Suspected Cushings or just hypo

[Incoguto]

Hey everyone,

My endo is sending me for an MRI of pituitary and CT of chest, pelvis, abdomen and adrenals.

My salivary cortisol seems to go up a lot after adding t3, my blood cortisol is over range and I'm having issues raising thyroid meds, keeping me in a hypo state.

Apparently I could have a tumour overproducing cortisol. Hopefully will get some answers on that within a month or so.

Has anyone here been diagnosed with Cushings syndrome or disease?

Symptoms seem to overlap with hypo.

Thank you 🤗

[Wua13262348]

I ran out of space when answering your "Fatigue And Coma" post. I have just noticed your further posts. I don't have Cushings .

You are asking specifically about Cushings in this post. I do not know (think you are 39 years old) if you are on a contraceptive pill or not. If taking contraceptive pill: elevated levels of total cortisol can be due to estrogen in contraceptive pills with estrogen and progesterone leading to pseudo Cushings Syndrome. Estrogen can cause an increase in cortisol-binding globulin and thereby cause the total cortisol level to be elevated. However, the total FREE cortisol, which is the active hormone in the body, as measured by a 24 hour urine collection test for urinary free cortisol is NORMAL, as too would a saliva test be.

I think salivary cortisol , like urine cortisol is measuring FREE cortisol.

The blood cortisol test is measuring TOTAL CORTISOL. 99% of this total cortisol is not free and is therefore not active hormone. Your SALIVA cortisol test is measuring the !% which is FREE, and is the active hormone.

Cushings would tend to present with persistent high blood pressure and insulin resistance, leading to high blood sugar. I believe you said your blood pressure is fine in your previous post. Since you have not reached your optimal dose of thyroid hormone intake, if cholesterol is too high, this should drop on optimal dosing. If you had Cushings, triglycerides would likely be high.

With Cushings a fatty deposit often develops between the shoulders /upper back/neck, fat around the abdomen and unexplained osteoporosis.

Many overweight people with high blood pressure or diabetes have some features of Cushings Syndrome, and a susceptability to pneumonia. I tend to think if your blood pressure is not persistently high , then you are unlikely to have Cushings.

I wonder if a contraceptive pill or HRT could be causing problems with your cortisol readings. I have no expertise at all in this area, and hope that someone will correct me if what I have said is wrong.

[EastLondon in reply to Wua13262348]

Just to add, I never had high blood pressure and still had Cushings. You do not need to have all the symptoms. As you say, many symptoms overlap with other medical issues so it can be very hard to detect.

[EastLondon]

Hi, I have been diagnosed with Cushing’s Disease caused by a pituitary tumour. Imaging is generally only completed once the biochemical evidence confirms Cushing’s Syndrome as 1 in 10 people will have an incidental pituitary tumour that is non-functioning. You should be having 2-3 24hr urine collections and an overnight dexamethasone suppression test. After this you would normally have an ACTH test to check for the source - high ACTH indicates pituitary source and low points to exogenous. At this point an MRI or CT would be requested. I thought I had hypothyroidism however post Cushings treatment it appears that is was all driven by Cushing’s

[Wua13262348 in reply to EastLondon]

That's interesting, hope you are much improved. It was "Incoguto" who was enquiring. Since you have replied to my post "Incoguto" will not have been alerted to your reply. You need to reply to her post for her to be aware of your reply, which I think she will find very helpful. I'm not tech savvy, so don't know if it is possible for me to "tag" her or not, especially as I would be trying to interfere with someone elses's reply if I were to try .