From the Research
Low cortisol levels can potentially decrease insulin resistance, but the relationship between cortisol and insulin is complex and influenced by various factors, including the presence of other hormonal imbalances or medical conditions. The most recent and highest quality study on this topic is from 2024 1, which found that daily plasma cortisol and cortisol response to dexamethasone suppression test are independent determinants of impaired glucose tolerance and insulin resistance in nondiabetic patients with hypertension. However, this study does not directly address the effect of low cortisol levels on insulin levels.
When considering the potential impact of low cortisol on insulin levels, it's essential to understand that cortisol normally acts as an insulin antagonist, promoting gluconeogenesis in the liver and helping maintain blood glucose levels 2, 3, 4.
- Low cortisol levels, as seen in conditions like adrenal insufficiency or Addison's disease, may reduce this opposing force, potentially leading to increased insulin sensitivity and higher insulin levels as the body tries to maintain glucose homeostasis.
- People with chronically low cortisol may experience hypoglycemia despite normal or elevated insulin levels.
- Treatment for low cortisol typically involves hormone replacement therapy with hydrocortisone or other glucocorticoids to restore normal hormonal balance.
- If low cortisol issues are suspected, it's crucial to seek medical evaluation, as proper diagnosis requires specialized testing and untreated adrenal insufficiency can be dangerous.
In terms of the relationship between cortisol and insulin, research suggests that cortisol secretion and abnormalities of glucose metabolism are linked, even in nondiabetic patients with hypertension 1.
- A study from 2019 found that higher morning serum cortisol was associated with higher fasting plasma glucose and lower β-cell function among participants without type 2 diabetes, and higher fasting plasma glucose and HbA1c in participants with diabetes 3.
- Another study from 2002 found that patients with glucose intolerance had impaired hepatic conversion of cortisone to cortisol, suggesting tissue-specific changes in 11beta-HSD 1 activity 4.
- A 2005 review proposed that hypocortisolism may occur after a prolonged period of hyperactivity of the hypothalamic-pituitary-adrenal axis due to chronic stress, and may have both detrimental and beneficial effects on the organism 5.
Overall, while the relationship between low cortisol and insulin levels is complex, it is essential to prioritize the management of cortisol levels to maintain normal hormonal balance and prevent potential complications associated with adrenal insufficiency or other related conditions.