Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
High Cortisol?
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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High Cortisol?

Hi!
I'm a 34 yo female and I've been hypothyroid for about 8 years, treated with synthroid. Two years ago I suddenly gained about 90 lbs in 8 months, although my diet and exercise did not change as far as I can figure. In fact, I was jogging 30 miles a week up until the last 10 lbs of the weight gain when it just got too hard to keep up.  Most weight went to my belly - I look pregnant (I'm not, though!).  In the past year I developed a fatty hump on the bottom of my neck that I'm very self conscious about and my skin has gotten to be pretty thin and fragile.  It tears and bruises easily and takes forever to heal from the most minor abrasions.   In the past 4 months I've started to get weak and shaky and feel very easily stressed out.  Oh, and insomnia has been really bad for the past year too.  At least one night a week, I don't sleep at all.  Other nights I sleep 4-5 hours tops. I feel fatigue, but not at all sleepy.  

I don't know what is going on.  Diet and exercise aren't helping.  My thyroid levels seem good - tsh is .92.  I've developed hypertension now, probably due to all this weight.  My doctor ordered a bunch of tests.  My sed rate was slightly elevated at 23 (0-20 range).  My potassium was in range, but right on the bottom cut off number.  LDH was right on the cutoff number at the high end of the range. And my cortisol was high at 25 (2-19 range).  This is the number my doctor seems most concerned about.

Could the cortisol be connected to thyroid?  Could I be over medicated? My doctor wants me to do more tests and mentioned seeing a cushings disease specialist if I get more high cortisol results. I've heard cushings is extremely rare, so it seems unlikely.  Could my insomnia cause the high cortisol levels? Is 25 even that high?

Thanks for any advice and input.  I'm feeling a bit lost...  I'm not sure if I'm on the right track for finding answers.

(Oh, I should add that I'm a vegan (have been for over 15 years) just in case that can effect bloodwork.)
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Would see an endocrinologist to test for Cushings.
Most high cortisol levels like this are related to normal stress reactions, but with the weight gain and high blood pressure, Cushings must be considered.  It's about 1 in 100,000 people.
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