Decreased Cortisol

Abnormally low serum cortisol concentration, reflecting impaired glucocorticoid production or secretion.

• Blood range

  • 6 a.m. to 8 a.m.: 10 - 20 mcg/dL (140 - 690 nmol/L)

  • Around 4 p.m.: 3 - 10 mcg/dL (80 - 270 nmol/L)

• Saliva and Urine Ranges

  • Morning saliva: 10.2 - 27.3 ng/mL

  • Night saliva: 2.2 - 4.1 ng/mL

  • 24-hour urine: 10 - 55 µg/day for adults

Causes

• Primary adrenal insufficiency

  • Autoimmune disease

  • Infection

  • Adrenal hemorrhage

• Secondary adrenal insufficiency

  • Abrupt cessation of corticosteroids

  • Pituitary tumor

  • Pituitary bleeding

  • Pituitary surgery

  • Pituitary radiation

  • Hypothalamic dysfunction