High Cortisol

[elaar]

Hi all, happy start to the weekend.

I see a lot of posts regarding low Cortisol, but I seem to have high Cortisol readings, and wondered if anyone had similar and/or had any clues as to what the issue could be?

I've been trying to work out why I have a lot of head pain first thing upon waking and at night before sleep. It's unlike headaches/migraines I've had before, feels like my brain is being squeezed, with internal tremor, and unable to handle external stimuli (definitely sounds hormone related to me). And still have a lot of vertigo during the day.

Cortisol upon waking: 636 nmol/L (range for 6am-10am is 73.8 - 507).

I've ordered a Cortisol saliva test so that I can see what's going on during the day.

My Thyroid results seem spot on to me (112.5ug levo, 10ug T3). All key vitamins are reasonable, I've been working on them.

TSH: 0.85 (0.27-4.2)

FT4: 17.9 (12 - 22)

T4 Total: 113 (66 - 181)

FT3: 5.7 (3.1 - 6.8) - Tested 8am, 12 hours after split dose.

Vit D: 138 (50-200)

Ferritin: 96 (30-400)

Folate: 25.5 (8.83-60.8)

B12: >150 High

The only other thing i've noticed is that fasting glucose upon waking is very high at ~7.1 (assuming my tester is reliable), and according to the web, that means I have diabetes, and yet Hba1C keeps coming back at 38-40ish, which is lower than the pre-diabetes range.

Thanks for any advice you can give, this is the main thing stopping me from leading a normal life at the moment.

[traveltime]

I can’t offer any suggestions in afraid but when you get your saliva test results you’ll have better picture. My morning serum (total) cortisol was a bit above range so I got a saliva test for a better picture too. My saliva (free cortisol) results came back very low. It seems I’m my body is good at storing things but less good at using them. You’ll know a bit more when the results come in. Depending on what your dhea-s and saliva dhea results say, you might like to do a (sex) hormone test too - that would also give you a picture about various hormone precursors.

[elaar in reply to traveltime]

Thanks for your input. I probably should have done the Saliva test before posting. My medichecks full blood test a few months back covered quite a few hormones. All seem normal apart from my SHBG has been above range for quite some time now, but doctors don't seem worried as my testosterone is top of range, so free testestorone is still okay despite SHBG.

[humanbean]

I've been trying to work out why I have a lot of head pain first thing upon waking and at night before sleep. It's unlike headaches/migraines I've had before, feels like my brain is being squeezed, with internal tremor, and unable to handle external stimuli (definitely sounds hormone related to me). And still have a lot of vertigo during the day.

The simplest cause of headaches I know of is dehydration. Perhaps try drinking a glass of water about an hour before you go to bed and see if it helps. It's free and isn't dangerous.

Is it possible you have hydrocephalus? It is a condition which can occur at any stage of life and there are several types and possible causes.

en.wikipedia.org/wiki/Hydro...

Another possibility is raised intracranial pressure :

en.wikipedia.org/wiki/Intra...

And obviously, any kind of head injury could cause head pain.

I'm not a doctor, but the only way of identifying any of the above, apart from the dehydration, is

a) A lumbar puncture.

and/or

b) An MRI scan, probably with contrast, but I'm not sure.

.

Edit : I didn't think of the obvious in someone with high cortisol - Cushing's Disease or Cushing's Syndrome :

Disease : en.wikipedia.org/wiki/Cushi...

Syndrome : en.wikipedia.org/wiki/Cushi...

.

If it turns out that you need any form of testing from the endocrinology department of a hospital you should find this link useful :

imperialendo.co.uk/Bible202...

[elaar in reply to humanbean]

Thanks for your comments humanbean. I probably should have added I had a head/pituitary and cervical spine MRI a month ago to rule out anything sinister (B12 defiiency, MS, brain degeneration, pituatary tumours etc.)

Dehydration is a possibility, I drink a lot of coffee and practically nothing in the evenings as it's likely I'll need to get up in the middle of the night for a wee if I try that

The head pain causes mass anxiety, unable to process anything, and if anyone tries to talk to me I need to leave the room. It's almost like a mini panic attack. This is why I think it must be hormone related rather than down to the usual things that cause headaches. But will definitely give it a try.

Hopefully Saliva tests will reveal whether it's Cushings or not, and give me extra clues.

Thanks

[SlowDragon Administrator]

Have you been assessed for sleep apnea

Sleep Apnea raises cortisol (wakes you up when you stop breathing)

publications.ersnet.org/con...

Sleep apnea much more common with thyroid patients

sleepcareonline.com/article....

[elaar in reply to SlowDragon]

Thanks Slow Dragon, no I haven't. Lately I seem to sleep pretty well, I don't tend to wake up until I'm meant to. No issues breathing wise when asleep (that I've noticed anyway). I'll have a read, thanks.

[Wozza25]

Hi Elaar,

Personally I've found ChatGPT to be formidable when it comes to diagnostics and two steps ahead of GPs (and specialists) in UK in my situation and people I know.

I wouldn't let it diagnose me but it's certainly good for giving ideas for further research.

chatgpt.com/share/67d69e9b-...

Personally if my waking glucose was that high, I'd invest in a CGM to monitor glucose (insulin) responses throughout the day over couple of weeks, get a lipid/liver profile blood test done and get some kind of wearable for sleep tracking.

Not sure any of this would be directly causing your headaches but might throw up clues for further investigation as to what is.

High cortisol raises glucose and thus insulin in the blood, so your readings may well be stress rather than lifestyle related and adapt quickly once under control.

If you do go down the road of getting hormones/testosterone levels checked, be sure to go for full panel and not just the single total T - absolutely pointless!

Hope you get to the bottom of it.