Elevated Cortisol- Not Cushings. Any ideas what else could be going on?

[Sharon21476]

I was told that all my blood work was normal except my DHEA and 24 hr. Cortisol were elevated. I most recently did a dex suppression test and have just found out that my cortisol was suppressed to 0.8. Recently, I have been waking up amped up and jittery, pounding heart (resting hb will go up to 105 doing nothing), anxious energy. weirder yet is it seems to slowly get better as the day goes on to where I feel most normal at night. Getting headaches sometimes which are not usually bad and sometimes only lasts a short while, I would say dizzy but feels more like my equilibrium is off? Sometimes nausea. The endo said elevated Cortisol and DHEA can not cause those symptoms, and to go to my PCP. Is there any thing that would cause all these strange symptoms?  It may be worth noting that over a month ago I was diagnosed with Asthma (which I never had) after three bouts of shortness of breath and given 6 days of prednisone (50 mg/day). I only took 3 days worth as I got that moon face and the side effects were horrible (much like the recent symptoms but times 50) and I also had the same reaction to the only 1mg of dexamethasone? If it lowered my cortisol, what else could cause that reaction because I honestly thought it upped it when I felt that way? Any answers are greatly appreciated! Oh and over the last year or so my bp is low quite often. Last month it was 98/58 and I have always been a 120/80 type of girl. In fact, the very next day it was normal (120/82) Is there anything that can cause these symptoms that is obviously not Cushings or am I just suffering from a sudden onset of some panic disorder? I got blood work this morning to test for a pheo but I do not have high bp.  Seems unlikely?
Testosterone, Free 0.8 pg/ml 0.0 - 2.2
FSH 6.1 miu/ml 3.4 - 33.4
Testosterone, Serium 64 ng/dl 14 - 76
TSH 0.778 uiu/ml 0.350 - 5.500
T4 7.4 ug/dl 4.5 - 12.0
T3 153 ng/dl 85 - 205
DHEA 805 ng/dl 112 – 722
DHEA-s 174ug/dl 45 – 270
24hr. Cortisol 155 0 – 50

[Sharon21476]

Oh and sorry!  Not on Prednisone for either.  Took three days worth about 4 weeks before the first 24 hr. cortisol.

[Sharon21476]

Thank you for your quick response!  Took two 24hr Cortisol urine tests and both were that elevated a week and a couple days apart.  Other one was just a fraction lower the endo said.  I am doing a 2 night midnight salavary test the next two nights and I had to get some more bloodwork done for plasma metanephrines (may have butchered the spelling)  today.  I believe it is because I feel very speedy, jittery and racing heart all day.  Any time I move (get up from a laying or standing position) and sometimes no reason at all, my heart will race and pound.

I have another question, if I am doing this correctly and do not need to re-post a question separately.  I went and got an old CT scan result that I had done for flank and low abdomonal pain almost a year ago, and here I have a 2cm lesion on my ovary.  Could that be causing all of this mess?

[Mark Lupo, M.D.]

Cushings is a hard diagnosis to make - the 155 Urine cortisol test is elevated (assuming it was not done while you were taking prednisone).  Would consider repeating that despite the normal dex supp test.  If still high, then seek a university based endocrine evaluation to determine why.  ie, if the result is >100 - it needs to be explained.  Many times elevated cortisol is due to stress, but levels this high need more evaluation.