Yeah... cyclical is deceptive - one day or so low (it can be a week, month or hour!) and then you will hype up and it is like a nasty roller coaster.
My tests were all over - and I failed all stim tests (so I was fine, just fine...). The guidelines for testing do note that the cyclical form does exist, but that it is very rare (hah!). Under those guidelines I would not be here.
I learned to test, for me, when I felt great! That is when my cortisol was high and my aches were gone. People had to gauge acne, aches etc to know and it is easy to miss the window.
Your friend hasn't been diagnosed as hypothyroid yet? Look up myxedema skin pinch test. Myxedema is unique to hypothyroidism. I cannot pinch any skin anywhere but the tops of my hands.
I've had many tests for Cushing's disease which were all normal. And yes i know you can miss Cyclical cushings but since correcting my severe magnesium deficiency and starting thyroxine i am noticing improvements in various symptoms.
My insulin resistance symptoms (that i know of): very high hip-to-waist ratio (was 0.96 now 0.95 - a healthy waist-to-hip ratio for women is 0.80 or less, men 0.90 or less), buffalo hump (over 12 years), acanthosis nigricans (brown to black velvety hyperpigmentation of the skin usually found in body folds), skin tags, grown 3cm (i blame this symptom on insulin resistance). My fasting glucose and two hour glucose tolerance test were both in normal range.
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"Can you be insulin resistant and still have normal blood sugars?
Yes! A person who is insulin resistance can, and often does, have normal fasting blood glucose levels and normal blood sugar after meals. People with insulin resistance can even “pass” an oral glucose tolerance test (OGTT).
But in order to maintain normal glucose levels during an oral glucose tolerance test, a person with insulin resistance will overproduce insulin. Elevated insulin levels is called “hyperinsulinemia.”"
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"Studies show an increased frequency of thyroid disorders in diabetics, and a higher prevalence of obesity and metabolic syndrome in people with thyroid disorders.
That’s because healthy thyroid function depends on keeping your blood sugar in a normal range, and keeping your blood sugar in a normal range depends on healthy thyroid function." - Thyroid, blood sugar & metabolic syndrome by Chris Kresser
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"Low serum and intracellular magnesium concentrations are associated with insulin resistance, impaired glucose tolerance, and decreased insulin secretion. Magnesium improves insulin sensitivity thus lowering insulin resistance. Magnesium and insulin need each other. Without magnesium, our pancreas won’t secrete enough insulin–or the insulin it secretes won’t be efficient enough–to control our blood sugar." - The Insulin Magnesium Story by Dr. Sircus
red star--how did you finally distinguish between cyclical cushings and insulin resistance?
So If I'm understanding you right, my friend could be hypothyroid, since her cortisol tests low---she did not have the 24 hour urine test, I was wrong, but she did hav the 24 hour saliva test, which was low. The puffiness in her face could also be caused by low thyroid---my husbands face puffed up when he tried to go off his meds. Her lack of reflexes could be due to low thyroid, and the fat hump could be because she has been diabetic since she was 16 (I think)--she is around 28, now. She is not obese, but she is thick through the middle, which I keep hearing can be due to low cortisol.
She has also never had a period since she had her baby---and I know that low thyroid can cause that also.
Did I follow you right?
Yes that's true. Metabolic syndrome is also known as syndrome X or insulin-resistance syndrome; the majority of patients with PCOS have insulin resistance and/or are obese; insulin resistance is a listed side effect of highly active antiretroviral therapy (HAART).
The hump is associated with metabolic syndrome which causes the fat distribution to get weird. I've got a little hump too. It likes to grow when i gain weight. Jerk hump!
Folks with insulin resistance, PCOS, and Cushings can get the hump. I've got a good friend who is on the AIDS antivirals who has a hump and has lost a lot of facial fat because of metabolic syndrome caused by his meds.
Horselip
"The investigators conclude that individuals with buffalo hump should be closely monitored for insulin resistance and diabetes." - Elevated insulin associated with buffalo hump in Australian study
I could of told them that! LOL
I had no idea the hump could be caused by insulin resistance--she is diabetic, could that cause it also? i felt like her symptoms matched hypothyroid more than cushings when I read through a list of symptoms.
I had no reflexes with hypothyroidism. This has returned somewhat with thyroxine althought i'm not optimally treated by any means. I thought i had cyclical cushing's but my buffalo hump is due to insulin resistance.
One of the papers i have from my doctor says slow reflexes are a sign of hypothyroidism.
Maybe she can find a doctor that will go by symptoms instead of the stupid TSH.
No idea on reflexes - could be a separate issue.
If she has high cortisol, it would suppress TSH. She can try to regulate her thyroid but it will be jumping all over. Still, she may feel better to at least be on something than nothing.
Good endos are hard to find anywhere.
Do you think that she should continue to also pursue the correct thyroid testing? We live in the wrong part of the country to find good endocrinologists.
what do you think of the lack of reflexes that she has?