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Dr Adi
Dr Adi, Professor
Category: Endocrinology
Satisfied Customers: 284
Experience:  Director of the Pediatric Diabetes Clinics at UCSF.
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Hi have been diagnosed with high cortisol and have boderline

Customer Question

Hi have been diagnosed with high cortisol and have boderline tsh
At the moment am having similar symptoms as before , fatigue, lack of concentration etc but I've noticed that my palpatations are worse this time I'm seeing another dr in a few weeks. He has conducted blood and urine tests, in the meantime I'm just worried about the palpatations though
What's your opinion
Submitted: 4 years ago.
Category: Endocrinology
Expert:  jbmd replied 4 years ago.
Hi--I'd like to help you with some advice. I can't treat or examine unfortunately, but you knew online cannot replace local medical care.

Do you have any heart disease you know of? Do you have chest pain? Skipped beats or just steady racing of your heart?

By borderline TSH, do you mean high or low? Did they put you on thyroid medication?

What was your cortisol and how did they test it? Did they do am and pm? Ask you to avoid strenuous exercise for days before it and lie down for 30 minutes before testing?

I want to give you the most excellent considered advice and for that I need some knowledge of your particular situation.
Customer: replied 4 years ago.

I had a saliva test done and resulted with high cortisol also my tsh has been boderline I am on blood ppressure meds and Zoloft at thr moment my heart checks where fine diagnosed with anxiety depression


tsh low

Expert:  jbmd replied 4 years ago.

Hi-You still didn't say if your heart is steadily racing without skipped or extra beats or being irregular--steady is most likely from stress, the thyroid, the Zoloft and not from intrinsic heart problems. How fast is your heart? Have they done an ECG or other test to see if normal and do you have any heart disease (you have high blood pressure). (Zoloft can raise blood pressure in some people)


As for the TSH-borderline low means that you are still in the normal range but low normal-- if still within normal, you should be normal. This can be confirmed by doing T3 and T4 levels if your "borderline" is really really close to or at low normal.


In some people SSRIs can raise cortisol levels, especially at the beginning of therapy, going away when the body catches up but severe stress definitely raises cortisol levels. It could be you are stressed and also your body for some reason hasn't adapted to the Zoloft.


How high was your cortisol (number) and how low was your TSH (number) if you have them? Have the levels been repeated to check? High cortisol can represent Cushing's disease (an adrenal problem) from adrenal adenomas but it can come from depression (which you say you have), hyperthyroidism (which you might have), liver or kidney disease. What else has been done (if anything) to check out whether the cortisol abnormality is from stress or something else?