Suffered with chronic fatigue for eight years and been on thryoid medication (levothyroxine and also tried liothyonine for some of that time).
I recently had an overnight dexamethasone suppression test as my random cortisol levels were very high and this one also came back abnormal (59 but they didn't give me the ranges).
They said that as the cortisol levels weren't sufficiently suppressed, they also want to run low dose and high dose dexamethasone suppression tests to exclude excess cortisol from the investigations.
Does anyone know about these cortisol tests and why they would do a high and low dose test? They don't ever explain anything and I just get sent a letter in the post. Im hoping this doesn't indicate I have cushings disease- my doctor wasn't concerned by the result but the endo was, so now I am confused!
Ask them to re-test your cortisol and ask them to do the saliva test. This gives a much better profile of your cortisol variation throughout the day. It could be high in the morning but perfectly OK during the rest of the day. But rather than speculate, get a retest because the dexamethasone suppression test you had is a bit rough and ready, the saliva test is better.
Hi LAHS, I asked my doctor about a saliva test the first time and he said he hadn't heard of it (maybe the endo will have or not something they want to do on NHS). I looked online and it looks like the next tests are a combination of blood and urine tests but I could be wrong.
Wow, I didnt expect that. What you do is take home 4 or 6 small test tubes any you spit into them every 4 - 6 hours (marking the time on the TT) from dawn to just before you sleep. They analyse these for cortisol levels then draw a graph of the results and you see two maxima on it: first thing in the morning (that's the time when cortisol gives you the energy to get up), then it sinks just before lunch (it has used itself up carrying you from breakfast to lunch), It will then peak again mid afternoon (I don't know why), and you will then see a decline until bed time (when it just lets you relax throughout the evening down to sleep). I am sure if you Googled this you could get a better description to show your doc. Private analytical labs do this routinely maybe you could draw your docs attention to this. Actually, I find that a doc who is interested in the endocrine system and willing to learn is far better than an endo who only knows about the T4/TSH relationship.
Soy la enfermera Shelly. Sé sobre esto, y hace muchos años me hicieron pruebas para descartar el síndrome de Cushing.
Las glándulas suprarrenales producen cortisol y por la mañana debería estar en su nivel más alto y luego disminuir durante el día.
Tomas la tableta de Dexametasona y luego te extraen sangre en intervalos. Si tienes demasiado cortisol en tu cuerpo, puede indicar el síndrome de Cushing y si tienes muy poco, la enfermedad de Addison.
El cortisol en sangre en EE. UU. debería ser de 5-23 mcg/dl y en el Reino Unido es de 2.3 -19.4. (ellos usan un método de prueba diferente).
Ahora, si tienes Diabetes o el inicio de ella, esto puede causar problemas de cortisol. También algunos medicamentos que puedas tomar pueden afectar los niveles de cortisol y prepárate para esto, LEVO puede afectar el nivel de cortisol.
Así que sospecharía eso primero si sabes a lo que me refiero. Ayudé a una señora en este foro que tuvo que pasar a NDT porque LEVO lo estaba causando.
Manténme informada sobre cómo te va, si tienes alguna pregunta no dudes en preguntar.
Yes I had researched that cortisol can be linked to blood sugar and it did make me wonder as although I have already been tested for diabetes, doctors are frequently asking me about this due to additional symptoms I have of going to the loo a lot and being thirsty all the time.
I saw that cushings can give similar symptoms to hypothyroidism which I thought was interesting- maybe this could be the missing link?! I didn't realise levothyroxine affected cortisol levels- it will be interesting to see if the levels decrease once I am off it (I am down to just 50mg now).
My Gp wasn't that concerned by my result, he said people with cushings usually produce results of 200+, but he said it was possible I might have it to a minor degree. Will let you know what the next round of tests come back with.
With the lady you spoke about, how did they know the levothyroxine was causing the cortisol levels to rise? Was it by eliminating the causes of cushings first?
La enfermedad de Cushing puede actuar como hipotiroidismo. La verdad es que la enfermedad de Cushing es bastante rara.
Es cierto que produces niveles muy altos de cortisol, como dijo tu médico. También tienes una "cara de luna", que es una cara redondeada y hinchada. Es muy notable y un síntoma que aparecería. También el aumento de peso te hace muy pesado y con una forma redondeada grande, dolores musculares. Comparte síntomas con problemas de tiroides.
La mujer que estaba ayudando pudo hacer que su médico probara diferentes cosas y tuvo resonancias magnéticas para descartar cualquier crecimiento en la glándula suprarrenal. También tuvo un análisis de orina de 24 horas, prueba de dexametasona, etc... luego su médico la retiró de LEVO, estaba tomando una dosis alta de Levo también, y sus niveles volvieron a la normalidad y pasó a NDT (Armour Thyroid).
La mayoría de los médicos en endocrinología probarán primero la enfermedad de Cushing, y luego la descartarán, pasarán a otra prueba para averiguar qué está pasando.
La diabetes puede ser borderline a veces y puede causar aumento de la sed, sensación de somnolencia, aumento de peso, mucha orina, dolores de cabeza. Estos son los más comunes. Quizás quieras comprar en la farmacia un medidor de glucosa en sangre y algunos son gratis de ciertas empresas, y probarte antes de una comida y las 2 horas después de una comida. Rango de referencia normal de glucosa en sangre EE. UU.: 80-120 mg. Cualquier cosa por encima de eso es borderline diabetes tipo 2 de inicio en adultos.
A veces, es tan simple como cambiarte de Levo y ver qué pasa. Bueno, 50 mcg es mejor que 100 mcg. Así que haz las otras pruebas y manténme informada, y me gustaría saber qué encuentran.
Thanks shelly that is really interesting and I will keep you posted on the results.
I was taking 150mg of levothyroxine at the highest level so have done well to get this far. The hope is to take me off it completely so I don't need any thyroid medication but if it's not possible I'm going to try NDT as nothing else has worked for me so far.