Cushings Disease

[Momma53566]

I have hypothyroidism.  My T3 level appears to be in the normal range.  We are adjusting my thyroid medication as my symptoms are severe along with a 12 pound weight gain in 6 weeks.  We tested for Cortisol for Cushings Disease.  I don't understand everything.  Below are my results.  Cortisol Urine Free Per Volume -- 7.17 ug/l.  Cortisol Urine Free Ration to CRT 6.58 ug/l CRT.  Cortisol Urine Free per 24-h 13.4 ug/d (<=45.00 standard range).  Cortisol Urine Free per volume 109 mg.  Cortisol Urine Free 24 hr 1989 (700-1600 standard range)

Thanks!

[Momma53566]

The only difference now is I am taking a full pill every day instead of a half pill on the 7th day.  This change was made about 2 weeks ago.

[Barb135]

Was 100 mcg your starting dose or was that an increase from a lower dose?  It takes approximately 4-6 weeks for a dosage change to take effect.  

If 100 mcg was your starting dose, it's very possible that it might be too high a dose.

[Momma53566]

Was on 100 6 days than 1/2 pill on 7th day.  Have been taking 100 7 days for 2 weeks now.

[Barb135]

How long have you been on the levo, 100 mcg/day?  If more than a few weeks, it looks like you could use an increase.

[Momma53566]

I am on levothyroxine for hypothyroid. 100 per day.  

[Barb135]

"Your 24 hour UFC is elevated but as you can see below this can be due to a few conditions."

"How did you know it was elevated?"  

From your lab report: "Cortisol Urine Free 24 hr 1989 (700-1600 standard"
range) "

Your thyroid hormone levels are very low in the ranges, indicating that you could be hypo, in spite of normal TSH reading.  Unfortunately, Total T3 is considered obsolete and of limited value.  You should ask your doctor for FREE T3, instead.  This gives a reading of the amount of hormone that is actually available for use by the cells.

Many doctors think that just because your labs are "in range" that you don't have a thyroid problem.  This couldn't be further from the truth.

[Momma53566]

How did you know it was elevated? I can't find anything consistent on the internet.

[Momma53566]

This is the only test thus far regarding Cushings.  My other labs were for hypothyroid.  They were 1.01 TSH (normal range 0.47-4.68). Free T4 0.83 (normal range 0.78-2.19). Total T3 1.22 (normal range 0.97-1.69).

[Red_Star]

The three most common tests used to diagnose Cushing's syndrome are 24-hour urinary free cortisol, 1 mg overnight dexamethasone suppression test, and late-night salivary cortisol.  Your 24 hour UFC is elevated but as you can see below this can be due to a few conditions.

High 24 hour UFC: Cushing's syndrome, severe liver or kidney disease, depression, hyperthyroidism, obesity, recent surgery, illness, injury, or whole body infection (sepsis).

What affects 24 hour UFC: having physical or emotional stress; pregnancy; low blood sugar (hypoglycemia); eating, drinking, or exercising before the test; taking medicines eg: estrogen, amphetamines, corticosteroids; not collecting exactly 24 hours of urine.

[Barb135]

Sorry, but gotta ask more questions.  What's the actual result for your T3?  Is it Free or Total? Did you have other tests done, along with it, such as Free T4 and TSH? Please post whatever thyroid results you have and include reference ranges, which vary lab to lab and have to come from your own report.

Cortisol levels are not my strong area, but I do know that cortisol should be higher in the morning, as we prepare for the day and lower in the evening as we prepare for sleep.  The last test you list is obviously over range, but I'm not sure exactly what it indicates.  Sorry about that.  Has your doctor given you any indication?

Is cortisol the only thing you had tested to diagnose Cushings?