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Original poster

Cortisol levels

4 replies

Melsy88 · 18/05/2025 10:16

Has a blood test, which included cortisol. Level came back as 165 (taken at 9am) with a reference range of 133 - 537: so within this range.
However looking online some sites seem to suggest it should be a lot higher, so I'm confused!
Anyone know if this is normal or not? Haven't felt well for a long time so just trying to get to the bottom of everything

OP posts:
Shcab · 18/05/2025 11:51

You need to be referred for a short synacthen test - that is too low for 9am. The guidelines suggest anything below 300 should be referred on. Even if you pass the short synacthen test there should be investigations into why your cortisol is so low…but good luck on getting those done as endocrinologists are notorious for not diagnosing anyone with adrenal insufficiency if they pass the SST even though there are other causes and it needs treatment. Good luck.

Original poster
Melsy88 · 18/05/2025 15:28

Shcab · 18/05/2025 11:51

You need to be referred for a short synacthen test - that is too low for 9am. The guidelines suggest anything below 300 should be referred on. Even if you pass the short synacthen test there should be investigations into why your cortisol is so low…but good luck on getting those done as endocrinologists are notorious for not diagnosing anyone with adrenal insufficiency if they pass the SST even though there are other causes and it needs treatment. Good luck.

Thanks for your reply. Do you know what things cause low cortisol?

OP posts:
Shcab · 18/05/2025 18:16

Melsy88 · 18/05/2025 15:28

Thanks for your reply. Do you know what things cause low cortisol?

Show quote history

It can be one of four things:

adrenal glands not working properly (usually autoimmune) - that’s Addisons disease and will be found or ruled out by the SST.

pituitary gland issue (secondary adrenal insufficiency)

hypothalamus issue (tertiary adrenal insufficiency)

long term steroid use (secondary adrenal insufficiency).

Most endocrinologists are pretty good at identifying Addisons disease and secondary if it’s caused by long term steroid use, but they forget about the other two causes and discharge you if they don’t find Addisons and you haven’t been on steroids long term 🙄

Lilxa89 · 17/09/2025 19:24

Hi how Re you now? I've been poorly for so long now and had new bloods the other day which has shown my cortisol at 256 at 9am so is classed a borderline and has referred me over to endo. Its worried me a little now :( I had read up on addisons and now worrying it'd that after being told ots just anxiety or low iron etc. Been taken iron folic acid vit d etc for a while now and no improvements so just get told oh its anxoety. This dr even said I think cortisol levels will be fine and more anxoety related then ahe messaged to say it was borderline and doing a referral due to that and my ongoing symptoms z

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