Low Cortisol Symptoms, Causes, and Treatments

Low Cortisol Cortisol, or hydrocortisone, is a steroid hormone (glucocorticoid) that is vital to the endocrine system released by the adrenal cortex to combat stress. Maintaining healthy levels of cortisol is essential to keeping in good health. Low cortisol levels can greatly affect the quality of your life, causing a plethora of unpleasant symptoms and health issues, both physical and psychological.

Learn more about cortisol, its functions, and its significance in your daily life in this health and wellness course about hormones.

What is Cortisol?

Cortisol is a steroid hormone produced by the zona fasciculata, the middle of three layers of the adrenal cortex located in the kidneys, and regulated by the pituitary gland in the brain. This hormone is important for the immune system, regulating blood pressure, the cardiovascular system, metabolism, and more.

Cortisol is nicknamed the “stress hormone” for its role in the fight or flight response, a physiological mechanism that releases hormones like adrenalin and cortisol to prioritize important body functions under stressful circumstances.

Synthetic cortisol can also be used as treatment for various disorders, such as inflammatory disorders, certain types of cancers, psoriasis, and more. However, too high a dosage of synthetic cortisol taken over long periods of time can result in a number of negative side effects, including increased blood pressure, thinning of the skin or limbs, fluid retention, fat build-up around the chest, abdomen, and face, and reduction in natural cortisol production.

Prolonged levels of stress can promote an elevation in cortisol levels that may produce damaging effects to the body. That’s why it’s good to learn how to reduce stress in your day to day life, which you can read more about with this stress management training course.

However, low cortisol levels are just as dangerous to one’s health.

Low Cortisol Symptoms

When the adrenal glands become inactive or fail to produce sufficient amounts of cortisol, the condition is called primary hypoadrenalism. Another name for this condition is Addison’s disease, an autoimmune disease where antibodies are sent to attack the adrenal cortex. Because it is a chronic disorder, these hostile antibodies are detectable in the blood long before they begin to do significant, notable damage to the person’s adrenal cortex.

The symptoms of low cortisol, or hypoadrenalism, include:

  • Mental and psychological ailments such as depression
  • Faintness and dizziness
  • Weakness and fatigue
  • Heart palpitations
  • Emotional hypersensitivity
  • Inability to cope with stress
  • Social anxiety
  • Muscle weakness
  • Headache, scalp ache, or general body ache
  • Severe or dull lower back pain
  • Extremely sensitive skin
  • Nausea, diarrhea, and vomiting
  • Abdominal pain and hunger pain despite an empty stomach
  • Extreme craving for salty foods
  • Anxiety and jitters
  • Clumsiness and confusion
  • Motion sickness
  • Insomnia and dark circles under the eyes
  • Low bladder capacity and symptoms of IBS
  • Irregular or non-existent menstrual period

Of course, these symptoms won’t all occur simultaneously, or immediately. Some people suffering from low cortisol will experience a couple of these symptoms, perhaps one after another. If you experience any one of these, or a combination of them, severely enough that it is affecting your day to day quality of life, you should consult a doctor or health expert right away.

If you happen to be experiencing the anxiety and stress symptoms particularly heavily, it may be worth it to take a stress and anxiety management course like this one while you await your doctor visit. The advice given in courses like this is generally applicable to life, even without Addison’s disease or low cortisol levels.

One of the only cases in which symptoms of low cortisol will manifest suddenly and acutely is when cortisol levels drop in a short duration of time, an ailment known as an Addisonian crisis. This can occur immediately, or following a brief period of minor symptom such as the ones listed above. It is difficult to determine when or how the effects of low cortisol levels will manifest, so it is recommended to be wary of any concerning symptoms and report them right away.

Causes of Low Cortisol

The circumstances and diseases that trigger low cortisol, or hypoadrenalism, vary. Besides the autoimmune disorder Addison’s disease, other causes include secondary hypoadrenalism, or a deficiency of ACTH. Secreted from the anterior pituitary gland, ACTH, or adrenocorticotropic hormone, is a polypeptide tropic hormone that elevates its production when the body suffers from low cortisol levels as a result of Addison’s disease. It’s possible for the body to develop a tumor as the result of increased ACTH, known as Cushing’s disease.

Another cause is tuberculosis. Tuberculosis is an infectious disease that usually attacks the lungs, but can also affect the adrenal glands and trigger hypoadrenalism. If the disease destroys the adrenal glands, it is irreversible.

Other rare disorders that can damage the adrenal glands and trigger low cortisol levels are:

  • Adrenal inflammation related to HIV
  • Congenital adrenal hyperplasia, an enzyme disorder
  • Amyloidosis
  • Bilateral adrenalectomy
  • Adrenoleukodystrophy
  • Sarcoidosis
  • Metastases

Addison’s Disease Diagnosis

One of the primary symptoms of Addison’s disease is the discoloration of the skin. If this symptom is severe, it can help diagnose low cortisol levels in the patient.

If enough symptoms manifest to be worrisome, a doctor will perform blood tests on the patient. These blood tests can reveal a number of telling symptoms that point to low cortisol, such as an increased level of potassium, a low level of sodium, and rarely, a high level of calcium.

When checked for low cortisol levels, it is best to be tested for other adrenal hormone deficiencies, such as aldosterone and ACTH.

Be wary, that patients suffering from Addison’s disease may often be misdiagnosed with an unrelated abdominal disease before they are correctly diagnosed with Addison’s. This can occur because of a common list of symptoms, and will be corrected as soon as further tests rule out the abdominal disease. This can waste valuable time, though, so it’s important to be wary of low cortisol levels and its associated diseases, and bring it up with your doctor if you have reasons to suspect it.

Low Cortisol Treatment

If a patient is diagnosed with low cortisol levels, they will most likely be prescribed oral hydrocortisone tablets as replacement therapy. Patients will have to regularly track the levels of cortisol in their blood throughout the day, starting from before their first daily dosage. A hydrocortisone regimen is designed to imitate the body’s natural levels of cortisol throughout the day, starting out high in the early morning and decreasing as the day goes on.

Cortisol supplements should only be taken for cases of severe cortisol deficiency, caused by serious disorders such as Addison’s or tuberculosis. If synthetic cortisol is taken when low cortisol levels are not severe enough to warrant it, this can result in a loss of natural cortisol production in the adrenal glands. Patients who see a decrease in their adrenal gland’s natural cortisol production will actually need to take extra cortisol during times of particular stress or activity, such as an illness, to make up for the lowered levels.

People with mild cortisol deficiency should take extra measures in their life to reduce and prevent unmanageable levels of stress, which is one of the primary causes of

Prevent Low Cortisol Naturally

Practicing natural stress reduction habits is vital to combating low cortisol levels, and keeping your adrenal glands producing just the right amount of hormones. You can check out this in-depth stress management course for useful tips, practice the physical, mental, and spiritual discipline of yoga with this course, or practice this daily, ten minute de-stressing exercise as taught in this course for major stress-relieving results.

Anxiety headaches are one sure sign of stress. You can read more about stress headaches here, but the key thing to remember, which the linked post outlines, is that prevention is definitely better than finding a short-term cure. Short-term cures, such as this acupuncture and massage point course, are good and healthy exercises to practice, but preventing stress in general is better in the long term.

One way you can combat stress is by practicing better time management. If you’re a busy person who struggles with balancing work, play, and studies, consider reading up on the time management skills outlined in this guide.

Even though this guide was written specifically for students, the advice still applies. Stay organized in all aspects of your life by utilizing to-do lists, cleaning up your living and working area regularly, and breaking down large, overwhelming goals into small, manageable ones. It’s also very important to understand your limits, and allow yourself a break when you feel yourself growing too stressed, as well as staying active and eating a healthy diet.

You can check out this in-depth course to time management for more, and this course on healthy cooking fundamentals to maintain a good diet.


Low cortisol levels can be an indication of a severe or mild disorder, and can produce severe or mild symptoms and effects itself if left untreated. Don’t let low cortisol, or hypoadrenalism, go undiagnosed.

Stay healthy, practice the stress reducing methods outlined in this course, and consult your doctor if you experience any and all combination of low cortisol symptoms.