Elevated Cortisol

Abnormally increased serum cortisol concentration above the reference range (morning peak: ~10-20 μg/dL or ~140-550 nmol/L) due to increased production, impaired regulation, or exogenous exposure.

Causes

• Exogenous glucocorticoid exposure

  • Prednisone

  • Oral contraceptives

• ACTH-dependent hypercortisolism

  • ACTH-producing pituitary tumor (Cushing's disease)

  • Ectopic ACTH production (lung cancer, carcinoid tumor, islet cell tumor)

• Adrenal gland tumor (ACTH-independent hypercortisolism)

• Metabolic/endocrine conditions

  • Diabetes mellitus

  • Severe obesity

  • Polycystic ovary syndrome (PCOS)

• Physiologic stress states

  • Chronic stress

  • Sleep disturbances

  • Acute or chronic illness

  • Intense exercise