Cortisol, often called your primary 'stress hormone,' is produced by the adrenal glands and plays roles well beyond stress response, including regulating blood sugar, blood pressure, metabolism, and inflammation. It follows a natural daily rhythm, typically highest in the morning and lowest at night, so timing matters when interpreting results, and sometimes multiple samples are collected across the day. Consistently high cortisol can point toward Cushing's syndrome (from a pituitary or adrenal tumor, or long-term steroid medication use) and cause symptoms like weight gain, high blood pressure, and skin changes. Consistently low cortisol can point toward adrenal insufficiency (Addison's disease or a pituitary problem) and cause fatigue, low blood pressure, and weight loss. Because levels vary so much throughout the day and in response to stress, single results are often followed up with more specific dynamic testing (like an ACTH stimulation test) when a disorder is suspected.