Lab marker · Low

Low Cortisol: what it means

A Cortisol result below the normal range is considered low. Here is what a reduced Cortisol can point to, and when it is worth discussing with a doctor.

Reference range: AM cortisol 6–23 µg/dL; values are highly time-of-day dependent

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What a low Cortisol can mean

  • Primary adrenal insufficiency (Addison's disease) — autoimmune destruction of adrenal cortex is the most common cause; classically presents with hyperpigmentation, fatigue, hypotension, hyponatraemia, hyperkalaemia.
  • Secondary adrenal insufficiency — pituitary failure or long-term steroid use suppressing the adrenal axis.
  • Adrenal crisis — acute hypotension and shock; life-threatening, often precipitated by infection or surgery.

When to discuss with a doctor

Symptoms suggesting cortisol excess (central obesity, purple striae, easy bruising, proximal muscle weakness, uncontrolled hypertension or diabetes) warrant endocrinology referral for confirmatory testing (24-hour urinary cortisol, low-dose dexamethasone suppression test, late-night salivary cortisol). Symptoms suggesting deficiency (fatigue, dizziness on standing, hyperpigmentation, salt craving, GI symptoms) need urgent evaluation — adrenal crisis is a medical emergency. Patients on long-term steroids should NEVER stop abruptly. Mediora.AI flags cortisol values in time-of-day context where available.

Conditions this can relate to

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Mediora.AI is informational - interpretation, not a diagnosis. A single out-of-range value is common and often benign; always discuss decisions with your doctor.