High Cortisol with Mental/Psycholoical Fatigue

Hormones
1

Can someone help me with any advice on my combination of symptoms (primarily fatigue with high cortisol) as I can’t find my combination with various internet searches and my brain is foggy on how best to approach my GP?

I’m a man in my late 50s who has always kept himself fit and relatively slim.

Main symptoms: I feel grotty with sleepiness and a chronic mental/psychological fatigue that feels as if my eyes are being dragged down and I have a lead cape over my shoulders.  Although I can run for several miles with music urging me on, my fatigue drags me down and I can do little more than vegetate; productive work is impossible and writing this will wipe my concentration and motivation for an hour or 2.  I also feel pretty depressed (the sleepiness and fatigue came first).

Secondary symptoms: brain fog, restless legs, tinnitus, pain from site of nose operation and tooth filling with no neurological cause, intermittent chronic dry cough, occasional feelings of suffocating and being trapped, muscle cramps

Indicators:

·         High Cortisol readings:

Waking H 33.16 [14.0 - 21.0 nmol/L]

12:00 4.92 [4 - 9 nmol/L]

14:00 H 8.57 [3 - 8 nmol/L]

16:00 H 7.94 [2.5 - 7.0 nmol/L]

18:00 2.98 [2.5 - 7.0 nmol/L]

Before Bed 1.89 [0.8 - 4.5 nmol/L]

·         High blood sugar (typically 6.3 on fasting). I understand this is common with high Cortisol.

·         High Cholesterol: 8.56 mmol/L (Less than 5.2), Triglycerides 2.35 mmol/L (Less than 2.26), HDL cholesterol 1.29 mmol/L

·         Levels of vitamins B12 and D just below ‘sufficient’ but supplementing has made no difference

·         Thyroid: all well within NHS limits, but TSH on high side, free T3 & T4 on the low side.  Supplementing with Thyroid S has made no difference.

·         Other blood tests within NHS limits.

·         Low body temperature

·         I have a CPAP machine for mild sleep Apnoea; readings from the machine and a pulse oximeter show that my breathing is within reasonable limits.

2

Have you checked Crushings Syndrome?

High cortisol is1st for Crushings.

3

Thank you

I discounted Cushings originally as my late night reading was low and I don't have such symptoms as a 'Moon Face'.  Spurred by your comment, I looked a bit further and came across the concept of pseudo-Cushings, where  conditions such as severe stresses (illness or emotional stress), alcoholism or alcohol withdrawal and psychiatric conditions such as depression, panic disorders and psychotic conditions.

Patients with pseudo-Cushings states have high plasma cortisol levels in the morning and much lower levels in the evening and at night, while patients with Cushings syndrome have high cortisol levels in both the morning and at night.

That makes my high Cortisol due to pseudo-Cushings rather than Cushings itself and suggests that the high Cortisol will clear up when I get the non-HPA cause sorted.  Unfortunately, that knowledge is of little practical help in actually identifying and sorting my issues, so I strive on in hope. 

4

StrivingOn,

I have never read about pesudo-Crushings, but that very well could be possible. Our bodies are so intricately made & everything needs to be in near perfect sync for us to be our best.

Either way, keep working for wellness as it could be right around the corner.

Best wishes for better health soon!