Frequently asked questions:Excess cortisol and testing
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Understanding excess cortisol
Cortisol is an important hormone that the body makes naturally. It helps manage stress, sleep cycles, how the body breaks down food (metabolism), blood pressure, and blood sugar.
When there's excess cortisol in the body, it can keep your blood pressure and blood sugar high, even if you’re doing everything you can to manage these conditions. This includes eating a balanced diet, exercising regularly, and taking your medications as prescribed.
High blood pressure and high blood sugar can be considered “uncontrolled” if your numbers stay high even after eating a balanced diet, exercising, and taking multiple medications.
If you think you have uncontrolled high blood pressure and/or high blood sugar, fill out the Cortisol Self-Assessment. This can be used to help start a conversation with a healthcare professional about whether getting a DST is right for you.
In addition to high blood pressure and/or high blood sugar, there are other symptoms that indicate excess cortisol could be the underlying problem. Some of them include:
difficulty sleeping (insomnia)
anxiety
depression
unexplained weight gain
feeling very tired (fatigue)
trouble remembering things, difficulty concentrating, brain fog, forgetfulness
extreme mood swings, irritability, anger, feeling “short-fused"
If you have excess cortisol, it may be due to a condition called endogenous hypercortisolism. This means, over time, the body has been making excess cortisol due to a growth on the adrenal gland, pituitary gland, or somewhere else in the body.
Cortisol is an important hormone that helps manage stress, sleep cycles, how the body breaks down food (metabolism), blood pressure, and blood sugar. However, if there’s too much cortisol activity, it can disrupt those systems over time.
When excess cortisol goes undetected, the risk of developing serious heart problems—like heart disease or stroke—can be up to 5 times higher.
Testing for excess cortisol
Your healthcare professional may be able to test your cortisol level, or they might refer you to a specialist, like an endocrinologist. You can also use this resource to help find a specialist in your area.
A DST is 1 of 3 tests available to measure cortisol levels and is the most sensitive testing option. It's also the first step to help a healthcare professional understand if a condition called endogenous hypercortisolism is causing your signs and symptoms. Additional testing may be necessary to confirm a diagnosis.
Fill out the Cortisol Self-Assessment before your next appointment and ask a healthcare professional if getting a DST is right for you.
Once your healthcare professional decides to test your cortisol level with a DST, here’s what you can expect:
Your healthcare professional will prescribe a 1 mg dexamethasone tablet. This tablet should be taken between 11:00 PM and 12:00 AM
The following morning, you will need to have your blood drawn between 8:00 AM and 9:00 AM. The blood sample will then be sent to a lab
The lab will use your blood sample to test your cortisol level. The results will be sent to you and your healthcare professional. Be sure to discuss the results with your healthcare professional
If your cortisol level is at or below 1.8 μg/dL, it could mean your uncontrolled high blood pressure and/or high blood sugar are being caused by something else. Talk to your healthcare professional about occasionally retesting your cortisol level, as it can change over time.
If your cortisol level is higher than 1.8 μg/dL, endogenous hypercortisolism could be the cause of your uncontrolled high blood pressure and/or high blood sugar. Your healthcare professional may want to run additional tests to confirm a diagnosis. Learn more about endogenous hypercortisolism.
μg/dL = micrograms per deciliter. This is a common unit for measuring how much of a substance is in your blood.
