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Dr. SH
Dr. SH, Physician
Category: Endocrinology
Satisfied Customers: 8770
Experience:  Doctor of Medicine
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I need help with the below results please: a 24 hour

Resolved Question:

Hello I need help with the below results please:
a 24 hour free cortisol urine test result of 138 ug would you consider this to be indicative of cushings? I have had this test done twice now and it's relatively the same result
My plasma cortisol at 08h00 was 6.60 ug
After a suppression test (taking the tablet at midnight and blood taken at 08h00 the following morning) this decreased to 0.50
My acth at 08h00 was 14.90 Pg
I have thyroid nodules but my FT3 and FT4 are normal. My tsh is 0.060
Glucose is 94 mg and after the tolerance test 107 mg
I have symptoms of cushings that my endo is concerned about, buffalo hump, red face, extreme exhaustion, joint issues, muscle pain, rapid weight gain
I feel very very ill. My blood pressure has always been low or normal but is fluctuating and getting very high. I also have chest pain and back pain.
Submitted: 1 year ago.
Category: Endocrinology
Customer: replied 1 year ago.
(Posted by JustAnswer at customer's request) Hello. I would like to request the following Expert Service(s) from you: Live Phone Call. Let me know if you need more information, or send me the service offer(s) so we can proceed.
Expert:  Dr. SH replied 1 year ago.
Thank you for your question.If you wish to talk over the phone with me please accept the premium offer.Thank you
Customer: replied 1 year ago.
Good morning Dr SH,Thanks for the offer of the phone call but if you could answer the questions I would appreciate this very much.
Expert:  Dr. SH replied 1 year ago.
Thank you for your response.If you have the test result with you at the moment, can you please attach the file here.I would appreciate that.Thank you
Customer: replied 1 year ago.
HiAttached, they are in Portuguese as I'm in Lisbon right now. Hope they are legitable.
I attach the thyroid ultrasound report as well. Not sure if this linked of not
Expert:  Dr. SH replied 1 year ago.
Thank you for your response.There is nothing in the blood tests that suggests Cushing's syndrome.The tests to assess for Cushing's are all okay i.e. the ACTH and the cortisol levels are fine.You should have your vitamin D levels checked to see if they are normal because low levels can cause one to have aches and pains in the body like what you are having.There is nothing in the lab reports that would point to the cause of your rapid weight gain that you are having.This session is open for any further questions that you may have. The only way I am credited here by the website and the money that you have deposited is released is when you rate me.Therefore, I would appreciate a rating when you are done asking.Kindest regards
Customer: replied 1 year ago.
Thank you. My 24 hour cortisol urine is elevated at 138 ug when the normal I have been informed is up to 50?
My vitamin D results are on the same test. I sent.
Expert:  Dr. SH replied 1 year ago.
Sorry i think I missed something, were you given dexamethasone prior to the test?
Customer: replied 1 year ago.
After the blood cortisol test result of 6.60 I took the dexamethasone tablet at 11pm and was then tested at 8am the following morning and it was 0.50
I font understand the high cortisol in urine, I have had this 24 hour test 3 times now and it is always 128 to 138
Expert:  Dr. SH replied 1 year ago.
The urine cortisol is a little on the higher side for the test but the blood cortisol was fine as far as I am concerned. This is a tricky situation. What does your endocrinologist say on this test result?Please let me know.
Dr. SH and other Endocrinology Specialists are ready to help you
Customer: replied 1 year ago.
Unfortunately I have a month long wait until my next appointment as she is very difficult to get to see.
Do you recommend I get an adrenal ct scan done? Thanks
Expert:  Dr. SH replied 1 year ago.
There is no harm in doing that, but as far as I am concerned, there is no convincing evidence on the blood tests that you certainly do have Cushing's Syndrome.Regards

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