Very very very low cortisol, less than 1 in the morning, what does this mean?

[oliviamarie12345]

I have had symptoms for two years of severe fatigue, headaches, muscle pain, muscle weakness, very thirsty all the time, etc. Exercise makes it worse, not better. My endo just tested my cortisol and it is less than 1 when tested in the morning. She said normal is at least a minimum of 6. What does this mean? She thinks I could have hypopituitarism. My pituitary is a little enlarged on an MRI. She just had me go friday for an ATCH stimulation test. What does this low cortisol mean? Please help!

[rumpled]

Typically, low cortisol people are thin. High cortisol people are heavy. It can cycle like crazy. Cortisol also has to be tested at certain times. It cannot be a random test. It normally fluctuates.

There can also be an issue with renin and aldosterone.

[luv2sew]

Hi! I just read your post & I too have been suffering for years.  Back in 2011 I went to a endocrinologist, did blood work & told me "there is nothing wrong with you, you're going through menopause" where his exact words.  So, here it is late 2012, still suffering with the same stuff, so I call his office & ask for a copy of the lab reports.  Low & behold .. it showed my Cortisol at 0.6 (very low), ALSO in 2011 my FAMILY doc had done blood work & it showed my DHEA  88 LOW. ALSO, in 2011 I had been put on Prednisone (for a severe infection in my foot) & that was like a MIRACLE!  I had never felt better!  The brain was thinking clearly, my clothes where getting loose etc.  I even went back to the doctor wanting MOORE Prednisone!, but I got a no...  In 2012 I have seen 3 Gastrologist & my doctor thinks I'm crazy.  So, I had a tantrum in her office & showed her the 2011 blood test with my low  Cortisol & she didn't think anything of it... but I demanded to be tested and guess what, now my Cortisol is super high. (I don't have the test results, but they called me & said I need to see a endocrinologist).  Ever since I was 13 years old I have battled with my weight etc.  ALL of my family members are tall & thin.  As a kid I would eat salt, just pour it in my mouth or slather it on a piece of bread, I still eat a lot of salt, (sodium levels are just above normal)  plus I have always drank a lot of liquids.  With what you have been through do you have any advice or how I can get the doc to listen to me?  I see the new endo doc on 2/1/2013, I wish it was sooner ..... I need help

[kevieb]

I'd suggest sking about NP Thyroid by acella---it is very similar to what the original formula of armour used to be.  armour now has too much cellulose in it--it is possible the thyroid medication may not absorb as well because of it.

I have adrenal insufficiency---I had lost a ton of weight before I was diagnosed.  I also have problems with hypoglycemia--but it seems to be better since I have been put on hydrocortisone.

I had all  kinds of hormones that were off and i was too low in a number of vitamins and minerals also---my doctor did extensive blood work.

Low thyroid and low cortisol often go together.

[jen1515]

Me too, I had the same cortisol reading in the morning, and have been put on a low dose of Armour thyroid.  I too am not fat, but I find if I gain any weight that it is always around the middle section.  I also suffer from hypoglycemia and have low progesterone. I am currently taking progesterone supplements.  I am told that progesterone and cortisol are competing for resources in the body so that if one is low than the other is likely to be low too.  I also know that cortisol and the thyroid are interrelated.  I get tested again in mid january to see if any of this is working.  So far I feel mildly better, but suspect I have more dose tweaking to do.  Any suggestions would be helpful.

[lvnvcc]

my cortisol is 3.4 in the morning
doc diagnosed me with under-active thyroid but I'm skinny???

[galliar]

Here is a history of the diagnoses.  It was very long and drawn out.  It took about 6 years.  It sounds like you are on the right track!

Diagnoses
Years ago as we were sorting out what was causing the problems, I was diagnosed with blood sugar issues, chronic fatigue syndrome, allergies, and other things.  Finally, through an Endocrinologist, some things began to surface.  First of all, they ran blood sugar tests along with insulin and found out that my insulin was 3x over the normal range when stimulated through a 5 hr Glucose Tolerance test.  The first test showed bs up to 185 and I might have diagnosed me with diabetes had it not been for the longer test.  It went back down to 45 in 2.5 hrs.  My Dr. Then told me that reactive HG was the diagnosis, but this in itself was only a symptom of something else out of balance.  He felt that it was Cortisol related.  He sent me through a series of tests, the standard ACTH stimulation, the 48hr ACTH stimulation with 2 24hr urine samples, and finally a saliva test from Diagnos Techs, prior to ever taking a steroid.  He was one of the few MD's who used the saliva test, but believed that it helped fine tune medication timing and showed an accurate picture of the Cortisol over time.  The ACTH stimulation showed levels that were far below the 18 resting level which I was told was typically the low end on non stimulated Cortisol levels.  The other urine test showed a suppressed average level the first 24hr period, and it actually went 50% lower after the stimulation, just like the test I had recently receeded back down at the 60min period.  The Dr. Said he had experienced this on a few occasions in the past, and further testing gave the same results.  The aldosterone also was on the low side.    The Dr. Informed me that it was the percent of rise after the stimulation that was the bigger concern, not the starting value, though it was very low also.  They also measured ACTH in the blood at the 0 minute test.  I do remember that the initial Cortisol values were much lower than 18 and the rise wasn't close to 50%, and sometimes went backwards at 60min.  They were unable to get Cortisol levels to rise very high.  The other things that we noticed was very high BUN, sodium at 35 and below on several tests, and other minerals out of the normal range.  After this point, they put me on 10mg of cortisone.  The affect was dramatic, and I felt better within a few hours.  Over time however, the symptoms began to return, so they increased the Cortisol and told me to take additional when stress hits and the symptoms start.