4-1.0) ZRT Labs
I truly appreciate your input, Just trying my best to get better!!
To all those with cortisol levels out of range at times during the day, I wanted to mention how I successfully adjusted mine. I purchased an Earthing Sheet for my bed. It literally “grounds” you, connects you to the earth’s rhythm through a wire, and signals to your body when it’s time to sleep/wake. (Sounds wacky, I realize!) but it regulated my cortisol levels almost immediately, as proven through 4x/day saliva testing. (I am not on any medications which might effect results.) Full disclosure, though….I AM still sick. I have Lyme disease. So while it did not “cure” me of my Lyme or my fatigue, it definitely lessened it. And, it absolutely cured my insomnia–within three days(!). My cortisol levels (though still low) came into normal range almost immediately, now showing the ideal “ski-slope” effect that we are all striving for. The sheets can be purchased at http://www.earthing.com, and they offer a 30-day trial which is helpful for those of us concerned about the cost. I was so enamoured by the positive physical effect that I ended up buying sheets for our entire family. I now travel with them too. Good luck to you all!
I just got back my cortisol test from an endocrinologist and it was 2, the nurse said when I called for my labs everything looked good, yet when I read about my Cortisol level I was stumped?! I am so frustrated! I have intense burning all over different areas of my body, scalp burns and have heart palpations which don’t help with my a fib. I have an appt with a neurologist this week. I just want answers but feel the medical field is so unreliable. Looking for answers in all the wrong places.. I guess?
Check into high mercury levels.
I have Primary Addisons and never give up hope trying to correct this through diet etc even though I am told It is not curable you cannot cure damaged adrenals .. When diagnosed my results from Adrenal crisis were that I produce no cortisol at all that was 6 years ago ..I take 12.5mg Hydrocortisone daily 10mg morning and half a tablet of Fludrocortisone and 2.5mg Hydrocortisone at 4pm I had a blood test at 10.30am yesterday before any meds which was 3 hours after waking and it was 1..Disappointed to say the least the main reason I had it tested as I forgot to take my meds all day I realised after I finished work at 5.15pm and then took them straight away trouble was I felt great confused.
Hello Fawne!
I’ve been struggling for years with low energy, weight gain and no sex drive so I had some hormone testing a few months ago and I’m wondering if you can help me understand my 24hr saliva cortisol results. I have the ski-slope circadian rhythm but my morning results are super high: 8am 44 nM (ref: 13-24 nM)
12pm 13 nM (ref: 5-10 nM)
My 4pm & 10pm results are both normal. My ND has recommended more sleep, less stress, and a few supplements, but I don’t understand why it’s so high in the morning to begin with. Can you give me any insight?
I’m doing what I can to alter my lifestyle but I feel like if I knew what would cause this, I could do a better job of controlling it. At least that’s what I’m hoping. I’m so tired of being tired.
Thank you for your time, your website has been so helpful!
Hi, I’m 22 years old. I have a history of cardiomyopathy and POTS, but the cardiomyopathy is better and POTS seemed to be under control. I cannot get any of my doctors to listen to me. My body is so fatigued that I can barely do daily things. Everytime I’m checked for the reason for my fatigue, I’m told that there is nothing wrong in my blood tests. Let me explain the whole story.
For months, I had adrenaline rushes. Weird, completely random adrenaline. My heart rate would rise and I would feel so jittery. I went to the ER numerous times just to be told that it’s my POTS or anxiety, which had been under control for years. Well, the adrenaline rushes continued. One night, I had a HUGE argument with my husband. It was a bad one. The next day, I felt off. I would get these random instances of weakness off and on throughout the day. The next day, I woke up with the worst fatigue I’ve ever experienced and it has never went away. My cardiologist said it sounded like adrenal fatigue to him. My cortisol was checked at, unfortunately, later in the evening around 8PM which showed a result of 2.2. I was also admitted to the hospital where I was checked for Addisons, and that was negative. My cortisol was at some point 7, but I honestly don’t know if it was in the morning or evening or what. I’m literally desperate. The endo I’m seeing is booked up until 3 months from now. Any insight would be greatly appreciated.
I also forgot to mention the weirdest thing…the fatigue and weakness seem to get better WITHOUT sleep. Very strange, I know
Not so strange to me. People with depression often feel less depressed without sleep.
Also, I think that for a limited amount of time the body rallies to energize itself, pushes through. So you feel more energy, can’t sustain that though, so it burns out. Just my theory based on some observations.
My blood specimen was collected at 4pm. My cortisol reading 212 nmol/L
(Normal range:74-286).
A doctor friend commented my cortisol level is low, causing me Water Retention.
I need your opinion and recommendation on how to increase my Cortisol level.
Appreciate your help and reply!
Hi,
I just had levels taken. At 8 am I was 0.6 at 2pm after having a shot of cortizone in my IV I was 3 then at 3 pm it was 18. I’m guessing this is low cortisol levels and doctor thinks its Addisons Disease. I was wondering your thought on this as well?
Hi Fawn,
I had a saliva cortisol test taken with these results:
7.6 with ranges from 3.7-9.5 (morning)
2.1 with ranges from 1.2-3.0 (noon)
2.8H   with ranges from 0.6-1.9 (evening)
11.5H  with ranges from 0.4-1.0 (night)
The report said that the evening ranges may be high from hydrocortisone cream but I don’t remember using any. I rarely use any, except maybe a smidgen on my right eye when I get some dry skin occasionally. It also said I could have Cushings but that it was highly unlikely being that I had such normal ranges morning and noon.
I did a blood spot as well which says my free T4 is within range (1.4 for range of .7-2.5) and my free T3 is also within range (2.9 for ranges 2.5-6.5), TSH is high at 3.3 with ranges .5-3.0.
Despite these tests I do not have any symptoms of hypothyroidism or adrenal fatigue. I do take Thytrophin by Standard Process (2 pills in AM and 2 in PM), without them I do have cold hands and feet and have NO energy to do anything.
My question to you is, Do you think these tests indicate the possible need for more thyroid support? My doctor had me start taking DHEA (15mg) and Pregnenelone (100mg) in January. She also gave me Armour Thyroid and said I could take it with the Thytrophin. I tried it for two days and couldn’t stop sweating, it was constant, I also felt like someone was squeezing my heart when I ran the second day I was on it. Subsequently I only took it those two days.
I appreciate all you do for us poor soles out hear.
I posted what I did to raise my cortisol levels but need suggestions to reduce it at night. I test every 6 months knowing by my lack of sleep that my cortisol levels at night are still way high. They are great in the day all within normal range. I see a therapist for stress which has been working out well, do EEG therapy, breathing exercises, HRT, have tried every supplement possible – been to see drs all over the county to no avail. If I could just get it to go down at night!!!
Hi Babbie, have you tried improving your sleep hygiene? Here are some tips – https://adrenalfatiguesolution.com/essential-guide-to-sleep-hygiene/
What is your reference for cortisol acting as an anti-inflammatory? Thanks.
Hi Sierra. Cortisol is a fairly well-known anti-inflammatory. Hydrocortisone creams, cortisone shots etc. https://www.ncbi.nlm.nih.gov/pubmed/15265778
There’s ambiguity here between time of day and an individuals routine. You say Cortisol levels are highest in morning, why? Because you’re waking? So if you go to sleep at 8:00am (morning) and rise at 17:00 (the afternoon) will cortisol levels be hign on waking. Is it really time of day or is the sleep cycle which casue the variations?
Pete I am wondering the same thing. I read somewhere that it adjusts to your sleeping pattern, especially to those who work overnight. I have had 3 cortisol tests done, the first one i didn’t sleep all night, the second one I took as soon as I was woke up in the morning and it was extremely low, the third one was around noon and they said that was fine. I just can’t get an answer if strange sleeping patterns can cause such a difference.
Hi there,
I had my cortisol levels tested at 7:20pm and the test came back 43 nmol/l the reference range was 85 – 460. They told me that I have Addison’s disease and am having further testing. Is that level as low as it sounds ?
Yes that is very low. Ideally you would get a 24 hour cortisol test to see how your levels look throughout the day. Your doctor should be able to check for Addison’s by running a blood test to look for antibodies associated with autoimmune Addison’s, and also an ACTH stimulation test.
He’ll my 14 year old had a cortisol blood test at 7:50 am. Result is 20. Is this in normal range? I do not have lab reference.
Hi Kelan, without the reference range from the lab, it’s very difficult to say.
Hi Fawne,
I got salivary cortisol test done a month ago. As directed by my doctor, I collected samples 4 times in a day – at 8.15 am (woke up around 7.45 am that day and rushed to collect the sample), at 12 noon, at 5 pm and 11.30 pm.
The reference range (Diurnal Rhythm Variation) given in the report for all these fours times is “5.0-15.0 for A.M.” and “1/2 of A.M. Values”. The result of my test is 38.70, 18.10, 7.14 and 3.90 respectively.
I have been stressed since the last 4-5 months. Since the last 1.5 months, I have been having very frequent and wild mood swings during the day. I also feel depressed, especially in the morning.
What can help me in this situation? My doc says that I should follow a particular meal plan. Will that help? Can you please guide?
Yes a meal plan can certainly help – https://adrenalfatiguesolution.com/adrenal-fatigue-diet/. But from your test it looks like you’ve been under significant stress. You need to address this before you move on to stage 3 or 4 of adrenal fatigue and HPA axis dysfunction. Start thinking about how you can identify your stressors, and what can be done to fix or eliminate them. Diet, gentle exercise, and supplementation can also help you to cope with stress more effectively.
One of the best things you can do is give up coffee and other stimulants. You are already stressed out enough – stimulants will make it worse in the long run. Look through this website for lots of tips on the various interventions that can help. Fawne’s books (including the free ones you get when you join the email list) are an amazing help too!
For someone that shows signs of going through all the stages of Adrenal Fatigue, this is very good advice from Annabel. You do not want this to get worse like many of us whose lives are suffering now.
I’m going to try to sum up 2 years of my daughter’s struggles short. Sorry for Any typos. 2 years ago my daughter stared her period at 10.5 years old got strep 2 months later took amoxicillin didn’t work still sick took a Pac for a week got Scarlett fever for week finally got better. The day after she’s better exaughsted all the time dizzy off and on nausea and palpitations. Went to cardiologist 6 months later they found a arrhythmia in heart still nausea and sometimes vomiting fatigue at 11 wants to just Lay in bed and watch tv on beautiful summer day. Now at 12 we have pcp run all blood thyroid cbc liver kidney cortisol which I asked for and got attitude about. My daughter drinks time of water for past year eats a lot of salt per Dr. Advise. Only pees 2 Times a day all blood work they day came back excellent but vitamen d low. Now her symptoms 2 years later is fatigue insomnia bad circulation reynauds. Nausea low blood preasure. Dizziness brain fog she’s in special ed Now. And a heart arrhythmia. She also has asthma. I made then check her cortisol again at 12pm it was 5.2 single test they wouldn’t do anything else the range was 2 to 16 should I take her to an endo. They are saying she’s having panicky attacks. But I refuse to believe she’s having a panic attack when she’s peeing on the toilet which is when her last episode was.please help they want send her to a phys. Dr.
Hello! Why does it appear that mainstream endocrinologists do not value the results of the 24 hour saliva test as much as the blood or urine? I read that the saliva is actually a good indicator of Adrenal fatigue so I Sony understand why many mainstream doctors do not believe the results to be valuable.
Saliva testing is reliable for cortisol but not for other hormone levels.
Hello! I am having a very difficult time trying to figure out what is going on w/ my body. I have hypothyroidism and am on 60mg of Armour Thyroid – my thyroid levels are all good right now. However, I have my menstrual cycle about every 2 weeks (I am 39 y/o), I also have extremely high testosterone and DHEA-Sulfate levels but normal estrogen and the other hormones. I’ve had an abdominal CT scan w/ nothing found and a uterine ultrasound w/ no fibroids or cysts (everything healthy). My cortisol is also out of whack. My daytime testing results are:
6-8am 13-24nM My result was 36
11am-1pm 5-10nM My result was 7
4-5pm 3-8nM My result was 2
10pm-12am 1-4nM My result was 4
I also had more saliva testing done for 3 nights in a row for just the evening. The results were:
0.010-0.090 is the reference range
0.120 for Night 1
0.149 for Night 2
0.056 for Night 3
Can anyone please help or provide feedback? My Endo thinks I have Cushing’s Disease and is having me do the 24 hour urine test along w/ a brain MRI – I do not think I have Cushing’s as I have such low blood pressure and do not have a lot of the other symptoms. I would be so grateful for any help or advice as this is so frustrating and stressful!