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What causes Cushing's syndrome?

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Posted on Tue, 19 May 2015
Question: I had a blood test done last year for cortisol, the reading was: CORTISOL * 622 nmol/l
I have acne, stress, anxiety.

I wonder if it is to do with cortisol or not.
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Answered by Dr. Binu Parameswaran Pillai (27 minutes later)
Brief Answer:
Timing of cortisol test is important

Detailed Answer:
Good day,
Noted your concern. I must say that a random cortisol has no great value. Could you please tell me what time of the day was it done?
Cortisol levels can rise in stress and anxiety. Cushing;s syndrome is a disease where cortisol levels can rise too high which can cause acne and anxiety/depression. Your levels were not so high though.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Binu Parameswaran Pillai (5 hours later)
Thanks for reply. It was done, if I remember at about 9am although I hadn't had any sleep.

What type of levels would be considered cushings disease?

Thanks
doctor
Answered by Dr. Binu Parameswaran Pillai (59 minutes later)
Brief Answer:
Random value can not diagnose cushings

Detailed Answer:
Okay, it is high normal for a 9 am cortisol. However, if you hadnt have sleep the night prior to the test, please disregard that test. Cortisol will be high in any stressed situation.

A random level of serum cortisol can not diagnose Cushing's disease. It is better to do a dexamethasone supression test. Other tests are midnight salivary cortisol, 24 hour urinary free cortisol etc.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Binu Parameswaran Pillai (1 hour later)
Is there anyway I can discount cushing's without having a new test?
doctor
Answered by Dr. Binu Parameswaran Pillai (8 hours later)
Brief Answer:
Need tests

Detailed Answer:
Well, an endocrinologist need to examine you first. If you have specefic features of cushing's syndrome, then you need to undergo screeniing tests for cushing's syndrome (which i mentioned earlier). Once screening test is positive, then you need confirmation tests. If that is positive, ten we eed to localize the lesion. That involves CT scans or MRI scans.

The easiest and simple non invasive screening test is either 24 hour urine free cortisol or Midnight salivary cortisol.


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

Endocrinologist

Practicing since :2003

Answered : 1435 Questions

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What causes Cushing's syndrome?

Brief Answer: Timing of cortisol test is important Detailed Answer: Good day, Noted your concern. I must say that a random cortisol has no great value. Could you please tell me what time of the day was it done? Cortisol levels can rise in stress and anxiety. Cushing;s syndrome is a disease where cortisol levels can rise too high which can cause acne and anxiety/depression. Your levels were not so high though.