Common Myths
Answers to common questions about common myths.
Questions on this page
- “Cortisol is always a harmful hormone.”
- “High cortisol automatically means Cushing syndrome.”
- “Low cortisol always means Addison disease.”
- “Every adrenal tumour is cancer.”
- “Normal potassium rules out an adrenal cause of hypertension.”
- “I can stop long-term steroids whenever I feel better.”
- WHEN SHOULD YOU SEE AN ENDOCRINOLOGIST?
“Cortisol is always a harmful hormone.”
No. Cortisol is essential for life. The problem is having too much or too little.
“High cortisol automatically means Cushing syndrome.”
No. Cortisol levels vary with time, stress and illness. Cushing syndrome requires appropriate clinical and biochemical evaluation.
“Low cortisol always means Addison disease.”
No. Low cortisol can occur because of primary adrenal disease, pituitary disease, medication-related adrenal suppression or other circumstances.
“Every adrenal tumour is cancer.”
No. Many adrenal masses are benign.
“Normal potassium rules out an adrenal cause of hypertension.”
No. Primary aldosteronism can occur even when potassium is normal.
“I can stop long-term steroids whenever I feel better.”
Not necessarily. After prolonged therapy, sudden withdrawal can cause adrenal insufficiency in susceptible individuals.
WHEN SHOULD YOU SEE AN ENDOCRINOLOGIST?
You should consider an endocrine evaluation if you have:
- Persistent unexplained fatigue, weight loss or low blood pressure
- Suspected adrenal insufficiency
- Known Addison disease
- Long-term steroid use or difficulty stopping steroids
- Episodes of severe weakness, vomiting or collapse
- Unexplained weight gain with features suggestive of cortisol excess
- Difficult-to-control hypertension
- Low potassium without an obvious explanation
- An adrenal mass found on CT or MRI
- Episodes of palpitations, sweating and headache
- Unexplained androgen excess
- Suspected congenital adrenal hyperplasia
- A personal or family history of endocrine tumours
Adrenal disorders can be subtle. The right diagnosis often requires understanding the pattern of symptoms, hormone levels, medications and imaging together.