Aa
A
A
Close
Avatar universal
Cushing syndrome (need help)?
Cushing syndrome (need help)?

I did twice 24 cortisol urine test the first one was 300 ug/day and second was 314 ug/day ( the range is 28---213 mcg/day)

I did twice ACTH plasma test the first one was 21.5 pg/ml not fasting at 3pm and second was 5pg/ml at 9 am fasting  ( the rangeis 7.20--63.3)

I also did dexamethazone suppression test 1 mg over night and the cortisol level went down to 0.91
(the range between 4.5---24)

I have high blood pressure , high uric acid , feel tired all time , gain weight , moon face , weakness and heart beating most the time after eating ,depression , upper back pain when i walk or stand for long time  , i am male 31 years old

does it mean i have cushing or not my internal doctor seem he doesnt know what to do !
Cancel
4 Answers
Page 1 of 1
657231 tn?1453836403
I thought I already responded to this - sorry about that...

Your urine tests are elevated. The ACTH tests may or may not be accurate depending on the handling (chilled tube, spun immediately, frozen promptly).

The range the lab gives is not the range for the dex test that is the normal range - however, you suppressed which for most doctors would be a fail, but for a expert would be a *source* test.

You have to see an expert. A GP cannot and does not know how to test for or treat Cushing's. You need a neuro-endo at a pituitary center. First you have to determine if you have it and then you have to determine source - pituitary, adrenal or other.

A normal endo can take over, but unless they are smart, they may just dismiss you on the suppression test.
Comment
Cancel
Comment
Avatar universal
Comment
Comment
Comment
Post Comment
Avatar universal
thank you for your answer , but is there anyway i can reduce my cortisol level from going up ?

also  is there other test to do ?
Comment
Cancel
Comment
Avatar universal
Comment
Comment
Comment
Post Comment
Avatar universal
i dont know if that will help

my potassium serume is 4.6 (range between 3.5 to 5)
      
      sodiume serume is 140 (range between135-145)

urinary creatine 0.52 gm/l  (range between 0.60 -1.68 g/L)

Comment
Cancel
Comment
Avatar universal
Comment
Comment
Comment
Post Comment
657231 tn?1453836403
Alas, there is no way to stop cortisol without medical intervention.

As you are male, you may be able to avoid surgery and take one of the newer medications, if they are approved in your country. There are a couple of short-term meds but they are not good options and have to be watched carefully.

Yes, there are other tests. Your doctor needs to do a LOT of other testing - including more cortisol testing like 8am cortisol serum, more 24 hour urine testing, midnight saliva testing, plus all pituitary, thyroid, androgen and all the rest of the adrenal hormones. That would be basic and a lot of the tests would have to be done over and over just to show a consistency.

There is no one test to rule Cushing's in or out - so you have to test to show you have it, then test (a stim test, MRI or IPSS) to show or confirm location. It just is not an easy thing.
Comment
Cancel
Comment
Avatar universal
Comment
Comment
Comment
Post Comment
Your Answer
Avatar universal
Answer
Do you know how to answer? Tap here to leave your answer...
Answer
Answer
Post Answer
A
A
Recent Activity
Avatar universal
Blank
GirlyBear15 commented on When Your Cold Is Not...
Dec 03
Avatar universal
Blank
replytorahul commented on Ear Mystery, Solved
Dec 02
Avatar universal
Blank
ItsMyParty Autoimmunity-Hashimotos, Ep... Comment
Nov 26
Top Thyroid Answerers
Avatar universal
Blank
MI
657231 tn?1453836403
Blank
Northern, NJ
Adrenal Insufficiency Community Resources