I have three questions I hope you can shed some light upon. Thank you in advance for your patience and that you share so much knowledge.
Please recall that I have a 4+/- cm adrenal tumor found incidentally.
The first question is this:
1) tests so far show hypercortisolism, however I have not received the result of (2) 11pm salivary swabs, so I don't know if I show a normal diurnal pattern. If my 11pm salivary cortisol results ARE normal, what weight does that carry in the whole picture. ?
2) How strong is the influence of high estrogen on cortisol level? I know that high estrogen causes a high cortisol level in a ""normal"" female, but would that influence still exist following dexamethasone suppression?
3) If I have a left adrenal tumor that is independently secreting cortisol, its almost certain that my right adrenal is near to, or completely non-functioning. So I understand the need to replace cortisol for several months after adrenalectomy and taper slowly down to stimulate the right adrenal to start functioning again.
Whew, finally, my 3rd question is: since the adrenal gland (cortex and medulla) secretes much more than cortisol, would I not also need to replace everything it secretes if my remaining gland is non-functioning???? ie. aldosterone, DHEA, other androgens????
Your thoughts are appreciated.