Cortisol Test Results

[Barker123]

I've been feeling fatigued for months and have a rough time getting and staying asleep or loosing weight despite tracking ever calorie and working out. So, I paid for a hormone blood test through Labcorp.  My TSH and T4 levels were in normal range. T4 1.1 ng/dl normal range 0.82-1.77 and TSH was 1.43 uiU/mL out of a normal range of 0.450-4.500.

All of the tests were within normal range except three things. My BUN/CREATINIE ratio was flagged as "low" for 8 out of a normal range of 9-23 and my EOS absolute count was flagged "high"  at 0.5 from a normal range of 0.0 to 0.4.  Neither of these are shocking to me because the bun/creatinine ratio can be caused by a lack of protein and as a vegan, i know I should be getting more.  The EOS count is not shocking either because I have celiac disease, asthma and eosinophilic esophagitis which might explain a high count.  The third test that read high was the Sex Hormone Binding Glob, Serum test which came in at 179.5 nmol/L out of a normal range of 24.6 - 122.0.  Not sure if my birth control is affecting that but all my other hormone tests (testosterone, estrogens, progesterone) were within normal level.

Now why I'm here.  My cortisol came in at 35.5 ug/dl with a normal range of am 6.2 to 19.4 and pm of 2.3 to 11.9.  The test was taken at 9:30 am.  Either way, my number is near double the upper range of either time range yet it wasn't flagged on my lab report as high.  What should I do with this info now? See the doctor or go right to an endocrinologist or just chalk it up to stress?

Thanks!

[rumpled]

The "cortisol is raised by stress" is a myth unless you are morbidly afraid of needles and screaming at the time of the test, just told about a death or someone tried to kille you during the test... Some docs even put in picc lines to preven the stress of a needle for long testing (yeah like that is not stressful!) but a friend's mom who was deathly afraid of needles and did almost pass out w the draw... Had a normal cortisol.

It may not have been flagged as cortisol needs to be tested at certain times to be diagnostic, but it peaks at 8am and should fall, not rise after. So yes, a trip to the endo is in order.

Sadly, most endocrinologists are pretty clueless when it comes to Cushing's disease so it pays to do some research on how to test (8 am fasting) and if the doc immediately wants to doc dex test, walk and find another (it means the doc has zero clue, and most people suppress as it is a great test for source, not exclusion). If they want one test and wait 6 months to see you... Ugh... Another bad sign.

Once you get imaging and enough proof, move on to a pituitary center. Get copies of everything.

[Barker123]

Thank you. I have absolutely zero fear of needles.  I have an appointment with my primary care this week because the endo I want to see refuses to see anyone without a primary care referral regardless of insurance not requiring one.

[rumpled]

Good luck. I know in my case I had to see over 10 regular endos and probably even more neuro-endos as I had cyclical Cushing's and most say hormones don't cycle. Period. Hah!