The short answer
Cortisol is the main hormone your adrenal glands make. It peaks early each morning, so the test is done at about 8 a.m.1,4 It’s a test for too little cortisol: a morning level under 5 µg/dL suggests your adrenal glands may not be making enough.2,3
Check your result
Type the number from your report. It stays on this page.
- Very low Under 5.0
- Low or borderline 5.0 to 9.9
- Probably enough 10.0 to 14.9
- Normal 15.0 to 19.4
- Above range 19.5 or more
- Low for the afternoon Under 2.3
- Typical for the afternoon 2.3 to 11.9
- High for the afternoon 12.0 or more
Enter your result to see what it means and what to do next.
Got a result from another lab? Ask Picardo about it. The app explains your results, and a physician can follow up.
The morning cut points of 5, 10 and 15 come from Endocrine Society and European guidelines;2,3,4 the upper limits and the afternoon range are Labcorp’s.1 Cut points depend on the lab’s test, and newer tests read about 20% lower than older ones.8 The bar isn’t to scale.
Very low: your adrenal glands may not be making enough
Guidelines suggest that a morning cortisol under 5 µg/dL, alongside a high ACTH, points to adrenal insufficiency, where your adrenal glands don’t make enough cortisol. It’s a first step before a stimulation test, not a diagnosis on its own.2,3 In people with pituitary disease, under 3 is a clear sign.4 Steroid medicines, including inhalers, creams and joint injections, can suppress your own cortisol and cause it too.3
See a clinician within a few days. If you’re vomiting or have diarrhea, feel faint or confused, are very weak or have severe belly pain, go to an emergency department or call 911, and tell them about this result and any steroid you take. These can be signs of an adrenal crisis, which is an emergency.2,3
- 1 If you don’t take steroids, a clinician will usually check ACTH alongside a repeat morning cortisol, then confirm with a stimulation test. A high ACTH points to a problem in the adrenal glands themselves.2
- 2 If you take a steroid medicine, tell your clinician, and don’t stop it suddenly.3
- 3 If you’re coming off steroids, guidelines suggest staying on a low daily dose and repeating the test in a few months.3
Low or borderline: a gray zone
This range can’t confirm or rule out adrenal insufficiency.3,4 Labcorp’s range starts at 6.2, so most of it won’t be flagged on your report.1 For people coming off steroids, guidelines suggest staying on a low dose and repeating the test in weeks to months.3 For people with pituitary disease, they suggest a stimulation test for any morning result from 3 to 15.4
Not urgent if you feel well. Worth following up, especially if you have symptoms, take steroids or have pituitary disease.
- 1 If you’re coming off steroids, don’t stop them on your own. Repeat the test when your clinician advises.3
- 2 If you’re tired, losing weight, dizzy when you stand or craving salt, ask a clinician about a stimulation test.2,4
- 3 Otherwise, repeat the test at about 8 a.m., with an ACTH level.2
Probably enough, depending on why you tested
What this means depends on why you were tested. If you’re coming off steroids, guidelines treat a morning level over 10 µg/dL as a sign your body is making its own cortisol again.3 If you have, or might have, pituitary disease, the Endocrine Society suggests a stimulation test for any morning result from 3 to 15, because this range doesn’t rule out a shortfall.4 That guideline is from 2016, and newer tests read lower than older ones, so the right line depends on your lab’s test.8
Not a worry if you feel well and were tested for another reason. Worth asking about if you have pituitary disease, take or recently stopped steroids, or have symptoms.
In the normal range
At this level, adrenal insufficiency is unlikely. It’s above the line the Endocrine Society’s pituitary guideline uses to make a shortfall unlikely, and above the line for recovery after steroids.3,4 No single level rules it out for certain, and studies have argued for cutoffs from about 10 to 17.2
Nothing to worry about for most people.
Above the lab’s morning range
This is above Labcorp’s morning range, but a single cortisol can’t diagnose Cushing’s syndrome, and guidelines recommend against using one to test for it.5 The usual reasons are more ordinary: the pill, oral estrogen, pregnancy, prednisone-type medicines, a recent hydrocortisone dose, severe stress and illness.1,2
Not a worry on its own.
- 1 If none of those apply and you have signs of Cushing’s, such as easy bruising, a red face, wide purple stretch marks and weak thigh or shoulder muscles, see a clinician.5
- 2 The tests for Cushing’s are different: a 1 mg overnight dexamethasone test (normal is 1.8 µg/dL or less), late-night saliva cortisol or 24-hour urine cortisol.5
Low for an afternoon test
Cortisol falls through the day, and guidelines don’t use an afternoon result to diagnose adrenal problems.1,4 This is below Labcorp’s afternoon range, though, so it’s worth checking with a morning test.1
Not urgent if you feel well. If you’re vomiting or have diarrhea, feel faint or confused, are very weak or have severe belly pain, go to an emergency department or call 911.2,3
Typical for an afternoon test
This is within Labcorp’s afternoon range.1 But it says little about whether you make enough cortisol, because guidelines read that from a morning test.4
Nothing to worry about.
- 1 If a clinician is checking your adrenal glands, ask for a test at about 8 a.m.4
High for an afternoon test
This is above Labcorp’s afternoon range.1 The usual reasons are the same as for a high morning result, such as the pill, oral estrogen, pregnancy, prednisone-type medicines or severe stress.1,2 It isn’t a test for Cushing’s syndrome.5
Not a worry on its own.
- 1 If you have signs of Cushing’s, ask a clinician about a dexamethasone test, late-night saliva cortisol or 24-hour urine cortisol.5
What is a normal cortisol level?
Labcorp’s range is 6.2 to 19.4 µg/dL in the morning and 2.3 to 11.9 in the afternoon.1 Guidelines read a morning result on a sliding scale: the higher it is, the more likely your adrenal glands are keeping up.3 They group morning results like this:2,3,4
Very low: your adrenal glands may not be making enough
Guidelines suggest that a morning cortisol under 5 µg/dL, alongside a high ACTH, points to adrenal insufficiency, where your adrenal glands don’t make enough cortisol. It’s a first step before a stimulation test, not a diagnosis on its own.2,3 In people with pituitary disease, under 3 is a clear sign.4 Steroid medicines, including inhalers, creams and joint injections, can suppress your own cortisol and cause it too.3
See a clinician within a few days. If you’re vomiting or have diarrhea, feel faint or confused, are very weak or have severe belly pain, go to an emergency department or call 911, and tell them about this result and any steroid you take. These can be signs of an adrenal crisis, which is an emergency.2,3
- 1 If you don’t take steroids, a clinician will usually check ACTH alongside a repeat morning cortisol, then confirm with a stimulation test. A high ACTH points to a problem in the adrenal glands themselves.2
- 2 If you take a steroid medicine, tell your clinician, and don’t stop it suddenly.3
- 3 If you’re coming off steroids, guidelines suggest staying on a low daily dose and repeating the test in a few months.3
Low or borderline: a gray zone
This range can’t confirm or rule out adrenal insufficiency.3,4 Labcorp’s range starts at 6.2, so most of it won’t be flagged on your report.1 For people coming off steroids, guidelines suggest staying on a low dose and repeating the test in weeks to months.3 For people with pituitary disease, they suggest a stimulation test for any morning result from 3 to 15.4
Not urgent if you feel well. Worth following up, especially if you have symptoms, take steroids or have pituitary disease.
Probably enough, depending on why you tested
What this means depends on why you were tested. If you’re coming off steroids, guidelines treat a morning level over 10 µg/dL as a sign your body is making its own cortisol again.3 If you have, or might have, pituitary disease, the Endocrine Society suggests a stimulation test for any morning result from 3 to 15, because this range doesn’t rule out a shortfall.4 That guideline is from 2016, and newer tests read lower than older ones, so the right line depends on your lab’s test.8
Not a worry if you feel well and were tested for another reason. Worth asking about if you have pituitary disease, take or recently stopped steroids, or have symptoms.
In the normal range
At this level, adrenal insufficiency is unlikely. It’s above the line the Endocrine Society’s pituitary guideline uses to make a shortfall unlikely, and above the line for recovery after steroids.3,4 No single level rules it out for certain, and studies have argued for cutoffs from about 10 to 17.2
Nothing to worry about for most people.
Above the lab’s morning range
This is above Labcorp’s morning range, but a single cortisol can’t diagnose Cushing’s syndrome, and guidelines recommend against using one to test for it.5 The usual reasons are more ordinary: the pill, oral estrogen, pregnancy, prednisone-type medicines, a recent hydrocortisone dose, severe stress and illness.1,2
Not a worry on its own.
- 1 If none of those apply and you have signs of Cushing’s, such as easy bruising, a red face, wide purple stretch marks and weak thigh or shoulder muscles, see a clinician.5
- 2 The tests for Cushing’s are different: a 1 mg overnight dexamethasone test (normal is 1.8 µg/dL or less), late-night saliva cortisol or 24-hour urine cortisol.5
What is cortisol?
Think of cortisol as a tide. It’s highest early in the morning and falls to about half by evening, so a result only makes sense next to the time your blood was drawn.1
Cortisol raises your blood sugar and calms inflammation, and your body makes more of it under stress.1
Your pituitary gland sets the level with a hormone called ACTH. When cortisol runs low, ACTH rises to push it back up.1 About 90% of the cortisol in your blood is bound to proteins.1 Blood tests measure the total, bound and free, so anything that changes those proteins changes your result.5
What can a morning cortisol test show?
Its main use is finding adrenal insufficiency, where your body doesn’t make enough cortisol. A test at 8 to 9 a.m. is the first one guidelines use, and they recommend against judging it from a test at a random time of day.3,4
It can’t diagnose Cushing’s syndrome, where your body makes too much. Plenty of everyday things raise a single cortisol, so guidelines recommend against using one to look for Cushing’s.5 If a clinician suspects it, they’ll use a dexamethasone test, late-night saliva cortisol or 24-hour urine cortisol instead.5
What throws off a cortisol result?
| Effect on your result | Why | |
|---|---|---|
| Oral estrogen, the pill or pregnancy | Higher | They raise the protein that carries cortisol in your blood.2,3 |
| Prednisone, prednisolone or methylprednisolone | Falsely higher | The test mistakes them for cortisol.1 |
| Hydrocortisone | Higher | It’s the medicine form of cortisol.1 |
| Dexamethasone | Lower | It’s long-acting and especially likely to suppress your own cortisol.3 |
| Steroid inhalers, nasal sprays, creams or joint injections | Can be lower | Any form of steroid can suppress your own cortisol.3 |
| An afternoon draw | Lower | Cortisol falls through the day.1 |
| Severe stress or acute illness | Higher or lower | Stress raises cortisol; serious illness lowers the proteins that carry it.1,2 |
| Advanced liver disease (cirrhosis), kidney disease that leaks protein or malnutrition | Lower | Less carrier protein means less total cortisol.2,3 |
| Biotin supplements | Can be wrong either way | Biotin interferes with the test. Stop it at least 72 hours before.1 |
If you’re on oral estrogen or the pill, a result in the normal range may hide a low one.2,3 Tell your clinician about any steroid you use, including inhalers, creams and joint injections.3
Is “adrenal fatigue” real?
No. “Adrenal fatigue” is the idea that long-term stress wears out your adrenal glands. The Endocrine Society says there’s no scientific proof it exists and no test that can detect it. The blood and saliva tests sometimes offered for it aren’t backed by good science.6 A review of 58 studies found nothing to show it’s a real medical condition.7
If you’re tired all the time, the cause is worth finding. Being told you have adrenal fatigue can mean the real cause is missed, and many supplements sold for it haven’t been tested for safety.6
What’s new in cortisol testing and treatment?
Newer cortisol tests are more specific, and they read lower. Roche’s second-generation test reads about 21% lower than its first.8 On that test, a 2024 study put the pass mark for a stimulation test at about 15 µg/dL at 30 minutes and about 17.6 at 60 minutes, rather than the long-standing 18.8 Guidelines still use 18, noting that it depends on the test.2,3 So a result close to any cut point is worth reading with your clinician.
On treatment: in December 2025, the FDA declined to approve relacorilant, a drug that blocks cortisol’s effects, for people whose bodies make too much cortisol. Its letter said the trials hadn’t shown well enough that the drug works, and that it is linked to liver injury, with 4 probable cases among about 300 people who took it.10 In a July 2026 company filing, its maker said it had resubmitted the application and that the FDA’s target date for a decision is December 17, 2026.9
Who should get a cortisol test?
It’s worth checking if a clinician suspects your adrenal glands aren’t making enough, for example if:
- You have symptoms that could mean adrenal insufficiency, such as tiredness, weight loss, dizziness when you stand and salt craving.2
- You have pituitary disease.4
- You’re coming off long-term steroids, and your clinician wants to check your body has taken over. Guidelines advise against testing while you still need a high dose.3
It isn’t a test for stress, tiredness on its own or Cushing’s syndrome.5,6 And guidelines don’t use it to screen people without symptoms.2
How to get a cortisol test, and what it costs
A cortisol test costs $5.00 through Picardo.
Cortisol test
- Results in 2 to 3 days, in the app
- Physician follow-up if you want one
- Free Labcorp draw, or $75 at home
- No other fees. HSA and FSA eligible.
Questions people ask
What time should I get a cortisol test?
At about 8 a.m. Cortisol peaks early in the morning and falls through the day.1 Most guideline cut points assume a draw between 8 and 9 a.m.;3,4 the primary adrenal insufficiency guideline allows 6 to 10 a.m.2 If you work nights, tell your clinician, because the usual ranges won’t fit.
Can stress raise my cortisol test?
Yes. Severe stress or illness can push it up.1 That’s one reason a single high result doesn’t mean disease.5 And no test can detect “adrenal fatigue.”6
Does a high cortisol mean Cushing’s syndrome?
Not on its own. Guidelines recommend against using a single blood cortisol to test for Cushing’s.5 If a clinician suspects it, they’ll use a 1 mg overnight dexamethasone test, or late-night saliva or 24-hour urine cortisol, usually measured twice.5 The pill makes the dexamethasone test falsely abnormal in about half of women taking it, so where possible they may ask you to stop estrogen for 6 weeks first.5
Should I stop my steroid before the test?
Only if your clinician tells you to, and never stop a long-term steroid suddenly on your own.3 When a clinician checks whether your body has recovered after steroids, guidelines advise testing at least 24 hours after your last dose, and longer after dexamethasone.3,4
Is a saliva or urine cortisol test better?
For Cushing’s, yes. Late-night saliva cortisol and 24-hour urine cortisol are first-line tests; a single blood cortisol isn’t.1,5 For adrenal insufficiency, a morning blood test is the one guidelines use.3,4 Saliva tests sold for “adrenal fatigue” aren’t backed by good studies.6
Often checked alongside
Test details
Sources
- 1 Labcorp. Cortisol, test 004051. Labcorp test menu. Accessed October 28, 2026. www.labcorp.com/tests/004051/cortisol
- 2 Bornstein SR, Allolio B, Arlt W, et al. Diagnosis and treatment of primary adrenal insufficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2016;101(2):364–389. doi.org/10.1210/jc.2015-1710
- 3 Beuschlein F, Else T, Bancos I, et al. European Society of Endocrinology and Endocrine Society joint clinical guideline: diagnosis and therapy of glucocorticoid-induced adrenal insufficiency. J Clin Endocrinol Metab. 2024;109(7):1657–1683. doi.org/10.1210/clinem/dgae250
- 4 Fleseriu M, Hashim IA, Karavitaki N, et al. Hormonal replacement in hypopituitarism in adults: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2016;101(11):3888–3921. doi.org/10.1210/jc.2016-2118
- 5 Nieman LK, Biller BMK, Findling JW, et al. The diagnosis of Cushing’s syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2008;93(5):1526–1540. doi.org/10.1210/jc.2008-0125
- 6 Endocrine Society. Adrenal fatigue. Endocrine Library. Updated January 25, 2022. www.endocrine.org/patient-engagement/endocrine-library/adrenal-fatigue
- 7 Cadegiani FA, Kater CE. Adrenal fatigue does not exist: a systematic review. BMC Endocr Disord. 2016;16(1):48. doi.org/10.1186/s12902-016-0128-4
- 8 Okutan S, Jørgensen NT, Pedersen LE, et al. Determination of cortisol cut-off limits and steroid dynamics in the ACTH stimulation test: a comparative analysis using Roche Elecsys Cortisol II immunoassay and LC-MS/MS. Endocrine. 2024;85(1):321–330. doi.org/10.1007/s12020-024-03752-0
- 9 Corcept Therapeutics. Form 10-Q for the quarterly period ended June 30, 2026 [company filing]. Washington, DC: US Securities and Exchange Commission; July 29, 2026. www.sec.gov/Archives/edgar/data/0001088856/000162828026050613/cort-20260630.htm
- 10 US Food and Drug Administration. Complete response letter: NDA 219398, relacorilant (Corcept Therapeutics). Corrected January 28, 2026. Accessed October 28, 2026. download.open.fda.gov/crl/CRL_NDA219398_20260128.pdf
Updated 3 Nov 2026.
This is general health information, not medical advice: talk to your clinician about your results and before changing any treatment.