When should I worry about my cortisol levels?

Feeling tired or stressed is almost never a cortisol problem and doesn't need a test. See your GP if things build up over weeks — unexplained weight changes, weakness, easy bruising, or feeling faint when you stand. Call 999 if someone is very unwell with severe vomiting, confusion, sudden bad pain, or collapse. This can be an emergency. On steroid tablets like prednisolone or hydrocortisone? Never stop them suddenly — read the steroid section below.

These don't need same-day help. But if they hang around for more than a few weeks, or keep coming back, get them checked.

Putting on weight around your tummy and face, while your arms and legs get thinner Purple or pink stretch marks across your tummy Bruising really easily Feeling weak — especially getting up from a chair or going up stairs A rounder, flushed face High blood pressure, or being newly told you have diabetes For women: periods going irregular, or new facial hair

Tiredness that rest just doesn't fix Losing weight and appetite without trying Craving salty food Feeling dizzy or light-headed when you stand up Patches of darker skin — on scars, knuckles, or inside your mouth Jot down your symptoms and how long you've had them before your appointment. It helps your GP decide if a cortisol test is worth doing.

Now and then, cortisol can drop dangerously low. This is called an adrenal crisis . It's rare, but it's life-threatening and needs emergency treatment. Call 999 or go to A&E if you or someone else has: Severe vomiting or diarrhoea Sudden, bad pain in the tummy, lower back, or legs Extreme weakness, confusion, or feeling really drowsy Fainting or collapsing Very pale, cold, clammy skin Don't wait to see if it passes. Tell the paramedics or A&E team if the person takes steroid medicine or has Addison's disease — it changes how they'll be treated.

If you take hydrocortisone, prednisolone, or dexamethasone — especially long-term — your body may be relying on that medicine for its cortisol. Two things matter most: Never stop suddenly. Always cut down slowly, guided by your GP or specialist. Follow your sick-day rules. If you get ill, run a fever, or can't keep tablets down, you might need a higher dose — or an emergency hydrocortisone injection if you're being sick. If you've got a steroid emergency card or an injection kit, keep it on you, and make sure someone close to you knows how to use it. Not sure what to do? Call 111 for urgent advice, or 999 if the person is seriously unwell.

For everyday stress or tiredness — no. A GP will usually only arrange a cortisol test (a blood test, sometimes saliva or urine) if your symptoms and a quick check point to a real imbalance. Buying a private "cortisol test" online without any guidance often causes more worry than it solves. Cortisol naturally rises and falls through the day, so a single result is hard to read on its own — it needs to be looked at alongside the full picture of your health.

If your tiredness or tension comes and goes with whatever life's throwing at you, eases off on holiday or after a good sleep, and you don't have the red-flag signs above — it's far more likely to be normal stress than a cortisol problem. Our guides on sleep and your body clock and lowering cortisol naturally are a much better place to start.

Can stress on its own cause a cortisol problem? No. Long-term stress can push cortisol up for a while, but it doesn't cause conditions like Cushing's syndrome or Addison's disease — those have specific medical causes. Are home cortisol tests reliable? On their own, not really. Cortisol changes a lot through the day, so one reading is hard to make sense of without medical context. If you're worried, see your GP. I'm always tired — is it my cortisol? Usually not. Tiredness has loads of common causes — sleep, low iron, your thyroid, stress. Your GP can help work out which one it is. What's the difference between Cushing's and Addison's? In simple terms: Cushing's syndrome is too much cortisol, and Addison's disease is too little. Both are uncommon and both need a doctor to diagnose.

What is cortisol? Cushing's syndrome Addison's disease Hydrocortisone How to lower cortisol naturally