Saliva Cortisol Results - all slightly high except midnight?

[MidwesternMom]

I have central hypothyroidism and some symptoms of other hormonal issues that may be pituitary related (thin skin , slow healing, buffalo hump <-- the worst ;(, fatigue and weakness.)  My pcp is sending me to an endo, but the appointment is several weeks away... so in my impatience I ordered a diurnal cortisol saliva test from zrt labs.

I was thinking "cushing's" as a possibility when I ordered this test.  Now I am thinking it isn't cushings because the midnight level was normal and the levels aren't *that* high.  Please tell me what you think.  Could these mean anything, or is it maybe just stress?

morning: 9.6 high (3.7-9.5)
noon: 3.1 high (1.2-3.0)
evening: 2.1 high (0.6-1.9)
night: 0.5 normal (0.4-1.0)

[rumpled]

Any test is good but can have its drawbacks - blood is still a point in time test so you have to be high (or low) right at that time. 24 hour Urine tests used to be hard for me as I was so high at night and so low during the day, I averaged ok! I only made a few abnormal ones... plus birth control pills skewed my results.

The moral of the story is test with a lot of forms, see what works for you -some of my buds love the midnight serum cortisol, I did well with midnight saliva tests, and others do well with urine tests - so you have to test to see what works for you. Most docs want a couple of forms before they diagnose you.

It is hard to be patient when you free like crud.

[MidwesternMom]

Thanks for the great response!  I hope my endo is a good one.  I'm not sure if this test is worth sharing with him or if it will just label me as a overly impatient!  LOL!

Do blood tests show a more accurate cortisol picture?

[rumpled]

One test does not make for a Cushing's diagnosis.

You did have just slight highs. Cushing's does not mean it has to be high at night - it just means that cortisol has to be high abnormally. A good doc will note the impaired diurnal rhythm, but them probably will not accept the lab - they always want to run their own tests.

Salivary and urine cortisol tests are *free* cortisol tests and can be impacted by any BCP, pain and many other meds, and those meds and even your body can bind free cortisol so your tests can appear lower or normal even while you are very sick. A cortisol binding globulin test can show that.

So one test can not rule anything on or out - you need a lot of tests. Cushing's is not simple to diagnose. I had it.