Question: What are the normal values for a serum cortisol, a 24-hour urine, and ACTH? Also, what is the generally accepted cortisol cut off point for an overnight low dose dexamethasone suppression test? Does the absolute number for these tests vary between labs? Answer: Normally, cortisol is secreted in short bursts and blood levels are… Continue Reading
Category Archives: Doctor’s Answers
Normal 24hr Urine Test With Cushing’s Symptoms
Question: I have symptoms of Cushing’s but my 24-hour urinary cortisol measurement is normal. Is it possible to have a normal test and still have Cushing’s? Answer: The 24h urine free cortisol test is an extremely sensitive and specific test for the presence of Cushing’s. When the level is high, it is likely that the… Continue Reading
Low Cortisol Levels in Cyclic Cushing’s
Question: Is it possible for someone with Cyclic Cushing’s to have too little cortisol at times? Answer: Patients with cyclic Cushing’s syndrome may not return to normal levels during the off period. Levels may indeed be low or there may be a reversal of the normal circadian rhythm such that low levels are seen in… Continue Reading
Imaging Pituitary and Ectopic Tumors
Question: My doctors are having trouble finding the location of my tumor. Is it common for a pituitary tumor not to show on an MRI and what techniques are used to find ectopic tumors? Answer: We cannot visualize the pituitary tumor by MRI in about 40% of the patients. We can confirm its presence in… Continue Reading
Diagnosis and Treatment at NIH
Question: What kind of patients does the National Institute of Health (NIH) accept for diagnosis and treatment of Cushing’s and how does one go about getting into NIH? Answer: The National Institue of Health in Bethesda, MD is the medical research facility supported by the US government. At the present time, the NIH accepts all… Continue Reading
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