Low Cortisol Symptoms And Causes
Low cortisol levels can cause extreme exhaustion and many other symptoms that can sometimes be life-threatening. This condition can be caused by chronic stress or certain underlying medical problems. Lets find out what is cortisol and what the symptoms and causes of low cortsiol levels are.
What is Cortisol?
Cortisol is a steroid hormone produced in the adrenal gland which binds to the glucocorticoid receptor found in all cells of the body. The glucocorticoid receptor plays an important role in regulating immune response, development and the metabolism of glucose.
The major functions of cortisol include suppressing the immune system, helping the body to use fats, proteins and carbohydrates for energy and increasing blood sugar through gluconeogenesis. Gluconeogenesis is a metabolic pathway that involves production of glucose from non-carbohydrate carbon substrate like glucogenic amino acids, lactate and glycerol. Through this process cortisol maintains levels of blood glucose, preventing them to drop too low and result in hypoglycemia.
Low cortisol levels cause symptoms that indicate adrenal fatigue or overuse. All kinds of stress experienced for a long period of time affect the adrenal glands resulting in severe fatigue that can cause variety of different symptoms.
Low Cortisol Levels Symptoms
Causes of Low Cortisol Levels
What Are Normal Acth Levels
Like cortisol, the level of ACTH in your blood normally peaks in the early morning and declines throughout the day, reaching its lowest level around midnight. This pattern can change if you work a night shift and sleep at different times of the day.
Because of this, ACTH tests usually require a morning blood draw. In general, the normal range for ACTH levels is 7.2 to 63.3 picograms per milliliter from 7:00 a.m. to 10:00 a.m.
Normal ranges can vary from lab to lab, time to time and person to person. If you need to get an ACTH test, your healthcare provider will interpret your results and let you know if you need to get further testing.
What Is Acute Adrenal Crisis
Definition:Acute adrenal crisis is a life-threatening state caused by insufficient levels of cortisol, which is a hormone produced and released by the adrenal gland.
Alternative Names: Adrenal crisis Addisonian crisis Acute adrenal insufficiency
Causes, incidence, and risk factors:The two adrenal glands are located on top of the kidneys. They consist of the outer portion, called the cortex, and the inner portion, called the medulla. The cortex produces three types of hormones, all of which are called corticosteroids.
Cortisol is a glucocortoid, a corticosteroid that maintains glucose regulation, suppresses the immune response, and is released as part of the body’s response to stress. Cortisol production is regulated by a small gland just below the brain called the pituitary gland. Cortisol is essential for life. Acute adrenal crisis is a medical emergency caused by a lack of cortisol. Patients may experience lightheadedness or dizziness, weakness, sweating, abdominal pain, nausea and vomiting, or even loss of consciousness.
Adrenal crisis occurs if the adrenal gland is deteriorating , if there is pituitary gland injury , or if adrenal insufficiency is not adequately treated. Risk factors for adrenal crisis include physical stress such as infection, dehydration, trauma, or surgery, adrenal gland or pituitary gland injury, and ending treatment with steroids such as prednisone or hydrocortisone too early.
Symptoms:
Complications:
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What Are The Complications Of Adrenal Insufficiency
You may have sudden severe symptoms. This is called acute adrenal insufficiency, or Addisonian crisis. This can occur when your body is stressed. That can happen for many reasons, such as an illness, fever, surgery, or dehydration. You may also have a crisis if you stop taking your steroids or lower the amount of your steroids suddenly. The symptoms of an Addisonian crisis include the symptoms of adrenal insufficiency or Addisons disease. But if an Addisonian crisis is not treated, it can lead to:
High Levels Of Depression And/or Low Level Of Anxiety And/or High Perceived Suffering
Some studies show a link with higher levels of depression and lower morning cortisol levels. (Though these findings are very mixed, and many studies show normal cortisol levels or even high cortisol levels. And it depends on the specific subtype of depression. In contrast, higher anxiety levels are associated with elevated morning cortisol levels.
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What Happens When Acth Levels Are Low
Low adrenocorticotropic hormone levels due to a pituitary gland condition usually cause low cortisol levels, whereas high cortisol levels due to an adrenal gland issue usually cause low ACTH levels.
Causes of low ACTH levels include:
- Cushings syndrome: Cushings syndrome from an adrenal tumor or by long-term use of corticosteroid medication for other conditions can cause low ACTH levels. This is because the excess cortisol prevents your pituitary gland from releasing regular amounts of ACTH.
- Hypopituitarism: This is a rare condition in which theres a lack of one, multiple or all of the hormones made by your pituitary gland. ACTH can be one of the affected hormones. Any type of damage to your pituitary gland, such as pressure on the gland, surgical damage or radiation therapy, can cause hypopituitarism.
A note from Cleveland Clinic
Adrenocorticotropic hormone is essential for regulating your cortisol levels. If youre experiencing symptoms of high or low cortisol levels, such as weight gain or loss and high or low blood pressure, respectively, its important to contact your healthcare provider. They may order cortisol and ACTH blood tests to see if your adrenal glands or pituitary gland are responsible for your symptoms.
Snack On Licorice Or Sip Licorice Tea
“Licorice raises urinary cortisol,” Dr. Gottfried says, citing a study published in the Journal of Clinical Endocrinology and Metabolism. “It’s generally recommended that people with low cortisol try a small dose of root extract, 600 milligrams,” she specifies. This is one instance where you want to go for the herb, not the candy. Otherwise, the added sugar in your licorice would cancel out the balance-restoring benefits.
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Immunisations For Childhood Illnesses
Immunisations are not contraindicated while on replacement hydrocortisone therapy and we would encourage families to complete all routine immunisations.
- If the child is taking medications other than hydrocortisone, you should ask your specialist treatment centre for advice.
- Parents should give double the dose of oral hydrocortisone for the 24-hour period around the injection. If you have any worries, please ring the specialist treatment centre for advice before the child is due to have the immunisation.
Children may develop a high temperature and/or a rash several days after some immunisations, particularly the MMR vaccine. Parents should keep a close eye on their child after the immunisation and follow the advice under temperatures if they become unwell.
Special Note For Children With Diabetes Insipidus Who Are Taking Ddavp
If the child needs:
Extra oral hydrocortisone for vomiting and/or diarrhoea, you should:
- Give them double doses of hydrocortisone and add in the 4am dose
- Do not give them any more DDAVP
- Allow them to drink if thirsty
- Take them to hospital for a blood test to check their plasma electrolytesIntramuscular hydrocortisone for any reason, you should:
- Give them an intramuscular injection of hydrocortisone
- Do not give them any more DDAVP
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What If I Have Too Much Cortisol
Though most of this article has focused on low cortisol levels, it can also be helpful to know more about high cortisol levels.
Over time, too much cortisol in the body can lead to Cushingâs disease . Several different factors can contribute to the development of Cushingâs disease, including pituitary tumors and certain types of medication like steroids.
As opposed to symptoms of low cortisol levels, symptoms of a high cortisol level can include:
- A round, flushed face
- Rapid weight gain
- Increased blood pressure
- Changes in skin, including bruises and purple stretch marks
- Weakened muscles
- Mood swings, anxiety, depression, or irritability
- Increased urination
What Causes High Levels Of Cortisol
Experiencing abnormally high levels of cortisol for an extended period of time is usually considered Cushings syndrome, which is a rare condition. Causes of higher-than-normal cortisol levels and Cushings syndrome include:
- Taking large amounts of corticosteroid medications, such as prednisone, prednisolone or dexamethasone, for treatment of other conditions.
- Tumors that produce adrenocorticotropic hormone . These are usually found in your pituitary gland. More rarely, neuroendocrine tumors in other parts of your body such as your lungs can cause high cortisol levels.
- Adrenal gland tumors or excessive growth of adrenal tissue , which cause excess production of cortisol.
What are the symptoms of high cortisol levels?
The symptoms of Cushings syndrome depend on how elevated your cortisol levels are. Common signs and symptoms of higher-than-normal cortisol levels include:
- Weight gain, especially in your face and abdomen.
- Fatty deposits between your shoulder blades.
- Wide, purple stretch marks on your abdomen .
- Muscle weakness in your upper arms and thighs.
- High blood sugar, which often turns into Type 2 diabetes.
- Weak bones and fractures.
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High Quality Foods And Supplements
To reduce biological stress, one of the best ways is of course by giving your pup high quality nutritious foods. This usually means easily digested animal-source foods and avoidance of grainy ingredients.
Probiotics are another good way to improve your dogs food quality. For dogs with digestive symptoms, give them digestive enzyme powders.
You can also buy off-the-counter dog food supplements. There are many supplements specifically labeled to be for canine adrenal support.
What Are The Symptoms Of Low Cortisol Levels
If your body is not producing enough cortisol, the symptoms will likely appear slowly and not at once. However, it is essential to keep an eye out and get help at the right time because this condition can be life-threatening if left untreated. Here are some symptoms of low cortisol levels that you need to keep an eye out for:
- Darkening of skin, especially in the folds
- Unexplained fatigue felt all the time
- Weakness in the muscles
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Where Are The Adrenal Glands And What Do They Do
The adrenal glands rest on the tops of the kidneys. They are part of the endocrine system, which organises the release of hormones within the body . Hormones are chemical messengers that switch on and off processes in the body.
The adrenal glands consist of two parts:
- the medulla which makes the hormone adrenaline which is part of the fight or flight response a person has when stressed.
- the cortex which releases several hormones.
The two most important are:If the body does not make enough cortisol, a tablet version is given. This tablet is called hydrocortisone and is given at regular intervals throughout the day. Without treatment your child will become very ill.
- Aldosterone this helps regulate the blood pressure by controlling how much salt is retained in the body. If a person is unable to make aldosterone themselves, they will need to take a tablet called fludrocortisone.
- Cortisol this is the bodys natural steroid and has three main functions:
- helping to control the blood sugar level
- helping the body deal with stress
- helping to control blood pressure and blood circulation.
What Is It Used For
A cortisol test is used to help diagnose medical conditions that cause too much or too little cortisol. These conditions include disorders that affect the adrenal glands:
- Cushing’s syndrome is a disorder that happens when your body has too much cortisol over a long period of time.
- Addison disease is a condition in which your adrenal glands are damaged and can’t make enough cortisol.
- Secondary adrenal insufficiency is a condition in which your adrenal glands don’t make enough cortisol because your pituitary gland isn’t working properly.
Cortisol testing is also used to monitor treatment for these conditions.
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What Happens When There Are Low Levels Of Cortisol
If there is an underproduction of cortisol, this means that there is an issue with either the pituitary or the adrenal gland. Not having the right levels in the bloodstream can result in a wide variety of problems that can be detrimental to healthy bodily functions.
Cortisol deficiency can be associated with Addisons disease that needs to be properly diagnosed by a doctor called an endocrinologist. After the right procedure and tests, they may prescribe Prednisone, a synthetic corticosteroid, as a treatment option.
What Causes Low Levels Of Cortisol
Having lower-than-normal cortisol levels is considered adrenal insufficiency. There are two types of adrenal insufficiency: primary and secondary. The causes of adrenal insufficiency include:
- Primary adrenal insufficiency: Primary adrenal insufficiency is most commonly caused by an autoimmune reaction in which your immune system attacks healthy cells in your adrenal glands for no known reason. This is called Addisons disease. Your adrenal glands can also become damaged from an infection or blood loss to the tissues . All of these situations limit cortisol production.
- Secondary adrenal insufficiency: If you have an underactive pituitary gland or a pituitary tumor, it can limit ACTH production. ACTH signals your adrenal glands to make cortisol, so limited ACTH results in limited cortisol production.
You can also have lower-than-normal cortisol levels after stopping treatment with corticosteroid medications, especially if you stop taking them very quickly after a long period of use.
What are the symptoms of low cortisol levels?
Symptoms of lower-than-normal cortisol levels, or adrenal insufficiency, include:
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What Causes Low Cortisol Levels
Cortisol is produced by the adrenal glands, so chronically low cortisol levels are a form of adrenal insufficiencyâmeaning the adrenal glands fail to make enough cortisol. Adrenal insufficiency can be broken down into 3 different categories:
- Primary adrenal insufficiency: Something directly affects adrenal gland function, leading to decreased cortisol production
- Secondary adrenal insufficiency: The pituitary gland fails to secrete enough of the hormone ACTHâthe hormone that tells the adrenal glands how much cortisol is needed
- Tertiary adrenal insufficiency: The hypothalamus releases an inadequate amount of the hormone CRHâthe hormone that tells the pituitary gland to produce ACTH
Letâs now explore each of these possible causes of low cortisol levels in more depth.
Prioritize Getting Enough Sleep
Dr. Gottfried says not getting consistent, good-quality sleep can really mess with your cortisol levels. She explains that when you are getting good sleep, cortisol levels peak within 30 minutes of waking up. “That peak sets off all your other hormones, including your thyroid and estrogen. We can measure this officially as the cortisol awakening response, a sign of a healthy stress response.”
When someone doesn’t get good sleep, she says that it muddles this awakening response. “That can disrupt the tango between estrogen and progesterone. It can cause your thyroid to slow down, which can then affect your metabolism by slowing it down,” she says. This is why getting consistently good sleep is important for bringing balance back to cortisol levels.
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So Now That You Know What It Feels Like To Have Low Cortisol Levels Here Are Some Lifestyle Factorsto Support Cortisol Levels
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Support your stress levels by getting outside in nature
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Increase healthy fats in your diet and include some high-quality carbohydrates at each meal.
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Sleep is essential and it is important that we balance your blood sugar with your meals and focus on low inflammatory foods. Also, choose your exercise wisely and favour gentle exercises like walking, yoga or pilates.
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Avoid caffeine as this stresses the adrenals.
Are you experiencing extreme fatigue and other symptoms of low cortisol these days?
If so you can learn more about ways to support low cortisol levels in my do at your own pace program Mend Your Menstrual Cycle.
Ready to explore getting some support from a practitioner? Take a minute to review the options for working together here.
Diagnosis Of Adrenal Insufficiency
Because the symptoms may start slowly and subtly, and because no single laboratory test may give definitive results in the early stages, doctors often do not suspect adrenal insufficiency at the outset. Sometimes a major stress makes the symptoms more obvious and precipitates a crisis.
Blood tests may show low sodium and high potassium levels and usually indicate that the kidneys are not working well. Doctors who suspect adrenal insufficiency measure cortisol levels, which may be low, and ACTH levels. ACTH levels tend to be high in primary adrenal insufficiency and low in secondary adrenal insufficiency. However, doctors may need to confirm the diagnosis by measuring cortisol levels before and after an injection of a synthetic form of ACTH. If cortisol levels are low, further tests are needed to determine if the problem is Addison disease or secondary adrenal insufficiency.
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Why Does My Dog Have Low Cortisol
Are you worried about your dog?
Have they been behaving a bit weirdly lately with odd symptoms that cant quite be explained?
Is your dog suddenly lacking energy or seems to be a bit anxious for no apparent reason?
Those symptoms are very common for a whole range of illnesses.
They are also symptoms of a dog with low cortisone.
Which is the condition that I want to focus on in this article.