Reasons for High Cortisol?

[mat2000]

Hi,

I hope that somone with experience in Cortisol can help me on this.

I have been diagnosed as secondary hypogonadism 1 year ago, I have low LH and T. About 3 months ago I discovered that I have elevated Cortisol level:

- 24hr urine Cortisol test was performed and it came high.
- After that ACTH was tested and it was high too.
- Dexamethasone suppression test was performed, the result was good and Cortisol was very low.
- A complete pituitary MRI was performed, the Pituitary is normal and there are no tumour or adenomas.
- My doc said that although my Cortisol lab tests are high, but I don't have the clinical symptoms of high Cortisol (like in Cushing's Syndrome).

This is very puzzling! what is causing this high Cortisol although pituitary and adrenal glands are both normal? (adrenal gland was not scanned but the High ACTH suggests that the problem is from pituatry side not from the adrenal)

Do you think that elevated Cortisol levels can be the main reason for a low LH in a secondary hypogonadism?

Edit: My Age is 34

 

[Alpin]

Well how high is the cortisol?
Test was done in the morning?
You're not on anything now eh?

 

[halfwit]

Get a sleep study done. Cortisol is the counterpart of adrenaline (norepinephrine), and is released to "bring you back down" after a fight-or-flight response. Sleep apnea (stop breathing in your sleep) is a definite trigger that can certainly muck with both cortisol and testosterone levels as your body has to release adrenaline to wake you up.

If that's not the case, extreme daily stress or an underlying disease may be the case. It would surprise you how many suffer from apnea though, hence it being my first guess.

My .02c

 

[3J]

do you lead a very stressful life??

whats your exercise routine look like??

 

[Alpin]

Fact of the matter is we don't know how "high" the OP's Cortisol is because he never provided us with a reading nor a reference range for it.
I'm sure many of us have had a random fluctuation for cortisol. I've had one test come back "high" 100 points over top of normal range but remainder of cortisol tests done on subsequent blood work revealed well within the normal range....
means F all. And btw I tested TT in all occasions with cortisol there was no change in T level on "normal" or "high" cortisol tests.

 

[mat2000]

Well how high is the cortisol?
Test was done in the morning?
You're not on anything now eh?

Cortisol (8AM): 34.8 ug/dl (range: 5 - 25)

That was Serum Cortisol test, I made 24hr Urine test after one month of that test and it was high (I dont remember the result but it was above 300).

No I am not on anything, never been on TRT, I don't take any medicines.

 

[mat2000]

Get a sleep study done. Cortisol is the counterpart of adrenaline (norepinephrine), and is released to "bring you back down" after a fight-or-flight response. Sleep apnea (stop breathing in your sleep) is a definite trigger that can certainly muck with both cortisol and testosterone levels as your body has to release adrenaline to wake you up.

If that's not the case, extreme daily stress or an underlying disease may be the case. It would surprise you how many suffer from apnea though, hence it being my first guess.

My .02c

Thanks for your input, no I don't have sleep apnea.
I never had deadache when I wake up, but I can hardly get out of bed at 8AM to start my day even if I get enough sleep (always).

 

[mat2000]

do you lead a very stressful life??

whats your exercise routine look like??

The first half of this year was very stressful and exausting for me I was working day and night to finish a project. But the second half of this year I had no stress.

My low testesterone symptoms started to appear (2 years ago) after 3 years of extreme depression and stress due to huge problems in my life (inlcuding a divorse and 1 year without job!), I know something happened to my body after that period, I even have traces of a tiny brain stroke in my brain MRI.

My lifestile is far from healthy, I don't exercise and I don't balance my diet and sleep. Just recently I started going to gem.

 

[halfwit]

Thanks for your input, no I don't have sleep apnea.
I never had deadache when I wake up, but I can hardly get out of bed at 8AM to start my day even if I get enough sleep (always).

Have you had a sleep study done? I didn't have headaches either, but they recorded me ceasing my breathing as often as every 30-55 seconds. Waking up even after 10 hours in bed was still a challenge. Obviously there are other causes, like those you listed - but if you haven't been tested, I certainly would.

 

[mat2000]

Fact of the matter is we don't know how "high" the OP's Cortisol is because he never provided us with a reading nor a reference range for it.
I'm sure many of us have had a random fluctuation for cortisol. I've had one test come back "high" 100 points over top of normal range but remainder of cortisol tests done on subsequent blood work revealed well within the normal range....
means F all. And btw I tested TT in all occasions with cortisol there was no change in T level on "normal" or "high" cortisol tests.

I read many studies that say elevated Cortisol suppresses the HTPA axis, I have extremely low T (175 ng/dl) with no clear reason, here is a summary of my findings so far:

- Low LH,FSH and T
- Normal Prolactin, E2, DHEA-S
- Normal Pituitary MRI
- Elevated Cortisol
- Elevated ACTH (which indicates that the problem is from Pituitary side not from the Adrenals)
- Normal results from Cortisol Suppression test (indicates that there is no abnormal Cortisol secretion like from a cancer)
- Normal Insulin and Glucose levels
- No Iron Overload
- Normal Thyroid Hormones
- Very low Vitamin D (10 ng/ml), I am taking 50000 UI per week but after 2 months I don't feel any change.

In summary there is no reason for my low T, except for Vitamin D and Cortisol, but honestly I don't think that Vitamin D will affect LH production, so the remaining suspect is Cortisol which is proven to suppress the pituitary. However I don't have clear symptoms of high Cortisol (as my endo said).

This is driving me crazy I know there is something totally wrong but I can't find the answer.

Edit: I forget to mention that my Age is 34.