newly diagnosed with low cortisol

[Angels2002]

Hello,  I had 4 surgical procedures, cystocele, rectocele, bladder repair & hysterectomy 11/03/2008 and my labs came back in the hospital with a cortisol level of -1.  It was difficult to get my blood pressure up, keep my pain at bay and I now 3 months later I have a host of symptoms that I cannot control or explain.  I have since had 2 more cortisol labs and they both came back -1.  I have an appt. with  my PCP to discuss the results next week. From what I am reading on low cortisol.... this could be very serious.  Am I jumping the gun?  I really am feeling weaker by the day, losing hair, very dry eyes & thirsty, extreme fatigue, iritability, can't focus, neck & shoulder blade pain, etc.  My job in healthcare admin is very stressful and I feel I'm losing it.  Suggestions?  Many thanks!

[lilly1212]

Is a reading of am cortisol at a 10 range (7.0-10.) zrt labs....a good morning cortisol reading????  I am still tired when I get out of bed......I had blood tests done a while ago where my am cortisol was a 19 range (5-25) and I felt great...popped out of bed!!!!!  I had blood work done after going off of a couple hormones and my am cortisol dropped to a 10 there also...I know blood cortisol and saliva cortisol readings are different, but ZRT labs is saying that if I go any higher than a 10 saliva reading for the morning, I will feel worse!!!  But I still don't pop out of bed....I am so confused......should I be trying to increase my am cortisol level or not????????  Someone please help...I am having an awful time of this.....My dhea is way high right now too.....doc told me to supplement when i really didn't need it.......

[Angels2002]

Ok.  All tests were done at 8:00AM...so this last one was 15 which is the higest and my doc was satisfied with this.  he does want to redo the test in 2 weeks at 8:00 am again and then just leave it be if it comes back within range again....wonder why the symptoms have not gone away?  This is still a mystery to me.  I'm going to keep researching to see if we are missing something.  Thanks so much for the questions and comments....wish you the best of luck and I'll stay in touch if I hear something else :-)

[rumpled]

Cortisol is time of day dependent - do you know what time of day those tests were taken? That is what I meant.

Cortisol varies by time of day. Highest in the morning, hits roughly half by 2-4 pm, lowers all day to hit a low by midnight, repeat.

Losing weight is actually a sign that things are not well if you were not trying.

[Angels2002]

Hi,  just had my CT today.  I had my 1st cortisol taken 24 hours post surgery - in the hospital....very much on morphine.  they ran the test due to plumeting BP and they could not get it normal for those 24 hours...so they ran a cortisol and it came back at less than 1..then had another one done 1 month later in AM and again 2 weeks later with the supression med...still below 1.  Then ran the test again last week in AM and it came back at 15....needless to say, my PCP wants to run it again in the AM while I'm waiting to see the Endo doc.    Yes, my weight is changing.  Thankfully, I've lost 12 lbs.  Started at 152 and now 140...I'm 5'5" and 49 years of age and no real reason for wt loss...other than stress I suppose?  Maybe my low cortisol was just due to surgery?  I'm still unsure and still don't feel any better even if it is 15 now.  Sorry you had to go through that with your doc and eventual surgery...I know it can be very frustrating getting your voice heard by some professionals in healthcare and the squeaky wheel does usually get the grease!   Good luck to you.  Thanks for the comments :-)

[rumpled]

What time was the cortisol taken? Cortisol normal varies a lot in the body. It rises and falls so time of testing is very important. Elevated DHEA is showing something is going on.
Is your weight changing - going up or down?
I have to tell you that I had an adrenal (abdominal) MRI - it was normal, CT, adrenals normal and the day before my surgery to remove my adrenals, the report said my adrenals were normal.
Then... my adrenal pathology showed they were 2x norrnal size and one was nodular.  The funny thing is that I had a CT a month after the surgery and that one came back... normal. So, there you go. BTW, this has happened to several of my buddies, not just me. And if you look around, you can see that imaging is not exactly er, definitive. The surgeon knew it but the inexperienced surgical resident was treating me like a second class imposter who was out to remove body parts and treated me like garbage until the big adrenals popped out. Then he was sweet. Huh.

I do know medications interfere but really - illness raises cortisol - your body needs it to heal so in a way it is good that your body is responding a bit to heal. It may be that. I have to stress dose (add steroids) if I get sick.

[Angels2002]

I go tomorrow for a CT with contrast of my Ab, pelivs & adrenals.  Not sure what this all means or where it will end up, but I'll hang in there until we can find a name for this...BTW just rec'd my new set of labs I did a couple of days ago...this makes 5 labs in 3 months, 4 with very low Cortisol and elevated DHEA and Aldosteron on the low side...I'm shocked to see my Cortisol at 15!!  What can this mean?  Was the test done right, was it handeled properly or are the previous ones wrong...symtoms are the same?  Does anyone know if taking Zithromyicine (Z-pak) and Amoxicillian can effect cortisol levels?  I am currently in the middle of the Amox. and took the Z-pak prior for a bout of Strep Throat.  I had to go to a 2nd antibiotic since the Z-pak did not do the trick.  The time span is 2 weeks being on one right after the other.  I was not on an antibiotic with the previous labs.