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5143317 tn?1383751420
Dex test for Cortisol
I'm not sure where to ask this, but I'm awaiting the results of an overnight Dex test.  The doctor did not tell me and I didn't think to ask, but the test was done not fasting.  Will this affect the results?
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5143317 tn?1383751420
Well I got the results of this test.   I didn't fast, so I'm not sure if the results are accurate, but it's 2.2 the range is (2.3-19.4)  dr said it's "normal", but still wants to do a 24 hr urine test.
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5143317 tn?1383751420
What does this result indicate if anything?
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It is a test for cushings disease.  Your results are one point below the range, which would indicate that cushings is not a problem.  But, I think that it takes more than one test to get a diagnosis-----this may be why your doc wants to do the 24 hour urine test, also.
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5143317 tn?1383751420
Just heard back from the dr's office. He said that the result is a "stress" response. I'm not real versed on the whole cortisol thing.  So what is a "stress" response to a dex test?  

Is this why I feel mentally wired all the time, like I can't focus on one thought because there are just too many in there?  Why any type of stress freaks me out and makes me cry?

Sorry to be asking so many questions, in the course of the last couple of days things have gone in a completely different way than I expected.  I was so certain that I had a thyroid problem because of family history. Now, seems it's something else.
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I have no idea what a stress response to a dex test is---hopefully someone else will.

I have adrenal insufficiency---and I don't deal well at all with stress---I kind of freak out and cry, too.

What kind of thyroid testing and results have you gotten, and what prompted them to do the dex test?
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5143317 tn?1383751420
I don't really know, he checked me all over for the "typical" cushings signs, but I don't have any, except weight gain around my waist. I do however, have depression, mood swings, can't handle stress, cry all the time for no reason, weight gain, unable to lose weight, and other symptoms typical of hypo thyroid. As well as I have a strong family history of thyroid and diabetes.

So they tested TSH, FT3, FT4 but those results were good.
TSH .634 (.450-4.5)
FT3 3.8 (2.0-4.4)
FT4 1.25 (.82-1.77)

Then they did the dex test and now I'm to do a 24 hour urine test.
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657231 tn?1453836403
Your other symptoms as just as *typical* so the doctor is correct to run more testing.

Just don't do the urine test too soon - dex has a half life and you want that out of your system.

I had Cushing's myself and know many with it - no one has the same set of symptoms. I have met skinny people with it, people with no sugar issues (me!), some with stretch marks, some without etc etc etc so it varies a LOT.

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5143317 tn?1383751420
I took the overnight dex test on Monday night, I plan on doing the 24 hour urine on Sunday. Will that be enough time for the dex to get out of my system.  

Also, do you know how not fasting could affect the dex test?  The dr didn't specify and I didn't ask.  
Something is definitely not right, I just started crying because I couldn't get the copy machine to work.... I feel like a loony bird, and this happens all the time.
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657231 tn?1453836403
I am not sure how fasting vs not effects the test. I always go fasting.

I am sorry your doctor did not give you proper instructions. I sat in an office once and overhead thru the thin walls a doc give all the wrong instructions to a poor patient once... and then come back in 6 months.

The elevated cortisol you have has made you more emotional. Many of us are the same.  Joy!
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5143317 tn?1383751420
WELL NOW WHAT?  I got my 24 hour cortisol test back and it's smack in the middle of the normal range 34 (0-50).  So are these symptoms all in my head? Do I need to go on the antidepressants that the gyno prescribed?  Could just taking some vitamin d supplements make things better?  Any ideas where to go next?  I'm a little discouraged today because after 6 weeks of various tests they have found absolutely nothing to explain the symptoms I'm having. For all intensive purposes I'm a healthy 38 year old with a weight problem, so why do I feel like crap?
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657231 tn?1453836403
One test does not a diagnosis make...

Just FYI - I had Cushing's myself and my tests were all over - high, low and normal. I had the cyclical/episodic type that most doctors sadly think does not exist.

Your doc *may* dismiss you on the normal urine test. BTW the dex test does not follow the normal range listed on the lab - it has its own range and that is 1.8 so you actually passed that one. It is actually more suspect for adrenal source. A good doctor would look at the symptoms and overall pic, and keep testing. Few of those are around so it may be Cushing's, or it can be a disease that mimics it like low growth hormone, or other hormone issue, or cyclical Cushing's. You should also get imaging on the pituitary AND the adrenals - and get more testing for both source and cortisol. Have you had any ACTH testing?
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5143317 tn?1383751420
No I haven't had any tests for ACTH yet. I haven't actually talked to the dr yet, because he's been out of town. He did email me and tell me that he doesn't think it's endocrine in nature.
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657231 tn?1453836403
I am only a patient - but if he is only basing that on the testing you have, he does not have sufficient data to say that. Been there, done that, have the t-shirt.

Get a doctor that will test more - beg your PCP for it, or get another doctor to run it. Just make sure it is done CORRECTLY - which is how most of us get hung up and diagnosis lags for years. Time of day matters, lab handling matters - chilling of the certain tubes and even the urine jug matters.

In the mean time, work on ruling other things out. That is what I did if you care to do that. I was complex in that I had endocrine and female issues and other stuff - mostly aggravated by the endocrine issues.
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5143317 tn?1383751420
Thanks so much for your help. I'm working now on helping to eliminate some things. I think alot of it may be sleep related,  however, I'm still getting tested for other things.
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657231 tn?1453836403
No problem.

I failed two sleep studies with my Cushing's - cortisol keeps  you from sleeping well. Most of my Cushie buds have Cpaps.
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