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Dr. Andrew Rynne

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What causes low cortisol levels?

Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Posted on Wed, 13 Aug 2014 in Thyroid Problem and Hormonal Problems
Question: My cortisol levels are low but the doctor didn't do anything about it. Is it ok to take something for it without my doctors approval. I'm on thyriod med and don't want to mess something up.
doctor
Answered by Dr. Shehzad Topiwala 16 minutes later
Brief Answer:
No

Detailed Answer:
Please do not medicate.

Endocrinology and hormones are complex to manage. Cortisol is one such hormone. A systematic formal evaluation is necessary to ascertain the cause of the low cortisol before anything is done about it.

It is important to know the time at which this cortisol blood sample was taken. And secondly, what is the exact value of this report?

To screen for a condition called adrenal insufficiency, blood cortisol must be tested at 8 am in the morning. Then there are various cut offs that suggest the possibility of this condition. Confirmation tests are then performed based upon the result of the 8 am cortisol, along with vital information obtained by examining the individual.

Are you on any medications at all? Sometimes meds like steroids (prednisone) and pain killers of certain kinds can lower the cortisol levels. Are you on any type of inhalers that may contain steroids?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shehzad Topiwala 9 hours later
I am on Armor thyroid medication. 60mg a day. I am tired all the time and the recent increase in my meds didn't make a difference. I also take a good multi vitamin daily. I take no other meds. We have tested various things included iron level, vitamin D, liver. Everything is clear. Then we ran a bunch of hormone tests. Out of 19 tests, 7 were out of the normal range. I've taken the results to 2 different doctors and they just say they're not familiar with those tests but they don't know why I'm always tired. I used to have lots of energy so I know this isn't normal. Cortisol tests were taken at 4 different times in one day. results were as follows 7AM 5.6, noon .9, 6PM 2.2, 9PM .5
doctor
Answered by Dr. Shehzad Topiwala 1 hour later
Brief Answer:
Follow up

Detailed Answer:
From your feedback, it is evident that adrenal insufficiency is quite likely.

I urge you to seek immediate care for this condition. There are tests to confirm this diagnosis such as ACTH levels and an ACTH stimulation test. Endocrinologists are familiar with the management of this problem. It can be fatal if untreated.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shehzad Topiwala 4 hours later
do I have to have a recommendation from my doctor or can I just call any endocrinologists office and schedule and appoint?
doctor
Answered by Dr. Shehzad Topiwala 6 hours later
Brief Answer:
Second follow up

Detailed Answer:
It all depends on the health plan/insurance program you have. Just call the endocrinologists' office and they will guide you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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