Cause of fluctuating Cortisol Results ?

[LisaG28]

Morning, Will try and condense the last 5 years of cortisol results, as thoroughly confused, cortisol Vs thyroid.

Cortisol was tested under endo who I had been referred to in 2015 with regards my thyroid. In Aug 2015 my results show a level of 992 ( V high) with an ACDH of 8.79, not sure if the latter is relevant. A Dexamethasone test results noted suppression down to a cortisol level of 59, still slightly above target, I'm taking the wording from letters at the time, don't profess to fully understand. Endo suggested I was depressed nothing to do with my thyroid. GP asked to repeat in 6 months, result showed serum cortisol of 24. Conclusion was that cortisol was not the cause of my weight gain. Under guidance from this forum, I undertook my own saliva testing from 2018 - 2019, all results were now low, with a comment suggesting phase 3 HPA Axis, started on adrenal support which had little impact ( stopped some time ago and focused on my thyroid and supporting nutrients). Given consistently low results went back to GP for a further serum cortisol test, result 333. Referred to Endo where I was dismissed out of hand.

In September last yr I undertook a private thyroid test with Blue Horizon, which includes Cortisol, result this time now shows a high result, 566 (113 - 456) test was at 8am and fasting. Didn't pay much attention at the time, until I saw a response recently from someone on here commenting on a similar result from a BH test. Comment suggested that their weight gain may be a direct symptom of their cortisol results.

In terms of my thyroid, it is not quite optimal in terms of the t3 result. TSH is usually under 1 with T4 at the top of its range and T3 around mid range, the highest being 5.1. I also looked to introduce T3 after the BH result is September, but stopped as I gained weight, went from 74kg to 82kg in a relatively short period of time. Now I am thinking that perhaps my cortisol was the underlying root cause and not the introduction of T3.

In terms of questions, does anyone know why my cortisol is fluctuating from high, to low and back to high and could this be the cause of my recent weight gain.I don't feel particularly stressed and my thyroid results don't show such extreme fluctuations. Would it be sensible to undertake another saliva test to see what is happening now, 6 months after the BH test. Or should i disregard and continue to focus on my thyroid and perhaps introduce T3 again.My last results in May:

125 levo 5 days 150 levo x2

TSH - 0.14 (0.27 - 4.2)

T3 5.1 (3.1 - 6.8)

T4 22.4 ( 12-22)

I have Hashi's and all vitamins are optimal.

Sorry for such a long winded post, but I'm at a loss as to what to focus on and next steps. Primary symptoms are weight gain, low body temp and resting heart rate.

Any inputs or thoughts would be greatly received.

Many thanks

[Hidden]

Apart from the first cortisol result the others aren't too bad. One condition that may explain your varying results is cyclical Cushing's syndrome. It's where cortisol levels can go up & return to normal levels in cycles, which can vary between weeks, months or even years. When cortisol is elevated it can cause weight gain, insomnia, face becomes fuller & flushed, you can get acne, reflux, high blood pressure, extra facial hair & almost feel quite well. Lower cortisol can cause you to want to sleep a lot, you maybe able to lose weight, but feel unwell. It's hard to diagnose as you have to catch the "highs". It;s worth keeping a diary of all of your symptoms to see if you can see a pattern at all.

[LisaG28 in reply to Hidden]

Thanks PaulineS, that's most helpful, will certainly start keeping track of symptoms. Apart from the recorded levels, I can't recall specifically how I felt at the time of the cortisol tests. May do another saliva test to see if the results have settled.