Thyroid UK

What does my 9AM Cortisol result mean?

Hello everyone,

If you read my previous posts, you would know that i have been suffering chronic fatigue for a long time with some additional problems but fatigue is the main thing (I am 22 male). I had so many blood tests and everything came back normal. So after a thorough research and spending so many hours on computer, i saw someone suggesting the fatigue could be related to adrenal insufficiency and to do a 9AM cortisol test. I did the test privately and got my result the same day today (455 nmol/L). I would really appreciate if anyone can interpret the result for me please? I will put whatever is writter on the result paper, down here.

"Cortisol - 455 nmol/L

Please note new reference range from 24/9/15 using the Roche Gen II assay

Results of >200 nmol/L average 26% lower than previous method

Reference range only applies to samples taken between 0600 - 1000 am only

Reference range: 172 - 497 nmol/L"

The above written is what's on the result paper. Any help is appreciated.


21 Replies


Apologies sent re previous reply... I didn't realise you weren't medicating and am sorry to hear you are still suffering. Is this a blood test?

The result is high within range so a doctor would assume you have a good supply of cortisol. However, blood tests measure the active and inactive cortisol.

Cortisol follows a circadian pattern so has big variations over the course of a 24 hour period and your blood test only gives you a morning reading.! !..

The Genova Saliva Stress Test measures only the active (available for use) cortisol, in four readings at strategic times of the day so giving an informative overall pattern.

It also measures DHEA which when balanced with cortisol will help to give optimal adrenal health.

Results will not only identify any highs and lows but help you decide what supplements will be beneficial. However, the test is generally unrecognised by GP's or endo's.

The cost is £77.00 which is a discounted price for ThyroidUK when code A42AQ is used.

If you do this test post results for members to comment.

You were deficient in Vit D and folate. Are you supplementing as these could cause thyroid dysfunction and adrenal stress.

Also have you had thyroglobulin antibodies tested ? ?. (TGAb)


Saliva Stress Test (test ref END01)


Disclaimer: I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.


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Hello Flower,

Thank you so much for your response. Yes, I was severely deficient in Vitamin D and also low folate around end of May and was given high dose Vitamin D3 tablet for a week and also 1 month supply of folate tablet, after a month and some time in July i had another blood test and it showed by Vitamin D and folate to be increased and in normal range. However, its been more than 6 months now and i have not been taking both of these tablet as my gp said i wouldn't need them, so now after 6 months, i feel lethargic and same as before so I asked my GP for another blood test to check my Vitamin D, B12 and folate level and I am expecting my results next week. Who knows if my levels have dropped back? Do you think i need constant vitamin D3 and folate to maintain my levels?


Yes (probably ! ! .) . . until the root cause of your condition is identified.

Post your results complete with ranges (numbers in brackets) for members to comment.



Ok sure. Thanks


Sorry, I may have mentioned 9am cortisol. NHS only uses blood tests, but if using NHS blood tests, it must be done at 9am (NHS reference ranges based on 9am result as levels change throughout day).

My daughter had an abnormal result but as the test was done at 10.15am, she had to go back for test to be repeated at 9am. Hope this makes sense.


Have you tried a trial of gluten and dairy free diet? May be worth a try to see if your symptoms improve.


Hi Josiesmum,

No, i have never tried it but when i had my private cortisol blood test, the doctor there suggested me, i could have celiac disease and told me to maybe try a gluten-free diet, but i didn't take it seriously as i did not know a simple diet change could have any effect on my body but i have done so much research on this disease and it lists all the symptoms i have (fatigue, memory loss, brain fog, anxiety, hairloss, mouth ulcers etc). I am someone who eats a lot of gluten through various food, so i can't completely ignore your suggestion. I am going to go on a gluten-free diet and see if any change occurs. Thanks for your response!


Remotheboss, Adrenals are always a tricky area, because the NHS guidelines do not acknowledge the existence of adrenal fatigue. The test you've taken is really only to check for the very extreme condition of Addison's disease. This is where your adrenals have pretty much stopped working and quickly leads to coma. Only a handful of people on this forum have ever had a positive test for it, and it is a condition you can be treated for in the NHS.

When people talk about exhausted adrenals or adrenal fatigue, this is something not acknowledged by the NHS, so you must self treat or find a private doctor who will perform it. This is tested with the 24-hour saliva test. Stop the Thyroid Madness website is a good place to start to read about the test and how to interpret it.

Personally, I had a slightly high out of range result from the blood test, but with the 24 hour test it turned out I had a very high morning result, but was very very low the whole rest of the day. So the single result was quite misleading.

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How do you treat high cortisol levels?


I don't rely know, because I've only had low. I took adrenal extract (nutri adrenal) and a few other things to help with it. There is lots on the forums about treating adrenals, though. You can either do a search or start your own thread and people will give you a lot of info.


This all seems like my own story..been struggling from last 2 years with severe fatigue.On blood tests I get repeatedly low in Vit D and Folate and ESR is raised everytime. Now from few months I am getting hypoglycemic symptoms and doctor has requested 9am Cortisol. Just wondering if that would be enough to fit the criteria as you mentioned aboutAdrenal fatigue .

Can you advise where can I do private test for salivary cortisol levels?


KN12, It sounds like your doctor is not treating your low vit D and folate. Both of these could be causing fatigue. What you should be seeing if the treatment is going well is that your levels consistently raise over repeat tests. It can take a year or more to get levels up to good levels.

For vitamin D all you need is a good quality supplement. The NHS will often give very low doses, you need several thousand international units per day, if not tens of thousands to start with. I've known the NHS give less than 1000 per day. You'll never get an increase with those low levels. Get a supplement that includes vitamin K, as it helps your body use it.

Folate I don't know as much about, but you will find advice on the forum about it. or start your own thread and members will give you advice.

Doctors tend to under play vitamins, not treat them well, and not understand how ill you can be if they're low. Also they don't understand that you need good, optimal levels, which means around halfway up the range. If a doctor tells you your levels are low, you know they're very very bad.



Thank you for replying.Its been now 3-4 years,I get low levels of vit D and doctor replace it every year, stays on lower normal but again drops in few months.

My worry is if I am having Adrenal fatigue as I get severe fatigue, hypoglycemic symptoms and always get low blood pressure in stressed situations .

Can any one suggest where can I arrange private blood test from?as asking GP would be a long battle..


It looks like you're on a vitamin D dose of under 1000 international units per day. This is a Mickey mouse dose that will never raise your levels.. I'm not an expert, but you will find good advice elsewhere in the forum. You need something like 20,000 per day, or even more for several weeks. Once your levels are good - which means close to the top of the range - you will need to stay on 2000-ish as a maintenance dose, probably forever. This is something you can actually get better from, just doctors are rubbish on nutrition and vitamins.

You can find details of mail order, finger prick tests on the ThyroidUK website. I use Blue Horizon and am very happy with the service, but Medichecks has just started getting popular on the forum and may work out a better deal.

You are seriously deficient in Vitamin D, as the NHS range goes down very very low. Once you get on good supplements you will likely feel a lot better quite soon. Yes, your adrenals are low and worth treating, too. It is a bit fiddly to do so, but there is advice throughout the forums.


Oops, I got you mixed up with another poster. I think most of what I said still applies, although I think you haven't had an adrenal test yet?

24hr saliva test is the best one. But the NHS doesn't believe in it, so you will have to self-treat.


Thank you SilverAvocado. Makes alot of sense. Ill look into the tests as vit dose us the higher one which my GP gives me and it is for several weeks .. thank yiu again


Just to share some update. I requested to arrange for 9 am cortisol and sample was taken at 9:55am. Results came back today and it is 147 . My GP said it is low..any thoughts??

Also I am on 20 000 IU dose of vit D3 now.


What's your doctor planning to do about the low cortisol ? My 17 yo son has similar symptoms especially hair loss, fatigue, weight loss, he had folate deficiency and treated for 3 months, had bottom of the range B12, they don't test vitamin D, last week his 9am cortisol was 317, haven't a clue if it's optimal or not.


Hi Gwenriberts..

Cortisol of 317 at 9am is adequate.. defficiency is below 100 or suspicious if btw 100-200 .

My GP has refered me to endocrinology after I requested that and my apt is in July..Ill keep yhe group updated..


Thanks for your reply, glad that you're being referred after you requested. 317 is a good enough level then, glad I can exclude it.


Yes as far I know 317 is normal value. normal range is I guess 200-800..

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