HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

What Does My Cortisol Level In Blood Of 996 Micrograms Indicate?

default
Posted on Wed, 9 Mar 2016
Question: My cortisol is 996 and acth 3. What does this indicate
doctor
Answered by Dr. Binu Parameswaran Pillai (2 hours later)
Brief Answer:
Depends on symptoms

Detailed Answer:
Good day Ms XXXXXXX

Welcome to health care magic. Thank you for asking the question. The cortisol level mentioned is towards the higher side. Again, cortisol levels can go up based on a number of factors including Stress, alcohol intake or if you are depressed. Acute illnesses are another reason why the cortisol levels go up. Cushings syndrome is another cause of abnormally high cortisol levels. I presume your doctor ordered cortisol rest to rule out cushings syndrome.
ACTH is produced in pituitary gland which stimulate the adrenal gland to produce cortisol. When cortisol levels go up for any reason ACTH levels should drop. In your case, the ACTH levels have dropped. This indicates that probably your adrenal gland is secreting excess cortisol independent of pituitary stimulation by ACTH. In some cases, pituitary ( or an ectopic source) make excess ACTH which further stimulates adrenal gland to produce cortisol. In this case,ACTH remains elevated despite high cortisol. This second situation is unlikely the cause in your case because ACTH levels have dropped.

In a normal person, ,ACTH levels are lowest at midnight avd highest at early mornings. In cushings syndrome this pattern may be altered.

However I must say that a raised random cortisol is not a confirmatory test for Cushings syndrome. You now need a suppression test ( dexamthasone suppression test ) to evaluate further.

What time of the day was cortisol and ACTH collected. Was the ACTH sample stored in cold syringe or was the sample frozen immediately? .What symptoms do you have? are you using any Hormonal pills for regulating periods or for contraception? ( this can change cortisol levels too).
All these factors matters. You need an endocrinology evaluation and after examination ,,they should do further tests.
Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Binu Parameswaran Pillai (57 minutes later)
Hi
The cortisol and acth were collected at 8am. I've had no recent illness or depression and don't drink any alcohol. I do have a meningioma in the right cavernous sinus that is inoperable. I did 32 radiation treatments a year ago. My periods have stopped. I'm not on any hormones or birth control Also my prolactin is 38 and I am productions breast milk
doctor
Answered by Dr. Binu Parameswaran Pillai (1 hour later)
Brief Answer:
Next steps

Detailed Answer:
Thank you for the reply.
I wonder if your doctor did an Estradiol ( E2) and FSH test? If FSH is high, that itself will cause flushing etc. In your case, since you have received radiotherapy near the pituitary area, the FSH is likely to be low.

The next step in your case is to do a Dexamethasone suppression test and /or a 24 hour urinary free cortisol test. If they too are positive, then we need to do a midnight cortisol and ACTH test and imaging of pituitary or adrenals based on the results of above tests. I am sure that your endocrinologist will arrange these tests. In the interim, please be relaxed.

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1438 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
What Does My Cortisol Level In Blood Of 996 Micrograms Indicate?

Brief Answer: Depends on symptoms Detailed Answer: Good day Ms XXXXXXX Welcome to health care magic. Thank you for asking the question. The cortisol level mentioned is towards the higher side. Again, cortisol levels can go up based on a number of factors including Stress, alcohol intake or if you are depressed. Acute illnesses are another reason why the cortisol levels go up. Cushings syndrome is another cause of abnormally high cortisol levels. I presume your doctor ordered cortisol rest to rule out cushings syndrome. ACTH is produced in pituitary gland which stimulate the adrenal gland to produce cortisol. When cortisol levels go up for any reason ACTH levels should drop. In your case, the ACTH levels have dropped. This indicates that probably your adrenal gland is secreting excess cortisol independent of pituitary stimulation by ACTH. In some cases, pituitary ( or an ectopic source) make excess ACTH which further stimulates adrenal gland to produce cortisol. In this case,ACTH remains elevated despite high cortisol. This second situation is unlikely the cause in your case because ACTH levels have dropped. In a normal person, ,ACTH levels are lowest at midnight avd highest at early mornings. In cushings syndrome this pattern may be altered. However I must say that a raised random cortisol is not a confirmatory test for Cushings syndrome. You now need a suppression test ( dexamthasone suppression test ) to evaluate further. What time of the day was cortisol and ACTH collected. Was the ACTH sample stored in cold syringe or was the sample frozen immediately? .What symptoms do you have? are you using any Hormonal pills for regulating periods or for contraception? ( this can change cortisol levels too). All these factors matters. You need an endocrinology evaluation and after examination ,,they should do further tests. Regards Binu