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Cortisol 46 advice please

My daughter has just got her result from a blood cortisol test and it is 46. Her G.P. told her to stop her levo which Dr. Skinner prescribed her, as she said she is hyper, but she does not any hyper symptoms. She has not seen any improvement on levo though. She .is now referring her to an endo. Would the levo have caused the cortisol to be low or has it nothing to do with it. Her TSH is 0.05 range 0.35 - 4.5 and T4 24 range 7.8 - 22 no T3 and is taking 175mcg levo. Any advice please

14 Replies

Browny, I would say that that is seriously low if it is a 9am cortisol result. The NICE guidelines are here:


"If the serum cortisol level is less than 100 nanomol/L, admit the person to hospital or refer urgently to an endocrinologist (use clinical judgement depending on the severity of symptoms). Adrenal insufficiency is highly likely."

Has she been referred on an urgent basis?



Hi Hampster, many thanks for your reply, G..P. has not referred on an urgent basis but she said she has private med. insurance so could be seen quickly. Do you know if the levo could have caused the low cortisol. She has been unwell for five yars and in desperation went to see Dr. S as she was not getting anywhere with the surgery. I have read the link no one has ever mention addisons


I don't know about the levo's affect on it, perhaps someone else might?

Here's another link:


And given your family history you might be interested to know that Dr Chandy has been looking at this:


If you look at the slideshow, slide 17 shows disease progression, with 25 - 50 being stage 5 critically clinical. He has developed a treatment protocol but it's not published on the website yet. You can watch his presentation about this here:

H x


Hi Hampster

You're a mind of information and I am so glad you are, you have helped so much over the last few weeks, first me, then my husband and now my daughter.

she has been struggling for five years with a diagnoses of CFS by her G.P.

I have read the links, Dr. Chandy is excellent, I have heard of him before, why can't more Doctors be like him.

I am hoping she can get to see the endo next week as she is going private.

I have also just read something about Sheenans Syndrome which is if I understood it right it can develop if you have lost a lot of blood when giving birth and effects your pituitary gland and symptoms can come on later, one being adrenal fatigue.

When more daughter had her first child he weighed 9lb 8oz and she did lose a lot of blood. Her symptoms started 18 months later which doctor put it down to postnatal depression then as time went on said it was CFS. I am now hoping we can get to the bottom of it. I will keep you posted. I hope you are keeping well.

Many thanks and very best wishes


What are the cortisol ranges


Hi She didn't ask, I will tell her to ring in the morning to ask.

All the G.P. said it was low and she would have to see an endo. It was taken at 9.00 am


Was the blood test a standard blood test where the gp was testing the blood in general.



She had been seeing Dr. Skinner and she mentioned adrenals as she was not getting any improvement from the levo so he asked her G.P. when she was having her next thyroid bloods tested to test for cortisol as well


what were her main symptoms?


Exhaustion, general aches and pains, some days struggling to climb the stairs, freezing cold hands and feet. low temp 35.0 am rising to 35.5 pm. irritability, no patience, cannot stand noise, insomnia.

but wanting to sleep during the day, and general depression


Typical of both thyroid and adrenals....hopefully endo will do futher tests. They might suggest the acth test.


Many thanks for your response, I am now hoping they will be light at the end of the tunnel.

Best wishes


46 is very low.

If your daughter starts to vomit (even once) during the time before seeing the endo - she should go straight to A&E and mention the low cortisol.


Many thanks Juliet for your reply, it has only just come through I think there has been problems with messages getting through over the last 2 days.

I have told her to ring the surgery tomorrow to rush things up.

Today she feels really achy and weakish, I am wondering now if it has been the low cortisol all this time causing her ill health and not her thyroid.

I will tell her your advice and thankyou for letting me know. Have you had similar problems?


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