Evaluating Cortisol Levels: Are They Within Normal Limits?
Hello everyone, I’m a 33-year-old female, weighing 165 pounds and standing at 5 feet 4 inches. Recently, I've been dealing with symptoms resembling a post-viral syndrome, which primarily includes persistent fatigue and fluctuations in my heart rate. To get some clarity on my condition, I conducted a saliva test to measure my cortisol levels. I would greatly appreciate it if someone could help me determine whether my results fall within normal parameters. The reason for my inquiry is that a healthcare practitioner (not a medical doctor) I've consulted has recommended a regimen of 5 mg of hydrocortisone twice daily for a month, claiming I have "low cortisol levels." I am quite skeptical about this suggestion and currently do not intend to pursue steroid treatment. Therefore, seeking a second opinion feels necessary. I plan to share these findings with my primary care physician to obtain her perspective, yet I hesitate to bring it up since she was not the one who ordered this specific test. She is already familiar with the health challenges I have been facing, such as referring me to a Long COVID clinic, conducting tests for sleep apnea, and performing routine blood tests. The cortisol levels from my test are as follows: - 7 AM: 296 ng/dL - 11 AM: 60 ng/dL - 3 PM: 50 ng/dL - 9 PM: 50 ng/dL I would be grateful for any insights or guidance regarding these results. Thank you!
Answers (1)
2/8/2026, 7:00:43 PM
OpenHealth AI
Your inquiry about cortisol levels is important, especially considering your ongoing symptoms of fatigue and heart rate fluctuations. Based on your saliva test results, we can draw some conclusions about your cortisol levels.
Main Points:
- Your cortisol levels appear to be within a normal range for the morning value, while the afternoon and evening values are low.
- It’s understandable to be skeptical about treatment suggestions, especially regarding steroid medications.
- It's good that you plan to discuss these results with your primary care physician.
Explanation:
Cortisol, often called the "stress hormone," follows a natural daily rhythm, peaking in the morning and gradually declining throughout the day. Here's a general guideline for cortisol levels measured in saliva:
- 7 AM: Normal morning levels can be between 250-720 ng/dL.
- 11 AM and later: Values typically drop but should still be higher than 20-40 ng/dL during the day.
Your morning level of 296 ng/dL is reassuringly within normal limits. The decline in the afternoon and evening to 60 ng/dL and 50 ng/dL respectively might suggest normal diurnal variation, but the low afternoon and evening levels could indicate an abnormal cortisol pattern, especially if you are experiencing significant fatigue.
Next Steps:
-
Document Symptoms: Keep a daily log of your fatigue, heart rate fluctuations, and any other symptoms to provide a clear picture to your physician.
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Consult Your Primary Care Physician: When visiting your doctor, bring the cortisol test results along with your symptom diary. Express your concerns about the recommended hydrocortisone treatment and ask for a detailed evaluation of your results.
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Inquire About Further Testing: It's reasonable to ask if any additional tests are recommended to assess your adrenal function or any underlying conditions contributing to your symptoms.
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Focus on Self-Care: During this time, pay attention to lifestyle factors that can help manage fatigue, such as:
- Getting enough rest and quality sleep.
- Staying hydrated and eating a balanced diet.
- Incorporating mild physical activity, such as walking, if tolerated.
Remember, your health is a priority, and seeking clarity on your symptoms and treatment options is perfectly valid. Taking these steps can empower you to make informed decisions about your health. Let me know if you need any more information or support!
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