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Dr. Andrea Pinto Lopez

Jul 06, 20227 min read

Low Cortisol

The information provided herein does not constitute an expert or medical advice, nor intended to replace such advice.


Cortisol is just one of the many hormones that keep you healthy, and it plays many important roles in the human body. Just as excess cortisol can harm your health, low cortisol can also cause different health issues. But how can you tell if you have low cortisol?

Keep reading this article to learn more about low cortisol, its causes, symptoms, and treatment.

What is cortisol?

According to the Society for Endocrinology, cortisol is a steroid hormone that is produced in the adrenal glands. The adrenal or suprarenal glands are two small glands that are located directly above each of your kidneys. After the glands produce cortisol, it’s released into your bloodstream and carried to your entire body.

Practically every type of cell in the human body has receptors for cortisol, which means that this hormone can affect every tissue and organ. Cortisol will have different effects depending on which type of cell it’s stimulating. According to the Cleveland Clinic, some of the functions of cortisol include:

  • Regulating the way your body responds to stress
  • Regulating blood pressure and blood sugar
  • Modulating inflammation levels
  • Helping to balance your sleep-wake cycle
  • Controlling how your body uses fats, protein, and carbohydrates

Your body is constantly regulating your cortisol levels. Despite the fact that cortisol is also known as “the stress hormone”, it isn’t only released when you’re facing a stressful situation. The timing of cortisol release is closely related to your everyday routine and your circadian rhythm. 

The release of cortisol is regulated by different hormones. One of these hormones is called the adrenocorticotropic hormone or ACTH, and it’s produced by the pituitary. ACTH stimulates cortisol secretion. If your ACTH levels are low, your cortisol will also be low. Cortisol that’s either too low or too high can lead to health problems.

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Causes of low cortisol levels

So what causes low cortisol? The main condition that causes low cortisol is known as adrenal insufficiency. But not all types of adrenal insufficiency are the same. 

According to Cedars Sinai, adrenal insufficiency can be primary, secondary, or tertiary. 

  • Primary adrenal insufficiency: this condition is also known as Addison’s disease. It happens when your adrenal glands become damaged and can’t produce enough cortisol. Addison’s disease is relatively rare, but it can happen at any age.
  • Secondary adrenal insufficiency: this type of adrenal insufficiency happens when your pituitary doesn’t make enough ACTH. This leads to insufficient cortisol production in your adrenal glands.
  • Tertiary adrenal insufficiency: in tertiary adrenal insufficiency, the problem starts in your hypothalamus. The hypothalamus has to make corticotropin-releasing hormone for the pituitary to release ACTH. If your hypothalamus doesn’t make enough corticotropin-releasing hormone, your ACTH and cortisol levels will be low.

There are different conditions that can lead to primary, secondary, or tertiary adrenal insufficiency. Some of these causes include:

Symptoms of low cortisol

The symptoms of low cortisol develop over a period of time, which can make them harder to identify. According to the Mayo Clinic, the signs and side effects of low cortisol can include:

  • Extreme fatigue
  • Weight loss
  • Decreased appetite
  • Low blood sugar
  • Salt cravings
  • Hyperpigmentation or darkening of the skin
  • Abdominal pain
  • Muscle or joint pain
  • Low blood pressure
  • Fainting or dizziness, especially upon standing
  • Nausea or vomiting
  • Diarrhea
  • Mood changes
  • Depression

Low cortisol symptoms in women

Additionally, women with low cortisol may experience loss of body hair and sexual dysfunction. Female patients can also have irregular or absent menstrual periods. Keep in mind that irregular spotting can be caused by other conditions, such as STDs. The best way to determine the cause of irregular bleeding is to get tested, including STD tests.

Low symptoms cortisol in men

Additionally, the effects of low cortisol levels on men can lead to erectile dysfunction and fertility problems.

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How does low cortisol affect the body?

If you have a dangerously low cortisol level, you could experience what is known as an Addisonian crisis. If left untreated, an Addisonian crisis can lead to shock or death. According to Johns Hopkins Medicine, an adrenal crisis can also cause:

  • Extreme weakness
  • Kidney failure
  • Severe abdominal pain
  • Extremely low blood pressure

Low cortisol treatment

The treatment for low cortisol will depend on the cause of the issue. In most cases, your doctor will prescribe hormone replacement to restore your cortisol levels back to normal. If your adrenal insufficiency is caused by another condition, such as cancer or an infection, you will also need to get treatment for the underlying condition.

You can learn more about other hormonal disorders and many other health topics at STDWatch.com now.

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Cortisol - yourhormones.info

Cortisol - my.clevelandclinic.org

Adrenal Insufficiency (Addison Disease) - cedars-sinai.org

Addison’s disease - mayoclinic.org

Adrenal Insufficiency (Addison’s Disease) - hopkinsmedicine.org

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