Low cortisol

[msaries0401]

My doctor did a baseline cortisol test around 7pm. It was 1.65 mcg/dl. I asked her about it and she said that your levels change through out the day & didn't seem worried. Today I did a suppression test, I took dexamethasone last night at 11pm & got my blood drawn at 8am. I feel really awful today. Extremely tired, more than usual, even after drinking a Monster. Should I be concerned about the baseline test?

[rumpled]

The suppression test is kinda supposed to suppress - it is the action of the ACTH.

If you have a decent doctor, he will test more. If you don't, they will give up now saying "this proves that you don't have an issue"... I failed all stim tests and I still had Cushing's as it works better, if you read up on the mechanics of the test, as a test of source (pituitary vs adrenal) than as a test of exclusion.

The suppression test is not used for low cortisol so that is strange.

Any other testing?

[msaries0401]

I should add that I take vyvanse 50mg and welbutrin 150mg daily, which could explain the high bp & heart rate.

[msaries0401]

I got my results back today for the suppression test. My blood was drawn at 7:51am and was <1.20 with the normal range being 3.09 - 22.40 mcg/dL. My doctor ordered the test to see if I was producing too much corisol, but instead it seems to be the complete opposite. Most of my symptoms are consistent with low corisol except my blood pressure has been higher than normal.

[rumpled]

I would not get testing done for cortisol at 7pm... It is not a time when there is a set range and it is not diagnostic to get a test then.

Cortisol in a normal person peaks at/around 8am then falls through the day so yes, it should be low at night. One test at 7pm gives the doc very little information imho.  

I would guess you got the stim test as you had other indications of low cortisol like low sodium?

Or are they testing for high cortisol? The dex test is for Cushing's. I had that myself.  I failed all the dex tests (different doses over time) and still had it. The test is more a test of source than exclusion, but many doctors use it as a test of exclusion....