Thyroid UK

Cortisol Level in ACTH Stimulation

Hi everyone ...

As mentioned many times before, I have dysfunctional pituitary gland with a TSH lower than 0.1 However, I suspect that there is also adrenal issues. Here is the results of the test:

First Sample Cortisol(8AM): 199 nmol/l (normal Range: 123-626)

Second Sample Cortisol(9AM after ACTH shot): 560 nmol/l (normal Range: 123-626)

In one hour, the cortisol is almost tripled indicating adrenal itself is working normally. IS my first sample considered OK or indicates possible secondary adrenal insufficiency?!

3 Replies

I thought µg/dL is more common for cortisol level:

First Sample Cortisol(8AM): 7.21 µg/dL (normal Range: 123-626)

after ACTH shot

Second Sample Cortisol(9AM): 20.29 µg/dL (normal Range: 4.56-22.69)



I would say your first sample is decidedly low but as your adrenals responded well to the stim test, your adrenals will be deemed as working. Have you had ACTH levels tested ? A deficiency of ACTH is a cause of secondary adrenal insufficiency as you require this for cortisol.

If all pituitary tests have been completed, they may not do anything for you and it will be up to you to get the adrenals in better health by trying to remove emotional & physical stress, and resting (as much as poss).

Address blood sugar swings by eating well, and gut issues to help nutrient absorption, lower thyroid antibodies to reduce inflammation, as all these will cause your adrenals to work harder..

Optimal thyroid hormones and iron//nutrients will help and you might be prescribed HC if you have a sympathetic doctor, or you could try adrenals glandulars or adaptogens to help restore adrenal health.


Healing Adrenals


Thanks Radd for your response and advice. Yes, it was tested at another time (after 3 months), the result was normal 30 pg/ml (normal 10-48).

I tried 5 mcg of prednisolone. I don't think I felt any improvement.

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