Cortisol all over the place? Please help

Hi,
I've just been diagnosed with severe reactive hypoglycaemia & have lots of other symptoms. (fatigue, cognitive problems etc)

I did a 36 hr fast in hospital and had my cortisol tested 7 times.
I tested normal 3 times, high twice (very high at 3:20am) and very low twice. Well, I think it's very low - 74 and 53 when normal range is130 - 450. (this is nmol/L)
What does this mean? My endo doesn't seem to think it's significant...

Thanks for your time, Zel.

[rumpled]

Timing of cortisol testing is critical. Cortisol normally varies and it has a circadian or diurnal rhythm - and that is what makes you wake up in the morning and go to bed at night - so a normal rhythm has cortisol reaching the peak at 8am roughly and then falling through the day to near nothing by midnight then rising again to reach peak in the morning. So, there is no *one* range - it varies by time of day - but being high at 3am is a bit odd, however, it is not usually diagnostic (there not being a range for 3am) but an odd diurnal rhythm can mean Cushing's syndrome. One set of testing usually can not rule adrenal issues in or out - usually one does a stimulation test, imaging, testing over time etc.

Fatigue can happen with both low and high cortisol (strange huh!) as well as the cognitive issues. What separates them is usually weight loss vs gain (but not always) and blood pressure although I had low BP with both high and low cortisol... What is your ACTH, renin, aldosterone, sodium, potassium etc?

[zeldazonk]

Thanks rumpled.
I have gained 10kg of fat around my abdomen (very unusual for me), have low BP and have been chronically, almost constantly hyper aroused for 20 years. Insulin is very high with reactive hypoglycaemia.
Here's some more detail.

CORTISOL
Normal ranges (nmol/L)
a.m. 160 - 650
p.m. 130 - 450

9:45am - 290
1:45pm - 498
5:45pm - 74
11:15pm - 53
3:20am - 736
7:15am - 362
11:15am - 444

It's just those four in the middle that are wacky - the mornings are ok...

ACTH
Normal ranges (ng/L)
9 - 51

9:45am - 21
1:45pm - Specimen Unsuitable
5:45pm - 7
11:15pm - 14
3:20am - 42
7:15am - 23
11:15am - 16

Sodium & Potassium are normal and she didn't test renin or aldosterone.

Any ideas?
Thanks for you time, Zel.

[zeldazonk]

I should also add I've been dxed with bipolar disorder and ptsd.
Zel.

[rumpled]

You do not have a normal rhythm - but that is only *one* day - and sadly, dang, not one of those tests were at a time of day that would be acceptable by my docs for diagnosis - how did your doc manage to put you in a hospital and do that? 8am and midnight are the normal times one would look at - although the 11:15 is close and that was really too high - PM ranges are usually afternoon, not night - so close to midnight you should be near zero so that one is really bad.

High BP, weight gain, and a friend of mine was diagnosed with bipolar with her Cushing's as well - so it is not out of the realm of possibility. Cortisol messes with the head. I have links in the health pages that may help you do research but you need another doctor for sure.