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Is my Cortisol normal?

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What is a normal Cortisol level?

Cortisol is the primary stress hormone produced by the adrenal glands, following a diurnal pattern — highest in the morning (6-8 AM) and lowest at midnight. Normal morning cortisol is 6-18 µg/dL. Chronically elevated cortisol (Cushing syndrome) causes weight gain, muscle wasting, and immune suppression. Critically low cortisol (Addison disease, adrenal insufficiency) is life-threatening. Even subclinical cortisol dysregulation — such as a flattened diurnal curve — is associated with accelerated biological aging, visceral fat accumulation, and impaired hippocampal neurogenesis.

RangeValues
Standard Reference6–18 µg/dL
High Risk> 23 µg/dL
Low Risk< 3 µg/dL

What causes abnormal Cortisol levels?

High cortisol can be caused by chronic psychological stress, sleep deprivation, overtraining, Cushing syndrome (pituitary adenoma, adrenal tumor, or ectopic ACTH production), long-term corticosteroid medications (prednisone, dexamethasone), excessive alcohol use, and severe obesity. Low cortisol is caused by Addison disease (autoimmune adrenal destruction), pituitary insufficiency, abrupt withdrawal from long-term corticosteroids, and adrenal hemorrhage.

When should you see a doctor?

See your doctor if morning cortisol is below 3 µg/dL (possible adrenal insufficiency — potentially life-threatening) or above 23 µg/dL (possible Cushing syndrome). Also consult if you experience unexplained weight gain (especially central obesity), muscle weakness, easy bruising, or persistent fatigue with salt cravings.

Cortisol and longevity

The cortisol diurnal curve is a powerful biomarker of stress resilience and biological aging. A healthy pattern shows a sharp morning peak (cortisol awakening response) followed by steady decline to near-zero at midnight. Chronic stress flattens this curve — blunting the morning peak and elevating nighttime cortisol. This flattened pattern is associated with visceral fat accumulation, hippocampal atrophy (impairing memory and cognition), immune dysregulation, accelerated telomere shortening, and increased all-cause mortality. Cortisol also directly antagonizes testosterone and growth hormone, two anabolic hormones essential for muscle maintenance and tissue repair in aging. Salivary cortisol testing with 4 daily samples provides the most complete picture of HPA axis function.

Where to get a Cortisol test

Labcorp Cortisol Test$89Everlywell Sleep & Stress Test$69

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Related biomarkers

These biomarkers are often tested alongside Cortisol for a more complete picture.

DHEA-S
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Testosterone
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HbA1c
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hs-CRP
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Frequently asked questions

What is a normal cortisol level?
Morning (6-8 AM) cortisol: 6-18 µg/dL. Afternoon: 3-10 µg/dL. Midnight: <5 µg/dL. Below 3 µg/dL in the morning suggests adrenal insufficiency. Above 23 µg/dL suggests Cushing syndrome.
Why does cortisol timing matter?
Cortisol follows a diurnal rhythm — it peaks within 30-45 minutes of waking (the cortisol awakening response) and declines throughout the day. A morning blood draw (6-10 AM) is essential for accurate interpretation. Saliva cortisol testing can capture the full diurnal curve with 4 samples across the day.
What causes high cortisol?
Chronic psychological stress, sleep deprivation, overtraining, Cushing syndrome (pituitary or adrenal tumor), long-term corticosteroid medication use, and excessive alcohol consumption. Obesity itself elevates cortisol through visceral fat-driven HPA axis activation.
How can I lower cortisol naturally?
Prioritize 7-9 hours of quality sleep, practice stress management techniques (meditation, breathwork), avoid overtraining, limit caffeine after noon, maintain social connections, and get regular moderate exercise. Ashwagandha has modest clinical evidence for cortisol reduction in chronically stressed adults.

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Sources: Reference ranges based on AHA/ACC, ADA, and AACE clinical guidelines. Biological variation data from Ricos/Westgard database. Longevity-optimal ranges reflect targets used by preventive and functional medicine practitioners.

  • Cortisol and the stress response — Cleveland Clinic

Last reviewed: April 2026. This tool provides general health information and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider about your specific results.

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