Can high cortisol levels lead to weight gain?

Question

Hi doctor,

Four years ago, I had a serum cortisol test that showed very low levels. At that time, I also had low blood pressure, and the doctors diagnosed me with Addison's disease. I was prescribed Prednisolone and took it for about two weeks, after which I felt better. Subsequent tests showed my serum cortisol levels were normal. Over the last three years, I have taken Prednisolone only when I experienced tiredness, low blood pressure, and fatigue.

I got married five months ago and started taking a contraceptive tablet. I used it for two months, then stopped for a month, and resumed taking it for another two months. During this period, I gained 33 pounds. I had been on a diet before marriage, but now I have gained a significant amount of weight. I had TSH, T3, and T4 tests done. The TSH levels were high, while T3 and T4 levels were normal, but my cortisol level was elevated.

What could be the cause of this, and what steps should I take?

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Addison's disease is caused by involvement of the adrenal glands and is also known as primary adrenal insufficiency. Secondary adrenal insufficiency, on the other hand, arises from a different mechanism, often involving the pituitary gland, which is considered the body's master gland due to its control over various other glands. Secondary adrenal insufficiency due to pituitary involvement frequently includes hypothyroidism.

Your reports suggest hypothyroidism, so you should take Levothyroxine along with Hydrocortisone. Consult your specialist doctor, discuss with him or her, and take the medicines with take the medicines with their consent.

Additionally, I recommend conducting a paired ACTH (adrenocorticotropic hormone) and cortisol test, as well as a brain MRI (magnetic resonance imaging) to rule out any pituitary gland pathology.

I hope this helps you.

Thank you.