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    Old 02-15-2005, 09:28 AM   #1
    Ltraci2
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    Trying to understand my Cortisol readings....

    Was sent over here from the Thyroid boards to do some reading. Figure I'd just ask too!

    TSH 2.57 MIU/L (.40-5.5)
    T-4 Free 0.9 NG/DL (0.8-1.8)
    T-3 Free 305 PG/DL (230-420)
    Cortisol at 8am 0.6 MCG/DL (4.0-22.0)

    Help??? lol I know nothing about Cortisol levels and am trying to educate myself before my appointment tomorrow.

    Traci

     
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    Old 02-15-2005, 09:51 AM   #2
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    Re: Trying to understand my Cortisol readings....

    I've been feeling crudy for years now. A bit of history. Divorced when my kids were 5 and 2. (they are now 14 and 11). Did ok as a single Mom for about 4-5 years, became a Christian, met a guy, got pregnant, got married. He had to move from WI to WA while I was pregnant. Baby born in October, got married the following March (we have our 5 year this March! ). After we moved, was a huge adjustment. New marriage, new job (for him), I am now a stay at home Mom - HUGE adjustment! lol I got most of my baby weight off - was down to 170. When Shawn (hubby) and I met, I was 140 and doing ok. I'm 5'7" and now 38. Well, 2 years ago, my hubby's Dad died and hubby went to HI to stay for a week or so. This was possible because hubby just got laid off from IBM. We didn't find a job until the following December - 10 months later. By then, we had gone thru all our savings and 1/2 of Shawn's IBM retirement. But, the job made Shawn move to WA DC! Shawn lived there til last July - about 7 months. That was a rough time again. Shawn moved back in July expecting to have a job with the sponsor company only to find out they didn't have a place. So, we are once again without a job.
    We lose medical benefits because we just can't afford Cobra at $1200/month. So, for 5 months we sink further into debt and barely hang onto the house. Shawn finally gets an offer in December (just a couple months ago) but after working there a month finds out that it is just wrong. (long story). Thankfully Boeing made an offer in January, and we are there now.
    So, can you say stress????????

    All this time, I'd been feeling tired, depressed, moody and such. Was on antidepressants for a while - only made me gain weight. Seems a couple years ago the weight just came piling on. I would excercise which usually used to work for me - and still gain.
    My sex drive has gone into the toilet, very moody, unhappy, irritable, no motivation, my hair gets oily within 24 hours (never happened before!), dry skin, can't sleep at night. I'm sure there is more, I just can't think of it. My weight at last check is 256, my cholesterol came up at 210 (140-200) on these last labs and I've been being treated for high blood pressure since last spring.

    Did I miss anything? Oh, no ER visits. No real dizziness. My memory has always been bad, but it seems that I tend to forget more and more. I used to be able to juggle the schedules pretty dang well, now I just fall apart.

    The endocrine I have only been to once (who ordered the labs) didn't think Cortisol was going to be a problem but tested it anyway - just in case. I see him tomorrow.

     
    Old 02-15-2005, 12:13 PM   #3
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    Re: Trying to understand my Cortisol readings....

    It is often possible to assess adrenal insufficiency based upon symptoms. Anyone who is tired, allergic, intolerant to cold, with symptoms of low blood sugar, weakness and low blood pressure, most likely has some degree of adrenal insufficiency.
    Blood tests may be useful to detect serious adrenal insufficiency. A serum sodium level less than 130 mEq/L and a serum potassium greater than 5 mEq/L may be noted. A low glucose levels and elevated blood urea nitrogen (BUN) may also be present. Other factors, however, can affect the serum readings.


    Found this on the web which just doesn't make sense. I have a metabolic panel with my labs.
    Glucose 112 MG/DL (68-115) (above says a low reading)
    UREA Nitrogen (BUN) 14 MG/DL (8-19) (is this considered elevated? Didn't think so)
    Sodium 139 MMOL/L (135-148)
    Potassium 3.8 MMOL/L (3.5-5.1) I'm on blood pressure meds which lowers potassium.

    I've also been gaining weight hand over fist - not losing. I'm reading and reading and just not able to piece anything together.



     
    Old 02-15-2005, 02:12 PM   #4
    sadie-mae
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    Re: Trying to understand my Cortisol readings....

    Hi!

    Something to consider (sort of goes against instinct in regards to your low morning cortisol)...

    The symptoms you describe are actually more supportive of Cushing's disease. (especially the marked unexplained weight gain and oily hair) The first thing that happens with Cushing's is loss of the natural diurnal variation of cortisol. Normally, cortisol is highest early in the morning and then drops over the course of the day. People with Cushing's flip this around, so their cortisol is relatively elevated late at night. Some people will still have highest cortisol in the morning and relatively high at night but a large number of people actually have their lowest cortisols in the morning and then rise substantially by midnight. So, they are backwards in their secretion of cortisol and it screws up everything!

    Chris is right-ask your doctor for one or several 24 hour urine free cortisol tests (or midnight cortisol salivaries) and, if there is a lab open at a local hospital near you, ask to do an 11pm blood cortisol level.

    Good Luck,
    Sadie

     
    Old 02-15-2005, 02:55 PM   #5
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    Re: Trying to understand my Cortisol readings....

    Really strange - I did some searching and coming up with opposite symptoms. I am tired all the time, but have weight gain, no loss of appetite, no nausea, no vomiting and high bp. None of the other symptoms either.


    The symptoms of adrenal insufficiency usually begin gradually. Characteristics of the disease are

    chronic, worsening fatigue
    muscle weakness
    loss of appetite
    weight loss
    About 50 percent of the time, one will notice

    nausea
    vomiting
    diarrhea
    Other symptoms include

    low blood pressure that falls further when standing, causing dizziness or fainting
    skin changes in Addison's disease, with areas of hyperpigmentation, or dark tanning, covering exposed and nonexposed parts of the body; this darkening of the skin is most visible on scars; skin folds; pressure points such as the elbows, knees, knuckles, and toes; lips; and mucous membranes

     
    Old 02-15-2005, 03:38 PM   #6
    Ltraci2
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    Re: Trying to understand my Cortisol readings....

    <i>Cushing's syndrome is a hormonal disorder caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol. </i><b>But mine was low. Of course it was only one reading. </b> <i>Sometimes called "hypercortisolism," it is relatively rare and most commonly affects adults aged 20 to 50. An estimated 10 to 15 of every million people are affected each year.

    Symptoms vary, but most people have upper body obesity, rounded face, increased fat around the neck, and thinning arms and legs. </i><b>No thinning on arms and legs. Fat all over.</b><i>Children tend to be obese with slowed growth rates.
    Other symptoms appear in the skin, which becomes fragile and thin. It bruises easily and heals poorly. Purplish pink stretch marks may appear on the abdomen, thighs, buttocks, arms and breasts. The bones are weakened, and routine activities such as bending, lifting or rising from a chair may lead to backaches, rib and spinal column fractures.</i><b>Haven't noticed anything here.</b>

    <i>Most people have severe fatigue, weak muscles, high blood pressure and high blood sugar. Irritability, anxiety and depression are common.</i><b>Now, while I don't know about SEVERE fatigue, I'm tired all the time the rest is sure true. Not sure about the blood sugar. Have been tested last summer for diabetes and came out fine. So they say. lol</b>

    <i>Women usually have excess hair growth on their faces, necks, chests, abdomens, and thighs. Their menstrual periods may become irregular or stop. Men have decreased fertility with diminished or absent desire for sex. </i><b>Can't really say any of this is true either. Certainly not my monthly. My sex drive is gone tho. (I'm a girl). </b>


    <i>Sometimes other conditions may be associated with many of the symptoms of Cushing's syndrome. These include polycystic ovarian syndrome, which may cause menstrual disturbances, weight gain from adolescence, excess hair growth and sometimes impaired insulin action and diabetes. Commonly, weight gain, high blood pressure and abnormal levels of cholesterol and triglycerides in the blood are associated with resistance to insulin action and diabetes; this has been described as the "Metabolic Syndrome-X." Patients with these disorders do not have abnormally elevated cortisol levels.
    </i><b>Found this paragraph interesting tho....................

     
    Old 02-15-2005, 03:42 PM   #7
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    Re: Trying to understand my Cortisol readings....

    Cushing's syndrome is a hormonal disorder caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol. But mine was low. Of course it was only one reading. Sometimes called "hypercortisolism," it is relatively rare and most commonly affects adults aged 20 to 50. An estimated 10 to 15 of every million people are affected each year.

    Symptoms vary, but most people have upper body obesity, rounded face, increased fat around the neck, and thinning arms and legs.
    No thinning on arms and legs. Fat all over.Children tend to be obese with slowed growth rates.
    Other symptoms appear in the skin, which becomes fragile and thin. It bruises easily and heals poorly. Purplish pink stretch marks may appear on the abdomen, thighs, buttocks, arms and breasts. The bones are weakened, and routine activities such as bending, lifting or rising from a chair may lead to backaches, rib and spinal column fractures.
    Haven't noticed anything here.

    <i>Most people have severe fatigue, weak muscles, high blood pressure and high blood sugar. Irritability, anxiety and depression are common.[/i]Now, while I don't know about SEVERE fatigue, I'm tired all the time the rest is sure true. Not sure about the blood sugar. Have been tested last summer for diabetes and came out fine. So they say. lol

    Women usually have excess hair growth on their faces, necks, chests, abdomens, and thighs. Their menstrual periods may become irregular or stop. Men have decreased fertility with diminished or absent desire for sex. Can't really say any of this is true either. Certainly not my monthly. My sex drive is gone tho. (I'm a girl).


    Sometimes other conditions may be associated with many of the symptoms of Cushing's syndrome. These include polycystic ovarian syndrome, which may cause menstrual disturbances, weight gain from adolescence, excess hair growth and sometimes impaired insulin action and diabetes. Commonly, weight gain, high blood pressure and abnormal levels of cholesterol and triglycerides in the blood are associated with resistance to insulin action and diabetes; this has been described as the "Metabolic Syndrome-X." Patients with these disorders do not have abnormally elevated cortisol levels.
    [b]Found this paragraph interesting tho....................

     
    Old 02-16-2005, 01:45 PM   #8
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    Re: Trying to understand my Cortisol readings....

    Well, I'm ok. I had been given a pill to take at midnight the night before my labs which was supposed to drive my Cortisol down.

    Whew! Now we are arguing over my thryoid. Doc says my labs are in the normal range, I didn't agree. So, I'm back on the thryoid board.

    Thanks Chris!

     
    Old 02-16-2005, 02:52 PM   #9
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    Re: Trying to understand my Cortisol readings....

    Hi,

    Oh...I hear the torture in you that I hear in myself. I am not diagnosed yet and I am going nuts trying to figure out what is wrong with me. I am currently awaiting more test results and another visit to the doctor. I empathize!!

    Cushing's is very much like other endocrine diseases in that everyone responds to hormonal abnormalities differently. Few ever have all of the symptoms of any disorder but that shouldn't rule out the disease. Also, it takes many years (many!) for full blown Cushing's to arise in most people, while some never get the whole picture of symptoms. So most start out with just a few symptoms and add on more with time. Symptoms may also come and go as cortisol levels can vary or be cyclical in the early stages of the disease. Along those same lines, dexamethasone suppression testing that turns out normally can be very misleading. Most in the early stages of the disease WILL suppress normally and their doctors will send them away. You really need a doctor who understands this and has a high index of suspicion, if it is indicated.

    There are quite a few Cushies who have true Hashimoto's which appears before Cushing's, I'm not sure if there is a relationship there or not. So, you don't have to have central hypothyroidism for the diagnosis. Some have concurrent sex hormone alterations due to FSH/LH abnormalities, some have GH deficiency, some don't...everyone is different with this one.

    You may have misunderstood me in my first post...it isn't what your cortisol is at any given moment in time, it is what it is OVER time. (Hence the 24 hour urine collections that Chris suggested) Quite a few cushies WILL have very low morning cortisol levels as a part of the "loss of diurnal variation" I mentioned but then later in the day have very high levels. Don't let your cortisol level throw you.

    PCOS can indeed cause quite the constellation of symptoms but it should not cause the fatigue you mention, unless you have undiagnosed diabetes (which you said you had been worked up for and didn't have) or uncontrolled high blood pressure (which would be a result of obesity, not PCOS directly). MANY women are misdiagnosed with PCOS when they have Cushing's, because the elements of PCOS (and metabolic syndrome X) are a PART of the big picture of Cushing's.

    That said, I certainly hope this isn't what is wrong with you. I hope you have an issues that is more easily addressed. But...if you don't look, you wont find a problem and this is something to just consider.

    Good Luck to you and know you are not alone in your frustration!
    Sadie

     
    Old 02-16-2005, 04:49 PM   #10
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    Re: Trying to understand my Cortisol readings....

    Awwww, thanks Sadie. It is just SO frustrating! Trying to argue with a doctor is like beating your head against the wall. I mean, what can you tell them 'Hey, I'm talking to all these women on a board and well, you are just wrong!'. I'm not the kind of person to think I have everything, I know I'm not just making things up.

    By they way, the doctor did call back interestingly enough. Wants to check my glucose over 3 different draws. My labs have been coming back with my glucose in the upper range and once over the upper range.

    The fun never ends, does it...................................... ........

    I also don't think I have the symptoms of adrenal fatigue - given what I've read. I'm truly more convinced their is a thyroid problem - and maybe a diabetes problem. I do have high blood pressure which I'm on meds for. And I'm in the obese range - 256 by last weight. Yuck! For someone who was 140 just 6 years ago, this is tough.

    Hang in there yourself and thanks for the prop of support,
    Traci

     
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