Know How Our Doctor Helped a Patient With Fluctuating Cortisol Levels

A patient who had been dealing with high cortisol levels in the morning and low cortisol levels in the evening consulted an Endocrinologist on iCliniq. She mentioned suffering from cognitive memory difficulties and mood issues and had also dealt with episodic depression for more than ten years. She added that she had gained much weight in the last couple of years and has PCOS (polycystic ovarian syndrome). She was very worried as her doctor explained that her high morning results were due to chronic stress, so she wanted to know if she needed any further tests.

Our doctor went through the query and said that there was nothing to worry about. He asked the patient to take a midnight salivary cortisol test, Dexamethasone suppression test, and 24-hour urine-free cortisol test. He said that these tests would help decide if further testing is needed.

The patient reverted after a few days, saying that she had an abnormal Dexamethasone suppression test and late-night saliva test with pretty elevated 24-hour urinary free cortisol (UFC). She asked the doctor whether these abnormal results were due to Cushing's syndrome or stress. She also said that her mental health had now been under control with medication.

The doctor went through the query and said it is hard to say that depression or stress had caused it. As all three tests were abnormal, he recommended the patient consult an endocrinologist in person to check for high blood pressure, diabetes, wide purple striae, and hump or fullness in the back of the neck or collar bones.

The patient reverted, saying that visiting specialists like endocrinologists needed a long wait in the place where she lives. So, she wanted to know that if it is not Cushing's disease, what else could it be, and if there are any food restrictions she needs to follow.

The doctor said that depression, various medicine intake, obesity, and alcohol abuse could also lead to similar results. He asked the patient to reach a mental health provider to keep her mood disorder under control and stop taking some medicines. He also instructed her to eat healthily and exercise regularly. He further explained that Cushing's syndrome could not be overruled even though the chances were less.

The patient got well informed by the doctor's explanation and thanked him. She said she would follow all the instructions suggested by iCliniq's doctor and was extremely grateful for his timely help.