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Q. I have fasting hypoglycemia, and my blood reports show high cortisol and insulin levels. Why?

Answered by
Dr. Utkarsh Sharma
and medically reviewed by Dr. Sushrutha Muralidharan
This is a premium question & answer published on Sep 11, 2021 and last reviewed on: Sep 15, 2021

Hello doctor,

I have always had issues with fasting hypoglycemia (not diabetic). I recently had blood work done which also showed abnormally high cortisol and insulin levels. Any ideas on what could cause these things together? Sudden weight gain about a year ago of 15 lbs. Already healthy person. I tracked my diet more strictly and worked out even more, but the weight did not budge. I have been gained at least 1/2 lb every one to two weeks for about a month. My blood test shows low T3 and low A1c. Kindly give your opinion.

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Hello,

Welcome to icliniq.com.

What about random and post-prandial blood sugar levels? Cortisol and insulin have opposing actions. Cortisol and growth hormones could be elevated as a compensatory mechanism to counter insulin release.

We need to rule out insulinoma. It is a rare tumor of the pancreas made of beta islet cells, the same cells in the pancreas producing insulin and controlling blood glucose. In normal circumstances, your pancreas makes more insulin when the blood glucose is high and less when the blood glucose is low. But an insulinoma secretes insulin consistently, even when the blood glucose gets too low than normal.

To diagnose if you have an insulinoma, your blood sugar, insulin, C-peptide, and proinsulin will be tested during a 72-hour rest. Additional imaging modalities like MRI (magnetic resonance imaging) and CT (computed tomography) may also be required.

I hope this was helpful.


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