Q: After a curve test where the cortisol level varied a group member asks why does the cortisol level vary so much and is there a high and low level one can judge by or does it depend entirely on the individual.

A: If the tablet of hvdrocortisone is taken in the morning fasting, circulating cortisol levels still rise to a peak at about 30-60 minutes and then slowly disappear over the next several hours until the next tablet is taken. The rate of absorption and disappearance is variable in different individuals and it is for this reason that I believe it is wise to monitor closely the circulating profile of blood cortisol levels through the day in patients on their replacement. This allows the doctor to alter the dose appropriately and tailor the particular dosage regimen to the individual. The chemistry of the rate of disappearance of cortisol in the blood is variable between patients like so many other features of human physiology. The individual profile must be judged on its own merit as a whole.