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Dr. Phil, MD
Dr. Phil, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 58683
Experience:  GP in the United States
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I have been struggling with severe fatigue and muscle

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I have been struggling with severe fatigue and muscle weakness, increasing over the past couple of months. Some physical signs of Cushing's syndrome and hypertension consister to and increasing on the last 3 readings, reaching 158/94 when it was last done. Inconsistent bowel movements have also been happening across the same period.
So far all bloods have come back normal, including FBCs, Lipids, Cholesterol, Hb1ac, Fasting glucose, TFT, LFT, T3, Vitamin D, Epstein-Barr and Tissue Transglutaminase.
Chest X Ray is clear as is colonoscopy.
My doctor thought it may be Cushings and ran an AM cortisol serum test, with no use of dexamethasone and this came back at the higher end of the normal range.
He is now suggesting it could be a post viral thing but and that we wait however I was wondering if an AM cortisol serum test on its own could rule out Cushings or if I should insist on a dexamethasone suppression test as well?

Thanks for this question

Actually the best test is doing to be a 24 hour urine free cortisol level

that should be done next

let me know if you have other questions.

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