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Low morning cortisol, high afternoon cortisol

Hi, guys.  I am having a bit of confusion over my test results.  I've had two different tests via my Hormone and Wellness NP, and I am seeing an endocrinologist this week about it, but I'm just wondering if anyone else has had this happen because I cannot find any reasonable explanation.  

First off, I am a 30 year old female, and I've had an array of crazy symptoms for years and have gone undiagnosed (well, misdiagnosed with fibromyalgia and chronic fatigue syndrome).  I've also been diagnosed with hypothroidism, PCOS, Endometriosis, and autonomic dysfunction.  My symptoms range from debilitating fatigue, hormonal symptoms, dizziness and fainting, and inability to keep a pregnancy.  Over the years, I have had consistently low levels of cortisol, but now things are changing.  My 8:00am cortisol level is 2.1, and my 1:00pm is 21.  It went from low to high in my results.  They were suspecting secondary adrenal insufficiency before due to the consistently low levels, but with that new afternoon level, I am really confused.  Also, I have extreme fatigue in the early morning (have to drag myself out of bed) but I get a giant boost of energy at night and have trouble getting to sleep.  My NP thought the cortisol levels could explain that, and she gave me a prescription for Cortef in the morning and sent me to the Vitamin store to pick up Phosphorylated Serine and Adrenal Adaptogens to control the nighttime level.  She didn't address why this could be happening, and I was worried about taking the Cortef with those high afternoon levels, so I recently switched to an endocrinologist who repeated the afternoon test.  I've just looked at the results online and it is high again.  I'm so confused.  

These are the exact results shown on my endo's site:  
MAY 19: 3p ACTH   19 NL; CORTISOL 21.1  ; 21HYX AB NEG; RENIN 3.48 NL; ALDO 12 NL; NA 139 NL; DHEA-S 153 NL

I will say, I do have INTENSE dehydration and sodium loss that has caused me to become a neurological patient as well, and I down 2-3 32 oz Powerades a day and consume probably 10-15 times the normal sodium consumption levels as my neurologists have suggested in order to keep my from getting dizzy and passing out all the time, so that may explain why my sodium level looks fine.  But that cortisol... how could it start the morning off low and end up high later in the day?  Does anyone else have any experience with this?  

Thanks so much in advance!  
2 Responses
Avatar universal
COMMUNITY LEADER
Sorry to say but that sounds like Cushing's.

I had it.  I also had low bp and had to start florinef with Cushing's. Normally one has high bp and it is not typical so the doc may or may not be equipped to take you on.  If the doc is not an expert with pituitary or has had many Cushing's patients before, he/she may not know the variables.

I would not take cortef. You will only add to your symptoms.  You need another medication and to find the source of your high cortisol so you can get back to a normal rhythm.
Avatar universal
Hi! Did you ever get a diagnosis? Its now 2018, so its been a while since you posted. I’d like to give my opinion based on my experiences but if you’ve already been diagnosed I’d like to hear the results. I currently have the same symptoms.
Thanks!
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