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Dr. David
Dr. David, Other
Category: Endocrinology
Satisfied Customers: 42805
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Need help interpreting test results. Low dose dex

Customer Question

Need help interpreting test results. Low dose dex suppression test: 0.9 (nurse said red range) and 11pm salivary cortisol of 0.03. Trying to diagnose cushings. I can send a list of symptoms/history if needed also.
JA: How long have you had the symptoms? What seems to make the symptoms worse or better?
Customer: Red cheeks my whole life, buffalo hump, striae completely covering abdomen all the way around, hair loss, excess facial/neck hair, excess chest/nipple/abdomen hair, ibs, horrible fatigue, tingling arms and legs, memory issues/speech stumbling, sleep apnea, irregular/absent periods. This has all progressively gotten worse over the past 8 years.
JA: Anything else in your medical history you think the doctor should know?
Customer: Vitamin d deficient also
Submitted: 3 months ago.
Category: Endocrinology
Expert:  khagihara replied 3 months ago.

You don't have Cushings.

Customer: replied 3 months ago.
Ok, what else could be going on? I am seeing an endocrinologist next month, my primary care doctor thinks I have cushings so he referred me.
Customer: replied 3 months ago.
What test would rule out cushings? Or what do you think is a likely diagnosis given my results and history?
Expert:  Dr. David replied 3 months ago.

This is Dr. David

have you had your thyroid hormone levels checked?

do you have excessive anxiety symptoms? excessive anxiety can cause fatigue, memory issues, irregular period.

have you had polycystic ovarian syndrome checked? this can cause weight gain, facial hair, insulin resistance

you need blood testing to check for blood androgen levels and an ultrasound to check for ovarian cysts for polycystic ovarian syndrome.

Customer: replied 3 months ago.
Tsh was high normal, i believe it was 2.1, fsh and estradiol were normal. Pcos was ruled out by gynecologist. I dont really feel like I have anxiety though. I'm not anxious or anything. I was on Lexapro about 5 years ago and I really didn't notice any change. Matter of fact, my symptoms just progressively got worse. I don't have insurance (so cost is a definite factor) so the doctor said he wants to rule out cushings before any further testing. What do you think my results could be indicative of?
Expert:  Dr. David replied 3 months ago.

Cortisol level should decrease after you receive dexamethasone.

Low dose dexamethasone suppression Overnight test 8 a.m. plasma cortisol should be lower than 1.8 mcg/dl

your cortisol level would be very very high if your adrenal glands were producing too much cortisol and would not suppress down with dexamethasone.

https://medlineplus.gov/ency/article/003694.htm

hair loss can be from low iron in your system, low vitamin D, low biotin, normal aging, or even low vitamin D

your symptoms don't point to one medical condition.

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