High Cortisol and High ACTH

Went to my doctor and she tested for my TSH (Already previously diagnosed with Hashimoto's) for a routine check up. I was telling her how I was experiencing for fatigue and what not so she decided to test my cortisol levels, ACTH, and my glucose.

Results:
Glucose: Normal
ACTH: 70.3 [Range: 7.2-63.3]
Cortisol: 24 [Range: 6.2-19.4]

She said that she wants to run more tests and now I'm going to have a 24- urine test. My question I guess is do I have a pituary or adrenal tumor? I read that the possibilities for having both high ACTH and Cortisol can be from steriod use (not me) or a tumor. Are there other possibilities? Is it likely that I have Cushings? Any help would be apprieciated!

[enzymelover]

It is possible when ACTH and cortisol are both elevated that you could have cushing's or an adrenal adenoma. You will need more testing to be sure. Your doc may do a dexamethasone suppression test, and test vasopressin level.
Has your sleep been disrupted? Having your circadian rhythm thrown off is common in Cushings.
There is a condition called ectopic ACTH syndrome, but it is very uncommon. The conditions you mention are much more likely.

I hope you get some answers asap.

[rumpled]

With both elevated, odds are that you have pituitary source. You may *flunk* the dex suppression test as pit source people do flunk that test. Pit source is the most common. She should also do a chest x-ray to make sure there is not a lung lesion just in case as that is the most common ectopic source, then there is the ovaries.

ACTH is a fussy test. If you read most of my posts, you will see that - make sure they run it right.

Have you have some steroid use? That is another form of Cushing's. But it is usually resolved by going off the steroids.

You have normal glucose, which is good however, having high glucose is a symptom and if you have a doctor that goes strictly by the book, you may have an issue getting diagnosed - it is possible to have Cushing's and NOT have all the symptoms. I never had many of the symptoms but I had it. You can see some of the pics in my profile. Poor healing was my worst symptom as well as the weight gain. I also got a blood disorder from it. All of us present a bit differently. Do you have the hump and the stretch marks?